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Tanya Edwards, MD
Cleveland Clinic Center for Integrative Medicine

Tanya Edwards, MD, is a Family Physician who consults at the Cleveland Clinic Center for Integrative Medicine. Dr. Edwards teaches complementary and alternative medicine at Case Western Reserve University School of Medicine where she established the Area of Concentration for Alternative Medicine. Her expertise includes inflammation, nutrition for the prevention and treatment of chronic illness, the clinical use of nutraceuticals, as well as mind-body therapies.

Daily Dose: The 6 Vitamins You (Really) Need

February 15, 2010

Dr. Tanya Edwards reveals the vitamins every over-fifty woman needs to feel truly fab.

(We’ll have a shopping list for you at the end.)

 

The Multi

  • ImageWhat’s the most important vitamin that everyone should be taking?
    • A multivitamin. Because none of us get 100 percent of everything that we absolutely need. Our standard American diet is grossly lacking in so many things.
  • Are all multi-vitamins the same?
    • I prefer a whole food multi vitamin. They’re made from food as opposed to synthetics. The theory--and this is based on theory and not necessarily clinical trials--is that whole food vitamins are in the proportions that you find in food and contain enzymes to help those vitamins work together. More like nature wants it.
  • How do you know if a vitamin is “whole food”?
    • If it doesn't say it right on the packaging, then it's not.
  • What if you’re a very healthy eater—do you still need supplements?
    • Even if your diet has plenty of fruits and vegetables, there have been so many changes in our U.S. farming practices, that often the soil is depleted of the minerals you need.
    • The other issue is, much of our produce is shipped from far away. When produce is shipped, it has to be picked before it's ripe, so it doesn’t have all the nutrients that it should. If a banana ripens en route to your grocery store, it's not gaining the nutrients that it would have gained if it were ripening on the tree.
  • I’ve noticed some multis have iron and some don’t—does it matter?
    • If you are over 50 and still menstruating, you should take a multi with iron. If you’ve stopped menstruating, you should take one without iron—as long as you're not anemic. Most multis with iron contain the recommended daily dose--18 milligrams per day.
  • If you take more than the recommended dosage of something, is that bad?
    • It can be for a lot of vitamins, including iron. Having extra iron in your body can act as a catalyst for oxidation--the production of free radicals. Those are the bad guys that cause disease. So having exactly the amount of iron that you need--no more, no less--is really important.

 

Fish Oil

  • ImageWhy should we take fish oil?
    • Because we are all deficient in omega 3 fatty acids.
  • What do those do?
    • Omega 3s are one of two essential fats our bodies need. The other is omega 6. We get way too many omega 6s in our diets and not nearly enough omega 3s. That tips the balance and causes inflammation. Omega 3s are highly anti-inflammatory.
  • Where do we get all these omega 6s?
    • Omega 6s are found in many nuts and seeds and also vegetables, vegetable oil and corn oil. Thirty years ago, when we were told to stop using lard in cooking, we all switched to vegetable oils. Now we have a lot of vegetable oils in our diets.
    • That’s not to say that omega 6s are not important. Our immune system uses them to mount a response and kill off viruses, bugs, cancer cells and those kinds of things. But omega 3s are your counter balance. They help to dampen the immune response. If you are eating way too many omega 6s and not enough omega 3s, your inflammatory response goes unabated.
  • And what happens in your body?
    • You have inflammation, which has proven to be the underlying cause of just about all of the diseases that we suffer from: heart attacks, strokes, cancer, high blood pressure and diabetes.
  • So I better run out and get this fish oil.
    • Absolutely.
  • What about flax seed oil? Isn’t that omega 3?
    • I don't recommend flax seed oil as your omega 3. That's the short chain omega 3; you need the long chain that is found only either in fish or algae.
  • Algae?
    • My vegan patients take an algae supplement, otherwise I recommend fish oil.

 

Vitamin D

  • ImageTell me why people need D.
    • D comes from the sun, but in the last 50 years our society has gone indoors. We were supposed to be outside, scantily clothed. As we've moved further away from the equator and indoors, we are not getting nearly enough. Fifteen years ago we thought vitamin D was only related to calcium in bone density, but now we know it’s related to hundreds of diseases. If you're deficient, you have an increased risk for heart attack, Parkinson's disease, Alzheimer’s, autism, high blood pressure...
  • But you wouldn't develop autism as an adult, would you?
    • No, no, no. But if you are pregnant and vitamin D deficient, you never know . . .
  • So should everyone be taking a vitamin D supplement?
    • No. You should get your blood tested first to find out how deficient you are. Then have it retested every three months so that your doctor can make sure the supplement you’re taking is exactly the amount you need to take all year round, regardless of the season.
  • When I get a full blood workup, is my D level automatically tested?
    • Probably not. It depends on how enlightened your physician is.
  • Oh my God, I'm calling him immediately.
    • Your vitamin D level needs to be between 50 and 80.
  • How many milligrams should we be taking?
    • It has to be tailored to you. I have some patients whose levels are maintained on 1,000 units a day. Other patients require 10,000 units a day.
  • Could too much vitamin D hurt me?
    • It could, depending on how much you take. If you're taking 1,000 or 2,000 units a day, I wouldn't worry about it. But more than that, and you could become vitamin D toxic. The symptoms of too much vitamin D are abdominal pain and lethargy.
  • So if I don't have either of those I shouldn't worry.
    • No.

 

Calcium

    • Image  All women over 50 need 500 milligrams of calcium twice a day, preferably with food.
  • Why twice a day as opposed to all at once?
    • Your body won't absorb more than 500-600 milligrams of calcium at one time. If you take them both at the same time then you will poop out the rest.
  • If you eat a lot of dairy in your diet, do you still need calcium?
    • If you're getting a lot of dairy in your diet--which by the way I don't necessarily recommend--add up the milligrams of calcium that you are getting from food. Maybe you don't in fact need extra calcium. You would need about three servings of a dairy product everyday.
  • What's the recommended daily dose of calcium?
    • 1,000mg. Unless you have osteoporosis, in which case it’s 1500.
  • If you start taking calcium when you're 60 will it mean you won’t get osteoporosis?
    • No. But it may decrease the progression of your osteoporosis.
  • If you start taking calcium when you're 30, does that help you prevent getting osteoporosis?
    • Yes, it does. I recommended that all adults, period, get about 1,000 milligrams of calcium, whether it's in your diet or as a supplement everyday.
  • So my daughter, who is 28, doesn't eat cheese, she may drink a little milk, she doesn't eat ice cream. I better have her start taking calcium.
    • Yeah. In addition to dairy products you can get calcium from other foods as well. Dark green, leafy vegetables have calcium.
  • She doesn't eat those either. Her diet is god-awful.
    • Broccoli is one of the best non-dairy sources of calcium.

 

Magnesium

  • Why magnesium?
    • 85 percent of Americans do not get enough magnesium in their diets.
  • ImageWhat does it come from?
    • The best source of magnesium is a grain called amaranth. One serving of amaranth per day provides your recommended daily allowance of magnesium. Two servings of pumpkin seeds or sunflower seeds, also provide that dose.
    • Dark green, leafy vegetables and whole grains and nuts are also sources, but they give you about 1/10th or 1/15th of your recommended daily allowance, so you’ve got to eat a lot.
  • What's the recommended daily dosage?
    • 400.
  • What happens with a low magnesium level?
    • Symptoms of decreased magnesium are headaches--particularly migraine headaches--Charlie horses, fatigue. Other symptoms are constipation and elevated blood pressure.
  • Can I get it from a supplement?
    • Check your multivitamin. Most don't have it. If that’s the case, just take it separately. If I have a patient with symptoms of low magnesium. I usually recommend about 500 milligrams at bedtime because magnesium will help you sleep.

 

Resveratrol

  • ImageAnd what is resveratrol?
    • Resveratrol is one of the newest kids on the block. It’s the antioxidant in red wine.
  • Is that something you'd recommend people take?
    • I'm seriously thinking about it. There are some very compelling new resveratrol studies showing decreases in oxidation, cholesterol and abdominal fat. In a study a year or so ago, rats who took resveratrol lived significantly longer than rats who didn't, and they did not age the same way as the rats who didn't take it. I think more information needs to come out--large studies on humans.
  • But you're looking at it?
    • Oh yeah, seriously.

THE FOF MUST-HAVE SHOPPING LIST: BUY THESE AT GNC FOR A 15 PERCENT DISCOUNT

  • Whole food multi-vitamin: Remember, our diets can’t provide it all
  • Fish Oil: Nothing fishy about this. We need it since we don’t get sufficient Omega 3.
  • Vitamin D: If your level isn’t between 50 and 80, this is essential.
  • Calcium: You can never hear enough times about the value of calcium for strong bones.
  • Magnesium: If you’re in the 15 percent of Americans who actually get enough of this, good for you.
  • Resveratrol: Lots of chatter about this in the medical community. We say it’s worth a try.
Comments
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blax - post on 17:36 on 03/04/2010


"I just saw this product at my local store where I get my natural products. I like the drink product, it tastes good."
mcarriere11 - post on 13:33 on 03/03/2010


"I have been taking all the above for a while and feel great never took magnesium starting tomorrow after call to Dr."
pearsonbrooklyn - post on 02:06 on 03/01/2010


"any thing that makes me look and feel great"
freebyrdmom - post on 14:30 on 02/25/2010


"What about biotin. Is this not good for skin, nails and hair."
carolynsmith411 - post on 01:05 on 02/25/2010


"I learned alot, and will be taking alot of the things I need to.(Will talk with Doctor first)!"
LadyPhoenix1821 - post on 17:59 on 02/24/2010


"funny, but all these vits you recommend - i have been taking for the past two years and others over my lifetime. i do think it plays a factor on my youthful appearance."
BLOSSOMSGRANDMA - post on 13:29 on 02/24/2010


"Neat info about the whole foods vitamins and the Resveratrol. Thanks"
jmkuck1960 - post on 11:37 on 02/24/2010


"Just what I need!"
ihcswife - post on 11:31 on 02/24/2010


"would like to try what you have to offer"
musicmn11 - post on 07:51 on 02/24/2010


"I am not good at taking pills - swallowing and remembering. Other than the Resveratrol, are the other supplements available in one pill?"
zahara46 - post on 07:06 on 02/24/2010


""I am blown away on tall of this i did not know any of these things about vitamins." i am really gonna consult with my cardiologist on what i should be taking in terms of the heart and blood medication that i am already taking. Thanks so much for this information..i am sure to spread the word with family and friends."
pdipalma - post on 06:46 on 02/24/2010


"Too funny, but just after I read this I was going to call my mom to make sure she was taking enough calcium and she called me. I chided her for only take 1200 mg but she says she makes up for it in her diet. She and I both have the same question though: if you can only absorb 500mg of Calcium at a time, why do they make the pills 600mg???"
TerriB - post on 05:46 on 02/24/2010


"I take all that is listed except resveratrol and keep hearing about its benefits so its TIME to get some"
justnan01 - post on 04:20 on 02/24/2010


"I will try anything to improve the aging of my skin."
travelin - post on 22:33 on 02/23/2010


"I have been reading about Resveratrol lately. I will be interested to learn more about it. Keep us posted, please."
cindy4bunches - post on 20:45 on 02/23/2010


"Instead of Resveratrol....can I just drink a bottle of Red Wine a day instead???"
mcrlcowen - post on 18:27 on 02/23/2010


"Very timely information. I am in need of a new vitamin regimen."
solnewyork - post on 17:30 on 02/23/2010


"Very informative. With our busy stressful life, we need some reminders and updates to help us stay healthy."
melissasrey - post on 16:05 on 02/23/2010


"This was an excellent commentary on supplements that woman need to hear."
kmcpherson on Thu, 03/25/2010 - 10:54.

Great info!

cdmtx65 on Wed, 05/05/2010 - 21:18.

great Combo ! i also take Brewers
Yeast .

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