Hazel is suffering through her third cold of the winter. When she complains at a
ID: 121957 • Letter: H
Question
Hazel is suffering through her third cold of the winter. When she complains at a local health food store, the clerk recommends several supplements to keep her healthy. These include a vitamin C supplement, a stress formula B vitamin supplement called B50, a supplement called Prevention Plus, and the herbal supplement Echinacea. Hazel checks the labels of these supplements she has purchased. The information is summarized in the table:
Supplement/Ingredient
Dose
%DV/Dose
Frequency
Total amount (%DV)
Vitamin C
500 mg
833%
3/day
1500 mg (2500%)
B50
Thiamin
50 mg
3333%
3/day
150 mg (10,000%)
Niacin
50 mg
250%
150 mg (750%)
Vitamin B6
60 mg
2500%
180 mg (7500%)
Riboflavin
50 mg
2941%
150 mg (8823%)
Biotin
50 mg
16.66%
150 mg (50%)
Pantothenic Acid
50 mg
500%
150 mg (1500%)
Folic Acid
50 mcg
12.5%
150 mcg (38%)
Vitamin B12
50 mcg
833%
150 mcg (2500%)
Prevention Plus
Vitamin C
1000 mg
1776%
1/day
1000 mg (1667%)
Zinc
15 mg
100%
15 mg (100%)
Echinacea
Echinacea
125 mg
6/day
750 mg
Review the ingredients in Hazel’s supplements. If she takes all these products at the frequency recommended in the table, will she be exceeding the UL for any nutrients? List them.
Did you find a UL for Echinacea? Why not?
Would you recommend that Hazel take these supplements? Why or Why not?
Supplement/Ingredient
Dose
%DV/Dose
Frequency
Total amount (%DV)
Vitamin C
500 mg
833%
3/day
1500 mg (2500%)
B50
Thiamin
50 mg
3333%
3/day
150 mg (10,000%)
Niacin
50 mg
250%
150 mg (750%)
Vitamin B6
60 mg
2500%
180 mg (7500%)
Riboflavin
50 mg
2941%
150 mg (8823%)
Biotin
50 mg
16.66%
150 mg (50%)
Pantothenic Acid
50 mg
500%
150 mg (1500%)
Folic Acid
50 mcg
12.5%
150 mcg (38%)
Vitamin B12
50 mcg
833%
150 mcg (2500%)
Prevention Plus
Vitamin C
1000 mg
1776%
1/day
1000 mg (1667%)
Zinc
15 mg
100%
15 mg (100%)
Echinacea
Echinacea
125 mg
6/day
750 mg
Explanation / Answer
Vitamin C of 500 mg if taken thrice daily would mean 1.5 g/day which is not associated with any significant adverse effects.Now, an important consideration is of %DV/Dose. At 1500 mg with 2500% DV, the daily value(DV) becomes 37, 500 mg which is 37.5 g and the recommended upper limit is 60 mg. So, acute GI toxicity along with renal stones can be obvious, as the dosage is manyfold higher.
With prevention plus, zinc is 15 mg with 100% DV once in a day is on par with the recommended dosage of 15 mg. Here, vitamin-c with 1667% DV for a dosage of 1000 mg results in 16670 mg which is 16.67 g again exceeding the threshold limit of 1.5 g/day of vitamin C as well as daily value of 60 mg.
Concentrating on total amount(%DV) for B50. Thiamin is 150 mg/day with %DV of 10,000 which results in 15000 mg which is 10000 times higher than the permissible DV of 1.5 mg. Niacin is 150 mg/day with %DV of 750 gives 1125 mg which is again manyfold higher than permissible DV of 20 mg. From observation, it can be concluded that almost all the ingredients are having %DV much higher than that required which may have a severe impact on the concerned person.
Echinacea is a herbal preparation used in case of colds, infections of the upper respiratory system and urinary tract infections. It can be even used to treat anxiety, strenthen immune system, and improve exercise performance. Proper UL cannot be traced as different conditions require different dosage as for anxiety 20-40 milligrams of echinacea have to be taken orally for seven days; to improve exercise performance, five 400 milligram doses of echinacea have to be taken orally four times daily for 28 days, etc. So, it keeps on varying.
I would recommend vitamin -c with a lower dose preferrable half the current dose with similar %DV, once a day as excess vitamin can cause severe damage to her health.
References
1. National institutes of health. (2009). Daily Value. Dietary supplement label database. A joint effort of the office of the dietary supplements and the US National library of medicine.
2. European Food Safety Authority. (2006). Tolerable upper intake levels for vitamins and minerals. Scientific Committee on Food, Scientific Panel on Dietetic Products, Nutrition and Allergies.
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