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Which Vitamin Form Should You Choose? continued...

Certain supplements are in pill form because they become ineffective, or even dangerous, if exposed to stomach acids. Some people need to take a liquid if they have difficulty absorbing vitamins or supplements from a pill, or even if they have difficulty swallowing capsules or pills.

And not all formulations of a particular vitamin are the same. For example, vitamin D supplements come as either vitamin D-2 (ergocalciferol) or vitamin D-3 (cholecalciferol), with some preliminary evidence showing that vitamin D-3 tends to be the more active form. Also, there are several different types of vitamin E, and some experts feel that a mixture of E's natural tocopherols and tocotrienols is the best. When in doubt, talk with your doctor about which supplement suits your needs.

Supplement Safety

The U.S. Food and Drug Administration (FDA) does regulate dietary supplements; however, it treats them like foods rather than medications. Unlike drug manufacturers, the makers of supplements don’t have to show their products are safe or effective before selling them on the market.

However, the FDA can force a supplement to be removed from the market only if it proves that the supplement is unsafe. However, there are some efforts in the works to bring supplement manufacturers up to certain standards (called GMP or Good Manufacturing Practices) that are similar to those for pharmaceutical makers. In addition, manufacturers are required to list contact information on the bottle in case there is an adverse effect. These effects are being collected through the FDA Medwatch system in the hopes of more quickly and efficiently finding suspect products and prohibiting their sale. 

“You’ve got to be careful, because some supplements can cause a response, some cause no response, and some can cause an adverse response,” notes Gail Cresci, RD, assistant professor of surgery and director of surgical nutrition at the Medical College of Georgia.

The bottom line: Do your research and exercise caution. Here are two more important safety tips:

  • If you eat a balanced diet rich in whole grains, fruits, and vegetables, look for a multivitamin with no more than 100% of the daily value of most vitamins and minerals.
  • Although vitamins are essential to our bodies, in high doses some vitamins can disrupt biochemical pathways, says Cresci. Avoiding high doses is especially important with the fat-soluble vitamins A, D, E, and K, because these vitamins build up in your body and can become toxic. (Water-soluble vitamins are excreted in urine if you take more than your body needs.)

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