20. Supplements Flashcards
1
Q
What is a supplement?
A
A concentrated source of a vitamin, mineral or other substance with a nutritional or physiological effect, sold in dose form
2
Q
In which states should we use supplements?
A
Deficiency
Therapeutic uses
Prevent disease
Maintain health
3
Q
Why are supplements needed?
A
Reduced nutrient content due to soil depletion Pesticides High yielding crops Long distance transportation Processing/toxins Weakened digestion Stressful lifestyles
4
Q
Which are the best forms to take as supplements?
A
Liquids
Powders
5
Q
Pros and cons of liquids as supplements?
A
Excellent absorption
Expensive
Less stable
6
Q
Pros and cons of powders as supplements?
A
Good for larger doses
Not good for ingredients that attract moisture
7
Q
Pros and cons of capsules as supplements?
A
Fewer excipients than tablets
Not efficient in large doses
8
Q
Pros and cons of tablets as supplements?
A
Cheap
Easy to produce in large quantities
More excipients (try to avoid)
9
Q
What are enteric formulations?
A
Used to ensure tablets survive stomach acid
Don’t release contents until SI
10
Q
What sort of supplement is good in enteric form?
A
Garlic capsules
11
Q
What are spore formulations good for?
A
Probiotics
survive stomach and release contents into SI
12
Q
What do we need to be mindful of with chewable formulation?
A
Coated to make more palatable
13
Q
What do we need to be mindful of with slow-release formulation?
A
Cheaper forms contain hydrogenated fats to hold tablets together longer
14
Q
What are the benefits of liposomal supplements?
A
High bioavailability/absorption
Increased oral uptake in mouth
Increased uptake in target cells
Easier to take than large tablets
15
Q
Examples of excipients in supplements
A
Stabilising agents Fillers Binding agents Emulsifiers Flavours Colours Sweeteners Preservatives
16
Q
Vitamins/minerals absorbed in duodenum
A
Ca
Mg
Fe
Zn
17
Q
Vitamins/minerals absorbed in jejunum
A
B vits
C vit
Ca
Mg
18
Q
Vitamins/minerals absorbed in ileum
A
B12
19
Q
How best to take water soluble vitamins?
A
With food
20
Q
Why should you avoid taking B vits in the evening?
A
Used for energy so may trigger or exacerbate insomnia
21
Q
How best to take fat soluble vitamins and CoQ10?
A
With food containing fat
22
Q
How best to take EFAs?
A
With food
Avoid high levels of opposing fat though
23
Q
How best to take amino acids?
A
With a carb food/drink
On an empty stomach
24
Q
When best to have a protein shake
A
Any time of day
Post exercise/surgery
25
How best to take minerals
With food
| adequate stomach acid is needed for digestion
26
When is it best to take Ca or Mg?
In evening to aid restful sleep
27
When is it best to take Zn?
On empty stomach before bed
28
What factors should be considered when working out dosage?
```
Age of patient
Size of patient
State of health
Deficiency or insufficiency?
Digestive capability
Lab test results
Safe therapeutic range
```
29
What is the elemental amount of a mineral?
The amount available for absorption after it's been freed from its carrier molecule
30
What are naturally sourced supplement ingredients?
Nutrients from vegetable, animal or mineral sources
31
What are synthetic supplement ingredients?
Manufactured with identical molecular structure to the same natural nutrients
32
What are food cultured supplement ingredients?
Nutrients (natural or synthetic) are added to yeast/algae suspensions where they concentrate within cells
33
What are the benefits of food cultured supplements?
Makes the nutrient more bioavailable
34
What are food based supplement ingredients?
Made by enzymatically reacting synthetic and natural vitamins with extracts containing vegetable proteins
35
Why aren't food based supplements common?
Low nutrient potency
Fluctuating nutrient levels
Limited shelf life
36
Why is a natural form of vit C better for building collagen?
Stays in the body longer
37
Why is a synthetic form of vit C better for detoxification?
Rapidly excreted from body and will take a large amount of free radicals with it
38
When may food based supplements not be enough to supply optimal dosage?
Poor dietary habits
Environmental factors
Chronic health conditions
Food sensitivities
39
What do naturopaths try to avoid in supplements?
```
Preservatives
Colours
Fillers
Binding agents
GMO
Irradiated products
```
40
Common organic mineral carriers
```
Citrate
Fumarate
Malate
Ascorbate
Glycinate
Picolinate
```
41
Common inorganic mineral carriers
```
Oxide
Sulphate
Chloride
Nitrate
Carbonate
```
42
Why are citrates good?
More bioavailable
| Requires less stomach acid to break bonds and free the mineral for absorption
43
Why are picolinates good?
High absorption
44
What is a chelator?
Substance that binds tightly to mineral atoms
45
What are the advantages of chelators?
Bypasses competitive absorption with other minerals
Body treats it as an AA and is efficient at absorbing these
Extends length of absorption sites
46
What are the disadvantages of AA chelates?
AA complexes may be too tightly bonded
Dosage can end up too low
May be expensive for clients
47
Which vitamins and mineral should Ca be taken with if supplementing?
D3/K2
| Mg
48
When can supplementary Ca be ineffective at preserving bone density?
If dietary intake is sufficient
49
What can too much Ca lead to?
Kidney stones
| Soft tissue calcification
50
Which Ca is easier to absorb - citrate or carbonate?
Citrate
51
Good forms of Ca
Citrate
Glycinate
Gluconate
52
Poor forms of Ca
Carbonate
Ascorbate
Oxalate
53
Why should Ca oxalate never be used as a supplement?
Can lead to kidney stones
54
Should Mg and Ca be taken together?
No, keep 2 hours apart to achieve highest serum levels
55
How does Ca interact with Zn and Fe?
May reduce absorption of these minerals
56
Why should excess intake of phosphorus in soft drinks, caffeine and dietary fat be avoided with Ca supplements?
These things will increase Ca excretion
57
How do corticosteroids and Ca interact?
Long term use of the drug can lead to reduced Ca absorption and inhibition of osteoblasts
58
How does levothyroxine and Ca interact?
Compete for absorption
| take 4 hrs apart
59
How does oestrogen therapy and Ca interact?
Increases absorption of Ca
| beneficial
60
How do antibiotics quinolones and tetracyclines interact with Ca supplements?
Ca hinders bioavailability of the antibiotics
61
Which vitamins and mineral does Mg need for absorption?
B6
D
Se
62
What is Mg absorption hindered by?
Phytates
Fibre
Alcohol
Excess saturated fat
63
Which form of Mg is good for insomnia?
Mg glycinate
64
What are the transdermal forms of Mg?
Mg chloride
| Mg sulphate
65
Which form of Mg is good for energy production?
Mg malate
66
What is Mg sulphate also known as?
Epsom salts
67
What is the cheapest form of Mg available?
Mg oxide
68
How do antibiotics and Mg interact?
Mg may reduce absorption of the antibiotics
| take 2 hrs apart
69
How do blood pressure meds and Ca channel blockers interact with Mg?
Mg may increase the risk of negative adverse effects
70
How does HRT, OCP and diuretics interact with Mg?
These may decrease Mg levels
71
Which are the best absorbed Fe supplements?
Ferrous citrate
Ferrous fumarate
Ferrous sulphate
72
What consideration should be given to ferrous fumarate and sulphate?
May inhibit absorption of vit E
73
Why is overdosing Fe in children bad?
Toxic
| Can be fatal
74
Why should Fe supplementation be avoided in GI bacterial overgrowth?
Fe feeds the bacteria
75
Why can Fe supplements cause free radical damage?
Fe has pro-oxidant effects
76
What should always be checked before commencing Fe supplementation?
Serum ferritin
| Transferrin
77
Drug interactions with Fe
Antibiotics
Thyroxine
Levodopa
78
Adverse reactions with Fe
Diarrhoea
Constipation
Nausea
79
In which conditions is Fe toxicity more common?
Haemosiderosis
Haemochromatosis
Thalassaemia
80
Which form of chromium is best for treating T2D?
Chr malate
81
Why should we be careful in supplementing chromium in diabetics?
It may increase the effects of some diabetes drugs
82
Which form of Zn may cause stomach irritation?
Zn sulphate
83
Which meds should be taken away from Zn?
Antibiotics
84
Which meds reduce Zn absorption?
Aspirin
| PPIs
85
Which forms of vit C are best for health maintenance?
Low dose food forms (rosehip, acerola)
86
Which forms of vit C are best for detoxification?
High dose ascorbic acid
| AO, quickly excreted
87
Why aren't tablets, chewables, fizzy tablets the best forms of vit C?
Sweeteners
Artificial colourings
Additives
88
Which forms of vit C are best to take?
Bioflavonoids (quercetin, rutin)
| Liposomal
89
What are the advantages of time-released vit C?
Maximise total absorption over the day
90
What are mineral ascorbates?
Buffered vitamin C
91
What are the benefits of buffered vit C?
Cause less GI upset
92
What needs to be considered when taking a buffered vit C?
The accompanying dose of mineral
93
What is Ester-C?
A patented form of buffered vit C
| Well absorbed and GI tolerated
94
Why should high dose vit C be avoided in those with haemochromatosis?
Vit C may increase Fe absorption
95
How do statins and vit C interact?
Vit C may affect lipid levels in those taking statins
96
In which circumstances may there be an increased need to supplement vit A?
Pancreatic disease
Eye disease
Measles
97
Pre-formed variants of vit A in supplements
Retinol acetate
| Retinyl palmitate
98
Provitamin A version in supplements
Beta carotene
99
Why is vit A supplementation not recommended for current or previous smokers?
Shown to accelerate lung cancer growth
100
What form of vit D3 do we find in supplements?
Cholecalciferol
101
What form of vit D2 do we find in supplements?
Ergocalciferol
102
Which is the most effective form of vit D in supplements?
Cholecalciferol
103
Which is the natural form of vit E?
D-alpha-tocopherol
104
When are Se supplements most commonly used?
Immune system health
| Supporting T3 production in hypothyroidism
105
Optimal forms of Se
Selenomethionine
| Selenodiglutathione
106
Active forms of B12
Methylcobalamin
| Adenosylcobalamin
107
What inactive form are most B12 supplements in?
Cyanocobalamin
108
Do B12 supplements still need IF?
Yes
109
What should be added to fish oils to prevent oxidisation?
AO
110
Why should we be wary of fish oils from liver?
Could contain pollutants
111
From what substance can vegan forms of EFAs be obtained?
Algae
