Vitamin and Supplement Guide 2023

By Dr. Frank Yap, MD

Diets consist of various nutrients, including macronutrients such as protein, fats, carbohydrates, and alcohol, as well as micronutrients such as vitamins, minerals, trace elements, and phytonutrients. In addition to these essential components, food also contains non-nutritional substances that can have biological activity.

Some of these substances, like toxins and contaminants such as alkaloids and aflatoxins, can be harmful to health. On the other hand, there are constituents like phytochemicals that have the potential to promote good health. As consumers, our focus is not solely on individual nutrients, but rather on the meals and foods we consume. These meal and food choices form the basis of our diet and hold the most significance for the general public.

Note for healthcare professionals: Virtual groups and internet forums—such as those hosted by International College of Human Nutrition and Functional Medicine at ICHNFM.ORG—can provide access to an assembly of international professional peers wherein sharing of clinical questions and experiences are synergistic.

This guide is not intended to extensively cover all aspects of clinical medicine, such as clinical pharmacology and prescribing (for which we recommend Epocrates.com and its associated app) and medical management (for which we recommend 5-Minute Clinical Consult via website, and app). However, it's also recommended that you do your own research with PubMed, Google Scholar and DuckDuckGo as some of the guides are not updated.

The micronutrients are by definition required in small amounts. Many are essential as they cannot be made in the human body. They include vitamins, minerals and trace elements. Vitamins are a group of organic compounds that have a variety of functions in the body and that are chemically different from each other. To show that a compound is a vitamin it is necessary to show a deficiency in experimental subjects and restoring the missing compound can reverse the deficiency. The name ‘vitamin’ is derived from ‘vital amine’; as the name suggests these essential compounds were initially thought to be amines.

Amines are organic compounds that contain a lone pair nitrogen atom.

Vitamins can be divided into fat-soluble and water-soluble groups; vitamins A, D, E and K are fat-soluble and may be stored in the body, the remainder being water soluble and the body has limited or no stores.

Consuming a balanced diet composed of fresh, whole and organic foods is the best health strategy that everyone should implement. However, not everyone is able to eat healthy at all times. For example, some people, despite their best effort, are unable to prepare home-cooked meals daily, meaning they sometimes have to resort to processed foods or restaurant meals.

Another reason is that there is problem with our current food supply – something that many health experts refuse to consider. Due to poor agriculture practices, plus the abundance of toxic pollutants in soils and waterways, the food we’re consuming right now is no longer as nutritious as it was many generations ago.

In both these cases, taking a supplement may be a wise decision.

Be Warned: Not All Supplements Are Good (or Even Effective) for You

Weight loss supplements are particularly notorious for producing negative publicity for the supplement industry. Not only are these generally ineffective, but they can put your health at risk as well. Yet manufacturers continue to sell these "miracle pills" for profit’s sake – but at the expense of people’s health.

In 2015, the U.S. FDA warned five companies to stop selling supplements containing BMPEA (beta-methylphenylethylamine) as part of an ongoing effort to clamp down on potentially dangerous weight-loss and body-building products. BMPEA is often hidden in supplements containing the botanical Acacia rigidula.

The FDA’s action was followed by a warning asking companies to stop selling dietary supplements containing the stimulant DMBA. DMBA and BMPEA are similar to 1,3-dimethylamylamine, or DMAA, which has already been banned by the FDA.

Muscle-building supplements, high-energy products and sexual “boosters” are also linked to certain side effects, unfortunately putting supplements in a negative light.

Take note that supplements that are known for being hazardous are those that are typically "spiked" with some form of pharmaceutical drug or synthetic ingredient. With very few exceptions, it's not the natural vitamin or herb in itself that is shown to be dangerous.

Check Out These Articles and Stay Informed About Vitamins and Supplements

So with the abundance of supplements out there, how do you know which ones are truly beneficial for you and which ones are only marketing fads, or worse, potentially dangerous for you?

U.S. News and World Report publishes a Pharmacist-Recommended Product Rankings list based on survey responses. Thousands of pharmacists nationwide were surveyed to pinpoint their recommendations on a range of over-the-counter products. U.S. News, in collaboration with Pharmacy Times, has compiled their responses to show how different brands stack up in more than 130 over-the-counter product categories.

We’ve also put together this comprehensive resource to help keep you informed about vitamins and supplements that are being marketed today. Discover all the important facts about supplements, their mechanisms of action and proven benefits, recommended dosage and potential side effects.

And because not all supplements sold today are good for you, as mentioned above, we’ve also included information on particular ones that have been riddled with controversies and may have potentially damaging effects – so you can stay away from them.

Read the Label Carefully Before Taking Any Supplement

If ever you choose to take a supplement to complement your diet, please read the label thoroughly before using it and only take the recommended dosage. Do not, for any reason, take more than the prescribed dose and if you experience side effects after taking a supplement, stop taking it immediately.

If you are suffering from any illness or taking any medication, I advise you to consult a medical doctor before resorting to any kind of supplementation, as certain supplements may come with contraindications. Pregnant women, breastfeeding mothers and children should not take any type of supplement without the approval of their doctor.

A Wholesome Diet, Along With Healthy Lifestyle Habits, Is Still the Best Way to Optimize Your Health

As much as possible, wholesome, organic foods should be your primary source of vitamins, minerals and other nutrients. Supplements should only be a complementary health strategy.

Remember that no supplement, no matter how high-quality or properly manufactured, can take the place of a balanced diet and a healthy lifestyle.

What's the difference between the RDA and the DV for vitamins and minerals?

The RDAs (Recommended Dietary Allowances) for vitamins and minerals are set by the set by the Institute of Medicine (IOM) of the National Academy of Sciences and for each nutrient, may vary depending on age, gender, and for women who are pregnant or lactating. The RDAs do not typically appear on food and supplement labels.

The DVs (Daily Values) are set by the US FDA. The DVs are actually based on the RDAs but are often not up-to-date.

When there is not enough evidence to establish an RDA, the AIs (Adequate Intakes) are the best estimate of intakes assumed to be adequate in apparently healthy individuals.

The new Dietary Reference Intakes (DRIs) are a set of four nutrient-based reference values that replace the former Recommended Dietary Allowances (RDAs) in the United States and Recommended Nutrient Intakes (RNIs) in Canada. The DRIs differ from the former RDAs and RNIs in that, in addition to preventing nutritional deficiency, the new reference values also aim to improve the long-term health and well-being of a population by reducing the risk of chronic disease through nutrition.

Nutrients are now assigned either an Estimated Average Requirement (EAR) and Recommended Daily Allowance (RDA) or an Adequate Intake (AI) value for each life stage category. Most nutrients also have a Tolerable Upper Intake Level (UL) to prevent the risk of adverse effects from excessive nutrient intakes.