Calcium can affect absorption of other minerals, much the same way it can affect certain prescription medications. For example, certain antibiotics, levothyroxine, and blood pressure medications should not be taken with calcium. Divalent metals such as iron, calcium, zinc, and magnesium compete in the intestine for the Divalent Metal Transporter (DMT-I) that transports these minerals across the intestine for absorption. This transporter can be overwhelmed by the presence of high concentrations of these minerals at one time and reduce absorption. As an example, assume the Daily Value for calcium is about 1,000 mg (varies with age). This bulky dose would compete for the other divalent metals (zinc, magnesium) and reduce absorption. This is why we eat our meals generally three or more times per day, because of the difficulty absorbing everything in any one meal. The largest dose of a divalent mineral in Vitamin100 Multivitamin is magnesium 420 mg. Now you know why calcium is better taken separately from other vitamins and minerals, as well as certain prescription medications, for optimal absorption.

The dose of vitamin D usually found in a multivitamin is negligible compared to what is needed for the Daily Value. Although the dietary reference intake is listed as 400-800 IU daily, many studies suggest a higher daily intake to maintain optimal blood levels. Most patients will require 1,000-5,000 IU daily of vitamin D to achieve an optimal blood level. This amount cannot be contained in a “one-a-day” vitamin and is better dosed separately. The same concept is true for calcium. These vitamins (calcium, vitamin D) are so bulky to achieve 100% Daily Value they cannot be contained in a “one-a-day” vitamin. Blood testing by your doctor is the best way to determine your individual vitamin D requirement.

The dietary reference intake for iron is 8- 18 mg depending on age, gender, and pregnancy. Multivitamins usually contain significantly less than 100% of this value. A “one-a-day” vitamin is misleading because you are not receiving all you need in one pill. The presence of iron in vitamins usually causes side effects such as nausea and/or constipation with little benefit. Too much iron can lead to other health problems such as hemochromatosis or iron overload. Iron in
supplements can also potentially mask an underlying anemia which can delay an important diagnosis. Iron is a divalent metal that competes for the DMT-I. If a person needs additional iron beyond dietary intake, it is best administered under medical supervision.

The vitamin K dose in Vitamin100 Multivitamin can help stabilize dosing of blood thinners such as Coumadin (warfarin). Higher doses may interfere with anti-clotting effects of blood thinners and should be avoided.

Mega-dosing of vitamins is not good. Vitamin100 Multivitamin is designed to provide 100% of the essential vitamins and minerals. When taken with your diet, it will help you achieve optimal intake without the danger of excessive dosing. Each vitamin and mineral have an associated deficiency state as well as toxic levels. Any symptom you may be experiencing from a deficiency state or from excessive dosing will resolve with the proper amounts of nutrients. Do not be fooled by advertisements that state more is better.

Too much of a good thing is no good! Excessive zinc increases the production of metallothionein, a heavy metal binding protein, by enterocytes. Excessive zinc ingestion can also lead to copper deficiency. Copper deficiency can cause numbness and tingling, lower extremity weakness, a unsteady walking. Copper binds with high affinity to metallothionein within the enterocytes leading to its excretion through the intestinal tract.

Yes! There are two issues involved with a multivitamin used as a prenatal or during pregnancy: folate (folic acid) and iron. The dose of folic acid recommended by experts as a prenatal or during pregnancy is 400 mcg daily. This daily dose has been shown to prevent certain birth defects and is the amount contained in Vitamin100Multivitamin. Guidelines on the use of iron supplementation as a prenatal or during pregnancy vary depending on the source of information. For example, recommendations from ACOG (American College of Obstetrics and Gynecology), CDC (Centers for Disease Control and Prevention), and USPSTF (United States Preventive Services Task Force) all vary on iron recommendations which is sometimes not needed.

• ACOG recommends screening all pregnant women for anemia and only treating those with iron deficiency anemia.
• CDC recommends all pregnant women begin taking an oral low dose of iron (30 mg/day) and be screened for iron deficiency anemia. Women who have iron deficiency anemia are then treated with an oral dose of iron ranging 60-120 mg per day.
• USPSTF states current evidence is not sufficient to recommend for or against screening for iron deficiency anemia in pregnant women or routinely supplementing with iron.

Dr. Datz supports taking Vitamin100 Multivitamin as a prenatal vitamin or during pregnancy and to follow the recommendations from your obstetrician regarding whether separate iron supplementation is needed. Vitamin100 Multivitamin is better tolerated by women since the absence of iron reduces the side effects usually caused by iron supplementation (e.g., upset stomach, cramps, constipation, nausea).

Vitamin D3 (cholecalciferol) is the natural form of vitamin D made by our body from sunlight exposure and is the form used in Vitamin Armor’s dietary supplement. A blood test measuring 25-hydroxy vitamin D is the best way to know if you are getting enough vitamin D in your diet and how much supplement you need to take.

The recommendations for managing deficient, insufficient, ideal levels is variable depending on the source of information. Generally, 1000 IU of vitamin D will increase vitamin D blood levels by approximately 10 ng/ml (25 nmol/L). The following table is developed as a guide to help with this decision.

Yes. Vitamin D levels are generally lower in the winter months and higher during the summer months due to variable sun exposure. Some patients may need to adjust their doses according to the time of year (e.g., a lower dose may be needed to keep the level ideal in the summer and a higher dose for the winter).

Yes. For example, signs of vitamin D toxicity are nausea, vomiting, constipation, poor appetite, weakness, weight loss, kidney damage, and hypercalcemia (elevated blood calcium). Hypercalcemia can cause confusion, kidney stones, and heart arrhythmias. Any of these symptoms should be evaluated by your healthcare physician, physician assistant, or nurse practitioner.