Health Savings News - Episode 23: Excessive Use & Overdose of Vitamins & Minerals

Note: This is a rough transcript of episode 23 of Health Savings News and has been lightly edited for clarity. It may not be in its final form.

Evan (00:09):

Hello and welcome to Health Savings News, the podcast about healthcare costs in America and how to save money on the often expensive care all kinds of people need. I’m your host, Evan O’Connor, joined by retired doctors Rich Sagall and Mike Woods. How are you guys doing today?

Mike (00:24):

Good.

Rich (00:25):

Good, thank you.

Evan (00:26):

Excellent. Each episode we discuss healthcare costs in America, offer tips for saving money, and relevant news that affects and reflects the expensive landscape of healthcare in America.

This week’s topic is excessive use and overdose of vitamins and minerals and recommended doses. Vitamins and minerals are essential for good health, but excessive amounts waste money and can be dangerous or occasionally fatal. More than half of American adults report using at least one vitamin supplement per month, but a federal panel of health experts suggest they may be wasting their time and money. Research has found that multivitamins don’t reduce the risk of heart disease, cancer, cognitive decline, or an early death.

Rich (01:02):

Vitamins and minerals carry out and help with numerous day-to-day functions in your body. Most of these involve biochemical reactions, vitamins, and some minerals are micronutrients because they’re needed in small amounts. They serve as catalysts, which is substances that increase the rate of a chemical reaction without undergoing any permanent chemical change themselves. Some minerals are needed in larger amounts because they are part of the structural parts of the body, such as calcium, phosphorus, and sodium. The difference between a vitamin and a mineral is a vitamin or organic and minerals or inorganic. They all serve important functions with the immune system, with vision, with bone strength, with muscle and nerve function, circulation, repairing damaged cells, converting food for energy and heart function. Most of these substances are not made in your body, so you have to take ’em from your diet.

Mike (01:57):

Yeah, most people get all the vitamins and minerals they need from their diet, and it’s only those with certain medical conditions or restricted diets that need supplemental intake. Even then. For the most part, these situations can be temporary and the amounts required to really exceed recommended daily amounts. And when you get higher amounts, they are usually only a short-term measure that should be taken only on the advice of your doctor or your dietician.

Rich (02:25):

Vitamins and mineral supplements may be recommended in certain circumstances to correct deficiencies such as folate for women who are pregnant or planning a pregnancy. Others who may be at a risk of a vitamin or mineral deficiency include women who are breastfeeding or have heavy periods, people with malabsorption problems such as diarrhea, celiac disease, cystic fibrosis, or pancreatitis. People who smoke, drink in excess or use illegal drugs, crash dieters or those who are follow very strict diets. The elderly, especially those who are disabled or chronically ill. Some vegetarians and vegans were not careful with their diet and supplements and people with food allergies.

Mike (03:10):

The two most common ways people get excessive vitamin in minerals is in fortified foods such as cereals, a snack bar and sports drinks, and using individual or multivitamin and or mineral supplements. They’re usually taken for perceived nutrient gaps, especially those with poor dietary habits. They take them to increase the possibility of better overall health and energy maybe to prevent cancer, heart, eye, and other diseases. While it’s commonly thought that vitamins and minerals can alleviate problems you might not even know you have or prevent problems you could possibly develop, with few exceptions, it is surprising how little evidence there is to support the routine use of vitamin and mineral supplements in otherwise healthy people. For prevention vitamins are most likely useful if you actually have a risk factor for a specific disease that vitamins can help with. The one that currently comes to mind is using preservation or similar or multivitamins for reducing the risk of macular degeneration if it runs in your family.

Rich (04:20):

Since vitamins and minerals are not regulated by the fda, which is a food and Drug administration, it’s not regulated in the same ways that prescription medicines are over the counter drugs are. There is no guarantee that the pills contain what the label says they do contain. A pill may have more or less of a vitamin and mineral than the package says it does, or the pill may not contain any of what’s stated on the label or it may contain other substances altogether. When you’re take a multivitamin or any multi ingredient supplement, you need to consider each ingredient separately, including those that are not vitamins or minerals. The actual amount of an active ingredient can vary from pill to pill and from brand to brand. There is no way to be a hundred percent sure of how much you’re taking. There may also be unlisted ingredients which may have some effect

Mike (05:08):

Before supplements come to the market. It’s really only up to the manufacturer to determine if a product is safe and whether the their labeling information is truthful or not misleading. The FDA can take action against such products that are deemed unsafe or that have misleading claims in improper labeling, but they can only do it after it comes to market when they’re notified about complaints related to the supplement.

Rich (05:36):

Many people fall into the trap of believing that if a little vitamin and mineral is good for you, then a lot is a lot better. This is an example of false reasoning as we will discuss. Taking too much of a vitamin or a mineral may be harmful.

Mike (05:49):

Yeah, I suspect most people are aware how dangerous vitamins can can be if taken in excessive amounts. They’d also be to learn that in 2017 vitamins caused almost 60,000 toxic exposures in the United States many of which were fatal. You also have to consider that 75% of these were in children less than five years old who don’t know any better than to take unknown pills and substances. Children are at the highest risk for these overdoses. In the overdoses that they’re most likely to get are large amounts of vitamin A zinc and niacin, which a lot of people who take supplements have around in their house. So to understand how vitamins can be toxic, it’s really important to know that there are two ways vitamins can travel and are stored in the body. There are fat soluble vitamins which dissolve in fats that travel in the bloodstream to where they are needed and they get deposited in fatty tissue. Now, fatty tissue turns over very slowly, so fat soluble vitamins are slowly eliminated from the body, mostly in the stool. And for these two reasons fat soluble vitamins can accumulate in the body if taken too often or in excessive amounts. Water soluble vitamins dissolve directly in the bloodstream and are quickly absorbed in the sites where they are needed and excessive amounts are limited in the urine. Water soluble vitamins usually need to be taken more often and very rarely accumulate in the body like the fat soluble vitamins do. But despite this, there is an amount beyond which the vitamin will accumulate and begin to cause short term and occasionally long term problems. If there’s been damage to the body, the amount varies by the vitamin.

Rich (07:39):

Taking mega doses of water, of soluble vitamins leads to expensive urine while taking excessive doses of fat soluble items produces expensive feces. The fat soluble vitamins of vitamins A, D, E, and K. Vitamin A is important for vision, maintaining immune system response and supporting normal organ function. More vitamin poisonings occur with vitamin A than any other vitamin. Acute toxicity can cause reddening irritation and patchy peeling of the skin, while chronic toxicity can cause more severe symptoms, including increased fluid pressure in the skull which is called intracranial Hypertension, vision changes, migraines, coma, and even death. Vitamin D helps with calcium absorption and building bones. Provitamin D can be produced in the skin by sun exposure, but many people either chronically or seasonally, may not get enough sun exposure and and need vitamin D supplements. Vitamin D toxicity can lead to abnormally high levels of calcium in the blood, which could result in kidney stones, nausea, recurrent vomiting, constipation, excessive thirst, confusion, occasion, and occasionally normal AB and occasionally abnormal heart rhythm. High chronic doses of vitamin D have also linked to increased risk of cancer, heart problems, bone fractures, and even death. Vitamin E functions as an antioxidant to protect and repair the body cells from damage. Excessive long-term use of vitamin E increases the risk of prostate cancer in men stroke and intracranial bleeding. Vitamin K, the last of the fat-soluble vitamins is important for blood clotting, although extremely rare, vitamin K toxicity can result in liver damage with jaundice, elevated bilirubin and hemolytic anemia, which is breakdown of the red cells. Other symptoms include difficulty breathing, muscle stiffness, trouble swallowing, swelling and rashes,

Mike (09:48):

Water soluble vitamins. We talked about the B vitamin complex and vitamin C because they’re water soluble. We talked about they don’t build up in excessive amounts chronically, but some of these vitamins are actually active by themselves and can cause symptoms. So there are eight B vitamins, B one or thiamine, B2 or riboflavin, b3, which is niacin B five, which is pantothenic acid, b6, which is perine B seven or biotin B nine folate or folic acid and B12 cobalamine in combination. They’re extremely important for the overall body metabolism and for the health of skin here, brain and muscle significant toxicity is only possible from excessive amounts of niacin, perine, and folic acid. Again, because the molecule itself is active within the body for example, excessive niacin can affect blood vessels and called cause dilation of blood vessels which result in flushing, itchiness and burning in the skin. Long-Term toxicity can also damage the liver, especially if you already have preexisting liver disease and in high enough doses can even result in death. Excessive perine or vitamin B6 can cause skin lesions, trouble with the digestion, headaches, irritability and fatigue, depression and nerve damage, which frequently can result in a loss of coordination sensation in the the legs, hands and feet. Loss of sensitivity to touch, difficulty walking in even loss of sensation to vibration or temperature. Even more excessive amounts of folic acid can at, can accelerate age related mental decline, impair the immune system, mask a potentially severe vitamin B12 deficiency and even increase the likelihood of cancer recurrence. So as we talked about above, not only does excessive vitamins and minerals not prevent cancer, in many cases, it actually can increase the risk. Vitamin C also known ascorbic acid is functions as an antioxidant that prevents damage to cells and enhances the growth and repair of tissues in the body. It’s not normally toxic, but if you take too much of it, you can get some GI symptoms. Many minerals are essential for good health. Some minerals like iron, sodium, calcium, potassium and phosphorus are needed in larger amounts because they’re significant parts of your body’s structure. Others are only needed in small amounts and are similar to vitamins and function as catalysts or co-factors and chemical reactions in your body. All of these minerals are readily available in any good diet and amounts that healthy individuals require. And supplements are only needed for specific conditions such as iron with most types of anemia, calcium for individuals with significant loss of bone mass sodium for those who lose significant amounts of salt in their sweat, like people with cystic fibrosis and potassium for excessive loss with diarrhea or certain kidney conditions.

Rich (13:08):

It’s important to remember that like vitamins access, mineral intake can be eliminated up to a point, but accumulation of some minerals can cause problems. Most essential minerals can cause severe problems if taken in high enough doses.

Mike (13:22):

So let’s start with the structural minerals, and probably the one that most of you are familiar with is calcium because it’s an important part of bone and tooth structure and it’s also a necessary, necessary part of normal blood clotting. Maintaining blood pressure, secretion of hormones activation of metabolic enzymes and the proper functioning of nerve cells, muscles in the heart. Accumulation of calcium in the blood can result in irregular heartbeat. Even cardiac arrest can result in muscle pain, mood changes, abdominal pain, kidney stones and vascular and soft tissue calcification.

Rich (14:04):

Fluoride, although not an essential mineral, helps to strengthen teeth and bones. Excessive amounts of fluorides can occur, but a significantly more than we get from fluoridated. Drinking water. Excessive amounts of fluoride may cause modeling or brown staining of the teeth, abdominal pain with nausea, vomiting and diarrhea, headache, abnormal taste in the mouth, eye irritation, abnormal calcium and potassium levels in the blood, tremors and weakness, breathing problems, slow heart rate or even cardiac arrest.

Mike (14:39):

Iron is a major component of hemoglobin, which is the chemical that carries oxygen in your blood and of myoglobin that is needed for muscle and function. So iron is necessary for the manufacturer of red blood cells and muscle cells. It is also needed for certain chemical reactions in the body and for the manufacturer of amino acids, structural collagen, neurotransmitters and hormones. Excessive amounts of iron can damage the lungs, liver and intestinal tract can also cause headaches, dehydration, low blood pressure, weak pulse, drowsiness, seizures, and even coma.

Rich (15:21):

Phosphorus is important for the building and protecting of bones and teeth. It’s also an important part of phosphor lipids, which are the substances of carry lipids in the blood and help move nut nutrients in and out of cells. It’s also important in the formation of dna, n a and rna, and it helps to convert food into energy, excessive amounts of flo, of phosphorus, lower calcium levels, and can result in bone loss, muscle problems, and increased risk of heart attacks and stroke.

Mike (15:51):

Now, potassium is another major component of your blood, another bodily fluids. It’s very crucial for maintaining a regular heartbeat, a normal muscle contraction and proper nerve conduction. Excessive amounts can cause muscle weakness, abdominal cramping, tingling and numbness and serious and sometimes fatal heart arrhythmias.

Rich (16:15):

Sodium is a significant component of the blood and helps to balance fluids in the body. It’s needed for muscle contractions and normal nerve impulses and is involved in the regulation of blood pressure. Excessive amounts of sodium result in what’s called hypernatremia, which can cause an increased thirst, weakness, increased blood pressure, generalized swelling, fluid buildup, muscle spasms, kidney damage, cellular damage, seizures and coma.

Mike (16:48):

Sulfur is an important part of some proteins, especially those needed for healthy hair, skin, and nails. Although excessive amounts of sulfur may result in a burning sensation of diarrhea, there’s really no reported severe reactions to overdoses or excessive doses of sulfur.

Rich (17:05):

Iodine could be in both categories since it’s a crucial part of thyroid hormone, but is also needed for proper nerve and muscle cell function. Reproduction and growth, excessive amounts of fluoride disrupt thyroid function and can result in thyroiditis, which is inflammation of the thyroid, hypothyroidism, hyperthyroidism and thyroid Popular cancer symptoms of excess iodine can include delirium, stupor, shock, and occasionally death.

Mike (17:37):

The next group is the minerals that are needed. As part of biochemical reactions. Chromium improves the activity of insulin, helps maintain normal blood glucose level and is needed to free energy from glucose. Excessive amounts of permium can result in asthma, lung, and nasal ulcers, including progression into cancers can cause skin allergies, reproductive and developmental problems and death if used in very high amounts.

Rich (18:07):

Copper has an important role in iron metabolism, the immune system and making red blood cells. Excessive amounts of copper can cause fever, nausea, vomiting, diarrhea, muscle spasms and weakness and metallic taste in the mouth. Very high doses can result in destruction of red, red blood cells, which is hemolytic anemia, kidney failure, liver damage with jaundice, and even death.

Mike (18:32):

Magnesium helps in the regulation of muscle. Nerve function, helps regulate blood sugar, blood pressure, and is part of the manufacturer of proteins, bone and dna. Excessive amounts can result in a irregular heartbeat, which he could even progress to cardiac arrest.

Rich (18:52):

Manganese has a role in bone formation and assists in metabolizing amino acids, cholesterol and carbohydrates. Excessive amounts of manganese can cause personality changes, tremor, abnormal walking headaches, trouble speaking, overactive reflexes, muscle contractions, breathing problems, low blood pressure, slow heart rate, hallucinations and psychosis.

Mike (19:19):

Molybdenum is an important part of many enzymes that are essential for protein and nucleic acid metabolism. Excessive amounts of meibum can cause achy joints, gout like symptoms in high blood levels of uric acid, which can result in kidney stones.

Rich (19:35):

Selenium helps regulate thyroid hormone activity and acts as an antioxidant that neutralizes unstable molecules that can cause damage. Excessive amounts of selenium can result in hair and nail loss or brittleness lesions of the skin and nervous system, skin rashes, modeled teeth fatigue and mood irritability.

Mike (19:56):

Finally, zinc is needed for proper growth, the making of dna, taste perception, supporting wound healing, immune function, and reproductive health, including regulation of ovulation and normal semen function. Excessive amounts of zinc can result in symptoms of fever, chills, cough, headache, fatigue, nausea, vomiting, abdominal pain and diarrhea can also cause significant gut irritation. Gastrointestinal bleeding lowering of the good cholesterol and loss, lost of taste and smell can also cause copper deficiency in all of the complications of that and result in frequent infections.

Rich (20:42):

To sum up, large amounts of omega doses of vitamin or minerals are expensive and have no benefit in the potential for harm when taking the amounts that exceed the body’s ability to eliminate the excess. Aside from extremely expensive urine and stool, there are many symptoms and consequences that vary from mild to serious to fatal depending on the specific vitamin or mineral and the amount taken. It’s also important to remember when seeing a physician make sure they know all the vitamins and mineral supplements you’re taking, cuz that may affect their prescribing practices.

Mik (21:17):

And again, I want to just re iterate the advice. If you feel like you want or need to take high doses of vitamin in minerals, please check with your healthcare provider first. He or she will be able to give you even more details about the consequences of excessive vitamin intake.

[segment break]

Evan (21:42):

One of the rotating segments will feature on health savings News is debunking health myths. Health myths and misinformation often spread wider and faster than true accurate information and can be harmful to public health. Some myths have circulated for decades and some of the ones that are new are recycled of long debunked ideas.

Rich (22:00):

A recent Cochran collaborative report came out saying that wearing masks had no effect on the transmissibility of the Covid virus. This has caused a lot of consternation and debate. Most people feel that this is an inaccurate conclusion. And the Cochran report, the Cochran Study Group, was unduly influenced by certain members who have longstanding position against mass and vaccines.

Mike (22:27):

Even though there may have been that bias associated with the study. I actually looked at the study myself and none of the conclusions in the study were actually all that firm. And my overall impression of it was that it has really nothing to contribute to any decision making when it comes to your personal preference for using a mask or for any recommendations that may come from the CDC or other regulating institutions.

Rich (22:56):

If someone is interested in learning about the problems with this report, I strongly suggest they go to the Science-Based Medicine website and read the latest entry by Dr. Steven Nola and we’ll put a link to that report in the show notes.

[segment break]

Evan (23:17):

The last segment of each episode, we suggest some of the culture, art, entertainment, and social causes we’ve been engaged with to each other and our listeners. This week I’m suggesting the House of Pod, a humor adjacent medical podcast hosted by Kave Hoda. It’s informative without being too serious, features, knowledgeable guests, and speaks on a level where anyone listening can comprehend what they’re saying.

Thank you so much for joining us for this episode of Health Savings News. Please subscribe, rate, and review us on Apple Podcast or wherever you’re listening to the show — it really does help. You can follow @NeedyMeds on Facebook, Instagram, LinkedIn, YouTube, Mastodon, and you can follow @HealthSavingPod on Twitter (for as long as Twitter remains around) for updates specific to this podcast and send questions, comments, and topic suggestions to podcast@needymeds.org. Our music is composed by Samuel Rulon Miller. His music can be found at musicisadirtyword.bandcamp.com. The Health Savings News podcast is produced by me, Evan O’Connor. All the sources we use in our research can be found in this episode’s podcast description on our website or your podcast of choice. Health Savings News is not intended to substitute professional medical, financial, or legal advice. Always seek the advice of a qualified healthcare professional or appropriate professional with any questions. Views expressed on Health Savings News are solely those of the individual expressing them. Any views expressed do not necessarily represent the views of Health Savings News, other contributors, the NeedyMeds organization or staff. Thanks again for listening. We’ll see you in two weeks with our next episode.