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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are Vitamin B12 And Prenatal Vitamin Supplements Safe To Take Daily?

Good afternoon,
I'm a 50 year old female and I take alot of vitamins because I don't eat as I should. I wanted to ask a few questions if that's ok. How much of the following is sufficient to take or am I missing something or should I discontinue.
1. Vitamin B12 1000mcg 2 times daily
2. Calcium w/D3 2 times daily
3. Vitamin C 1000mg 1 time daily
4. Multi-vitamins 1 daily
5.Ginko Biloba 120mg 1 daily
6. Fish Oil 1200mg - Omega 360 mg 1 daily
7. Biotin 10,000 mcg 1 daily
8. Collagen 1 daily
9. Prenatal vitamins ( I ran out ).
10. Glucosamine Chondroitin MSM 2 daily
Thank you in advance
Mon, 4 Sep 2017
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Dietitian & Nutritionist 's  Response
Good morning,
My first question is why are you taking all of these? Why don't you have your diet analyzed and see what you are low in and just take those or change your diet to get the nutrients you are low in? This looks like way too many pills.

For example, you are taking calcium with vitamin D. Do you drink dairy? Do you have osteoporosis? How much calcium do you get from your diet and how much in your pills? Did you know that too much calcium (of which vitamin D will increase absorption of) may cause blockage of the arteries? Supplements should be taken only if ordered by the doctor or Registered Dietitian.

Fish Oil: As a source of DHA and EPA, essential fatty acids needed daily, is a good supplement if you do not eat fatty fish or marine food. It is good for inflammation, a condition that exists in obesity, heart disease, diabetes and most chronic illnesses.

Biotin is good for the hair and nails, is water soluble and any excess should be eliminated in urine.

Prenatal-too much iron and other nutrients. Do not take with multivitamin. Now taking so many competing nutrients not getting benefits from many. Don't take iron with calcium for example, or they will bind together and cannot be absorbed.

Glucosamine-limited evidence it may help degradation of collagen and minor results in reduction of joint swelling. Not convinced evidence supports its use.
collagen-consume with your vitamin C

Many people are low in vitamin D and need supplementation. The level of supplementation really depends on your blood level which you want above 25 or 30, depending on the lab. Deficiencies require pharmacological doses for a short period and then maintenance doses.

The requirement for B12 is only 2.2 mcg per day so it looks like you are doing an overkill there. But, it is water soluble so it you take too much it is excreted in your urine.

Vitamin c is fine, but may cause heartburn if not taken with food.

Multivitamins-best to get hypoallergenic without a bunch of competing minerals in them.

Ginkgo Biloba?For usage of EGb-761 at 240-360 mg daily
as a therapeutic option in people who already are experiencing cognitive
decline, then it appears to be reliably effective and comparable to 10 mg
Donepezil. Usage of Ginkgo biloba for the purpose of reducing the risk of cognitive decline (as a preventative supplement) is currently not supported by evidence. So, if you are taking Ginkgo for cognitive decline, the dosage suggested is twice what you are taking. I do not find any evidence for any other therapeutic effect.

Concerns and Recommendations: Development of a "bezoar" from undigested pills and fiber. Caution to keep adequately hydrated and free from constipation. Cut out prenatal, not needed at all. Fish oil should be high quality or buy omega-3s instead of fish oil (DHA and EPA). Double Ginkgo if condition for use exists or discontinue. Check blood level of vitamin D. Do not take more than 1,ooo mg of calcium per day unless recommended by doctor and less if dairy consumed.

Sincerely, Kathy J. Shattler, BS, MS, RDN

I sincerely hope I have helped answer your questions.
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Are Vitamin B12 And Prenatal Vitamin Supplements Safe To Take Daily?

Good morning, My first question is why are you taking all of these? Why don t you have your diet analyzed and see what you are low in and just take those or change your diet to get the nutrients you are low in? This looks like way too many pills. For example, you are taking calcium with vitamin D. Do you drink dairy? Do you have osteoporosis? How much calcium do you get from your diet and how much in your pills? Did you know that too much calcium (of which vitamin D will increase absorption of) may cause blockage of the arteries? Supplements should be taken only if ordered by the doctor or Registered Dietitian. Fish Oil: As a source of DHA and EPA, essential fatty acids needed daily, is a good supplement if you do not eat fatty fish or marine food. It is good for inflammation, a condition that exists in obesity, heart disease, diabetes and most chronic illnesses. Biotin is good for the hair and nails, is water soluble and any excess should be eliminated in urine. Prenatal-too much iron and other nutrients. Do not take with multivitamin. Now taking so many competing nutrients not getting benefits from many. Don t take iron with calcium for example, or they will bind together and cannot be absorbed. Glucosamine-limited evidence it may help degradation of collagen and minor results in reduction of joint swelling. Not convinced evidence supports its use. collagen-consume with your vitamin C Many people are low in vitamin D and need supplementation. The level of supplementation really depends on your blood level which you want above 25 or 30, depending on the lab. Deficiencies require pharmacological doses for a short period and then maintenance doses. The requirement for B12 is only 2.2 mcg per day so it looks like you are doing an overkill there. But, it is water soluble so it you take too much it is excreted in your urine. Vitamin c is fine, but may cause heartburn if not taken with food. Multivitamins-best to get hypoallergenic without a bunch of competing minerals in them. Ginkgo Biloba?For usage of EGb-761 at 240-360 mg daily as a therapeutic option in people who already are experiencing cognitive decline, then it appears to be reliably effective and comparable to 10 mg Donepezil. Usage of Ginkgo biloba for the purpose of reducing the risk of cognitive decline (as a preventative supplement) is currently not supported by evidence. So, if you are taking Ginkgo for cognitive decline, the dosage suggested is twice what you are taking. I do not find any evidence for any other therapeutic effect. Concerns and Recommendations: Development of a bezoar from undigested pills and fiber. Caution to keep adequately hydrated and free from constipation. Cut out prenatal, not needed at all. Fish oil should be high quality or buy omega-3s instead of fish oil (DHA and EPA). Double Ginkgo if condition for use exists or discontinue. Check blood level of vitamin D. Do not take more than 1,ooo mg of calcium per day unless recommended by doctor and less if dairy consumed. Sincerely, Kathy J. Shattler, BS, MS, RDN I sincerely hope I have helped answer your questions.