Do doctors take vitamins
Food supplements: be careful with B vitamins
Many adults regularly take nutritional supplements in the hopes of doing something good for their bodies. That is why the market for vitamins, iron supplements and Co. is booming. They belong to the "essential substances", ie those substances that the body urgently needs but cannot produce itself. However, food supplements are usually superfluous for healthy people. Those who eat a balanced diet get all the nutrients, vitamins and minerals they need.
VIDEO: Food supplements: be careful with B vitamins (6 min)
Bad diet cannot be compensated for
However, food supplements cannot compensate for a poor diet either, experts warn. Only in individual cases, during pregnancy, in old age and with chronic illnesses - for example Crohn's disease or severe inflammation - can a nutrient deficiency arise, which must be compensated for with supplements.
Avoid vitamin B12 deficiency
A vitamin B12 deficiency occurs over a long period of time: the full B12 stores in the liver are emptied over time if there is no more replenishment from food. A deficiency can lead to neurological complaints such as dizziness and severe headache attacks. Those affected can also be confused or forgetful, often suffer from depressive mood swings and general weakness.
Vitamin B12 is involved in blood formation, but also important for cell growth and the functioning of the nerves. In patients with Crohn's disease, chronic inflammation in the intestines prevents the absorption of vitamin B12. Something similar can happen to people who take gastric acid inhibitors or blood thinning medication on a daily basis. They change the pH value in the stomach and thus inhibit the absorption of micronutrients. The so-called intrinsic factor is important for B12 uptake. This protein, which is formed in the stomach, ensures that the cobalamin bound in B12 is split off in the small intestine. This is the only way it can be stored in the body. If the drugs destroy the intrinsic factor, no vitamin B12 can be absorbed. Diabetics who take metformin should also have their vitamin B12 levels checked regularly.
Seniors are particularly affected
A vitamin B12 deficiency often occurs in the elderly, because around 40 percent of the elderly have a certain inflammation of the gastric mucosa that affects the absorption of B12. If it turns out that absorption via the stomach does not work, the B12 with cobalamin that has already been split off can also be administered by injection. Usually a few syringes are enough to fill up the reservoir for a longer period of time. The B12 is produced by microorganisms, especially soil bacteria. Animals absorb the B12 in different ways, for example when grazing in the pasture or wallowing in the mud. People benefit from this when they consume animal products. In addition to meat, fish and seafood, eggs and dairy products also contain vitamin B12, so that vegetarians can also absorb enough vitamin B12. The vitamin B12 contained in plant-based foods such as spirulina algae and sauerkraut or mushrooms, on the other hand, is an analogue that humans cannot ingest and use directly. On the contrary - this analogue even blocks the uptake of the "correct" B12. This is why vegans need to pay particular attention to their vitamin B12 levels. But even people who eat animal products are often affected by a B12 deficiency. One reason for this is that animals kept indoors in conventional fattening often have no contact with the soil bacteria that produce vitamin B12.
Before taking: a doctor's blood test
But not everyone who is tired, dizzy or eats little meat has an iron or vitamin B12 deficiency: only a blood test at the doctor can clarify whether you need a supplement. Because the hasty intake of iron and vitamin preparations or other food supplements can also have harmful side effects: Too much vitamin E in capsule form promotes the development of lung cancer. Antioxidants like vitamins C and E can make exercise less effective. In turn, years of high-dose intake of vitamin B6 can increase the risk of lung cancer in men.
Overdose of vitamin B12 highly risky
Many vitamin B12 supplements contain a dose that is well above the recommendations and daily needs. Current studies show that this can be risky - and definitely not beneficial. The Federal Institute for Risk Assessment (BfR) suggests a daily maximum amount of 25 micrograms of vitamin B12 per day for dietary supplements. The German Nutrition Society (DGE) considers an intake of 4 micrograms per day through food and dietary supplements to be appropriate. But the food supplements available in stores exceed these values many times over. And that is not without its problems, because according to current studies, too high a vitamin B12 level in the blood could be linked to an increased risk of lung cancer. B12 is an important growth factor for all cells - and this also applies to cancer cells. The vitamin does not directly trigger cancer, but it does accelerate the development of undetected cancer precursors in the body. The dietary supplement industry points out that there is no legally binding maximum amount for the dosage of B12 in dietary supplements. Nutritionists consider this problematic because these preparations are packaged in a similar way to pharmaceuticals and thus give the false impression that they are just as controlled and tested before they go on sale. Even if acute poisoning or side effects are not yet known, users of high-dose vitamin B12 preparations must expect chronic side effects.
Food supplements only under medical supervision
For some time now, vitamin K2 has been touted as a miracle cure for cancer, osteoporosis and heart attacks. However, there is a lack of relevant scientific knowledge. In general, dietary supplements can affect the effects of chemotherapy and radiation in cancer patients. They should therefore only be used under medical supervision.
Supplements helpful under certain conditions
In the prevention of respiratory diseases and age-related macular degeneration, dietary supplements administered under medical supervision can be useful.
Certain diets, high alcohol consumption and smoking often lead to a higher need for certain nutrients. Those who follow a vegan diet must ensure that they consume sufficient amounts of all essential nutrients from the food they eat. The need for iron in particular is more difficult to meet with purely plant-based foods.
Exhausted and listless despite a healthy diet?
Anyone who feels exhausted and listless despite a healthy diet should consult a doctor. If, for example, he detects an iron deficiency, the cause must be found and, for example, internal bleeding ruled out. In the elderly, poor appetite or not eating meat due to chewing difficulties can contribute to iron deficiency. In addition, there are natural changes in the gastrointestinal tract in the elderly, which reduce iron absorption in the body. The fact that blood formation in the bone marrow decreases over the years further exacerbates the effects of iron deficiency. As a result, the blood can carry less oxygen around the body, which leads to chronic fatigue.
Which supplements can be useful
The staple food salt has been enriched with iodine since the 1980s - the classic household salt as well as the salt used in industry for, for example, sausage or cheese. That paid off. Illnesses caused by iodine deficiency have practically disappeared in Germany.
For elderly and sick people, it can be useful to supplement the diet with omega-3 fatty acids, protein, zinc and selenium. People with cardiovascular diseases or the risk of vascular calcification can also take omega-3 fatty acids as a precaution, as can protein to prevent the breakdown of muscles and the gums. Selenium maintains hair health and promotes wound healing. It must be supplemented in older people who no longer eat properly.
Folic acid for pregnant women
Pregnant women and women who want to become pregnant should take folic acid to prevent malformations in the child. For all other people, caution is advised, because if cancer precursors have formed in the intestine, a high intake of folic acid can promote the growth of malignant tumors.
Vitamin D: Many are undersupplied in winter
According to the Robert Koch Institute, 60 percent of Germans are not adequately supplied with the "sun vitamin" D - especially in winter. A vitamin D level that is too low increases the risk of osteoarthritis and osteoporosis. If the value is too low, experts recommend taking 1,000 IU (international units) of vitamin D per day. They are taken once a day in the form of tablets or drops.
Spermidine: important for autophagy
The spermidine offered in pharmacies as a dietary supplement made from wheat germ extracts to prevent dementia is an organic compound that occurs in all living things and is important for what is known as autophagy. This is a cell's own recycling process in which the cell regenerates itself by digesting old or defective components. But viruses are also recognized as waste products and thus rendered harmless. Researchers at the Charité have discovered that the spermidine concentration in cell cultures infected with the new coronavirus SARS-CoV-2 is greatly reduced - similar to the MERS coronavirus, which inhibits the autophagy mechanism in order to be able to reproduce better. In the laboratory, the multiplication of the new coronavirus could be slowed down significantly by treatment with spermidine. Further studies will have to show whether this effect can also be used clinically.
|task||Deficiency symptoms||contained in|
|Vitamin A||important for the function of the eyes and cell growth, strengthens the skin and mucous membranes||Night blindness, dehydration of the lacrimal glands, disorders of sperm formation, water head in newborns||yellow and orange vegetables and fruits, spinach, kale, liver, cod liver oil (precursors of vitamin A)|
|Energy metabolism, nerve tissue, heart muscles||Fatigue, loss of appetite, memory disorders, confusion, edema, muscle wasting, heart failure||Nuts, seeds, wheat germ, peas, beans, lentils, potatoes, yeast, lean pork|
|Energy and protein metabolism||cracked corners of the mouth, inflammation of the lining of the mouth and the cornea of the eye||Milk, eggs, cheese, offal, meat, fish, vegetables (e.g. spinach or asparagus)|
|Blood formation, functions of the nervous and immune systems, amino acid metabolism||Inflammation of the eyes, nose and mouth, scaly rashes on the face and head, anemia, numbness in the hands and feet||Liver, kidneys, nuts, seeds, meat, fish, cabbage, green beans, avocados, bananas|
|Blood formation, breakdown of individual fatty acids||Anemia, tiredness, burning tongue, numbness (risk of deficiency, especially for vegans and the elderly)||Liver, kidneys, fish, milk, eggs, cheese, fermented plants such as sauerkraut|
|Folic acid||Cell division and new cell formation, blood formation, protein metabolism||Anemia, dementia, arteriosclerosis, pregnancy: deformities of the embryo||Yeast, liver, wheat germ, soybeans, spinach, grapes, cheese, eggs|
|Biotin||Protein, fat, carbohydrate metabolism||Rash, exhaustion, nausea, depression, muscle pain, dizziness, loss of appetite||Yeast, liver, egg yolks, tomatoes, nuts, sardines, soybeans|
|Vitamin D||Regulation of calcium and bone metabolism, bone formation and strengthening||Softening of the bones, rickets, osteomalcia and osteoporosis||oily fish such as herring or eel, veal, mushrooms|
|vitamin C||Formation of connective tissue, wound healing, antioxidant effect (cell protection)||Increased susceptibility to infection, |
Scurvy (poor wound healing, muscle wasting, and bleeding gums)
|Rose hips, sea buckthorn, citrus fruits, peppers, strawberries, kiwi, cranberries, broccoli, tomatoes, cabbage|
|Vitamin K||Blood clotting, formation of bone protein||Blood coagulation disorders, spontaneous bleeding, often cerebral haemorrhage in newborns||Egg yolks, fatty dairy products like cheese, cabbage, spinach, sunflower oil, liver, poultry|
|niacin||supports biochemical processes for energy production in the cells||general weakness, severe deficiency leads to pellagra disease (with inflammation of the skin, diarrhea and neurological disorders)||Nuts, eggs, milk, fish, meat, offal|
|Pantothenic acid||involved in biochemical reactions such as fat and carbohydrate metabolism, cholesterol synthesis||Stomach pain, tiredness, abnormal sensations such as numbness or tingling and burning in the feet||Yeast, cereals, mushrooms, legumes, egg yolks, herring, liver|
Experts on the subject
Prof. Dr. rer. nat. Martin Smollich, pharmacologist
Institute for Nutritional Medicine
University Medical Center Schleswig-Holstein, Lübeck Campus
Ratzeburger Allee 160
(0451) 31 01 84 01
Dr. Niels Schulz-Ruhtenberg, specialist in general medicine, nutritional medicine and sports medicine
Doctors practice at the Kaiserkai
At the Kaiserkai 46
(040) 64 66 17 60
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