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What to take,
how much you need
and which to buy
Every patient is unique, as is every illness. This book is intended as a source of
information only. Readers are urged to work in partnership with a qualified,
experienced practitioner before undertaking (or refraining from) any
treatments listed in these pages.

© Copyright 2003. What Doctors Don’t Tell You Limited

First published in various editions of PROOF! from 1990 to 2002.

Editor and co-publisher: Lynne McTaggart. Publisher: Bryan Hubbard

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including recording, photocopy, computerised or electronic storage or retrieval system, without
permission granted in writing from the publisher.

While every care is taken in preparing this material, the publisher cannot accept any responsibility for any
damage or harm caused by any treatment, advice or information contained in this publication. You should
consult a qualified practitioner before undertaking any treatment.
Introduction Why we need supplements

Fat-solubles Vitamin A (retinol) & beta-carotene 27
Vitamin D (calciferol) 29
Vitamin E (tocopherol) 31
Vitamin K 35
Water-solubles Vitamin C (ascorbic acid) 38
B vitamins 41
Vitamin B1 (thiamine) 42
Vitamin B2 (riboflavin) 43
Vitamin B3 (niacin) 44
Vitamin B5 (pantothenic acid) 44
Vitamin B6 (pyridoxine) 45
Vitamin B12 (cobalamin) 49
Folic acid (folate)
Biotin 53
Choline 54

Macros Calcium 57
Phosphorus 59
Magnesium 60
Potassium 65
Micros Zinc 68
Iron 71
Copper 75
Manganese 77
Chromium 78
Selenium 80
Iodine 83


Essential amino acidsIsoleucine, leucine and valine 87
Lysine 89
Histidine (semi-essential) 90
Methionine 90
Phenylalanine (LPA, DPA, DLPA) 91
Tryptophan 92
Non-essential Arginine 93
amino acids Cysteine (NAC) 94
Tyrosine 96
Alanine 97
Glutamine 98
Glutamic acid (glutamate) 99
Glycine 99
Taurine 100
Coenzyme Q10 (ubiquinone) 101
L-dopa (L-dihydroxyphenylalanine) 104
Carnitine 107
Essential fatty acids 107
Omega-3 Fish oil & cod liver oil (EPA/DHA) 108
Omega-6 Evening primrose oil (GLA) 110
Linseed/flaxseed oil 112
Conjugated linoleic acid (CLA) 114

BioCare Limited 118
Bioforce (UK) Limited 119
Higher Nature 120
Holland & Barrett 121
Lamberts Healthcare 122
Nature’s Answer 123
Nutri Centre/@ Tesco 125
Ortis 126
Quest Vitamins 127
Solgar Vitamin and Herb 129
Viridian Nutrition Limited 130


T reat supplements with respect. There are lots on offer: some good,
some bad, some completely useless. On the whole, you get what
you pay for. Some preparations may seem expensive compared with
their cheaper alternatives, but PROOF! tests have shown, time after
time, that it’s the quality of the preparation and the reputation of the
supplier you should look out for, not just the price tag.
According to nutritional therapist Denise Mortimore, author of
Nutritional Healing (Element Books, 1998), a number of elements have
a leaching effect on supplements (which should be taken with food;
eating slowly improves your digestion and how your body absorbs
vitamins and minerals). Alcohol leaches nutrients straightaway, as do
tea and coffee, so avoid drinking them at mealtimes. Chemicals in
tobacco smoke also leach nutrients and use up antioxidants as well, so
you shouldn’t smoke for at least 30 minutes either side of a meal.
(Of course, you shouldn’t smoke at all.)
These days, with our highly depleted soils and the long time-lapse
between the harvesting of food and its appearance on your table, it is
virtually impossible to get all the nutrients your body needs from food.
There is also your own biochemical individuality. Some people
naturally require more of one nutrient than the norm. Another issue is
the state of your digestive system. You can have the healthiest diet in
the world, but be highly deficient in many nutrients if you don’t have
enough stomach acid to make them available to your body.
Vitamins aren’t just useful to keep you well. Copious research shows
that higher than normal intakes of some vitamins and minerals are
beneficial for treating certain conditions and their prevention.
The bottom line, however, is this: Assessing your intake needs is
not really about minimum or recommended levels of nutrients—which

are used only to ward off vitamin-deficiency diseases—but, as the
late Nobel Laureate Linus Pauling recommended, it’s about optimal
nutrition, providing the body’s cells with levels of vitamins and
minerals that help them function at their best.
If you’re facing a lot of stress at work or at home, or you’re in your
30s or 40s, you’d do well to add on other supplements. Virtually all of
us could use extra magnesium and zinc. Many women need extra B
vitamins, particularly B6.
But the best insurance policy of all is to have a biochemical MOT,
preferably by an experienced nutritional practitioner, who may
recommend a series of sweat tests, blood tests and hair-mineral
analyses to determine which supplements you really need. The Biolab
Medical Unit in London (tel: 020 7636 5959) and the Great Smokies
Diagnostic Laboratory in the US [tel: +(828) 253 0621] carry out such
tests for practitioners.
If heart disease or cancer runs in the family, then a diet high in
vitamins C, E and beta-carotene is a good protective measure. You
should also consider taking antioxidants to quash free radicals,
molecules which cause cancerous changes in the body’s cells. Again,
some of the best nutritional antioxidants to go for are vitamin A and
beta-carotene, vitamins C and E, selenium, coenzyme Q10 and
Our thanks go to Harald Gaier, Pat Thomas, Tony Edwards and
other WDDTY writers, whose work has contributed to this volume.
We are especially grateful to Sharyn Wong, for helping to edit this
book, and to Clive Couldwell, for putting it all together.
Lynne McTaggart

Why we need vitamins
I n 1992, the Earth Summit in Rio confirmed that the average US
farm soils were 85 per cent depleted of minerals compared with a
worldwide depletion of 75 per cent. But this was hardly a new story.
As far back as 1936, a US Senate report (Document 264) stated that
American farms and ranges were depleted of minerals and so, there-
fore, was the food. The researchers who wrote the Senate document
tested a large, representative sample of soils.
The implications of their report were staggering. It meant that some
99 per cent of the public were deficient in a vast array of minerals.
Even at that time, it was recommended that the diets of farm animals
and people should be supplemented with minerals.
The only thing that has changed since that time is that the overall
problem has worsened. Today’s soils—even organic soils—contain
very little of what humans need every day of their lives. Consequently,
most ‘food’ that arrives on our tables has very little in the way of
vitamins and minerals essential to human health.
The story of how our soil has become virtually devoid of essential
minerals is one of commerce and greed. Although the following details
concern American farming conditions, their approach to fertilisation
is now being replicated in most countries in the West.
Early in the 19th century, families farming on America’s prairies
or high plains couldn’t stay put for long. These pioneering types didn’t
apply the refinements long used in Europe to restore fertility, such as
cover crops, crop rotation and having fields lie fallow. The soil yielded
ample food for five to eight years but, soon after that, the corn grew
only two feet high and couldn’t make ears.
These early farmers weren’t putting anything back into the ground,
so the soil was “played out”. If they made it through the first winter,

the survivors trekked farther west to start over. This practice went on
without end.
Then, late in the 19th century, NPK was introduced—a fertiliser
consisting of nitrogen (N), phosphorus (P) and potassium (K). For
farmers who would have had to move west regularly, at first this
appeared to be a great boon.
But carrying on such a practice 100 years later is nothing less than
a gigantic, harmful, worldwide fraud. The three numbers on fertiliser
bags at any garden shop show their contents ratios. With those three
minerals in proportions right for local conditions (plus water, warmth
and light), plants will look healthy, and yield the maximum tons and
bushels—the kind of yield that ensures the farmer gets paid.
Chemist Justus von Liebig (1803–1873) of Germany originated the
absurd theory that N, P and K provided all the needed minerals for
animals and humans. This was because, given his crude equipment,
only those three substances showed up in the ash from burning plant
material. The 11th edition of the Encyclopedia Britannica indicates
that, ultimately, he completely recanted the theory. More up-to-date
technology revealed to him a long list of other minerals in the ash after
incineration of plant tissues.
But, submitting to pressure from chemical and fertiliser manufac-
turers, many publications omitted Liebig’s long, detailed recantation.
As a result of this commercial decision, horticulture in the West has
continued to embrace NPK fertiliser, and the hundreds of millions of
people worldwide who consume the fruits of Western agriculture are
eating foods that are dangerously deficient in nutrients.
Farmers grow crops, harvest them to feed us or to send abroad, and
fertilise the soil with NPK. Then they grow more crops, cut the plants
down, and apply NPK, over and over. Thus, for nearly a century, we’ve
been mining our farm soils and not replacing a full range of minerals.
NPK fertiliser yields large, plump vegetables and fruits that may
taste like cardboard due to a lack of minerals. And the use of only
three nutrients weakens the plants, making them more susceptible to

pests. In addition, NPK fertiliser is highly acidic, and so disrupts the
pH (acid-to-alkaline) balance of the soil.
The ability of soil to bind elements reaches its maximum under
neutral or slightly alkaline conditions. Acidic conditions destroy soil
microorganisms, the function of which is to transmute soil minerals
into a form that crop plants can use. Without these microbes, minerals
become locked up and unavailable to the plants (Townsend Lett Docs,
1996; Aug/Sept: 114–8).
One study showed that more than a third of the soils in the Great
Plains—the agricultural heart of America—has a soil pH of less than
5.5 whereas, to be alkaline, soils should have a pH above 7 (Oklahoma
State Univ PT, 2000; 12: 1). Acid soils are low in magnesium and
usually calcium, says the Canadian Ministry of Agriculture and Food.
Stimulated by NPK fertiliser, the plant grows, but is deficient in vital
trace minerals. In their absence, plants take up heavy metals such as
aluminium, mercury and lead from the soil. These are passed on to us
through the food chain, and are readily assimilated into our bodies if
we are deficient in protective nutrient minerals. Our bodies then retain
toxic minerals, traces of agricultural chemicals and a lot of chemical
wastes purposely added to fertilisers, causing long-term damage to
our health (Wilson D, Fateful Harvest: The True Story of a Small Town, a
Global Industry and a Toxic Secret, NY: HarperCollins, 2001).
According to an international study of micronutrients in various
parts of the world: “Current farming methods, particularly the
excessive use of agrochemicals, cause severe manganese [and other]
deficiencies, both in the soil and in the crop it yields. Manganese, zinc,
and iron have been particularly low in samples studied” (FAO Soils
Bull, 1990; vol 63).

Liming the soil

Often, to counteract the extreme overacidity of the soil, farmers will
resort to ‘liming’ the soil—that is, adding dolomite limestone. This
practice adds calcium and magnesium, changes the soil pH and greatly

increases the plant’s foliage. But it also severely depletes soil of man-
ganese and other trace minerals (Pfeiffer C, Zinc and Other Micro-
nutrients, New Canaan, CT: Keats Publishing, 1978). Manganese is
further depleted by insecticides, which inactivate choline-containing
enzymes. This, in turn, prevents uptake of manganese and other
minerals by the plants (J Orthomolec Med, 1996; 11: 69–79).
Modern ‘hybridised’ grains not only taste inferior and promote
allergy much more than ‘heirloom’ grains, but they are also weak and
unsturdy and, unlike heirloom grains, require chemicals to protect
them (Earthletter, 1994; 4: 12). Pesticide sprays further weaken plants
and then, like wolves culling a deer herd, insects attack the weakened
plants, leading to the use of more pesticides in a vicious cycle. More
than 500 species of insects are now pesticide-resistant.
Unlike us, plants can make some amino acids, essential fatty acids
and vitamins, but nothing can make a mineral, considered the king of
the nutrients. Vitamins, proteins, enzymes and amino acids as well as
fats and carbohydrates need minerals to carry out their own tasks.
When soils have been drained of the other 50-plus minerals that
people and animals require, food will lack them, too. Magnesium,
chromium, vanadium and others that are essential for the avoidance
of disease and for robust good health are much more deficient in
our food supply than most vitamins, leading to the development of
mineral-deficiency diseases. Most Americans are clinically deficient in
chromium, magnesium and manganese, especially teenage girls and
the elderly (Am J Clin Nutr, 1969; 22: 1332–9).
A dietary analysis of vegans—vegetarians who eat nothing but plant
material—found that their food contained well above the recommen-
ded daily allowance of various vitamins. But, among minerals, the
percentages of zinc in food was only 96 per cent of the RDA, with
selenium desperately low at only 46 per cent of its already low RDA
(Bland JS, Prev Med Update, 1996). Thus, even copious amounts of
plant foods will never be enough to prevent deficiency diseases of a
variety of minerals.

Low selenium is a risk factor for both cancer and heart attacks. Low
selenium levels are also critically important in patients with HIV/
AIDS (Funct Med Update, April 1997; Funct Med Update, May 1997).
The protein content of wheat and other grains is a reliable index of
declining soil fertility (Price W, Nutrition and Physical Degeneration,
New Canaan, CT: Keats Publishing, 6th edn, 1997). In 1900, wheat was
90 per cent protein; now it is down to 9 per cent. You would have to
eat 10 slices of bread to gain the nutrients formerly available in one
slice. In 1948, there were 158 mg of iron in 100 g of spinach. By 1965,
100 g of spinach contained only 27 mg of iron; in 1973, this had fallen
to 2.2 mg and, now, the level is suspected to not exceed 1 mg.
So Popeye would have to eat some 200 cans of spinach to get the
same rejuvenating effect he had 50 years ago from a single can
(Gemmer E, ‘Who stole America’s health?’[lecture], 1995).

Nitrosamines in your food

Nitrogen-based fertilisers can affect plants in other ways. Convention-
ally managed soils present nitrogen to plants in large doses that affect
the overall protein quality of the plant. But a large amount of nitrogen
in the soil produces other problems as well. When levels of nitrogen
exceed what the plant can use for photosynthesis, the excess is stored
away in the form of nitrates. When these nitrates are consumed, they
may be converted to carcinogenic nitrosamines (the same carcinogens
found in cigarette smoke and cured meats) during digestion (National
Research Council, ‘The health effects of nitrate, nitrite and N-nitroso
compounds’, Washington, DC: National Academy Press, 1981).
Conventional fertilisers can increase nitrosamine formation in yet
another way. There is evidence that they increase the number of
bacteria on plants which, in turn, facilitates the conversion of nitrate to
nitrite—a nitrosamine precursor (Ahrens E et al., ‘Significance of
fertilization for the post-harvest condition of vegetables, especially
spinach’, in Lockeretz W, ed, Environmentally Sound Agriculture, New
York: Praeget, 1983).

Studies also show that the fungicides used on foods while in storage
can react with nitrates in the plant to form nitrosamines (Nutri Health,
1985; 217–39). Antioxidants in food might normally protect against
harmful nitrosamines but, unfortunately, studies show that levels of
vital antioxidants, such as vitamins C and A, are also declining.

Plummeting levels of vitamins

Minerals are not the only nutrients missing from conventionally
farmed foods. There is evidence to suggest that the vitamin content
of fruits, vegetables and grains has also seriously declined over the last
50 years.
Chemistry researchers R.A. McCance and E.M. Widowson were
commissioned by the Medical Research Council to produce a report,
entitled ’Chemical Composition of Food’, in 1940. These same tests
were then carried out periodically—later, as requested by the Ministry
of Agriculture, Fisheries and Food (MAFF) and the Royal Society of
In 1991, a comparison was made between the current results of the
tests and those of 1940. The results offer a stark view of the hugely
diminishing nutritional quality of vegetables, fruits and even meat
over just 50 years. Although analytical procedures have changed
during the years between 1940 and 1991, in 1940, methods were “no
less accurate than the modern automated ones, but they took a much
longer time”, wrote the authors.
At these two periods of time, 28 raw vegetables and 44 cooked
vegetables, 17 fruits, and 10 types of meat, poultry and game were
examined. The table on p 19 is a sample of the greatest individual
mineral losses (measured in mg/100 g in each sample). On looking at
these data, it is evident that you’d have to eat 10 tomatoes in 1991 to
obtain the same copper one tomato would have given you in 1940, and
three oranges to get the iron you got 50 years ago.
Even more worrying, seeding the soil with only certain minerals
(sodium, phosphorus and potassium) has now drastically altered the

Food type Loss

Carrots 75 per cent less magnesium, 48 per cent less calcium,

46 per cent less iron, 75 per cent less copper
Broccoli (boiled) 75 per cent less calcium
Spring onion 74 per cent less calcium
Spinach (boiled) 60 per cent less iron, 96 per cent less copper
Swede 71 per cent less iron
Watercress 93 per cent less copper
Potatoes 30 per cent less magnesium, 35 per cent less calcium,
45 per cent less iron, 47 per cent less copper
All meats 41 per cent less calcium, 54 per cent less iron
All fruits 27 per cent less zinc
Apples and oranges 67 per cent less iron

ratios between minerals that naturally occur in food. In 1940, there

was a two-to-one ratio between phosphorus in calcium; now there is
a one-to-one ratio, which means that the phosphorus content of many
foods has increased. Swedes now contain 110 per cent of the phos-
phorus they once did. Given that there are critical ratios of certain
minerals in the human physiology (such as between calcium and
phosphorus, or calcium and magnesium), these false new ratios may

In InI1999, nutritionist Alex Jack compared the nutrient values

have profound effects on the body’s chemistry.

stated in the current US Department of Agriculture (USDA) handbook

with those published in 1975 and discovered a decline in a number of
minerals—for example, cauliflower had 40 per cent less vitamin C
than in 1975. He wrote to the USDA asking for an explanation, but
they declined to comment. Organic Gardening magazine championed
Jack’s efforts and published an open letter to the USDA demanding
that they answer him. When an answer finally came, it was full of
bureaucratic doubletalk, mostly blaming unreliable methods of testing
back in the Dark Ages of 1975.

In March 2001, Life Extension magazine also took up Alex Jack’s
cause. With his help and the use of USDA nutrient tables (this time
from 1963), the magazine ran its own comparison. The results? The
vitamin C content of peppers had plummeted from 128 mg to 89 mg.
The provitamin A in apples had dropped from 90 mg to 53 mg. Broc-
coli and collards (greens) had lost half their total provitamin A content
and cauliflower’s vitamin C content has declined by 50 per cent.
Besides being grown in depleted soil, the majority of today’s fruits,
vegetables and grains are stored for long periods of time before being
sold. They may then be stored for an even longer period of time after
purchase before being eaten or used in cooking.
One study, which documented the historical decline in the mineral
content of fruits and vegetables between 1930 and 1987, came up with
some startling conclusions (Br Food J, 1997; 99: 207–11). Modern
potatoes, for instance, were shown to have 40 per cent less potassium
than potatoes grown 50 years earlier. Carrots contain nearly half the
calcium they once did and 75 per cent less magnesium. Tomatoes
contain 90 per cent less copper. Among fruits, apples contain two-
thirds less iron than they once did, as do oranges and apricots. In
general, across 20 common fruits and vegetables, the trend was that
foods were less nutritious than they once were.

The influence of pesticides

The reason vegetables have so few vitamins is only partly explained
by the fact that we are growing plants in depleted, artificially fertilised
soil. It is also the use of pesticides that affects the nutrient quality of
food—either directly or indirectly.
The application of herbicides, pesticides and fungicides during
growth and in storage undoubtedly allows farmers, retailers and
consumers to continue with poor practices (such as storing produce
for long periods of time) that encourage nutrient loss. In addition,
many classes of herbicides alter plant metabolism and thus nutrient
composition. For example, those that inhibit photosynthesis (such as

triazine or phenylacetics) produce effects similar to low-light condi-
tions. Under such conditions, the carbohydrate, alpha-tocopherol and
beta-carotene content of a plant is reduced while protein, free amino
acid and nitrate levels are increased (Z Naturforsch, 1979; 34C: 932–5).
Bleaching herbicides also reduce beta-carotene by inhibiting caroten-
oid production (Weed Sci, 1991; 39: 474–9). Sulphonylurea herbicides
inhibit the synthesis of branched-chain amino acids (Weed Sci, 1991;
39: 428–34).
Vitamin C, beta-carotene and vitamin E are, or course, important
antioxidants, and the implications of this decline are profound. These
nutrients are protective against the free radicals generated in our
bodies not only by normal metabolism, but also by the wide range of
toxins we encounter in our everyday environments. In addition, they
protect us from the many disorders we associate with ‘normal’ ageing.
Men with the lowest intake of vitamin C have a 62 per cent increased
risk of cancer and a 57 per cent increase of dying prematurely from
any cause (Am J Clin Nutr, 2000; 72: 139–45).
Flavonoids such as beta-carotene have been found to protect against
stroke (Arch Intern Med, 1996; 156: 637–42), so low levels of beta-
carotene, retinol and vitamin E are associated with a higher risk of
developing cancer (J Epidemiol, 1992; 135: 115–21).
Plunging scholastic scores and growing behavioural problems may
also be related to soil depletion. The human brain requires vitamins,
minerals and amino acids to produce neurotransmitters and other
important brain compounds. Altered brain chemistry due to a
deficiency of even one nutrient can give rise to diminished mental
capacity as well as mental/emotional disturbances and behavioural
disorders, eating disorders (anorexia and bulimia), drug and alcohol
addiction, autism and violence (Int J Biosoc Res, 1981; 1: 21–41).
Ample research confirms that children engaged in violent crime
typically exhibit pronounced deficiencies of trace minerals such as
lithium, chromium and vanadium. Surprising excesses of other
minerals often accompany these deficiencies.

Organically grown foods
Organic vegetables and fruits are usually better than conventionally
farmed foods, but they may not be treasure troves of the necessary
minerals either. The term ‘organic’ means that no poisonous or
commercial fertilisers were used in the past two or three years. This
may protect consumers as well as farmers against potential causes
of cancer, but there is nothing about a label of organic that ensures that
food is grown in mineral-rich soil.
If the soil in which crops are raised has been fed only NPK for
decades before organic treatment began, the food is still likely to be
mineral deficient. Levels of some of the desirable nutrients in organic
food are still, on average, 75 per cent too low (Australas Health
Healing, 1995; Aug–Oct: 43–5).
Weathered manure helps those organic farms where it is used,
provided the animals are grassfed rather than grainfed, or raised in
countries like the US, which mandate that farm animals are fed all the
required minerals.
Although there have been more than 40 studies in this field, com-
paring results is difficult since these studies are a very mixed bag of
organic vs conventionally grown food or comparisons of farming
systems. Organic consumers may be healthier in other ways, organic
food may be stored differently and even different weather conditions
can affect nutrient content.
Nevertheless, when all the data are reviewed together, there is a
clear trend supporting the notion that organic foods are more nutri-
tious (J Alt Complement Med, 2001; 7: 161–73).
One study found that organic fruits and vegetables in the samples
tested were better than what can usually be purchased at your local
supermarket. In this test, organic foods offered up to four times more
trace elements, 13 times more selenium, and 20 times more calcium
and manganese than supermarket foods. And organic foods contained
40 per cent less aluminium, 29 per cent less cadmium, 25 per cent less
lead and 28 per cent less rubidium—all elements commonly associated

with disease (J Appl Nutr, 1993; 45: 35–9).
However, the difference in nutrient content between organic and
conventional produce could also be explained by the difference in
water content between the two types of produce (Alt Ther Health
Med, 1998; 4: 58–69). As a result of the fertilisers used in modern
farming practices, conventional crops have a higher proportion of
water than organic foods. The higher amount of water in conventional
crops may well dilute the available nutrients, resulting in a less
nutrient-dense food (Alt Ther Health Med, 1998; 4: 58–69; Knorr D et
al., ‘Quantity and quality determination of ecologically grown foods’,
in Sustainable Food Systems, Westport, CT: AVI Publishing, 1983:
Is organic produce better for you? Yes, of course it is. But the claim
for the superiority of organic foods should not based on nutrient
content alone. In some ways, the nutrient-content argument may even
be misleading as it’s not what is in organic foods, but what is not in
them that provides the crucial distinction.

Remineralising the soil

Some farmers remineralise the soil with rock dust and report greatly
increased yields of more pest- and disease-resistant, nutrient-rich
crops. Some regard this as the ultimate resolution of pandemic dietary
mineral deficiencies.
“Remineralisation causes a phenomenal growth of the microorgan-
isms in the soil and increases the nutrient intake of plants. It counters
the effects of soil acidity, prevents soil erosion, increases the water-
storage capacity of the soil, contributes to the building of precious
humus complexes, has antifungal properties and, when you spray it on
plants, it repels insects as well,” says one report (World Res Inst Bull,
March 1995; Acres-USA, January 2001: 22–3).
Remineralisation with rock dust may also enhance and speed up
the process of composting (Australas Health Healing, 1996; May–July:
55–6). Reports from Germany and Australia also tell of greatly

improved forest growth where soil has been remineralised (World Res
Inst Bull, March 1995).
Zinc is now regularly added to fertiliser in Middle Eastern coun-
tries, and selenium to fertiliser in Finland and China. American walnut
farmers use a special fertiliser that is rich in manganese since walnut
trees will not grow without it. In California, trace elements are added
to the irrigation water for rice paddies according to the deficiencies
found, leading to extremely rich harvests.
These may all offer solutions, but can’t be used wholesale. Soil
remineralisation has yet to prove practical for large-scale agriculture,
and doesn’t provide an immediate supply of absorbable minerals for
consumers. It would also need to be repeated regularly.
The second-best solution is to supplement with vitamins and min-
erals to give your body what the soil—depleted of minerals—and the
food—depleted of vitamins—cannot.
Recently, the Journal of the American Medical Association reversed
a long-standing position and declared that doctors should now recom-
mend that all patients, even healthy ones, routinely take vitamin
and mineral supplements (JAMA, 2002; 287: 3127–9).
So it’s now official: vitamin and mineral supplements aren’t a luxury
to be consumed by the hypochondriac few or those in need of thera-
peutic doses. Vitamin and mineral supplements are essential for the
maintenance of basic levels of human health.
In the face of these long-standing conclusions, the effect of the
recently passed food supplements directive of the European parlia-
ment could be catastrophic. This directive, passed in March 2002, will
ban many vitamins and minerals, and lower the levels allowable in
many others. The premise of the directive is that high-dose supple-
ments are an expensive exercise in overkill. The often-repeated
rationale for the new law is that you can obtain all the vitamins and
minerals you need from food.
Yet, food supplements are no longer a just-in-case insurance policy.
They are quite literally tomorrow’s bread and butter.

Part 1
V itamins are important because they help chemical reactions start
in the body. They’re often referred to as enzymes (or catalysts)
because of this.
It’s best to take fat-soluble vitamins with meals because your body
will absorb them better. Water-soluble vitamins can be taken with or
without food.
Eat foods high in the B vitamins and vitamin B supplements early
in the day because they kick-start your body’s metabolism. If you have
to take large quantities of any vitamin, divide the dose up so that you
take it two to four times a day. This helps you absorb it better and
you’ll reduce the amount you excrete.
Whether natural vitamins are better than synthetic vitamins
depends on the vitamin. For example, natural-source vitamin A in the
form of oceanic beta-carotene from Dunaliella salina algae is more
potent that synthetic beta-carotene and contains more of the important
carotenoids such as alpha-carotene, cryptoxanthin, zeaxanthin, lutein
and lycopene. Most vitamin C is in the form of ascorbic acid, and many
of the B vitamins are produced by bacterial fermentation (similar to the
way yoghurt is made). All vitamins are chemically processed so that
they can be put into a tablet or capsule.
Quality producers usually avoid using sugar, lactose, artificial
colours and common allergens as excipients (the substances that hold
the tablets together). Other suppliers may not be as discriminating.
But here’s the caveat. On their own, vitamin supplements will help
provide your body with the nutrients it needs if you’re on a very low-
calorie diet (less than 1200 a day). However, to build and maintain
body function, you need a mixture of protein, fat and carbohydrates—
in fact, a variety of foods which should supply you with the correct

balance of vitamins (and minerals). Unless your doctor or nutritionist
has recommended that you take a specific vitamin for a particular
health problem, you may be wasting your money on supplements.


Vitamin A (retinol) & beta-carotene

Why it’s important

Vitamin A is commonly known as the anti-infection vitamin. It can
prove invaluable during times of infection, when our need for this
vitamin begins to skyrocket, by helping the body regulate the immune
system (Int J Vitam Nutr Res, 1997; 67: 71–90; Nutr Rev, 1998; 56:
S38–48). It may also help prevent bacteria and viruses from entering
your body by bolstering the skin’s defences (Proc Nutr Soc, 1998; 57:
159–65; Nutr Health, 1996; 10: 285–312; FASEB J, 1996; 10: 979–85), and
can be used as an anti-inflammatory to treat acne and psoriasis (J Am
Acad Dermatol, 1982; 6: 620–9).
As for how much vitamin A to take during an infection, according
to John Stirling, technical director at BioCare, Birmingham, dosages
vary wildly from country to country and between practitioners. In
Germany, viral infections are treated with 10,000 IU, providing the
patient isn’t pregnant while, in the US and Australia, 25,000–50,000 IU
are given. “Generally, English practitioners tend to be more
conservative, using 5000 IU as their baseline dosage, but going up to
10,000 IU,” he says.
When working in a clinic in Germany, Stirling often gave 500,000 IU
for seven days (for the duration of the infection or until an adverse
symptom appeared), but only with the patient under strict medical
supervision and with close laboratory monitoring. “Certainly, we
wouldn’t have done this with anyone who was pregnant or had a
history of kidney stones, where vitamin A might increase the uptake of
calcium,” he says.

Retinol is one of the most usable forms of vitamin A. It’s found in
animal foods such as liver and eggs. Some plant foods contain orange
pigments called ‘pro-vamin A carotenoids’that the liver can convert
to retinol. Beta-carotene is one such carotenoid found in many foods
(Phamacol Ther, 1997; 75: 185–97; Eur J Clin Nutr, 1996; 50 [Suppl 3]:
Zinc helps the body use vitamin A (Clin Chim Acta, 1979; 93: 97). A
number of animal studies have highlighted vitamin A’s relationship
with cancer, showing that vitamin A or beta-carotene could prevent the
development of bladder, breast and skin cancer (Fed Proc, 1979; 38:
2528; Fed Proc, 1983; 42: 768).
Vitamins A and E protect against arteriosclerosis by helping to
reduce blood-fat levels, which increase the risk of dying from the
condition (Acta Vit Enzym, 1980; 2: 135–46).
Austrian researchers found low levels of vitamin A and carotene in
190 patients with thyroid disease (Acta Med Aus, 1983; 10: 71–3).
The vitamin also plays an important role in vision and bone growth
as well as maintaining the surface linings of the eye and your
respiratory, urinary and intestinal tracts (Pediatr Nurs, 1996; 22: 377–
89, 456; Proc Nutr Soc, 1999; 58: 289–93).
A 1982 German study has suggested a relationship between low
blood levels of vitamin A in alcoholics and impaired hearing. Fifty-
nine patients with chronic alcohol liver disease, but with no history
of ear infection, head injury, exposure to high levels of noise pollution
or taking streptomycin, and not suffering from hereditary deafness,
had their hearing ability tested. Alcoholics across all age groups were
found to have a hearing impairment, and all of those in the study had
low levels of vitamin A, retinol-binding protein, beta-carotene and zinc
(HNO, 1982; 30: 375–80).

Dietary sources
It’s important to regularly eat foods that provide vitamin A or beta-
carotene even though your body can store vitamin A in the liver

[stored vitamin A will help meet your needs when your intake of pro-
vamin A carotenoids or vitamin A is low (J Nutr, 1994; 124: 1461S–6S;
Eur J Clin Nutr, 1996; 50 [Suppl 3]: S7–12)]. Such foods comprise a
considerable array of fruit and vegetables that are widely available,
but which must be eaten fresh. These include carrot, mango, sweet
potatoes, spinach, cantaloupe, vegetable soup, pepper, apricots,
spinach, broccoli, oatmeal, tomato juice, peaches, papaya, orange and
asparagus (Br J Nutr, 1999; 82: 203–12; Am J Clin Nutr, 1999; 70: 1069–
76; Cancer Epidemiol Biomarkers Prev, 1997; 6: 617–23; Gac Sanit, 1999;
13: 22-9; J Agric Food Chem, 1999; 47: 1576–81).
One study also showed that grating the carrots and pureeing the
papaya will help the body handle the beta-carotene in these foods
more efficiently (J Nutr, 2001; 131: 1497–502). Research is also being
carried out on the cauliflower, one mutant version of which has shown
beta-carotene concentrations several hundred times higher that in
normal cauliflower (Plant J, 2001; 26: 59–67).
Another study has suggested that a diet rich in vitamin C and beta-
carotene can increase your lifespan. Researchers found that those who
ate two oranges and two carrots a day could reduce the risk of death
in middle age by over 30 per cent. The eating habits of 1556 men
employed by an American telephone manufacturing company were
tracked for 24 years. Those who were eating appreciably more vitamin
A and beta-carotene had a reduced risk of developing cancer or heart
disease (Am J Epidemiol, 1995; 142: 1269–78).
In supplements, vitamin A may be prepared as its acetate form or
from sources of palmitic acid (a fatty acid) such as retinol palmitate
(from palm oil). It can also be prepared from fish-liver oils. Beta-
carotene can be synthetic or naturally derived from the carotenoids
(yellow and red pigments) of certain plants (such as carrots and algae).

Supplement dosage
The recommended daily retinol equivalent (RE, the minimum amount
to prevent a deficiency disease) is 800 mcg for women (equivalent to

around 2664 IU) and 1000 mcg for men (3330 IU) (Int J Vitam Nutr Res,
1997; 67: 71–90). A generally recognised safe upper limit for vitamin A
intake from the diet plus supplements is 1600–2000 mcgRE (5328–6660
IU) per day (Am J Clin Nutr, 1989; 49: 358–71; Int J Vitam Nutr Res
Suppl, 1989; 30: 42–55).
Women of childbearing age are advised to limit their total daily
intake of vitamin A from foods and supplements combined to no more
than 1600 mcgRE (5328 IU) per day. Nevertheless, some nutritionists,
such as WDDTY panel member and University of California associate
professor Dr Melvyn Werbach, suggest that as much as 7508 mcgRE
(25,000 IU) can be taken safely.

Provitamin A carotenoids, such as beta-carotene, are generally
considered safe because they are not associated with specific adverse
health effects. The conversion of pro-vitamin A carotenoids to vitamin
A decreases when body stores are full, which naturally limits how
much more of it you can store. A high intake of pro-vitamin A
carotenoids can turn the skin yellow, although this is not considered
dangerous to health (Council for Responsible Nutrition, 1997: 26–7).
However, vitamin A can be toxic. Symptoms can arise suddenly after
consuming very large amounts of vitamin A over a short period of
time, and present as dizziness, blurred vision and muscular inco-
ordination (J Clin Pharmacol, 1997; 37: 551–8; Adv Exp Med Biol, 1994;
352: 187–200; Am J Clin Nutr, 1989; 49: 358–71). Vitamin A toxicity can
also cause severe birth defects (J Am Diet Assoc, 2000; 100: 1068–70;
Am J Clin Nutr, 2000; 71: 1325S–33S).

Vitamin D (calciferol)

Why it’s important

Vitamin D’s main role is to maintain normal levels of calcium and
phosphorus in the blood. It helps the blood absorb calcium which, in

turn, helps to form and maintain strong bones. Vitamin D prevents
rickets in children and osteomalacia in adults—skeletal diseases that
lead to defects that weaken bones—so, without vitamin D, bones can
become thin, brittle, soft and misshapen.
Vitamin D deficiency is seen more often in postmenopausal women
and older people (N Engl J Med, 1992; 327: 1637–42; J Clin Invest, 1985;
76: 1536–8; Lancet, 1989; 2: 1104–5; Am J Clin Nutr, 1993; 58: 882–5) and
has also been linked to hip fractures (Endocrinol Metab Clin North
Am, 1998; 27: 389–98). Bone loss increases the risk of fractures, but
vitamin D supplements have been associated with a lower bone loss in
older women (Am J Clin Nutr, 1995; 61: 1140–5) and may be of partic-
ular benefit to elderly sufferers of osteoporosis (Lancet, 1987; i: 306–7).
Studies have shown that vitamin D is as necessary as calcium in
reducing hip fractures in women (N Engl J Med, 1992; 327: 1637–42).
Those suffering from hearing loss may benefit from vitamin D sup-
plementation. Following two cases of deafness associated with vitamin
D deficiency in 1981, eight other such patients at the London Hospital
were also found to have low levels of vitamin D (J Laryngol Otol, 1983;
97: 405–20).
Vitamin D may protect against some cancers. Dietary surveys have
found a link between a high intake of dairy foods and a decreased
incidence of colon cancer (Ann NY Acad Sci, 1999; 889: 128–37; Gut,
1998; 43: 578–85; Am J Clin Nutr, 1997; 66: 1277–82). One survey found
an association between a higher calcium and vitamin D intake and a
lower incidence of colon cancer (Int J Cancer, 1997; 73: 525–30).

Dietary sources
Only a few foods naturally contain significant amounts of vitamin D,
such as fatty fish and fish oils.
Exposure to sunlight is an important source of vitamin D. The sun’s
ultraviolet rays trigger vitamin D synthesis in the skin (Am J Clin Nutr,
1994; 60: 619–30). Sunscreens with a sun protection factor (SPF) of 8
or higher will block these UV rays (but it is still important to routinely

use sunscreen if you’re out in the sun longer than 10–15 minutes).
Vitamin D is available in two forms: D2 and D3. The most commonly
used form is vitamin D2 (ergocalciferol), prepared from a special strain
of yeast, whereas D3 is found as cholecalciferol (from sheep and cattle)
or derived from fish-liver oil. In humans, both forms appear to have
the same activity.

Supplement dosage
The US Food and Nutrition Board of the Institute of Medicine recom-
mends a daily dose of 25 mcg (1000 IU) for babies up to 12 months, and
50 mcg (2000 IU) for children, adults, and pregnant or breastfeeding
women. Dosages over 1000 IU a day are not recommended except as a
therapeutic programme for psoriasis.

Taking too much vitamin D can lead to nausea, vomiting, loss of
appetite, constipation and weight loss (J Nutr, 1989; 119 [12 Suppl]:
1825–8). It can also raise the level of calcium in the blood, which can
make the heart beat irregularly.
But it’s unlikely you’ll overdose on vitamin D through diet alone,
unless you routinely consume large amounts of cod liver oil, but you
can overdose on supplements. Taking 10,000 to 15,000 IU a day
regularly can lead to weight loss, paleness, constipation and fever as
well as high blood pressure, premature hardening of the arteries,
calcium deposition in muscles and soft tissue, soft bones and kidney

Vitamin E (tocopherol)

Why it’s important

There are eight different forms of vitamin E, and each one operates
differently in the body (Am J Clin Nutr, 1995; 62: 1501S–9S). Alpha-
tocopherol is the most active form of vitamin E in humans. It is a

powerful antioxidant (molecules which protects your cells against the
effects of free radicals, which may contribute to the development of
chronic diseases such as cancer). It’s thought that vitamin E prevents
cancers from developing by boosting your immune system (J Exp Clin
Cancer Res, 1997; 16: 11–4). Tumours are low in antioxidant-containing
enzymes (Am J Clin Nutr, 1979; 23: 1066).
A high intake of vitamin E has been associated with a decreased
incidence of prostate and breast cancers (Semin Cancer Biol, 1998; 8:
263–73). Another study examining the effect of diet (including vitamin
E) on 18,000 postmenopausal women with breast cancer did not find
an association between a higher vitamin E intake and a reduced risk
of developing breast cancer (Am J Epidemiol, 1992; 136: 3127–37).
However, one study of women in Iowa suggested that increasing
vitamin E intake may reduce the risk of colon cancer, especially in
those under age 65 (Cancer Res, 1993; 15: 4230-7).
Vitamin E may also help reduce the lipoperoxides (carcinogens that
activate other carcinogens) that are formed during chemotherapy.
Many anticancer drugs create more lipoperoxides, which further
increases the need for some kind of antioxidant defence mechanism.
UK research has shown that, when rats were given vitamin E
supplements alongside the anticancer drug 5-fluorouracil, both liver
and blood lipoperoxide levels were significantly lower than when the
anticancer drug was given on its own (Anticancer Res, 1983; 3: 59).
Elderly people may benefit from taking therapeutic levels of vitamin
E, according to a study by the Human Nutrition Research Center on
Aging at Tufts University in Boston. Healthy individuals were assign-
ed to take either vitamin E (at dosages of 60 mg, 200 mg or 800 mg) or
a placebo for 235 days. Those taking 200 mg a day of vitamin E had a
sixfold increase in the amount of antibody made in response to hepa-
titis B infection and a significantly greater antibody response to the
tetanus vaccine. The vitamin supplements did not affect the antibody
response to diphtheria, immunoglobin concentrations or the numbers
of immune system T and B cells (JAMA, 1997; 277: 1380–6).

Researchers at the Institute of Post Graduate Medical Education
and Research in Calcutta used vitamin E as an antioxidant and free-
radical-trapping agent for women fitted with intrauterine contra-
ceptive devices (IUDs), which have been associated with increased
menstrual blood loss (menorrhagia). The 51 women who took part in
the study were given 100 mg of vitamin E orally each day for two
weeks, regardless of where the day fell in their menstrual cycle. Nearly
all of the women responded positively to the vitamin treatment, as
evidenced by the restoration of their menstrual blood loss to normal
levels (Int J Fertil, 1983; 28: 55–6).
New data suggest that supplementing with vitamin E can help to
lower the incidence of asthma, rhinitis and hayfever. Researchers in
Nottingham surveyed the vitamin intake of a random sample of 2633
adults, aged 18 to 70. Each of the individuals supplied information
on their intake of vitamins E and C, magnesium, polyunsaturated fats
and other nutrients through a food-frequency questionnaire.
The study participants were also assessed to determine their sensi-
tivity to grass pollen, cat fur and other allergens, as well as to provide
information on the nature of their asthma or hayfever.
On putting all the information together, the researchers found that
those with the highest daily intake of vitamin E were least likely to
suffer from allergen-sensitive atopic conditions such as asthma,
rhinitis and hayfever. In addition, vitamin E did not appear to be more
effective in combination with any other nutrient (Lancet, 2000; 356:
Results from the Alzheimer’s disease Cooperative Study showed
that adding vitamin E to treatment with the MAO (monoamine oxi-
dase) inhibitor selegiline appeared to slow the loss of ability to per-
form basic daily activities (N Engl J Med, 1997; 336: 1216–22).
Vitamin E may help prevent or delay coronary heart disease (Can J
Cardiol, 1997; 13: 957–65). Observational studies have associated lower
rates of heart disease with a higher vitamin E intake. A 1994 review
of 5133 Finnish men and women, aged 30 to 69, suggested that an

increased dietary intake of vitamin E was associated with a lower
death rate from heart disease (Am J Epidemiol, 1994; 139: 1180–9).
The Heart Outcomes Prevention Evaluation (HOPE) Study followed
10,000 patients who were at a high risk of heart attack or stroke for four
and a half years (N Engl J Med, 2000; 342: 154–60). However, the results
suggested that it is unlikely that daily doses of vitamin E provided any
protection against cardiovascular disease. Patients did not experience
significantly fewer heart problems or chest pains compared with those
who received a sugar pill (placebo). However, the study is still ongoing
to ascertain whether a longer period of treatment with vitamin E
supplements will provide protection against cardiovascular disease.
Antioxidants in general are being studied to find out whether they
can help prevent or delay the development of cataracts, opacities on
the lens of the eye that impair vision. Observational studies have
found that lens clarity, which is used to diagnose cataracts, was better
in people who were regular users of vitamin E supplements and in
those who had higher blood levels of vitamin E (Ophthalmology, 1998;
105: 831–6). A study of middle-aged male smokers, however, did not
demonstrate any effect of vitamin E supplements on the incidence of
cataract formation (Acta Ophthalmol Scand, 1997; 75: 634–40).
Fluid retention is a result of abnormal changes in pressure inside of
capillaries—tiny blood vessels in the body—which can cause fluid to
leak into the surrounding tissues, where it accumulates in the tissue
spaces around and between cells. Fluid retention brings a number of
symptoms, including bloating, muscle aches, fatigue and other flu-like
symptoms. Vitamin E can help strengthen capillaries, thus preventing
such leakages (Vitamins, 1961; 28: 129).
Researchers studying the effect of vitamin E in a double-blind study
of 75 women suffering from premenstrual syndrome (PMS) and benign
breast disease found that the vitamin supplement had a greater effect
on controlling the symptoms of PMS than did a placebo. They con-
cluded that vitamin E supplements may be of value in women who
suffer from severe PMS (J Am Coll Nutr, 1983; 2: 115).

Dietary sources
Vegetable oils, nuts and green leafy vegetables are the main dietary
sources of vitamin E.
As supplements, vitamin E is usually in the form of oils (mixed
tocopherols or alpha-tocopherols from soybean and cottonseed oils),
although some manufacturers do produce a dry, powdered version.
The natural form of D-alpha-tocopherol is the only form the body
can use. Synthetic vitamin E, or D,L-alpha-tocopherol, may block the
natural form of the vitamin from passing through cell membranes
(Murray MT, Encyclopedia of Nutritional Supplements, Prima Health,
1996). Manufacturers must therefore use greater amounts of synthetic
vitamin E to provide an equivalent amount to that found in natural
D -alpha-tocopherol.

Supplement dosage
Take to 1000 IU of vitamin E daily for up to four weeks; 400 IU for up
to six months.

The health risks of taking too much vitamin E is low (Free Radical Biol
Med, 1992; 13: 55–74). A recent review of vitamin E safety in the elderly
showed that taking vitamin E supplements for up to four months at
doses of 530 mg (or 800 IU) had no significant adverse effects on their
general health, body weight, levels of body proteins, lipid levels, liver
or kidney function, thyroid hormones, amount or kinds of blood cells
and bleeding time (Am J Clin Nutr, 1998; 68: 311–8).

Vitamin K

Why it’s important

The critical role of vitamin K in blood-clotting has long been known.
As a fat-soluble nutrient, it is converted into substances that allow
blood to aggregate or form clumps. Without them, cuts would not stop

bleeding naturally, and the usual, normal tiny damage that occurs in
blood vessels would lead to internal bleeding.
On their own, newborn babies have extremely low levels of vitamin
K in the blood or maintained in the liver. If this level of vitamin K is
not raised, there could be a tiny risk of vitamin K deficiency bleeding
or, as it is more commonly called, haemorrhagic disease of the
newborn (HDN). Often, it starts as bleeding from the nose or umbilical
stump and progresses to the brain or other site to cause internal
haemorrhaging. This can range from a very mild to a fatal condition
(about 7 per cent die and 30 per cent suffer mental impairment). Those
considered most at risk include premature babies, those delivered with
forceps or with ‘difficult’ caesarean sections, those with liver disease or
those born to mothers taking anticonvulsants or medication which
prevents blood from clotting (WDDTY, vol 6, no 4, p 8).
The conventional wisdom is that the infants who are most at risk of
developing vitamin K deficiency are the ones who are exclusively
But, according to active-birth pioneer and primal health researcher
Michel Odent, this is only half right. While it is true that breastmilk is
low in vitamin K, it is also true that colostrum—the early milk secreted
immediately after birth and for several days after-wards—is very rich
in vitamin K. Therefore, one reason why babies suffer from HDN, he
suggests, is that they are improperly breastfed—this is, they are taken
away from the mother and not put to the breast immediately after
being born.
The heart drug warfarin is known to increase the risk of haemor-
rhage because of its effect on blood coagulation. However, a recent
study found that supplementing with low-dose oral vitamin K can
significantly reduce this risk by normalising coagulation time (Lancet,
2000; 356: 1551–3).
Vitamin K is also required for kidney function, bone growth and
repair, and may help prevent osteoporosis.

Dietary sources
Dark-green leafy vegetables (such as kale, spinach and broccoli), green
tea and cheese are excellent dietary sources of vitamin K.
In supplements, vitamin K is available as K1 (phytonadione), which
is derived from the chlorophyll in plants, or as K2 (menaquinone),
made by bacteria from the human gastrointestinal tract, or as K3
(menadione), a synthetic derivative. According to Michael T. Murray,
author of Encyclopedia of Nutritional Supplements (Prima Health, 1996),
the chlorophyll-derived K1 is considered the best source of vitamin K.

Supplement dosage
The UK Department of Health recommends that doctors switch to oral
vitamin K for low-risk babies, giving a dose at birth, a further dose a
week later and a third dose six weeks after birth to those babies who
are breastfed (infant formulas contain vitamin K; see WDDTY, vol 6,
no 4, p 11).
Doses of vitamin K are individualised and should only be given
under medical supervision.

Vitamin K toxicity is rare, although megadoses greater than 500 mcg
can be toxic.
The routine use of vitamin K injections for newborn babies in the
early 1990s caused controversy when two retrospective studies
suggested an association between these injections and the develop-
ment of childhood leukaemia and other forms of childhood cancer.
However, a further two large retrospective studies carried out in the
US and Sweden reviewed the medical records of 54,000 and 1.3 million
children, respectively, and found no evidence of a such a relationship
between childhood cancers and vitamin K injections at birth (N Engl J
Med, 1993; 329: 905–8; BMJ, 1993; 307: 89–91).


Vitamin C (ascorbic acid;

works well with bioflavonoids)

Why it’s important

Vitamin C is the most popular and familiar of all the vitamins. It’s the
body’s most important antioxidant and is therefore critical to proper
immune function; it can help protect against heart disease and may
alleviate the pain of rheumatoid arthritis.
It is possible that natural vitamin C, which contains bioflavonoids
(a group of brightly coloured compounds that often appear in fruits
and vegetables), may actually work better than the synthetic form of
the vitamin. Animal studies have shown that bioflavonoids help the
body to store and use vitamin C, but other studies in humans have
produced conflicting results (Nutr Rep Int, 1983; 27: 875–80).
Vitamin C also plays a key role in tissue growth, wound-healing and
adrenal gland function. Its benefits have been demonstrated in people
with diabetes and those with cataracts.
In a double-blind, placebo-controlled trial, 500 mg daily of vitamin
C, taken for 50 days, was found to cut in half the risk of developing
reflex sympathetic dystrophy (RSD) after a wrist fracture. Trauma to
any site on the body, such as bone, muscle, nerve or blood vessels, can
lead to RSD, with symptoms such as swelling, pain and osteoporosis-
like features. In this study, only 7 per cent of those taking the
supplement developed RSD, compared with 14 per cent among those
given a placebo (Lancet, 1999; 354: 2025–8). The authors concluded
that, if vitamin C was effective in this small-scale trial, it may also
prove to be effective as a prophylaxis (preventative, just-in-case
treatment) in other forms of trauma.
Another recent study has shown that hypertensive patients
suffering from stress may benefit from vitamin C supplementation.
This randomised, double-blind, placebo-controlled trial found that

blood pressure dropped significantly after continuous supplemen-
tation (Lancet, 1999; 354: 2048–9).
Patients were divided into two groups: one received an initial dose
of 2 g of ascorbic acid and the other received a placebo. Two hours after
the initial dose, the mean, diastolic and systolic blood pressure
measurements were roughly the same in both groups. However, after
a month of supplementation with 500 mg daily of vitamin C, the
treatment group experienced a drop in mean blood pressure from an
average of 110 mmHg to 100 mmHg. Systolic pressure dropped on
average from 155 mmHg to 142 mmHg, and diastolic pressure dropped
from 85 mmHg to 80 mmHg. No adverse effects were observed.
Numerous 25-year-old studies inspired by the late Linus Pauling
have shown that high doses of vitamin C can greatly reduce the muta-
genic (mutation-causing) and carcinogenic (cancer-causing) substances
within the bowel (Cancer, 1981; 47: 1121–5).
The most widely known benefit of vitamin C is in the treatment of
scurvy, a disease that causes bleeding gums, poor wound-healing,
aching bones and muscles, and bruising. Scurvy is not as common
today as it was in the olden days, although it can still be seen in the
elderly on rare occasions.
One double-blind study demonstrated that taking supplements of
200 mg of vitamin C and 200 mg of bioflavonoids four times daily as
soon as the characteristic tingling that precedes a cold sore outbreak
becomes apparent could halve the time from its onset to remission
(Oral Surg, 1978; 45: 56–62).
Even a small increase in your daily vitamin C intake can signifi-
cantly reduce the chances of early death from all causes. In a pros-
pective population UK study (EPIC–Norfolk), researchers collected
data on 19,496 men and women, aged 45 to 79, and put them into five
gender-specific groups according to blood levels of vitamin C.
The subjects were followed for about four years and their causes of
death documented. For both men and women with the highest blood
concentrations of vitamin C, the risk of death due to all causes, cardio-

vascular and ischaemic heart disease was about 25 per cent lower than
those with the lowest blood levels of vitamin C. The study also found
that high vitamin C levels were linked to lower rates of death from
cancer in men, though not in women.
Overall, researchers found a 20 per cent reduction in all-cause
mortality risk associated with each increase in blood vitamin C
concentrations of 20 mmol/L, equivalent to an increased daily intake
of fruits and vegetables of about 50 g (Lancet, 2001; 357: 657–63).
For morning sickness, vitamins C and K taken together (under
professional supervision) have been shown to resolve the condition
within 72 hours in 91 per cent of cases (Am J Obstet Gynecol, 1952; 64:
Over the years, controversy has raged regarding just how effective
vitamin C is in curing the common cold. It’s thought that ascorbic acid
might not prevent infection (as Pauling suggested some years ago), but
may instead minimise the symptoms associated with it (Int J Tiss, 1983;
5: 141–3).
Consuming a gramme of vitamin C a day may help infertile men
regain their fertility. One US study maintains this happened in just
four days. Dr Earl Dawson and his team at the University of Texas
Medical Branch in Galveston gave 35 male patients with low ascorbic-
acid levels 500 mg of vitamin C in a capsule every 12 hours as part of
a 60-day regime. They found that sperm activity improved as vitamin
C levels increased. Dawson reported that, in 12 cases, the patient’s wife
subsequently became pregnant. The wives of those taking the placebo
did not (JAMA, 1983; 249: 2747–51).

Dietary sources
Citrus fruits, berries and vegetables such as broccoli, brussels sprouts,
peppers and cabbage are all good dietary sources of vitamin C.
All vitamin C compounds start as ascorbic acid but, as this is known
to irritate some people’s stomach and is not as well absorbed as other
forms, ascorbic acid is often prepared in different ways to increase its

absorbability. These forms include buffered C—when it is combined
with sodium, calcium, magnesium or potassium ascorbate—and Ester-
C, a patented form reported to improve its uptake by the body.

Supplement dosage
Scientists have long debated how much you actually need; however,
its important function in healthy nutrition is widely accepted. Take at
least 1 g of vitamin C per day. If you are recovering from an infection
or live in an urban area, consider taking 2–3 g daily.
It may be preferable to take this vitamin as calcium or magnesium
ascorbate powder since high doses of other forms of vitamin C can
cause loose stools and diarrhoea.

Nausea and diarrhoea may result from higher dosages. Large doses
of vitamin C may cause a false-positive reaction to diabetes tests and
a false-negative reading in tests for blood in the stool.
Alcohol, analgesics, anticoagulants, oral contraceptives, antidepres-
sants, steroids and smoking can decrease the body’s vitamin C levels.
Several reports have also suggested that vitamin C lozenges can
erode the enamel on teeth. The pH of vitamin C, in its ascorbic form, is
less than two, making it a very strong acid in the mouth. One premolar
kept in a vitamin C solution became rough and lost 5 per cent of its
mass in two weeks. The authors of this report suggest you should
swallow rather than chew vitamin C supplements (J Am Dent Assoc,
1983; 107: 252–6).

B vitamins

Why they’re important

The B vitamins (B1, B2, B3, B5, B6, biotin, folic acid and B12) should
always be taken together because of the way they work together to
support the way the body uses carbohydrates, fats and proteins, and to

maintain healthy skin and muscle tone. They also help the immune
and nervous systems to function more efficiently. Because this group
of vitamins is water-soluble, if you take too much, you will merely
pass them out through the urine.
Most B vitamins used in supplements are derived from bacteria,
yeast, fungi or moulds, and bought in bulk by vitamin manufacturers
from large pharmaceutical companies. Some vitamin makers combine
synthetic B vitamins with yeast to mass-produce ‘food-grown’ B
vitamins. Another process involves vegetable-protein derivatives
combined with yeast cells.

Vitamin B1 (thiamine; activated by


Why it’s important

Thiamine was the first B vitamin to be discovered, around 1930, and
early supplements of this vitamin were thought to cure beriberi. Symp-
toms of beriberi in adults can include diarrhoea, oedema (water
retention), weight loss, heart failure and neurological problems.
Vitamin B1 also helps convert excess glucose into stored fat.
Thiamine improves circulation, digestion and brain function. It also
possesses antioxidant properties that protect against the damaging
effects of alcohol, smoking and ageing.
High levels of thiamine are thought to prevent Parkinson’s disease.
In one laboratory study, thiamine was one of the best inhibitors of
dopamine oxidation (Lancet, 1988; i: 363).

Dietary sources
Brown rice, egg yolks, fish, lean pork, milk and whole grains are
dietary sources rich in vitamin B1. Other sources include most nuts,
broccoli and raisins.

Supplement dosage

Take 50 mg of vitamin B1 a day.

Alcohol, sugar, coffee, black tea and sulphites can all reduce the
amount of thiamine in the body. Oral contraceptives, antibiotics and
sulpha drugs can also have the same effect. If you consume large
amounts of carbohydrates, your need for thiamine will increase.
Magnesium is required to activate thiamine in the body.

Vitamin B2 (riboflavin; works with vitamin

helps absorb B3, B6 and iron)

Why it’s important

You need vitamin B2 to maintain healthy skin, nails and hair. It is
essential for the production of red blood cells and antibodies, and for
growth. This vitamin works with vitamin A to maintain as well as
improve the mucous membranes of the digestive system, and helps
the body absorb vitamin B3 (niacin), vitamin B6 (pyridoxine) and iron.
Studies suggest that vitamin B2 is especially useful in the treatment of
migraine headaches and sickle cell anaemia.

Dietary sources
Rich dietary sources include organic meats, cheese, egg yolks, yoghurt,
milk and poultry. Other sources are green leafy vegetables, broccoli,
soy products and enriched bread. Cooking does not destroy riboflav-
in, although it can be destroyed by exposure to light.
It is recommended that riboflavin be taken with an equivalent
amount of vitamin B6, and that it works best when taken with the
other B vitamins and vitamin C.

Supplement dosage
Take 50 mg of vitamin B2 daily.


Vitamin B3 (niacin)
None documented. B2 is easily destroyed by alcohol and antibiotics.

Why it’s important

Niacin is involved in more than 50 different chemical reactions in the
body. It provides benefits attributed to the B vitamins as a whole, as
well as being useful in regulating blood sugar levels, lowering choles-
terol and triglyceride levels, and improving circulation. Taking niacin
may reduce depression, hyperactivity and insomnia.
Pellagra results from a deficiency of niacin and shows itself in a
range of symptoms, which can include anxiety, depression, dementia,
diarrhoea, dizziness, weight loss and tongue inflammation.

Dietary sources
Rich dietary sources of vitamin B3 include organ meats, poultry, whole
grains (except corn), nuts, fish and milk.

Supplement dosage
Take 50 mg a day (as niacin) or 100 mg (as niacinamide).

The most common side-effect of niacin is flushing of the skin that
generally occurs 20–30 minutes after ingestion. Other possible side-
effects are stomach irritation, nausea and liver damage.

Vitamin B5 (pantothenic acid)

Why it’s important

In combination with other B vitamins, pantothenic acid is needed for
converting food into energy, manufacturing red blood cells, producing
bile, and utilising fats and carbohydrates efficiently. It can also
improve the body’s ability to withstand stress and reduce the toxic

effects of many antibiotics.
Pantothenic acid is also thought to prevent premature ageing and
wrinkles, and to protect against cellular damage caused by excessive

Dietary sources
The best food sources are organ meats (liver, kidney), carrots, fish,
poultry and milk. Other dietary sources include nuts, brown rice,
beans and bananas.
For optimal activity, it is suggested that vitamin B5 be taken with
vitamins A, C and E as well as the other B vitamins.

Supplement dosage
Take 500 mg daily.

None has been documented. Vitamin B5 is intricately involved with
the actions of the other B vitamins, as well as coenzyme Q10 and

Vitamin B6 (pyridoxine)

Why it’s important

Taking vitamin B6 can help pregnant women who suffer early-morning
sickness and nausea. The good effects of the supplement have been
known since the 1940s. After some bad press in the US, it was taken
off the market because it was believed to cause birth defects when
used with doxylamine. However, the concerns involved doxylamine
and not the pyridoxine (B6) element.
Researchers decided to retest the efficacy of the treatment, but this
time using pyridoxine on its own. They carried out a large, double-
blind study of 342 pregnant women from Thailand, half of whom were
given pyridoxine while the remainder were given a placebo. After

five days, the pyridoxine group reported a great improvement in their
nausea and vomiting attacks (Am J Obstet Gynecol, 1995; September).
The nervous and immune systems also need vitamin B6 to function
efficiently (Z Ernahrungswiss, 1996; 35: 309–17; Proc Nutr Soc, 1994;
53: 625–30; NY Acad Sci, 1990; 585: 404–23; Postgrad Med J, 1997; 73:
617–22), and it is also needed to convert tryptophan (an amino acid) to
niacin (Biosci Biotechnol Biochem, 1995; 59: 2060–3).
In 1962, clinician and researcher Dr John Marion Ellis began to use
vitamin B6 to treat carpal tunnel syndrome (Ann NY Acad Sci, 1990;
85: 302–20).
Your body needs vitamin B6 to make haemoglobin, the substance
red blood cells that carries oxygen to your body’s cells. Vitamin B6
also helps increase the amount of oxygen carried by haemoglobin. A
vitamin B6 deficiency can result in a form of anaemia that is similar to
iron-deficiency anaemia.
When your calorie intake is low, your body needs vitamin B6 to help
convert stored carbohydrates or other nutrients to glucose (sugar) to
maintain normal blood sugar levels. While a shortage of vitamin B6
will limit these functions, supplements do not enhance them in well-
nourished individuals (Biochem J, 1991; 278: 113–7; Experientia, 1994;
50: 127–9; J Nutr Sci Vitaminol (Tokyo), 1991; 37: 349–57).
A deficiency of vitamin B6, folic acid or vitamin B12 may increase
levels of homocysteine, an amino acid normally found in the blood
(N Engl J Med, 1995; 332: 286–91). There is evidence that a raised
homocysteine level is an independent risk factor for heart disease and
stroke (JAMA, 1998; 279: 359–64; Ann Rev Med, 1998; 49: 31–62; Neth
J Med, 1994; 45: 34–41; JAMA, 1993; 270: 2693–8; Clin Chem, 1995; 41:
173–6; J Am Coll Nutr, 1997; 16: 258–67; Clin Biochem, 1995; 28: 155–62;
J Am Coll Nutr, 1998; 17: 435–41; J Clin Invest, 1996; 98: 177–84).
Evidence suggests that high levels of homocysteine can damage
coronary arteries or make it easier for blood-clotting cells (platelets) to
clump together and form a clot.
Vitamin B6 deficiency can result from a poor-quality diet. Symptoms

are seen during the later stages of a deficiency, when the intake of
proper nutrients has been very low for some time. Signs of vitamin
B6 deficiency include dermatitis (skin inflammation), glossitis (a sore
tongue), depression, confusion and convulsions.
Researchers have been investigating the relationship between those
taking vitamin B6 and a wide variety of neurological conditions such
as seizures, chronic pain, depression, headache and Parkinson’s
disease. Vitamin B6 is needed for the synthesis of neurotransmitters
such as serotonin and dopamine, which are required for normal nerve
cell communication (Ann NY Acad Sci, 1990; 585: 250–60).
Lower levels of serotonin have been found in people suffering from
depression and migraines. So far, however, vitamin B6 supplements
have not proved effective in relieving these symptoms (Contraception,
1997; 55: 245–8).
Alcohol abuse can result in neuropathy—abnormal nerve sensations
in the arms and legs (Am J Med, 1999; 107: 17S–26S). A poor dietary
intake of nutrients contributes to this condition, and dietary supple-
ments that include vitamin B6 may prevent or decrease its incidence
(Ann NY Acad Sci, 1990; 585: 250–60).

Dietary sources
Vitamin B6 is found in a wide variety of foods, including cereals,
beans, meat, poultry, fish, and some fruits (bananas) and vegetables
Vitamin B6 is available as pyridoxine hydrochloride and pyridoxal-
5-phosphate, which is the more active form. However, for most people,
the pyridoxine form is satisfactory as long as sufficient riboflavin and
magnesium, needed for its conversion, are available. Those with liver
disease may have difficulty converting pyridoxine so, in these cases,
injectable pyridoxal-5-phosphate may be preferable to oral pyridoxine.

Supplement dosage
Patients taking 50–200 mg of vitamin B6 a day for decades had 73 per

cent fewer chest pains and heart attacks than those who did not. The

usual recommended dose, however, is 50 mg once or twice a day.

Ironically, too much vitamin B6 supplementation—doses greater than

2000 mg a day—may also result in nerve damage to the arms and legs
in some people (N Engl J Med, 1995; 332: 286–91), although the con-
dition will revert to normal once the supplements are stopped. Chronic
intake of doses higher than 500 mg daily for many months or years
can produce nerve toxicity. For this reason, the US Institute of
Medicine’s Food and Nutition Board has established an upper
tolerable intake of 100 mg a day for all adults.
There have been documented cases of neuropathy caused by
excessive vitamin B6 taken to treat carpal tunnel syndrome (Arch Phys
Med Rehabil, 1985; 66: 634–6). However, a review of the literature
found that supplementation of up to 500 mg a day is safe for most
people (Townsend Lett Docs, 1990; June: 338–9). Nevertheless, it is best
to check with a health professional before taking high-dose vitamin B6
supplements for an extended period of time.
Vitamin B6 is a popular remedy for treating the discomforts asso-
ciated with premenstrual syndrome (PMS). Indeed, a review of 10
randomised controlled studies carried out between 1966 and 1998
found convincing data to support vitamin B6 as a therapeutic option
for PMS (BMJ, 1999; 318: 1375–81). This meta-analysis showed that
50 mg once or twice a day may alleviate the overall and depressive
symptoms of PMS without causing harm.
There is disagreement regarding the need for routine vitamin B6
supplementation when taking isoniazid, a antituberculosis drug
known to interfere with the metabolism of vitamin B6 (Pediatr
Pharmacol, 1984; 4: 199–202; Arch Intern Med, 1990; 150: 1751–3).
Acute isoniazid toxicity can result in coma and seizures that are
reversed by vitamin B6 but, in a group of children receiving isoniazid,
no cases of neurological or neuropsychiatric problems were observed
regardless of whether or not they took a vitamin B6 supplement.

Vitamin B12 (cobalamin)

Why it’s important

Vitamin B12 helps maintain healthy nerve cells and red blood cells. It
is also needed to make DNA, the genetic material in all cells (Sem
Hematol, 1999; 36: 35–46).
Vitamin B12 is bound to the protein in food. Hydrochloric acid in
the stomach releases B12 from protein during digestion. Once released,
B12 combines with a substance normally present in the stomach called
intrinsic factor (IF) before being absorbed into the bloodstream and
used by your body (Proc Assoc Am Physicians, 1997; 109: 462–9;
Gastroenterology, 1995; 3: 329–44). An absence of IF prevents normal
absorption of B12 and results in pernicious anaemia. Anyone with
pernicious anaemia usually needs to have vitamin B12 injected directly
into the muscle.
As a general rule, most people who develop a B12 deficiency have
an underlying stomach or intestinal disorder that limits how much of
the vitamin their bodies can absorb (Am J Clin Nutr, 1997; 66: 750–9)—
certainly not enough from food to maintain healthy body stores
(Baillière’s Clin Haematol, 1995; 8: 639–55).
Characteristic signs of a B12 deficiency include fatigue, weakness,
nausea, constipation, flatulence, loss of appetite and weight loss (J
Am Geriatr Soc, 1998; 46: 1199–206). Deficiency can also lead to
numbness and tingling in the hands and feet (Medicine, 1991; 70:
229– 44). Additional symptoms of B12 deficiency include difficulty
in maintaining balance, depression, confusion, poor memory and
soreness of the mouth or tongue (Nutr Rev, 1996; 54: 382–90).
Vegetarians and vegans who do not eat meat, fish, eggs, milk or milk
products are consuming no vitamin B12 and so may have a high risk
of developing a deficiency (Crit Rev Clin Lab Sci, 1996; 33: 247–356;
Sem Hematol, 1999; 36: 19–34), although the minimum daily require-

ment is small at 1 mcg. In fact, according to Dr Reed Mangels, as
reported in Simply Vegan: Quick Vegetarian Meals by Debra Wasserman
(ISBN: 0-931411-20-3), B12 deficiency is actually quite rare even among
long-term vegans.
Deficiency symptoms can be slow to appear because it usually takes
years to deplete normal body stores of B12. However, severe symptoms
can show up quickly in children and breastfed babies of women who
follow a strict vegetarian diet (Eur J Obstet Gynecol Reprod Biol, 1992;
45: 155–63).
Vitamin B12 injections are also given for bursitis, a painful inflam-
mation of one or more of the little sacs (bursae) that contain synovial
fluid, which helps to smooth the gliding of your muscles, tendons and
skin over your bones and joints. One study examined 40 patients
given daily injections of 1000 mcg of B12 into the muscle for seven to
10 days, followed by three times a week for two to three weeks, and
once or twice weekly for another two to three weeks. All but three of
the patients improved, reporting a rapid relief of pain often within a
few hours (Indust Med Surg, 1957; 26: 20–2).

Dietary sources
Vitamin B12 is naturally found in animal foods including fish, milk
and milk products, eggs, meat and poultry. Reliable sources of this
vitamin for vegetarians and vegans include nutritional yeast (different
from brewer’s or torula yeast), made from Saccharomyces cerevisiae and
available as yellow flakes or a powder.
Tempeh, miso and sea vegetables are reported to contain large
amounts of vitamin B12, but the true, bioavailable amount appears to
depend on the type of processing the food has undergone (Am J Clin
Nutr, 1988; 48: 852–8; Am J Clin Nutr, 1987; 47: 89–92). Small quantities
can be found in organically grown plants such as spinach.
For the ideal nutritional synergy, it is recommended that vitamin
B12 be taken with iron, calcium, sodium, potassium and vitamin C.

Supplement dosage

Take 50–100 mcg a day.

None has been documented.

Folic acid (folate)

Why it’s important

Folate and folic acid are forms of a water-soluble B vitamin. Folate
occurs naturally in food whereas folic acid is the synthetic form of this
vitamin, and is used in supplements and fortified foods.
Folate gets its name from the Latin word ‘folium’, meaning ‘leaf’. A
key observation of researcher Lucy Wills nearly 70 years ago led to the
identification of folate as the nutrient needed to prevent the anaemia
of pregnancy. Dr Wills demonstrated that the anaemia could be
corrected by a yeast extract. Folate was identified as the corrective
substance in yeast extract in the late 1930s and was extracted from
spinach leaves in 1941.
Folate is necessary for the production and maintenance of new cells
(Semin Oncol, 1997; 24: S18-30–9). This is especially important during
periods of rapid cell division and growth, such as infancy and
pregnancy. Folic acid is therefore very important for all women who
may become pregnant. An adequate folate intake both just before and
just after a woman becomes pregnant protects against a number of
congenital malformations, including neural tube defects (Epidemiol-
ogy, 1995; 6: 219–26), which result in malformations of the spine (spina
bifida), skull and brain (anencephaly). The risk of neural tube defects
is significantly reduced when supplemental folic acid is consumed
together with a healthy diet prior to and during the first month
following conception (JAMA, 1988; 260: 3141–5; JAMA, 1989; 262:
However, a study carried out in Hungary involving 7500 pregnant
mothers taking folic acid (0.8 mg daily plus other vitamins) followed-

up their babies into the first year of life. They found little difference
between supplemented and unsupplemented babies except that those
taking the folic acid/vitamins had more asthma, bronchitis and
allergic skin problems (Arch Dis Child, 1994; 70: 229–33).
Further analysis of their data also revealed a 16 per cent higher rate
of miscarriage than in the group not taking supplemental folic acid and
vitamins—51 more spontaneous abortions, or nearly twice as many as
the number of birth defects avoided. If these statistics are valid, this
leaves women, especially those prone to miscarriage, with a terrible
dilemma—if a pregnant woman doesn’t take folic acid, she reduces her
chances of having a normal, healthy baby; if she does take folic acid,
she may be increasing her chances of not having a baby at all.
Clearly, what is needed here is more research to fully understand
why birth defects occur and, although it is known how folic acid
works, science is still in the dark as to how it works and whether it
works in tandem with a good-quality diet and supplementation
programme. Without this, women cannot make informed, rational
decisions regarding taking or refusing to supplement, depending on
their individual risks.
Folate is needed to make DNA and RNA, the building blocks of
every single cell in your body. It also helps prevent the changes to
DNA that could lead to cancer (Carcinogenesis, 1998; 19: 1163–71).
Several studies have associated diets low in folate with an increased
risk of breast, pancreatic and colon cancers (Ann Intern Med, 1998;
129: 517–24). Findings from a study of 121,000 nurses suggested that
long-term (15-year) folic-acid supplementation was associated with
a decreased risk of colon cancer in women aged 55–69 years (Tidsskr
Nor Laegeforen, 1996; 116: 250–4). Researchers are continuing to
investigate whether enhanced folate intake from foods or folic acid
supplements can reduce the risk of cancer.
Folate is important for cells and tissues that rapidly divide (Semin
Oncol, 1997; 24: S18-30-–9). Cancer cells divide rapidly, and drugs that
interfere with folate metabolism are used to treat cancer. Methotrexate

is a drug often used to treat cancer because it limits the activity of
enzymes that need folate. But methotrexate is toxic (Ann Surg, 1998;
227: 772–8; Anticancer Res, 1998; 18: 2895–9; Leuk Lymphoma, 1998;
29: 205–9), producing side-effects such as inflammation in the
digestive tract that make it difficult to eat normally. Leucovorin is a
form of folate that can help to reverse the toxic effects of methotrexate
(Blood, 1998; 92: 2471–6).
Anticonvulsant medications such as Dilantin (phenytoin) are known
to increase the need for folate (Am J Clin Nutr, 1988; 48: 1445–50; Prog
Neuropsychopharmacol Biol Psychiat, 1989; 13: 841–63).
A deficiency of folic acid is also associated with the development of
Parkinson’s disease (J Neurol Neurosurg Psychiatry, 1986; 49: 920–7).

Dietary sources
Leafy greens such as spinach, dried beans and peas, cereals and grain
products, and some fruits and vegetables are rich food sources of
It is recommended that folic-acid supplements are best taken with
vitamins B6, B12 and C.

Supplement dosage
Take between 400–800 mcg daily.

None has been documented.


Why it’s important

Biotin is essential for the way it creates and utilises fats and amino
acids. The maintenance of healthy hair, skin and nails depends
especially on biotin.

Dietary sources
Cheese, organ meats and soy products are the best dietary sources of
biotin. Other sources include eggs, nuts, broccoli, sweet potatoes and
Biotin is best taken with the B vitamins, especially B5 and B12, as
well as vitamin C. Athletes and bodybuilders should remember that,
as raw eggs block biotin uptake, they may be at risk of a deficiency.

Supplement dosage
Take between 200–1000 mcg a day.

None has been documented.
Nevertheless, long-term use of antibiotics can cause biotin
deficiency since the ‘good’ bacteria found in the intestines produce
biotin. Alcohol interferes with the way the body absorbs and utilises
biotin, and biotin is also intricately linked with the actions of the other
B vitamins as well as coenzyme Q10 and carnitine.


Why it’s important

Although choline is not strictly a vitamin, it is an essential nutrient.
Despite the fact that we humans can synthesise it in small amounts,
choline must be consumed in the diet to maintain health (Science, 1998;
281: 794–5).

Dietary sources
The bulk of the body’s choline is found in specialised fat molecules
known as phospholipids, the most common of which is phosphatidyl-
choline, or lecithin, which is about 13 per cent choline by weight.
Very little information is available on the choline content of foods
(Nutrition, 2000; 16: 669–71). Milk, eggs, liver and peanuts are

especially rich in choline.

Supplement dosage
National surveys provide no information on the dietary intake of
choline. Strict vegetarians who consume no milk or eggs may be at
risk of inadequate choline.
We recommend that you take between 500–700 mg a day.

None has been documented.

Part 2
U nlike vitamins, minerals are inorganic—plants and animals do
not produce them. Minerals are stored in various parts of the
body, but mainly in bone and muscle tissue, so it’s almost impossible
to take too much of them.
There are two types. The macro (or bulk) nutrients, such as calcium,
magnesium, potassium and sodium, play an important part in the
wellbeing of your body’s bones and teeth. Others have more specific
functions. The 12 or so micro nutrients are similar to vitamins in that
they act as coenzymes and help your body’s metabolism.
Your body needs large amounts of the macro nutrients, and much
smaller quantities of the micro nutrients. Some of these, like selenium,
are required in such small amounts that they are known as trace
minerals. Nevertheless, those miniscule portions play such a vital role
that debilitating illness ensues without them.
Like vitamins, minerals work together to help chemical reactions
happen throughout the body. If you have an absence of one, this will
severely disrupt how the others function. Making sure your minerals
are balanced is a problem that is best addressed by a professional
experienced in nutritional medicine.


Calcium (works with vitamin D, magnesium)

Why it’s important

The most abundant mineral in the body, calcium plays a vital role in
the growth and maintenance of strong bones, gums and teeth. How
efficiently your muscles, including the heart, work depends on your

maintaining an adequate calcium level. Blood-clotting,
nerve function and a normal blood pressure rely on
calcium as well.
It has been thought that calcium helps to prevent
osteoporosis in adults (and rickets in children).
Yugoslavian studies have shown that people who maintain high
calcium levels throughout life have fewer fractures (Cont Nutr, 1977; 2:
2; Am J Clin Nutr, 1979; 32: 540).
It also appears that the average woman’s diet is relatively deficient
in calcium. Women over 45 typically consume 450–500 mg of calcium
a day. At this low level of intake, they could lose 1.5 per cent of their
total bone mass within a year (Fed Proc, 1981; 40: 2418–22). Often,
their liquid intake is largely composed of soft drinks which contain
phosphoric acid, which can ultimately stimulate the release of calcium
from the bones.
Researchers at Columbia University, New York, studied the calcium
absorption of 142 healthy pre- and perimenopausal women. Poor
absorption did not depend on how much or how little calcium they
took. Instead, it was related to a higher-fibre diet, alcohol consump-
tion, physical activity and symptoms of constipation.
Women approaching the menopause are often advised to switch to
a low-fat diet to remain healthy; yet, the results of this study suggest
that this may be doing more harm than good. The authors suggest that
public health recommendations for a low-fat, high-fibre diet need
reassessing to prevent not just bone disorders, but other chronic con-
ditions, such as hypertension and colon cancer, which calcium could
help protect against (Am J Clin Nutr, 2000; 71: 466–71).
A team working for the Agricultural Research Service at North
Carolina State University says eating yoghurt and other dairy products
can reduce cholesterol in seven days. They don’t know why, but say it
could be because of the increased calcium intake from these high-
calcium products. A study of 21 people showed that the effects of
yoghurt and calcium supplementation were more marked in women

(whose bodies, it’s thought, use calcium differently from men’s). Their
total cholesterol levels were reduced while levels of HDL (‘good’)
cholesterol were raised (Nutr Rep Int, 1983; 28: 1225–32).
A number of reports have suggested that calcium and magnesium
can be used as a supplement to treat certain forms of hypertension,
depending upon which of the two minerals your body responds to best
(N Engl J Med, 1983; 309: 888–91).
The results of a study carried out at Johns Hopkins University in
Baltimore and Centro Rosarino de Estudios in Argentina suggest that
increasing your calcium intake could help prevent eclampsia (Int J
Gynecol Obstet, 1983; 21: 271–8).

Dietary sources
Dairy products, tofu, dark-green leafy vegetables, sardines, salmon
and almonds are excellent dietary sources of calcium.

Supplement dosage
Around 500–800 mg per day (1200 mg/day in pregnancy). Amounts
over this aren’t well absorbed. Calcium is best taken as calcium citrate,
lactate or gluconate.

Excessive intake of calcium can damage the heart, liver and kidney.
Soft-tissue calcification or constipation are other possible side-effects
of a high calcium intake.
To absorb calcium properly, you also need to take vitamin D, mag-
nesium and phosphorus. Alcohol, dietary fat and fibre can interfere
with how calcium is absorbed. Eating a lot of protein, sodium, sugar or
caffeine can make you lose calcium in the urine.


Why it’s important

Phosphorus is an essential mineral that is required by every cell in
the body. The majority of the phosphorus in the body is found as
phosphate (PO4). Approximately 85 per cent of the body’s phosphorus
is found in bone.

Dietary sources
The main food sources are the protein food groups of meat, fish and
poultry, and milk and dairy foods. Beef liver is another good source, as
are pulses and beans, almonds and eggs. A meal plan that provides
adequate amounts of calcium and protein will also have an adequate
amount of phosphorus.
Wholegrain breads and cereals contain more phosphorus than
refined cereals and breads made from refined flour. However, the
phosphorus in wholegrain products is in the form of phytin, a form of
phosphorus that is not absorbable by humans.
Fruits and vegetables contain only small amounts of phosphorus.

Supplement dosage
800 mg a day (1200 mg in pregnancy).

None has been documented.


Why it’s important

Magnesium is needed for more than 300 biochemical reactions that go
on inside your body. It also works in tandem with potassium and
About half of your body’s magnesium stores are found inside body
tissue and organ cells, and half are combined with calcium and
phosphorus in the bone. This mineral helps maintain normal muscle
and nerve function, and keeps heart rhythm steady and bones strong.

It is also involved in energy metabolism and protein synthesis (Am J
Clin Nutr, 1987; 45: 1305–12).
Only 1 per cent of the magnesium in your body is found in the
blood. Your body works very hard to keep blood levels of magnesium
constant (J Bone Miner Res, 1998; 13: 749–58).
Magnesium can also protect against asthma, wheezing and other
breathing disorders. A research team from the City Hospital in
Nottingham, led by Dr John Britton, monitored the intake of mag-
nesium from food of a randomly selected group of adults, aged 18–70,
living in the city. Of these, 24 per cent suffered from wheezing and
were put on a diet containing 100 mg of magnesium—more than that
of the rest of the study group. As a result, their chances of a wheezing
attack were significantly reduced.
To achieve this result, the study group took a dosage of more than
400 mg of magnesium a day, far higher than the UK Recommended
Daily Allowance of 30–270 mg, but close to the US recommendation of
350 mg/day (450 mg/day in pregnancy).
An intravenous solution of magnesium sulphate may also be the
best way to treat patients suffering from acute asthma attacks. That’s
the conclusion of two recent reviews of all the major relevant studies.
One was a meta-analysis of seven randomised trials involving a
total of 668 patients. Magnesium was associated with a significantly
lower rate of hospital admissions for patients with severe asthma, but
not for those with moderate asthma. Patients with severe asthma who
received magnesium also showed significant improvements in their
breathing and lung capacity (Ann Emerg Med, 2000; 36: 181–90).
The other meta-analysis was of nine trials of intravenous magnes-
ium (including the seven in the previous review), and used a different
method of analysis and different endpoints. They found a 16 per cent
improvement in airways function with magnesium compared with a
placebo (Ann Emerg Med, 2000; 36: 191–7).
Scientists at the Radcliffe Infirmary in Oxford have proved that the
use of magnesium supplementation to treat pregnant women with

eclampsia is more effective, and far less expensive, than drug
alternatives such as diazepam (Valium) and phenytoin.
Eclampsia is a disorder that affects one in 2000 deliveries in the
developed countries and causes convulsions in the pregnant woman;
it accounts for around 50,000 maternal deaths a year, although this is
seen mainly in Third World countries. Scientists fear that many women
have died needlessly because doctors have preferred a drug-based
remedy, even though there has been no scientific evidence to prove
that such drugs are more beneficial than magnesium.
From 1906, when magnesium was first suggested as a treatment
for eclampsia, to 1987, when phenytoin was introduced, around four
million women have died due to the condition. Some of these could
have been spared if doctors had relied on science, rather than dogma.
One research group had described the use of magnesium sulphate as
“more of a matter of habit, if not religious conviction, than a
scientifically established treatment”.
Arguments over which of the various anticonvulsant drugs to use
have been vociferous, if not vitriolic, the Radcliffe researchers report.
Although magnesium treatment was first suggested 16 years ago, and
has been a popular treatment in the US for the past 60 or so years,
only 2 per cent of British obstetricians have used it, preferring drug
remedies instead.
The Radcliffe study, called the Collaborative Eclampsia Trial, looked
at the records of 1680 women treated for eclampsia; 453 were given
magnesium, 452 received diazepam and 387 took phenytoin. Those
given magnesium had a 52 per cent lower risk of their convulsions
recurring than those given either diazepam or phenytoin.
The women taking the magnesium were also less likely to develop
pneumonia or to be admitted into intensive care than those taking
phenytoin. In addition, the babies born of the magnesium group were
significantly less likely to be intubated—needing the insertion of a
breathing tube—or to be admitted to a special care nursery.
The researchers also believed that magnesium should be given as

a ‘just-in-case’ remedy for women suffering preeclampsia before the
occurrence of the first fit (Lancet, June 10, 1995).
Evidence suggests that magnesium may play an important role in
regulating blood pressure as it is a powerful vessel dilator. In a study
of 61 dietary elements used to predict high blood pressure, the chief
indicator was low magnesium (Am J Clin Nutr, 1987; 45: 469–75). In
three studies of hypertensive patients with low magnesium levels
due to taking diuretics, magnesium supplements substantially lowered
their blood pressure (J Am Coll Nutr, 1989; 8 [Suppl S]: 685–805).
Diets that provide plenty of fruits and vegetables, which are good
sources of potassium as well as magnesium, are consistently associated
with lower blood pressure (Clin Cardiol, 1999; 22: 1111–5; Compr Ther,
1999; 25: 95–100; N Engl J Med, 1997; 336: 1117–24). The DASH study
(Dietary Approaches to Stop Hypertension) suggested that high blood
pressure could be lowered significantly by a diet high in magnesium,
potassium and calcium, and low in sodium and fat (Ann Epidemiol,
1995; 5: 108–18; Clin Cardiol, 1999; 22: 6–10; Arch Intern Med, 1999;
159: 285–93; Nutr Rev, 1994; 52: 367–75).
In another study, the effects of various nutritional factors on high
blood pressure were examined in more than 30,000 US male health
professionals. After four years of follow-up, the researchers found that
a greater magnesium intake was associated with a lower risk of
hypertension (Circulation, 1992; 86: 1475–84).
Magnesium deficiency—the most common trace-mineral deficiency
in the Western world—can cause metabolic changes that may con-
tribute to heart attacks and strokes (Cell Mol Biol Res, 1995; 41: 347–59;
Ann Thorac Surg, 1995; 59: 942–7; Thromb Haem, 1996; 75: 939–44).
There is also evidence that low body stores of magnesium increase the
risk of abnormal heart rhythms which, in turn, may increase the risk of
complications associated with a heart attack. Population surveys have
associated higher blood levels of magnesium with a lower risk of
coronary heart disease (Intl J Epidemiol, 1999; 28: 645–51; Am Heart J,
1998; 136: 480–90; J Am Coll Nutr, 1995; 14: 71–9). Dietary surveys have

also suggested that a higher magnesium intake is associated with a
lower risk of stroke (Circulation, 1998; 98: 1198–204).
Magnesium deficiency may also be a risk factor for postmenopausal
osteoporosis. This may be due to the fact that magnesium deficiency
changes how the body uses calcium (Osteoporos Int, 1996; 6: 453–61).
Several studies have suggested that magnesium supplementation
may improve bone mineral density, but researchers believe that further
investigation into the role of magnesium in bone metabolism and
osteoporosis is needed.
Magnesium is important in the metabolism of carbohydrates. It may
influence the release and activity of insulin, the hormone that helps
control blood glucose levels (Diabetologia, 1990; 33: 511–4). High blood
glucose levels increase the loss of magnesium in the urine which, in
turn, lowers blood levels of magnesium (Arch Intern Med, 1996; 156:
1143–8). This explains why low blood levels of magnesium (hypo-
magnesaemia) are seen in poorly controlled type 1 and type 2 diabetes.

Dietary sources
Green vegetables, such as spinach, provide magnesium because the
centre of the chlorophyll molecule contains magnesium. Nuts and
seeds are also good sources of magnesium.
Although magnesium is present in many foods, it usually occurs in
small amounts. As with most nutrients, your daily requirement for
magnesium cannot be met from a single food. Furthermore, the
condition of today’s soil, which is so depleted of many important
minerals, means that virtually everyone who doesn’t supplement is
deficient in magnesium. Eating a wide variety of foods, including five
servings of fruits and vegetables daily, can help, but almost everyone
needs to take extra.
The magnesium content of refined foods is usually low. Granary
bread, for example, has twice as much magnesium as white bread
because the magnesium-rich germ and bran are removed in the
processing of white flour.

Water can provide magnesium, but the amount varies according to
the water supply. Hard water contains more magnesium than soft
water. Magnesium is lost in cooking and in processed foods and, as a
result, most people take in far too little (Lancet, 1994; Aug 6).

Supplement dosage
Between 200–600 mg/day.
As well as magnesium, you may also benefit from supplemental
potassium and calcium, since low magnesium is often associated with
low potassium which, in turn, affects calcium levels. The best forms
to take are magnesium citrate, magnesium gluconate or chelates.

Very high doses of magnesium supplements, which may be added to
laxatives, can cause diarrhoea, even when the kidneys are working
normally (Ann Emerg Med, 1996; 28: 552–5). The elderly are at risk of
magnesium toxicity because kidney function declines with age and
they are more likely to take magnesium-containing laxatives and
Signs of excess magnesium can be similar to those of magnesium
deficiency and also include nausea, loss of appetite, muscle weakness,
difficulty breathing, extremely low blood pressure and an irregular
heartbeat (Compr Ther, 1997; 23: 168–73; Mayo Clin Proc, 1995; 70:
1091–2; J Toxicol Clin Toxicol, 1996; 34: 735–9).


Why it’s important

An abnormally low potassium concentration in the body is referred to
as hypokalaemia, usually the result of an excessive loss of potassium
due to, for example, prolonged vomiting, the use of some diuretics or
some forms of kidney disease.
A number of studies have shown that people who have relatively

high potassium intakes from their diet have lower blood pressures
compared with those with a relatively low intake of potassium (Am J
Med Sci, 1997; 314: 37–40). Data from more than 17,000 adults who
participated in the Third National Health and Nutritional Examination
Survey (NHANES III) indicated that higher potassium intakes were
associated with significantly lower blood pressures (Arch Intern
Med, 2001; 161: 589–93). The results of the Dietary Approaches to Stop
Hypertension (DASH) trial provided even stronger proof that a
potassium-rich diet is good for maintaining normal blood pressure
levels (N Engl J Med, 1997; 336: 1117–24).
In 1997, an analysis of 33 trials involving 2609 subjects assessed the
effects of increased potassium intake, mostly in the form of potassium
chloride (KCl) supplements, on blood pressure (JAMA, 1997; 277:
1624–32). Increased potassium intake (2300–3900 mg/day) resulted in
slight, but significant, blood pressure reductions that averaged 1.8/1.0
mmHg (systolic/diastolic) in those with normal blood pressure and
4.4/2.5 mmHg in those with hypertension.
Further analyses showed that the blood pressure-lowering effects
of potassium were more pronounced in those with higher salt intakes
and in trials where black individuals made up the majority of the
participants. A recent clinical trial of 150 Chinese men and women
with borderline-to-mild hypertension found that moderate supple-
mentation with 500 mg a day of potassium chloride for 12 weeks
resulted in a significant 5-mmHg reduction in systolic, but not
diastolic, blood pressure compared with placebo (J Hypertens, 2001;
19: 1325–31). As with many Western diets, the customary diet of this
population was high in sodium and low in potassium.
Several large studies have also suggested that increased potassium
intake lowers the risk of a stroke. A study of 43,000 men followed for
eight years found that men in the top fifth of dietary potassium intake
(averaging 4300 mg per day) were only 62 per cent as likely to have
a stroke than those in the lowest fifth (averaging 2400 mg per day;
Circulation, 1998; 98: 1198–204).

A similar study of 85,000 women followed for 14 years found a much
more modest association between potassium intake and the risk of
stroke (Stroke, 1999; 30: 1772–9). Taken together, however, the data
suggest that a modest increase in fruit and vegetable intake (rich
sources of dietary potassium), especially in those who have
hypertension and/or relatively low potassium intakes, may signif-
icantly reduce the risk of stroke.
Four cross-sectional studies have reported a strong association
between dietary potassium and bone mineral density (BMD) in pre-
menopausal, perimenopausal and postmenopausal women and elderly
men (Am J Clin Nutr, 2000; 71: 142–51; Am J Clin Nutr, 1997; 5: 1831–9;
Am J Clin Nutr, 1999; 69: 727–36). The average dietary intake of the
study participants ranged from about 3000–3400 mg per day, while the
highest potassium intakes exceeded 6000 mg a day and the lowest
intakes ranged from 1400 to 1600 mg/day. In all of these studies, BMD
was also associated with fruit and vegetable intake.
Increasing dietary potassium levels by eating more fruit and vege-
tables, or by taking potassium bicarbonate supplements, has been
found to reduce the amount of calcium lost through urine. Potassium
deprivation has also been seen to increase calcium excretion (Semin
Nephrol, 1999; 19: 487–93; J Nutr, 1993;123: 1623–6).
For all but those taking diuretics, an ordinary diet usually provides
adequate amounts of potassium, so long as you consume plenty of
fruits and vegetables.

Dietary sources
Potassium-rich foods include dried fruit, vegetables and nuts.

Supplement dosage
3500 mg a day, although you generally get adequate amounts from


Hyperkalaemia occurs when you take in more potassium than your

kidneys can get rid of.


Why it’s important

Zinc stimulates the activity of around 100 enzymes—substances that
kickstart biochemical reactions in the body (J Lab Clin Med, 1994; 124:
322–7). It supports a healthy immune system (Nutr Rev, 1998; 56:
27–8; Nutrition, 1995; 11: 93–9), is needed for healing wounds (Ann
Pharmacother, 1996; 30: 186–7), helps maintain your sense of taste and
smell (Proc Assoc Am Physicians, 1997; 109: 68–77) and is required for
DNA synthesis.
The immune system is badly affected by even moderate degrees of
zinc deficiency, and a severe deficiency can depress immune function
(Am J Clin Nutr, 1998; 68: 447S–63S). Zinc is needed to develop and
activate T lymphocytes, the white blood cells that help fight infection
(Am J Physiol, 1997; 272: E1002–7). When zinc supplements are given
to people with low zinc levels, the numbers of T-cell lymphocytes
circulating in the blood increase and the ability of lymphocytes to fight
infection improves. Studies show that poor, malnourished children
in India, Africa, South America and Southeast Asia have shorter bouts
of infectious diarrhoea after taking zinc supplements (Am J Clin Nutr,
1998; 68: 476S–9S).
Zinc supplements are often given to help heal skin ulcers or bed
sores (Nurs Times, 1995; 91: 68, 70). In a study of 159 patients, taking
zinc sulphate orally and using a zinc paste locally significantly helped
reduce the number of canker sores in 81 per cent of the patients after
six months (J Rev Stomatol Chir Maxillofac, 1986; 87: 339–43).
A study of over 100 employees of the Cleveland Clinic in the US
showed that zinc lozenges cut how long colds lasted by half (Ann
Pharmacother, 1998; 32: 63–9).

Zinc supplements can also help prevent childhood pneumonia. A
review of 10 randomised, controlled trials on populations in the
developing countries, conducted by researchers from Johns Hopkins
School of Public Health and the World Health Organization, showed
that supplementation was more effective than any other intervention
in preventing pneumonia (J Pediatr, 1999; 135: 689–97).
Low levels of zinc, selenium and calcium have been linked with
Alzheimer’s disease and other forms of dementia (Prog Clin Biol Res,
1983; 129: 197–206; J Radioanalyt Nucl Chem, 1987; 113: 515–26; Ann
Neurol, 1984; 1591: 42–8).
Zinc also supports normal growth and development during
pregnancy, childhood and adolescence (Acta Paediatr Scand Suppl,
1985; 319: 158–63; Ageing [Milano], 1995; 7: 77–93). Women who take
zinc supplements during pregnancy give birth to bigger babies.
Researchers at the University of Alabama in the US found that a
daily dose of 25 mg of zinc throughout pregnancy, starting from the
nineteenth week, had a significant effect on the birth weight of the
newborn. It also helped reduce the numbers of premature babies and
those with very low birth weights.
Researchers allocated 580 pregnant black women—who tend to have
smaller babies—into two groups: one took zinc supplements, the other
a placebo. The zinc group gave birth to babies with a significantly
greater birth weight and head circumference, scientists discovered.
The researchers believe their findings are strong enough to suggest
that zinc should be included as part of the recommended daily intake
of all pregnant women, something that nutritionists like Dr Stephen
Davies have been maintaining for years (JAMA, 1995; Aug 9).
Women should keep their zinc levels topped up especially during
the later stages of pregnancy. Low zinc levels have been linked to a
long labour (Lazebnick N et al. in Hurley LS, ed, Trace Elements in Man
and Animals, vol 6, New York: Pan Books, 1988: 605).
For rhinovirus infections involving the conjunctiva of the eyes,
naturopath Harald Gaier suggests taking zinc gluconate lozenges that

contain 23 mg of elemental zinc every two hours while you’re awake
(J Antimicrob Chemother, 1997; 40: 483–93).
Zinc is the most important mineral for sufferers of age-related
macular degeneration (AMD), as concentrations of zinc are higher in
the retina than in any other organ. Part of the ageing process, the
macula—an oval-shaped depression in the central part of the retina
and the part of the eye with the greatest visual acuity as it
distinguishes details—begins to deteriorate. Consequently, people
with AMD have a blurred or blind spot directly in the centre of vision.
According to What Doctors Don’t Tell You panel member Dr Melvyn
Werbach, author of the sourcebook Nutritional Influences on Illness
(Tarzana, CA: Third Line Press, 1996), zinc deficiency in the retina may
reduce the activity of catalase, an enzyme found in the tissues of the
macula. Reduced activity of this enzyme is associated with AMD (J Am
Coll Nutr, 1991; 10: 536). Low levels of zinc in the retina may also
interfere with the way the body uses vitamin A (J Nutr, 1975; 105:
In one double-blind study of 151 patients, those given zinc suffered
significantly less loss of visual acuity than those given a placebo after
one or two years (Arch Ophthalmol, 1988; 106: 192–8).
Zinc levels are higher in the prostate than anywhere else in the male
body because high levels are required to metabolise male hormones.
When the prostate is enlarged, zinc doesn’t bind as well to the prostate
cells. In cases of benign prostatic hypertrophy (BPH; an enlarged
prostate), 30–45 mg of zinc daily is considered a therapeutic dose
(WDDTY, vol 11, no 10, p 8).
Work by scientists such as Dr Neal Ward, of the Chemistry
Department at the University of Surrey, has emphasised the impor-
tance of zinc status, ingestion of additives and heavy-metal burden
(such as lead, cadmium and mercury) in children with symptoms of
attention-deficit and hyperactivity disorder (ADHD).
Early work found that zinc deficiency caused hyperactivity
syndrome in rats (Pediatr Res, 1975; 9: 94–7) and that additives such as

tartrazine (E102), one of 15 azo dyes permitted in food, can trigger
hyperactive behaviour in some children (Arch Gen Psychiatry, 1981;
38: 714–8; J Pediatr, 1994; 125: 691–8). One double-blind, placebo-
controlled study of hyperactive children by Ward and his coworkers
showed that tartrazine reduced blood and saliva zinc levels, and
increased the levels of zinc excreted in the urine (J Nutr Med, 1990; 10:
415–31). In his latest analysis, Ward also found a progressive decline in
blood zinc levels in four children using Ritalin, the psychostimulant
given to ADHD patients, over 12 months.

Dietary sources
Zinc is found in a wide variety of foods. Oysters contain more zinc
per serving than any other food, but red meat and poultry provide the
majority of zinc in the diet. Other good food sources include beans,
nuts, certain seafood, wholegrains and dairy products. Zinc absorption
is greater from a diet high in animal protein than a diet rich in plant
proteins. Phytates, which are found in wholegrain breads, cereals and
other products, can decrease the amount of zinc absorbed by the body
(Eur J Clin Nutr, 1997; 51 [Suppl 1]: S17–9; Int J Food Sci Nutr, 1995; 46:
53–63). Nevertheless, like magnesium, very few of us get enough zinc,
so supplementation is nearly always a must.

Supplement dosage
Take 15–30 mg daily as zinc citrate, gluconate or chelate.

Too much zinc—150–450 mg per day—has been associated with low
copper status, altered iron function, reduced immune function and
reduced levels of high-density lipoproteins (HDL, the ‘good’ cholester-
ol; JAMA, 1980; 244: 1960–1).


Why it’s important
Iron deficiency is a major problem that affects about 20 per cent of the
world’s population in both developed and developing countries. It can
impair physical endurance, the capacity to work, and infant growth
and development, and depress immune function.
Iron is an important component of proteins involved in the way
oxygen is transported around the body and metabolised (Ann Rev
Nutr, 1986; 6: 13–40). Almost two-thirds of the iron in your body is
found in haemoglobin, the protein in red blood cells that carries
oxygen to your body’s tissues. Smaller amounts of iron are found in
myoglobin, a protein that helps supply oxygen to muscle, and in
enzymes that assist biochemical reactions in cells.
About 15 per cent of your body’s iron is stored for future needs
and used when dietary intake is inadequate. The remainder is in your
body’s tissues as part of the proteins that help your body function.
Adult men and postmenopausal women lose very little iron except
through bleeding. Women with heavy monthly periods can lose a
significant amount of iron.
Your body usually maintains normal levels of iron by controlling
the amount it absorbs from food, but iron overload is a condition in
which excess iron is found in the blood and stored in organs such
as the liver and heart. It is associated with several genetic diseases,
including haemochromatosis, which affects approximately 1 in 250
people in northern Europe. People with this condition absorb iron very
efficiently. Unfortunately, this can result in a buildup of excess iron in
the organs and cause damage to them through, for example, cirrhosis
of the liver and heart failure (Semin Hematol, 1998; 35: 55–71; Nutr
Rev, 1998; 56: s30–7, s54–75; Curr Opin Hematol, 1994; 1: 101–6).
Haemochromatosis is often not diagnosed until the excess iron
stores have damaged an organ. Iron supplementation may accelerate
the effects of the condition, an important reason why adult men and
postmenopausal women who are not deficient in iron should not take
iron supplements. Individuals with blood disorders who require

frequent blood transfusions are also at risk of iron overload and should
not take iron supplements.
Many men and women who engage in regular intense exercise have
marginal or inadequate levels of iron in their bodies (Med Sci Sports
Exerc, 1995; 27: 831–43; Am J Dis Child, 1992; 146: 1201–5; Int J Sports
Med, 1991; 12: 173–9). Researchers have estimated that daily iron loss
increases in those who engage in regular exercise. Research also
indicates that iron has a shorter biological half-life in highly trained
runners. For these reasons, the need for iron may be 30 per cent greater
in those who engage in regular intense exercise (Med Sci Sports Exerc,
1980; 12: 61–4).
Iron supplementation can help children improve their verbal
learning and memory. Researchers at Johns Hopkins University in
Baltimore, Maryland, studied 73 girls from local schools who were all
deficient in iron. Half were given 650 mg of oral ferrous sulphate twice
a day while the rest were given a placebo. After eight weeks, both sets
of girls were tested for their verbal learning and memory. Those who
had been given the iron supplements performed better. Neither group
showed any improvement in attention, however, even though other
studies have also found this to be a benefit of iron supplementation
(Lancet, 1996; 348: 992–6).

Dietary sources
There are two forms of dietary iron: heme and non-heme. The heme
form of iron is found in meat, fish and poultry. Your body absorbs
heme iron very efficiently. Iron in plants such as lentils and beans is
arranged in a different chemical structure called non-heme, which is
not as well absorbed as heme iron. Iron-enriched flours, cereals and
grain products are good dietary sources of non-heme iron (Nutr Rev,
1997; 55: 210–22).
Experts recommend eating food that enhances iron absorption along
with iron-rich food, particularly when consuming non-heme iron.
Nutrients that improve non-heme iron absorption include vitamin C,

citric acid, iron citrate and the amino acid cysteine. Citrus fruits are
good sources of citric acid, and cysteine is plentiful in amaranth,
cottage cheese, fish, poultry, shellfish and soy products. Collectively
known as the MFP factor, certain animal proteins found in meat, fish
and poultry also enhance absorption of non-heme iron.
Cooking foods in iron skillets or steel cookware may improve iron
content of foods.

Supplement dosage
Take 10 mg a day, but avoid iron sulphates, which irritate the
intestines. Also, be aware that some medicines may interact with iron
Iron pills work best when taken on an empty stomach or between
meals, either an hour before or two hours after eating. Take them with
at least eight ounces of water or juice. Orange juice is ideal because
vitamin C enhances iron absorption. If the iron supplements cause
stomach upset, take them with food or right after a meal.
Iron supplements may also lose much of their value when taken
with some foods. Consume milk, cheese, yoghurt, eggs, spinach, tea
or coffee, wholegrain breads and cereals only in small amounts, or
avoid them altogether for an hour before or two hours after taking
iron. Don’t take iron supplements within less than an hour or two of
taking antacids or calcium supplements.

Because very little iron is excreted from the body, higher than normal
levels can have a toxic effect. Excessively high levels of iron contribute
to Parkinson’s disease (Can J Neurol Sci, 1990; 17: 286–91).
Ingesting as few as five or six high-potency tablets can provide
amounts of iron that can be fatal to a child weighing 10 kg (22 lb).
Consuming 1–3 g of iron can be fatal to children under six, and lower
doses can cause severe symptoms, such as vomiting and diarrhoea
(MCN Am Matern Child Nurs, 1995; 20: 234).

Several studies have led researchers to examine the association
between high iron stores and coronary heart disease. It appears that
rates of heart disease among women increase when monthly periods
stop, a time when levels of stored iron increase. Also, some researchers
have suggested that lower rates of heart disease among people living
in developing countries may be due to low meat (and iron) intake.
High-fibre diets, which prevent iron from being absorbed, can also
contribute to low levels of iron being stored (Lancet, 1981; 1: 1293–4;
J Clin Epidemiol, 1996; 49: 1345–52; J Clin Epidemiol, 1996; 49: 1353–8;
J Clin Epidemol, 1996; 49: 1359–62; Kidney Int, 1999; 55 [Suppl 69]:
A study carried out in the 1980s in Finnish men also linked high
iron stores with an increased risk of heart attacks (Circulation, 1992; 86:
803–11). However, not all studies have supported this relationship (N
Engl J Med, 1994; 330: 1119–24), including a 1999 review of 12 studies
that failed to show a strong association (Circulation, 1999; 99: 852–4). It
is also true that older women are more likely to suffer from traditional
cardiovascular disease risk factors, such as high blood pressure and
elevated blood cholesterol, rather than high iron levels.
People with hereditary haemochromatosis run an increased risk of
liver cancer. Because iron accumulates in the liver, it can increase the
production of free radicals.


Why it’s important

Copper is thought to play an important role in developing and
maintaining the immune system, but how it does this is not yet known.
Neutropenia (abnormally low numbers of white blood cells called
neutrophils) is a sign of copper deficiency in humans. Adverse effects
of insufficient copper on immune function are most pronounced in
babies. Infants with Menkes’ syndrome, a genetic disorder that results
in severe copper deficiency, suffer from frequent and severe infections

(Am J Clin Nutr, 1998; 67 [5 Suppl]: 1064S–8S; Nutr Rev, 1998; 56:
In a study of 11 malnourished infants showing evidence of copper
deficiency, the ability of certain white blood cells to engulf pathogens
increased significantly after one month of copper supplementation
(Nutr Res, 1985; 5: 1327–34).
Low levels of copper in the body can lead to anaemia (Semin
Hematol, 1983; 20: 118–28). Copper is also vital to the retina although,
with age-related macular degeneration (AMD; see Zinc, pp XX),
copper levels are often elevated, which can prove toxic to the macula
(India J Ophthalmol, 1981; 29: 351–3).

Dietary sources
Copper is found in a wide variety of foods and is most plentiful in
organ meats, shellfish, nuts and seeds. Wheat-bran cereals and whole-
grain products are also good sources of copper.

Supplement dosage
Take 1–2 mg a day.

These are rare, although acute copper poisoning has been seen when
drinks were stored in copper containers and water supplies were
contaminated (Am J Clin Nutr, 1998; 67 [5 Suppl]: 1069S–73S).
Taking the Pill or hormone replacement therapy (HRT) can cause
abnormally high copper levels in women (Davies S, Nutritional
Medicine, Pan Books, 1987). High levels of copper can also affect the
levels of zinc in your body, and raised blood levels of either mineral
are linked with AMD (Ann Ophthalmol, 1985; 17: 419–22). So, if you’re
taking, or have been taking, HRT, you should have your copper levels
Significantly higher levels of copper in the cerebrospinal fluid have
been found in Parkinson’s patients, and the higher the levels of copper,

the worse the patient’s symptoms (Lancet, 1987; ii: 238–41).
According to a team at Mississippi State University, excess copper,
particularly with low levels of zinc, is associated with high blood
pressure (Biol Trace Element Res, 1983; 5: 165–74).
Symptoms of acute copper toxicity include stomach pain, nausea,
vomiting and diarrhoea, which help prevent copper from being taken
in and absorbed by the body. More serious signs include severe liver
damage, kidney failure, coma and death.


Why it’s important

Manganese is a mineral element that is both nutritionally essential and
potentially toxic. Its name is derived from the Greek word for ‘magic’.
Ironically, scientists are still working to understand the diverse effects
of manganese deficiency and manganese toxicity in living organisms.
Wound-healing is a complex process that requires large amounts of
collagen. Manganese is needed to activate prolidase, an enzyme that
provides the amino acid proline so that collagen can form in human
skin cells (Exp Toxicol Pathol, 2000; 52: 149–55).
A study in healthy postmenopausal women found that a supple-
ment containing manganese (5 mg per day), copper (2.5 mg per day)
and zinc (15 mg per day) combined with a calcium supplement (1000
mg per day) was more effective than the calcium supplement alone in
preventing spinal bone loss over two years (J Nutr, 1994; 124: 1060–4).
Two more recent studies have found that supplements containing a
combination of glucosamine hydrochloride, chondroitin sulphate and
manganese ascorbate can help relieve pain in those suffering from
mild-to-moderate osteoarthritis of the knee compared with a placebo
(Mil Med, 1999; 164: 85–91; Osteoarth Cartil, 2000; 8: 343–50).

Dietary sources
Rich sources of manganese include wholegrains, nuts, leafy vegetables

and tea. Foods high in phytic acid, such as beans, seeds, nuts and soy
products, or foods high in oxalic acid, such as cabbage, spinach and
sweet potatoes, may slightly inhibit manganese absorption. Although
tea is a rich source of manganese, the tannins present in tea may
moderately reduce the absorption of manganese.

Supplement dosage
Take 5–19 mg/day or 20 mg/day when under medical supervision.
Do not exceed this dose.

Manganese toxicity is a well-recognised health problem for people
who inhale manganese dust. Unlike ingested manganese, inhaled
manganese is transported directly to the brain before the liver can
metabolise it (Environ Health Perspect, 1998; 106 [Suppl 1]: 191–201).
Symptoms of manganese toxicity generally appear slowly over a
period of months to years. In its worst form, manganese toxicity can
result in a permanent neurological disorder with symptoms similar to
those of Parkinson’s disease, including tremors, difficulty walking and
facial muscle spasm. This syndrome is sometimes preceded by psy-
chiatric symptoms such as irritability, aggressiveness and even
hallucinations (Neurotoxicology, 1999; 20: 227–38).


Why it’s important

Over many years, the Biolab Medical Unit in London conducted a
computer analysis of more than 40,000 patients which showed that
chromium levels fall markedly as we age. Chromium levels are lower
in men than women from age 20 on, and then fall dramatically between
40 and 65, the ages when coronary artery disease is known to increase.
One Israeli study found that the aorta or main coronary artery of
patients dying of coronary artery disease contained very little

chromium compared with a group of controls (Am Heart J, 1980;
99: 604–6).
There’s also evidence that societies with an increased intake of
refined sugar have a very high incidence of coronary artery disease.
Low chromium levels have been shown to be a major factor in the
formation of high blood cholesterol levels in numerous laboratory
studies. Although animal studies cannot be applied to humans, we
have seen that giving chromium supplements will lower high blood
cholesterol, and highly processed foods low in chromium will result in
high cholesterol levels. This suggests that high blood cholesterol does
not itself cause coronary heart disease, but is simply a marker that
something else, like inadequate chromium intake, is awry.
Because chromium is known to enhance the action of insulin, and
chromium deficiency has resulted in impaired glucose tolerance,
chromium insufficiency is also thought to be a contributing factor to
the development of type 2 (non-insulin-dependent) diabetes (Nutr Rev,
1999; 57: 329–35). Those who have this condition (especially if they’ve
had it for two years or more) have lost higher levels of chromium
through their urine than healthy individuals (J Trace Element Med
Biol, 1999; 13: 57–61).
Several studies of male runners also showed that urinary chromium
loss was increased by endurance exercise, suggesting that chromium
needs may be greater in people who exercise regularly (Am J Clin Nutr,
2000; 72 [2 Suppl]: 585S–93S).

Dietary sources
Processed meats, wholegrain products, bran cereals, green beans,
broccoli and spices are relatively rich in chromium. Foods high in
simple sugars, such as sucrose and fructose, are not only low in
chromium, but have also been found to promote chromium loss (Ann
Rev Nutr, 1999; 19: 279–302).

Supplement dosage

Take 100–125 mcg a day.

Several studies have demonstrated the safety of daily doses of up to
1000 mcg of chromium for several months (Diabetes, 1997; 46: 1786–91;
Am J Clin Nutr, 1997; 66: 427–37). However, there have been a few
isolated reports of serious adverse reactions to chromium in the form
of chromium picolinate. Kidney failure was reported five months after
a six-week course of 600 mcg of chromium picolinate per day (Ann
Intern Med, 1997; 126: 410), whereas kidney failure and impaired liver
function were reported after the use of 1200–2400 mcg per day of
chromium picolinate for four to five months (Ann Pharmacother, 1998;
32: 428–31).


Why it’s important

Selenium is an important part of the antioxidant enzymes that protect
cells against the effects of the free radicals produced during normal
oxygen metabolism. The body has developed defences such as
antioxidants to control levels of free radicals because they can damage
cells and contribute to the development of some chronic diseases
(Pharmacol Ther, 1998; 79: 179–92).
Selenium is also essential for normal functioning of the immune
system and thyroid gland (J Nutr, 1997; 127: 948S–50S; Can J Physiol
Pharmacol, 1991; 69: 1648–52; Am J Clin Nutr, 1993; 57 [2 Suppl]:
Gastrointestinal disorders, such as Crohn’s disease, can affect the
way selenium is absorbed by the body. Most cases of selenium
depletion or deficiency are associated with severe gastrointestinal
problems, such as in individuals who have had more than half of their
small intestines surgically removed (Am J Clin Nutr, 1992; 56: 933–7).
Some studies indicate that death from cancer, including lung,

colorectal and prostate cancers, is lower among people with higher
selenium blood levels or intake (Nutr Cancer, 1997; 28: 125–9; Cancer
Epidemiol Biomarkers Prev, 1997; 6: 63–9; Am J Epidemiol, 1998; 148:
975–82; Nutr Rev, 1997; 55: 277–9; Mutat Res, 1985; 154: 29–48; Eur J
Cancer Prev, 1999; 8: 91–103; J Trace Elem Electrolytes Health Dis, 1990;
4: 73–7). Recent laboratory work with rats prone to cancer shows that
selenium may prevent colon tumours from forming as well as stop
them growing any further when they’ve become established (J Natl
Cancer Inst, 1997; 89: 506–12).
However, not all studies have shown a relationship between
selenium and cancer. In 1982, over 60,000 participants in the Nurses
Health Study who had no history of cancer submitted toenail clippings
for selenium analysis so that researchers could measure the previous
year’s selenium levels. After three and a half years, the researchers
compared toenail selenium levels of nurses with and without cancer.
They could find no apparent benefit of higher selenium levels (J Natl
Cancer Inst, 1995; 87: 497–505).
These conflicting results emphasise the need for additional research
on the relationship between selenium and chronic diseases such as
cancer. A study that may help to answer some of the questions con-
cerning the effect of selenium supplementation on cancer risk has
started in France. The Supplementation en Vitamines et Minéraux
Antioxydants, or SU.VI.MAX Study, is a preventional trial using doses
of antioxidant vitamins and minerals that are one to three times higher
than recommended intakes, including a daily supplement of 100 mcg
of selenium. More than 12,000 men and women are being followed for
eight years to determine the effect of supplementation on the incidence
of chronic diseases such as cancer and cardiovascular disease (Int J
Vitam Nutr Res, 1998; 68: 3–20).
Some population surveys have shown an association between a
lower antioxidant intake with a greater incidence of heart disease
(Biofactors, 1998; 7: 113–74). Additional lines of evidence suggest that
oxidative stress from free radicals may promote heart disease

(Biochem Mol Biol Int, 1995; 35: 117–24). It is the oxidised form of
low-density lipoproteins (LDL or ‘bad’ cholesterol) that helps plaque
build up in coronary arteries (Circulation, 1998; 97: 1930–4). Selenium
is one of a group of antioxidants that may help to limit the oxidation of
LDL cholesterol and thereby help to prevent coronary artery disease
(Biochem Mol Biol Int, 1995; 35: 117–24; J Cardiovasc Risk, 1996; 3:
Surveys of patients with rheumatoid arthritis, a chronic disease that
causes pain, stiffness, swelling and loss of function in the joints, have
shown reduced selenium levels in the blood (Biol Trace Elem Res, 1996
53: 51–6; Ann Rheum Dis, 1994; 53: 51–3). Some individuals with
arthritis also have a low selenium intake (Semin Arthritis Rheum,
1997; 27: 180–5).
Selenium deficiency is commonly associated with HIV/AIDS, and
has been associated with a high risk of death from this disease (Altern
Med Rev, 1999; 4: 403–13; J Acquir Immune Defic Syndr Hum
Retrovirol, 1997; 15: 370–4). Of 24 children with HIV who were
observed for five years, those with low selenium levels died at a
younger age, which may indicate faster disease progression (J Acquir
Immune Defic Syndr Hum Retrovirol, 1999; 15: 508–13). An
examination of 125 HIV-positive men and women also associated
selenium deficiency with death (J Acquir Immune Defic Syndr Hum
Retrovirol, 1997; 15: 370–4).

Dietary sources
Plant foods are major dietary sources of selenium in most countries
throughout the world. Selenium can also be found in some meats and
seafoods. Animals that eat plants grown in selenium-rich soil have
higher levels of selenium in their muscle. In the US, meats and bread
are common sources of dietary selenium (Int J Vitam Nutr Res, 1996;
66: 342–9; J Am Diet Assoc, 1991; 91: 179–83). Some nuts—in particular,
Brazil nuts and walnuts—are also very good sources of selenium.

Supplement dosage

Take up to 200 mcg a day.

High levels of selenium in the blood can result in a condition called

selenosis (Can J Vet Res, 1986; 50: 297–306). Symptoms include
gastrointestinal upset, hair loss, white blotchy nails and mild nerve


Why it’s important

Iodine is an essential component of the thyroid hormones triiodo-
thyronine (T3) and thyroxine (T4), and is therefore essential for normal
thyroid function. To meet the body’s demand for thyroid hormones,
the thyroid gland traps iodine from the blood and converts it into
thyroid hormone, which is stored and released into the circulation
when needed.
Iodine deficiency is now accepted as the most common cause of
preventable brain damage in the world. According to the World Health
Organization (WHO), iodine-deficiency disorders (IDD) affect 740
million people throughout the world, and nearly 50 million suffer from
some degree of IDD-related brain damage (
Infant death is higher in areas of iodine deficiency, and several
studies have demonstrated an increase in childhood survival when
iodine deficiency is corrected (Lancet, 1997; 350: 771–3). Infancy is a
period of rapid brain growth and development. Sufficient thyroid
hormone, which depends on adequate iodine intake, is essential for
normal brain development. Even in the absence of congenital
hypothyroidism, iodine deficiency during infancy may result in
abnormal brain development and, consequently, impaired intellectual
development (J Nutr, 2000; 130 [2S Suppl]: 493S–5S).
Iodine deficiency during pregnancy has been associated with an

increased incidence of miscarriage, stillbirth and birth defects. More-
over, severe iodine deficiency during pregnancy may result in
congenital hypothyroidism (sometimes referred to as cretinism; J Nutr,
1996; 126 [9 Suppl]: 2427S–34S).
Iodine-deficient women who are breastfeeding may also not be
able to provide sufficient iodine to their infants, who are particularly
vulnerable to the effects of iodine deficiency.
Iodine deficiency in children and adolescents is often associated
with goitre. The incidence of goitre peaks in adolescence and is more
common in girls. School children in iodine-deficient areas show poorer
school performance, lower IQs and a higher incidence of learning
disabilities than similar children in iodine-sufficient areas. A recent
analysis of 18 studies concluded that iodine deficiency alone lowered
mean IQ scores in children by 13.5 points (Am J Clin Nutr, 1996; 63:
782–6; Nutr Rev, 1996; 54: S72–8).

Dietary sources
The iodine content of most foods depends on the iodine content of the
soil in which they were grown. Seafood is rich in iodine because
marine animals concentrate the iodine from seawater. Certain types
of seaweed (such as wakame) are very rich in iodine. Processed foods
may also contain slightly higher levels of iodine due to the addition of
iodised salt or food additives, such as calcium iodate and potassium
Eaten in excess, walnuts, sorghum, cassava, almonds and apples
contain a substance that may impair the thyroid gland’s ability to
concentrate iodine (Rea W, Chemical Sensitivity, Boca Raton, FL: Lewis
Publishers, 1996, p 1656).
Also, although the precise mechanism is not understood, it appears
that a component in soy fibre depletes iodine. For this reason,
manufacturers of soy formula provide low-fibre infant formulas
fortified with iodine. Nevertheless, cases of infant goitre still occur,
although abnormal levels of thyroid-stimulating hormone return to

normal once the soy formula is stopped (Pediatrics, 1995; 96: 148–50).

Supplement dosage
(If you want to avoid cow’s milk, another option is goat’s milk.)

Take 500 mcg daily; if possible, take kelp because this is an excellent
source of iodine. Multivitamin preparations containing more than 100
mcg (0.1 mg) of iodine per capsule may cause thyroid problems (Nutr
Health Rev, 1996; 75: 4). If you have an underactive thyroid, do not
take iodine supplements or allow dietary levels to exceed 1 mg per
day as too much iodine can impede the production of thyroid hormone
(Pizzorno JE, Murray MT, Encyclopedia of Natural Medicine, Optima,

Acute iodine poisoning is rare and usually occurs only with doses of
many grammes. Symptoms of acute iodine poisoning include burning
of the mouth, throat and stomach, fever, nausea, vomiting, diarrhoea,
a weak pulse and coma (
What is common is drowning in iodised salt, which affects the
thyroid, especially in populations that consume adequate amounts of
iodine from fish, vegetables or sea vegetables. In a study carried out in
northwestern Spain, where iodised salt is obligatory, the incidence of
overactive thyroid was higher than usual, especially among women (J
Endocrinol Invest, 1994; 17: 23–7). The highest prevalence of chronic
autoimmune thyroiditis is seen in countries with the highest intake of
iodine, such as the US and Japan.
Large doses of iodine in any form may cause a marked increase in
thyroid hormone release, resulting in hyperthyroidism (an overactive
thyroid), or a sudden drop in thyroid hormone production, resulting in
hypothyroidism (an underactive thyroid) (Nutr Health Rev, 1996; 75:

Part 3
The Acids
A mino acids are the building blocks from which proteins are
made. As well as building cells and repairing tissue, they form
antibodies to fight invading bacteria and viruses. They also carry
oxygen throughout the body and help the muscles work properly.
Some of these acids are ‘essential’ (histidine, isoleucine, leucine,
valine, lysine, methionine, phenylalanine and tryptophan)—they can’t
be made by the body and must come from your diet. Others are ‘non-
essential’ (arginine, cysteine, taurine and tyrosine)—these can be made
by the body with proper nutrition.
Unlike vitamins and minerals, you have to take amino acid
supplements about half an hour before eating because they compete
with the amino acids already present in food, so the body won’t absorb
them as well as it could do.
Animal foods are a rich source of many essential acids. You can also
get them from a wide variety of plant foods. Previously, it was thought
that vegetarians had to have a balanced meal containing all of the
essential amino acids at one sitting to get adequate amounts of protein.
However, research has shown that, while consuming a proper mix of
amino acids is important, it is not necessary to consume them all at the
same meal (Am J Clin Nutr, 1994; 59 [Suppl]: 1203S–12S).


Isoleucine, leucine and valine

Why they’re important

You can’t survive without these essential amino acids, also known as
branched-chain amino acids (BCAAs). They must be present in your

diet. You need them to maintain muscle tissue and to look after the
stores of glycogen (a form of carbohydrate that can be converted into
energy) within the muscle (Nutrition, 1996; 12: 485–90). They can also
help prevent the protein inside the muscle from breaking down when
you exercise (Am J Physiol, 1994; 267: E1010–22).
Patients with hepatic encephalopathy, a liver disease that can lead
to coma, have low concentrations of these amino acids in their body,
and research suggests they could benefit from its supplementation
(Gastroenterology, 1989; 97: 1033–42). The therapeutic effects of these
acids have also been shown in children with liver failure (Am J Clin
Nutr, 1992; 56: 158–63) and in adults with cirrhosis of the liver (Ann
Intern Med, 1998; 37: 429–34).
Patients with chronic kidney failure could also benefit. A pre-
liminary study found that their breathing and quality of sleep were
improved when they were given these acids intravenously during
kidney dialysis (Kidney Int, 1991; 40: 539–43).
BCAAs may help in recovery from hangover and are widely taken
by bodybuilders for muscle bulking (these three essential amino acids
make up about one-third of the body's muscle tissue).

Dietary sources
Dairy products and red meat contain the greatest amounts of these
amino acids, although they are present in all foods that contain

Supplement dosage
There are no recommended daily allowances for individual amino
acids. However, supplemental intakes of the BCAAs have been studied
in the range of 5–20 g/day as tablets, and 1–7 g/L in liquid form,
with no adverse effects. Athletes involved in intense training often
take 5 g of leucine, 4 g of valine and 2 g of isoleucine per day to prevent
muscle loss and increase muscle gain, but most research does not
support this use of BCAAs. Higher intakes should be avoided as they

may inhibit the absorption of other amino acids from the diet and
cause gastrointestinal distress.

None has been documented. If you take too much of them, they are
converted into other amino acids which are used for energy or
converted to fat. However, over the long term, too much protein in the
form of amino-acid supplements may be toxic to the liver and kidneys.


Why it’s important

You need lysine for growth and to help maintain the body’s nitrogen
balance. It works in many ways because it is incorporated into many
of the body’s proteins, which are used for a variety of purposes.
Lysine is used to treat cold sores or genital herpes because it inter-
feres with the way the herpesvirus replicates (J Am Coll Nutr, 1997; 16:
7–21). It also seems to help the body absorb and conserve calcium
(Nutrition, 1992; 8: 400–4).

Dietary sources
Brewer’s yeast, dairy products, fish and meat all contain significant
amounts of lysine.

Supplement dosage
1000 mg/day.

None is consistently reported in humans, although abdominal cramp
and diarrhoea have been reported from time to time (J Am Coll Nutr,
1997; 16: 7–21). High amounts of lysine have also been linked to an
increased risk of gallstones (Nutr Rep Int, 1984; 29: 117) and high levels
of cholesterol (Experientia, 1982; 38: 266–7).


Why it’s important

Histidine is a semi-essential amino acid (protein building block)
because adults generally produce adequate amounts of it, but children
may not. It is also a precursor of histamine, a compound released by
immune system cells during an allergic reaction.
Research into its role is limited, but rheumatoid arthritis sufferers
usually have low levels of histidine, so taking supplements might
improve symptoms (J Chron Dis, 1977; 30: 115–27).

Dietary sources
Dairy, meat and poultry, and fish are good sources of histidine.

Supplement dosage
There are no recommended daily allowances for individual amino
acids, but most people don’t need to supplement histidine. Human
studies have used 1–8 g/day.

None has been documented.


Why it’s important

Methionine belongs to a group of compounds called lipotropics,
chemicals that help the liver process fats (lipids). It also supplies the
body with a number of compounds it needs for metabolism and
People suffering from AIDS have low levels of methionine. A
preliminary study has suggested that 6 g of methionine a day may
improve memory recall in those with AIDS-related conditions (AIDS,
1997; 11: 1066–7).

Other studies have suggested that 5 g of methionine per day could
help treat some symptoms of Parkinson’s disease (South Med J, 1984;
77: 1577). However, another form of methionine, S-adenosyl-
methionine, or SAMe, may actually worsen the symptoms of
Parkinson’s and should be avoided until more is known (Mol
Neurobiol, 1994; 9: 149–61; Behav Neural Biol, 1993; 59: 186–93;
Neurochem Res, 1993; 18: 325–30).
Most of us consume plenty of methionine through a typical diet.
Lower intakes during pregnancy, though, have been associated with
neural tube defects in newborn babies (Teratology, 1997; 56: 295–9).

Dietary sources
Meat, fish and dairy are all good sources of methionine. Vegetarians
can obtain methionine from wholegrains.

Supplement dosage
500 mg/day.

Animal studies suggest that diets high in methionine may increase the
risk of atherosclerosis (hardening of the arteries) by increasing the
levels of cholesterol in the blood as well as the level of homocysteine,
a substance linked to heart disease and stroke (J Optim Nutr, 1994; 3:
80–3). This idea has not yet been tested in humans.

Phenylalanine (LPA, DPA, DLPA)

Why it’s important

It’s a building block for the various proteins that are produced in the
body. L-Phenylalanine (LPA) can be converted to L-tyrosine and then to
L -dopa, norepinephrine (noradrenaline) and epinephrine (adrenaline).

LPA can also be converted to phenylethylamine, a substance that

occurs naturally in the brain and appears to influence mood.

D -Phenylalanine (DPA) is not normally found in the body and can’t
be converted to L-tyrosine, L-dopa or norepinephrine. DPA is therefore
converted into phenylethylamine, which affects mood. DPA also
appears to influence certain chemicals in the brain that determine how
we feel pain. Thus, DPA has been used to treat chronic pain (Adv Pain
Res Ther, 1983; 5: 305–8).
DLPA is a combination of LPA and DPA. DLPA has been used to treat
depression (J Clin Psychiatry, 1986; 47: 66–70).

Dietary sources
You can find LPA in most foods that contain protein whereas DPA
does not normally occur in food. However, when phenylalanine is
synthesised in the laboratory, half of it appears in the L-form and the
other half in the D-form. These two compounds can also be synthesised
individually, but it is more expensive to do so. The combination
supplement (DLPA) is often used because it costs less to produce and
both components exert different health-enhancing effects.

Supplement dosage
1000 mg/day of DLPA.

None is known.


Why it’s important

This amino acid helps to regulate mood. Parkinson’s patients are often
deficient in this vital amino acid because another, L-dopa, competes
with it.
In one case study of a small number of patients, supplementing
with tryptophan improved the mental disturbances which had been
observed (Acta Med Scand, 1973; 194: 181–9). In another study where

patients all received L-dopa, but only half were also given tryptophan,
all showed improvement in various motor skills, but only those
receiving the tryptophan improved in functional ability, mood and
drive (Lancet, 1972; i: 654–7).

Dietary sources
Tryptophan can be found in meat and poultry, fish, eggs and dairy
products as well as various plant sources.

Supplement dosage
The usual dosage is 500 mg/day (for up to six months), but
supplementing with 2 g of tryptophan three times a day can help the
physical symptoms of Parkinson’s.
However, tryptophan has been banned in the UK ever since a bad
batch of the supplement, produced and sold in the US, was found to be
responsible for an epidemic outbreak of eosinophilia–myalgia syn-
drome (a blood disorder with severe muscle pain) in 1989. The supple-
ments were linked to 1500 cases of chronic illness and 30 deaths.

Regular L-dopa supplementation can lead to malabsorption of L-
tryptophan, which can, in turn, lead to depression and a number of
other symptoms, usually categorised as side-effects of the drug.



Why it’s important

The body usually makes enough arginine even if you’re not getting it
in your diet. But, during times of unusual stress (including infection,
burns and injury), the body’s production may not be able to keep up.
Arginine helps wound-healing in both humans (Surgery, 1993; 114:

155–60) and animals (Am J Clin Nutr, 1983; 37: 786–94) by increasing
protein synthesis. It removes excess ammonia from the body and
stimulates the body’s immune function.
Its ability to increase protein synthesis can help cells to replicate
more quickly. Arginine may therefore help people with inadequate
numbers of certain cells. One study found that men with low sperm
numbers had an increase in sperm counts when they supplemented
with arginine (J Urol, 1973; 110: 311–3).
In 1999, a double-blind study using 1.5 g of arginine for three
months in a group of women with interstitial cystitis reported
considerable improvement compared with a placebo (J Urol, 1999; 161:
Preliminary evidence suggests that arginine may help regulate
cholesterol levels (Nutr Rep Int, 1987; 35: 5–13). Arginine also appears
to act as a natural blood thinner (J Am Coll Cardiol, 1997; 29: 479–85).

Dietary sources
Dairy, meat and poultry, and fish are good sources of arginine. Nuts
and chocolate also contain significant amounts.

Supplement dosage
1000 mg/day.

None is documented.

Cysteine (NAC)

Why it’s important

Cysteine is rarely used as a dietary supplement. N-acetyl cysteine
(NAC), derived from cysteine, is more commonly used.
Cysteine is one of the few amino acids that contains the mineral
sulphur (which the body needs to make proteins, including those that

form hair, muscles and skin). This allows cysteine to bond in a special
way and maintain the structure of proteins in the body. The body also
uses cysteine to produce taurine.
Cysteine can be converted into glucose and used as a source of
energy. Cysteine strengthens the protective lining of the stomach and
intestines, which may help prevent damage caused by aspirin and
similar drugs (Ind J Exp Biol, 1996; 34: 634–40). It may also play an
important role in way immune system cells communicate with each
other (J Bone Joint Surg, 1935; 16: 185–8).

Dietary sources
Meat and poultry, organ meats, fish, eggs, beans and dairy products
are all good sources of cysteine. Sulphur is also found in garlic and

Supplement dosage
Typical dosage recommendations are in the range of 250–1500 mg of
NAC daily for most therapeutic benefits. In a dosage of 1.8 g/day,
NAC was shown to help people with pulmonary fibrosis, and it may
be the treatment of choice in the often fatal adult respiratory distress
syndrome (ARDS).
Vitamins B6 and B12, and folate are necessary for cysteine synthesis,
which may not work as it should in those with chronic illnesses. In
such cases, higher doses—as much as 1000 mg three times daily for a
month at a time—may be needed.

None is documented. Intakes of around 60–80 g/day can be consumed
without causing significant adverse effects.
However, extended supplementation with NAC may lead to minor
zinc depletion. Also, taking high doses of cysteine may be harmful,
and may cause nausea, vomiting and diarrhoea.


Why it’s important

L -Tyrosine is a non-essential amino acid (protein building block) that
the body synthesises from phenylalanine, another amino acid.
Tyrosine is important to the structure of almost all proteins in the
body. It is also the precursor of several neurotransmitters, including
L -dopa, dopamine, norepinephrine (noradrenaline) and epinephrine

(adrenaline). L-Tyrosine, through its effect on neurotransmitters, may

affect several health conditions, including Parkinson’s disease and
other mood disorders.
Studies have suggested that tyrosine may help people with
depression (Psychopharmacol Bull, 1982; 18: 7–18). Preliminary find-
ings indicate a beneficial effect of tyrosine, along with other amino
acids, in those affected by dementia, including Alzheimer’s disease
(J Am Geriatr Soc, 1977; 7: 289–98).
Due to its role as a precursor of norepinephrine and epinephrine
(two of the body’s main stress-related hormones), tyrosine may also
ease the adverse effects of environmental, psychosocial and physical
stress (Brain Res Bull, 1989; 22: 759–62; Milit Med, 1989; 154: 144–6;
Aviat Space Environ Med, 1995; 66: 313–9; Brain Res Bull, 1999; 48:
203–9; Pharmacol Biochem Behav, 1994; 47: 935–41; Brain Res Bull,
1994; 33: 319–23; Physiol Behav, 1995; 57: 223–30).
L -Tyrosine is converted by skin cells into melanin, the dark pigment
that protects against the harmful effects of ultraviolet light. Thyroid
hormones, which have a role in almost every process in the body, also
contain tyrosine as part of their structure.
People born with the genetic condition phenylketonuria (PKU) are
unable to metabolise the amino acid phenylalanine. Mental retardation
and other severe disabilities can result. While dietary phenylalanine
restriction prevents these problems, it also leads to low tyrosine levels
in many (but not all) people with PKU. Tyrosine supplementation may
be beneficial in some people with PKU, though the evidence is con-

flicting (Am J Clin Nutr, 1996; 64: 74–5).

Dietary sources
Dairy products, meats, fish, wheat, oats and most other protein-
containing foods contain tyrosine.

None has been documented.

Supplement dosage
1000 mg/day.


Why it’s important

Alanine is found in prostate fluid, so it may be responsible for a
healthy prostate. Forty-five men suffering from benign prostatic
hyperplasia (BPH; enlarged prostate) took 780 mg of alanine per day
for two weeks, followed by 390 mg for the next two and a half months.
They also took it with equal amounts if two other amino acids—
glycine and glutamic acid. Researchers found that the BPH symptoms
were reduced (J Am Geriatr Soc, 1962; 10: 426–30).
Because alanine is synthesised in the body and can easily be
obtained from a variety of protein foods, it’s unlikely you will have an
alanine deficiency (J Nutr, 1995; 125: 2907–15).

Dietary sources
Meat and poultry, fish, eggs and dairy products are sources of alanine
as well as some protein-rich plant foods.

Supplement dosage
Most of us don’t need to take alanine supplements. However, you
should aim to get 500 mg/day of this amino acid.

None is documented.


Why it’s important

Glutamine is the most abundant amino acid in the body and is
involved in more metabolic processes than any other amino acid.
It’s converted to glucose when the body needs more glucose for
energy. It serves as a source of fuel for the cells lining the intestines.
Without it, these cells waste away. It is also used by white blood cells
and is important for immune function.
Animal research shows that glutamine acts as an anti-inflammatory.
Working with N-acetyl cysteine, it promotes the synthesis of gluta-
thione, a naturally occurring antioxidant that is believed to be
beneficial to those infected with HIV (Lancet, 1992; 339: 1603–4). One
study showed that when critically ill people were injected with
glutamine, their survival rate increased (Nutrition, 1997; 13: 752–4).

Dietary sources
Glutamine is found in many high-protein foods, such as fish, meat,
beans and dairy products.

Supplement dosage
500 mg/day.

None is documented.

Glutamic acid (glutamate)

Why it’s important

Glutamic acid (glutamate) boosts the central nervous system.

Although glutamine and glutamic acid have similar names, they are
structurally different. The fluid produced by the prostate gland
contains significant amounts of glutamic acid, which may play a role
in the way the prostate normally functions (see Glutamine above).

Dietary sources
Glutamic acid is found in high-protein foods such as meat, poultry,
fish, eggs and dairy products. Some protein-rich plant foods also
supply glutamic acid.

Supplement dosage
If you’re healthy, you probably don’t need to take glutamic acid as a
supplement, although 500 mg/day is considered a safe dosage.

Glutamic acid is generally free of side-effects for the vast majority of
people who take it. However, overstimulating the body’s glutamate
receptors is thought to cause certain neurological diseases, such as
amyotrophic lateral sclerosis (Lou Gehrig’s disease) and epilepsy.


Why it’s important

Glycine is a non-essential amino acid used by the body to build
proteins. It is present in considerable amounts in prostate fluid.
Glycine may play a role in maintaining the health of the prostate. A
study of 45 men with benign prostatic hyperplasia (BPH, an enlarged
prostate) found that 780 mg/day of glycine for two weeks and then
390 mg/day for the next two and a half months, taken in combination
with equal amounts of the amino acids alanine and glutamic acid,
reduced symptoms of the condition (J Am Geriatr Soc, 1962; 10: 426–
30). This effect has been reported by others (J Maine Med Assoc, 1958;
49: 99–101, 124).

Glycine also enhances the activity of neurotransmitters (chemical
messengers) in the brain that are involved in memory and cognition
(J Clin Psychopharmacol, 1999; 19: 506–12).

Dietary sources
Glycine is found in many foods high in protein, such as fish, meat,
beans and dairy products.

Supplement dosage
The usual dosage is 500 mg/day, although glycine is abundant in a
standard diet.

None has been documented.


Why it’s important

Taurine is one of the most abundant amino acids in the body, and is
found in the central nervous system and skeletal muscle, particularly
in the brain and heart.
Although newborn babies cannot synthesise taurine, healthy adults
make their own out of other amino acids. As taurine is not found in
vegetable protein, vegetarians deficient in methionine or cysteine may
have difficulty in manufacturing it.
Dietary or supplemental intake is thought to be more important in
women as the female hormone oestradiol depresses the formation of
taurine in the liver.
One of taurine’s pivotal roles is in the proper digestion of fats,
absorption of fat-soluble vitamins and production of bile salts.
In addition, the higher the concentration of dietary taurine, the
better the blood pressure control. In one study, taking taurine as a
supplement reduced hypertension (Circulation, 1987; 75: 525).

Dietary sources
The best dietary sources of taurine are protein foods such as meat,
poultry, eggs, dairy and fish. Beans and nuts, which are rich sources
of protein, don’t contain taurine, but they do contain methionine and
cysteine (which can be made into taurine by the body).

Supplement dosage
Most people don’t need to supplement taurine. WDDTY panellist
Melvyn Werbach recommends 500 mg/day, though others suggest
1000 mg/day for up to six months. However, for those suffering from
specific conditions, such as congestive heart failure, research supports
the use of 2–6 g three times a day for four weeks.

Taurine has not been linked with any toxicity and is thought to be safe.

Coenzyme Q10 (ubiquinone)

Why it’s important

Although not an amino acid, coenzyme Q10 (CoQ10) is involved in the
production of adenosine triphosphate (ATP) and, thus, in the synthesis
of nucleic acids and proteins. It enhances the function of enzymes
and plays a vital role in converting nutrients into energy. It is so
fundamental to the process of creating energy that nearly every cell in
the body contains this substance. CoQ10 is found in various concentra-
tions in different organs, with the highest amounts in those which
produce large amounts of energy, such as the heart, liver, kidney and
pancreas (J Am Chem Soc, 1959; 81: 4007–10).
Because of its role in energy production, CoQ10 has proved to be
useful in chronic fatigue syndrome (CFS)/myalgic encephalomyelitis
(ME). Studies have shown that supplementation, even at low levels of
30 mg/day, resulted in symptomatic improvement (N Carol Fam
Physician, 1992; 43: 6–11).

It also has a role in preventing a wide range of diseases, and can
normalise blood pressure, increase exercise tolerance and boost
immunity. Both the systolic and diastolic blood pressures of patients
taking 100 mg of CoQ10 for 10 weeks fell significantly and remained
lower, even after stopping treatment (Curr Ther Res, 1990; 47: 841–5).
Try CoQ10 to deal with symptoms related to poor heart function,
stamina and immune response. Patients with cardiovascular diseases
such as angina, mitral valve prolapse and congestive heart failure all
require an increased tissue level of CoQ10 (Proc Natl Acad Sci USA,
1985; 82: 901–4; Drugs Exp Clin Res, 1984; 10: 487–502). Heart tissue
biopsies in patients with various heart disorders were shown to have a
CoQ10 deficiency in 50–75 per cent of cases (Int J Vitam Nutr Res, 1972;
42: 413), a finding that has been supported by studies of CoQ10 blood
levels (Am J Cardiol, 1990; 65: 521–3). It is believed that supplementing
with CoQ10 may help prevent heartbeat irregularities (J Exp Med,
1983; 141 [Suppl]: 453–63) as well as cell damage to the heart during a
heart attack (J Clin Pharmacol, 1990; 30: 596–608).
Patients suffering from Lyme disease (a bloodborne disease) need
around 200–300 mg daily of standard brands, or 90 mg daily of
pharmaceutical-quality brands, divided into two daily doses
(WDDTY, vol 12, no 3, p 4).
CoQ10 is also a free radical scavenger and acts as an antioxidant.
In patients with a depressed immune system, it may help to activate
macrophages, the body’s helpful scavenger cells. Its use in those with
HIV/AIDS remains controversial, but supplementation may prove
helpful as AIDS patients often have heart function failure similar to
that of those with CoQ10 deficiency (Proc Natl Acad Sci USA, 1991;
88: 1646–50).
It has also been shown that those with AIDS or AIDS-related
complex (but not patients with HIV) have significantly lower blood
levels of CoQ10, which may contribute to other problems. In one
small study, supplementing with 200 mg/day of CoQ10 produced
significant improvement in symptoms in five out of seven such

patients, with no opportunistic infections at follow-up four to seven
months later (Biochem Biophys Res Commun, 1988; 153: 888–96).
Patients with other immune function disorders, such as diabetes,
may also benefit from CoQ10 supplementation. Like heart patients,
diabetics also appear to be deficient in this nutrient (J Med, 1976; 7:
307), and several small studies have shown that CoQ10 helps to
stimulate insulin synthesis (Jpn J Clin Exp Med, 1981; 58: 1349–53; Diag
Treat, 1978; 66: 2327–32; J Vitaminol, 1966; 12: 293).
There have been reports that CoQ10 can help relieve symptoms
of muscular and neuromuscular degeneration. In a double-blind cross-
over study of 122 muscular dystrophy patients, half of those taking
CoQ10 found relief of a range of symptoms, including tiredness, and
were able to increase physical exertion. When the treatment groups
crossed over to the other treatment, three-quarters of those who had
previously taken placebo improved while only one patient who had
changed from CoQ10 to placebo had a relapse of symptoms. All other
patients improved cardiac function (Proc Natl Acad Sci USA, 1985; 82:
Finally, in a case report of a 65-year-old man with upper motor
neurone disease, 30 mg of CoQ10 three times a day for three weeks
resulted in a dramatic improvement in symptoms. Having been able to
walk for only one mile—with difficulty—before supplementation, he
was walking for eight miles with greater ease after supplementing
with CoQ10 (Int Clin Nutr Res, 1989; 9: 62–3).

Dietary sources
The best natural sources of CoQ10 are sardines and mackerel, pork,
spinach, soya oil, peanuts, sesame seed and walnuts. It can be syn-
thesised in the body, but is easily destroyed by the use of stimulants
and sugar. Its absorption is aided by the presence of B vitamins and

Supplement dosage
The therapeutic daily intake ranges from 10–90 mg/day, and you
should take at least 60 mg/day, with daily doses up to 100 mg being
well tolerated. Intakes of 100–200 mg/day have been studied with
no apparent adverse effects, but muscle damage was noted in at least
one study of 120 mg/day for 20 days.
It is more effective to take CoQ10 emulsified into an oil-based
supplement such as olive oil, as this aids its absorption.

CoQ10 has a good safety profile. Reported side-effects are rare, and
tend to present as various forms of epigastric distress (such as heart-
burn, nausea or stomachache), which can be prevented by taking the
supplement with a meal.

L -Dopa ( L -dihydroxyphenylalanine, or
works with vitamin B6)

Why it’s important

This amino acid forms the cornerstone of medical treatment for
Parkinson’s disease. Autopsy studies on the brain of patients with
Parkinson’s show that such patients have a massive deficiency of
dopamine (Fed Proc, 1973; 32: 183–90).
A precursor of dopamine, synthetic L-dopa is taken in an attempt to
restore the imbalance between dopamine and acetylcholine.
WDDTY panellist Dr Mervyn Werbach says that when you take L-
dopa, the mainstay of your nutritional programme should be a low-
protein diet. L-Dopa must compete with numerous other amino acids
to pass across the blood–brain barrier. Since the objective is to get as
much L-dopa to your brain as possible, you need to eliminate the
competition, which is fed to your body through ingested protein.
In one small study, patients on a high-protein diet were compared

with two groups of patients on low-protein diets, one of which ate
evenly distributed protein throughout the day while the other
consumed 90 per cent of the daily quota of protein solely during the
evening meal. Those consuming protein only in the evening exper-
ienced significant improvement in symptoms, including a lessening of
tapping and tremor (Neurology, 1989; 39: 552–6).
If you do start on a low-protein diet, it’s important that your doctor
monitors you, as your levels of L-dopa may have to be reduced.

Dietary sources
The legume Vicia faba—also called fava, faba, broad bean or horse
bean—contains L-dopa, the same chemical found in many levodopa-
containing medicines for treating Parkinson’s disease. The young pod
and its immature (green) beans contain the greatest amounts, while the
mature, or dried, bean has the least. Three ounces (about 84 g or a half-
cup) of fresh green fava beans, or 3 oz of canned green fava beans,
drained, may contain 50–100 mg of L-dopa.
Small studies have shown that the L-dopa in fava beans can help
control the symptoms of Parkinson’s as effectively as do medications
containing levodopa. Indeed, a few people report that the fava effects
last longer than the effects from drugs.

Supplement dosage
This is only given as a supplement for those who have Parkinson’s
disease. Most doctors have to walk a tightrope on dosage, providing
enough medication to rid the patient of symptoms while avoiding a
dose that is high enough to bring on adverse side-effects.

L -Dopa has a number of side-effects, including abnormal movements
of the extremities, face and trunk, short-term memory loss and confu-
sion, and nausea and vomiting.
Many nutrients also interact with levodopa and affect its perform-

ance. Vitamin B6, for example, is essential for L-dopa absorption
because an enzyme that converts L-dopa to dopamine depends on its
presence. Treatment with L-dopa can raise blood concentrations of
pyridoxal-5-phosphate, the precursor of vitamin B6, whereas L-dopa
plus a decarboxylase inhibitor may cause a vitamin B6 deficiency
(Clin Sci [Lond], 1979; 56: 89–93). Other nutrients affecting levodopa
include tyrosine, phenylalanine and high levels of dietary protein.


Why it’s important

L -Carnitine is one of the body’s ‘essential’ nutrients and releases
energy from fat. It also plays an important role protecting the heart.
One study shows that, after patients with diabetes and high blood
pressure were given 4 g of L-carnitine per day, irregular heartbeat and
abnormal heart functioning decreased significantly (Minerva Med,
1989; 80: 227–31).
Research also shows that if you take L-carnitine as part of your
exercise regime, you’re less likely to experience muscle soreness (Int
J Sports Med, 1996; 17: 320–4). L-Carnitine has also been given to
patients suffering from chronic lung disease: 2 g of L-carnitine taken
twice a day for two to four weeks led to positive changes in lung
function and metabolism during exercise (Int J Clin Pharmacol Ther
Toxicol, 1986; 24: 453–6).
Infants with beta-thalassaemia major, a severe form of haemolytic
anaemia that manifests in the newborn period, usually require blood
transfusions, which can eventually result in iron overload. L-Carnitine
stabilises red blood cells, and supplementation may decrease the need
for blood transfusions. In a preliminary study, children with beta-
thalassaemia major who took 100 mg of L-carnitine per 1 kg (2.2 lb) of
body weight per day for three months had a significantly decreased
need for blood transfusions (Acta Haematol, 1998; 100: 162–3).

Dietary sources
Dairy and red meat contain the greatest amounts of L-carnitine.
Therefore, people whose intake of meat and dairy products is limited
tend to have lower levels of L-carnitine.

Supplement dosage
500 mg/day.

None has been documented.


The body needs a certain amount of fat if it’s to grow and function
properly. However, the kind of fat the body needs for good health—
essential fatty acids (EFAs)—can’t be produced by the body itself. You
have to take them in via a healthy diet.

Omega-3 fatty acids

Fish oil and cod liver oil (EPA/DHA)

Why it’s important

Fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexa-
enoic acid), both omega-3 fatty acids. Unlike the omega-3 fatty acid
(alpha-linolenic acid) found in flaxseed and other vegetable oils, EPA
and DHA keep blood triglycerides in check (high levels of which are
generally linked with an increased risk of heart disease) and may stop
atherosclerosis from getting worse (Ann Intern Med, 1999; 130: 554–
62). EPA and DHA also prevent blood from clotting too quickly.
There is some evidence that omega-3 fatty acids from fish oil may
help regulate heart rate. EPA and DHA have been reported to help

prevent cardiac arrhythmias (J Nutr, 1997; 127: 383–93).
EPA and DHA also have an anti-inflammatory effect on the body.
Fish oil is therefore used to help people with various inflammatory
conditions, such as Crohn’s disease (Gastroenterology, 1991; 100: A228)
and rheumatoid arthritis (Arthritis Rheum, 1995; 38: 1107–14).
The anti-inflammatory effects of EPA and DHA may also account for
the findings of some reports showing that fish oil supplementation
may be helpful for kidney diseases (N Engl J Med, 1994; 331: 1194–9;
J Am Dietet Assoc, 1997; 97: 5150–3; J Am Soc Nephrol, 1999; 10:
1772–7) and may help protect against chronic obstructive pulmonary
disease (N Eng J Med, 1994; 331: 228–33).
The omega-3 fatty acids in fish oil help to balance the omega-6 fatty
acids, found mostly in vegetable oils. When these two groups of fatty
acids are out of balance, the body releases chemicals that trigger
inflammation. People appear to produce more of these inflammatory
chemicals when experiencing psychological stress (such as sitting
exams). With a fatty acid imbalance, the body’s inflammatory response
to stress seems to be a lot worse (Biol Psychiatry, 2000; 47: 910–20).
Probably as a result of their effect on prostaglandins responsible for
dilating the blood vessels, a double-blind trial found that omega-3
fatty acids from fish oil helped to treat people with Raynaud’s disease
(Am J Med, 1989; 86: 158–64).
Schizophrenia is linked with abnormalities in fatty acid metabolism,
and preliminary research suggests that fish oil supplementation may
help people with schizophrenia (Lipids, 1996; 31: S163–5).
At least four studies have reported a reduced blood level of omega-
3 fatty acids in people with depression (J Affect Disord, 1996; 38: 35–46;
J Affect Disord, 1998; 48: 149–55; Biol Psychiatry, 1998; 43: 315–9;
Psychiatr Res, 1999; 85: 275–91).
EPA and DHA also modulate immune function (Nutr, 1998; 14:
627–33), probably as a result of their effect on prostaglandin pro-
duction. Perhaps as another result of this prostaglandin effect, fish oil
has helped prevent some types of cancer in animals (Lipids, 1986; 21:

285; J Natl Cancer Inst, 1985; 75: 959–62; J Am Coll Nutr, 1995; 14: 325)
and humans (Nutr Cancer, 1995; 24: 151–60), although this evidence
remains preliminary.

Dietary sources
The UK government recommends two portions of oily fish (salmon,
mackerel, herring, sardines, albacore tuna, black cod or sablefish) a
week, which provides around 2–3 g of fatty acids—equal to three or
four 1000-mg fish-oil capsules. Organic grassfed animals, eggs from
grainfed chickens, and wild game are also useful sources.
Cod liver oil contains large amounts of EPA and DHA. Fish-oil
supplements typically contain 18 per cent EPA and 12 per cent DHA,
although more purified (higher in EPA and DHA) fish-oil supplements
are sometimes available. DHA is also available in a supplement that
does not contain significant amounts of EPA.

Supplement dosage
The usual dosage is 1000 mg/day of fish oil, containing 180 mg of EPA
and 120 mg of DHA. Nutrition expert Patrick Holford recommends
a supplement dosage of 500 mg/day plus 500 mg/day from the diet.
However, a weekly dosage of 1500 mg of EPA/DHA has also been

Elevations in blood sugar and cholesterol levels may occur in some
people who take fish oil (Diabetes, 1988; 37: 1567–73). The increase in
blood sugar appears to be related in part to the amount of fish oil used
(Ann Intern Med, 1995; 123: 911–8).
Evidence suggests that adding vitamin E to fish oil may prevent the
fish oil-induced increase in blood sugar (Nutr Res, 1995; 15: 953–68).
In other studies, the impaired sugar metabolism sometimes seen with
fish-oil supplementation was prevented by a half-hour of moderate
exercise three times a week (Diabetes Care, 1997; 20: 913–21).

While supplementation with fish oil consistently lowers triglycer-
ides, the effect of fish oil on LDL (‘bad’) cholesterol varies: in some
people, fish oil supplementation has been reported to increase LDL
levels (Am J Clin Nutr, 1987; 45: 858). Those who took fish oil as well
as 15 g of pectin every day were reported to have reductions in LDL
cholesterol (Am J Clin Nutr, 1997; 66: 1183–7). This suggests that pectin
may overcome the occasional problem of increased LDL cholesterol
reported in people who supplement with fish oil. The LDL cholesterol-
raising effect of EPA and DHA can be prevented by taking garlic and
chromium supplements (or presumably including garlic in the diet)
along with EPA and DHA (Am J Clin Nutr, 1997; 65: 445–50).

Omega-6 fatty acids

Evening primrose oil (GLA)

Why it’s important

Evening primrose oil (among others) contains gamma-linolenic acid
(GLA), a fatty acid that the body converts to a hormone-like substance
called prostaglandin E1 (PGE1). Prostaglandins, unlike most other
hormones, don’t come from just one organ, but are made in many parts
of the body. PGE1 has anti-inflammatory properties and may also act
as a blood-thinner and blood-vessel dilator.
Evening primrose oil’s anti-inflammatory actions have been studied
in double-blind studies with rheumatoid arthritis patients. Some, but
not all, have reported that supplementation provides such patients
with significant benefits (Ann Pharmacother, 1993; 27: 1475–7).
Other studies show that GLA, the primary active ingredient in
evening primrose oil, may help to fight cancer (S Afr Med J, 1982; 62:
505–9). Injecting GLA into tumours caused the cancer to regress (Pros-
tagl Leukotr Essent Fatty Acids, 1992; 45: 181–4). Other preliminary
evidence in people with cancer found “marked subjective improve-
ment” (Br J Clin Pract, 1987; 41: 907–15), although not all studies have

found GLA to be helpful (BMJ, 1987; 294: 1260).
Evening primrose oil has also been shown to lower cholesterol levels
(Atherosclerosis, 1989; 75: 95–104), and improve the skin itching,
redness and dryness associated with kidney dialysis (Nephron, 1999;
81: 151–9; Nephron, 2001; 83: 170–1). Premenstrual syndrome, diabetes,
scleroderma, Sjögren’s syndrome, tardive dyskinesia, and eczema and
other skin conditions can interfere with the body’s ability to make
GLA. In preliminary studies, evening primrose oil supplementation
has helped people with these conditions (Diabetes Care, 1993; 16: 8–15;
Med Hypoth, 1984; 14: 233–47; Br J Dermatol, 1987; 117: 11–9).

Dietary sources
Polyunsaturated fats are rich in omega-6. In addition to evening prim-
rose oil, other nutrients are needed by the body to make prostaglandin
E1. It has been suggested that magnesium, zinc, vitamin C, niacin and
vitamin B6 should be taken alongside it.

Supplement dosage
The suggested dosage is 50–100 mg/day as a supplement (including
50 mg/day from the diet) to as much as 700 mg/day.
As most people tend to consume more omega-6 than omega-3, the
suggested ratio between the two has been two units of omega-3 to one
of omega-6. However, according to recent research by Dr Udo Eras-
mus, the pendulum appears to have swung too far in the opposite
direction, with people developing omega-6 deficiencies. His recom-
mendation now, like that of the World Health Organization, is that
there should be a one-to-one ratio between the two fatty acids.

Evening primrose oil may make the symptoms of temporal lobe epi-
lepsy worse (and can sometimes be mistaken for schizophrenia) (Pros-
tagl Med, 1981; 6: 375–9; J Orthomolec Psychiatry, 1983; 12: 302–4).
High levels of omega-6 have been implicated in increased rates of

asthma. Toddlers who consumed large amounts of margarine and
foods fried in vegetable oil were found to be twice as likely to develop
asthma (Thorax, 2001; 56: 589–95).

Linseed/flaxseed oil

Why it’s important

Like most vegetable oils, flaxseed contains linoleic acid, the essential
fatty acid needed for survival. But, unlike most oils, it also contains
significant amounts of omega-3 as alpha-linolenic acid (ALA).
The body turns ALA into eicosapentaenoic acid (EPA)—an omega-
3 fatty acid found in fish oil—which, in turn, is converted into
beneficial prostaglandins. While fish oil has been shown to have anti-
inflammatory activity, such an effect of flaxseed oil has not yet been
demonstrated conclusively.
Some doctors argue that, because ALA can be converted to EPA and
DHA (the fatty acids found in fish oil), flaxseed oil should be useful for
the same conditions as fish oil. However, as the conversion of ALA to
EPA and DHA is limited, this theory may turn out to be incorrect.
While numerous studies have shown that fish oils are beneficial for
rheumatoid arthritis, flaxseed oil failed to work for this condition in
the only known trial of its use (Rheumatol Int, 1995; 14: 231–4). In 1994,
a diet purportedly high in ALA was successful in preventing heart
disease (Lancet, 1994; 343: 1454–9), but that study altered many dietary
factors so ALA may not have been solely responsible for the outcome
(Lancet, 1994; 344: 893–4).
However, flaxseed oil may help lower cholesterol (Am J Clin Nutr,
1991; 53: 1230–4) and research specific to flaxseed oil indicates that it
can also lower blood pressure (J Hum Hypertens, 1990; 4: 227–33).

Dietary sources
In addition to its presence in flaxseed oil, small amounts of ALA are
also found in soy and walnut oils. In general, it is easy—and pref-

Supplement dosage
erable—to obtain all your ALA needs from food sources.

Take no more than one tablespoon a day.

None is documented. However, there is conflicting information on the
effect of flaxseed oil and one of its major constituents, ALA, on the risk
of cancer. Most laboratory and animal studies suggest a possible
protective role for ALA against breast cancer (Breast Cancer Res Treat,
1995; 34: 199–212; Prostagl Leukotr Essent Fatty Acids, 1995; 53: 135–8;
Carcinogenesis, 1996; 17: 1373–6; J Nutr, 1990; 120: 1601–9; FASEB J,
1991; 5: 2160–6). But one study in animals and a preliminary study in
humans have suggested an increased breast cancer risk with high
dietary ALA intake (Lipids, 1986; 21: 285–8; Int J Cancer, 1998; 76:
491–4). Another preliminary clinical study reported that higher breast
tissue levels of ALA were associated with less advanced breast cancer
at the time of diagnosis (Br J Cancer, 1994; 70: 330–40).
As for prostate cancer, a test-tube study reported that ALA
promoted cancer cell growth (Anticancer Res, 1996; 16: 815–20), but
preliminary human studies have shown ALA to be associated with
either an increased or decreased risk (J Natl Cancer Inst, 1993; 85:
1571–9; Int J Cancer, 1997; 71: 545–51; J Natl Cancer Inst, 1994; 86:
281–6), or no change at all (Cancer, 1999; 86: 1019–27).
Advocates of flaxseed oil speculate that a potential association
between ALA and cancer may be due to the fact that meat contains
ALA, thus implicating ALA when the real culprits may have been
other components of meat. In some studies, however, saturated fat
(and therefore probably meat) were taken into consideration, and ALA
was still correlated with an increased cancer risk.
The association between ALA and cancer may eventually be shown
to be caused by substances found in foods rich in ALA rather than by
ALA itself. However, ALA has been reported to become mutagenic
(able to cause precancerous changes) when heated, a cause for concern

among some doctors (J Natl Cancer Inst, 1995; 87: 836–41).
The effects of ALA on its own and of flaxseed oil on the risk of
cancer in humans remain unclear, with most animal and test-tube
studies suggesting protection, and some preliminary human trials
suggesting otherwise. Given the findings so far, it is still too early to
suggest that ALA and flaxseed oil will either cause or protect against
human cancer.

Conjugated linoleic acid (CLA)

Why it’s important

Conjugated linoleic acid (CLA) is a slightly altered form of linoleic
acid. Preliminary animal and test-tube research suggest that CLA
might reduce the risk of several types of cancer—breast, prostate,
colorectal, lung, skin and stomach (Anticancer Res, 1998; 18: 1429–34;
Cancer Res, 1997; 57: 5067–72; Am J Clin Nutr, 1997; 66 [Suppl]:
1523S–9S; J Nutr, 1997; 127: 1055–60). Whether CLA will have a similar
protective effect in humans has yet to be demonstrated, although
current unpublished work in humans shows an improved immune
Taking linoleic acid and calcium supplements during the third term
of pregnancy seems to significantly reduce the risk of preeclampsia in
women at high risk for this complication.
Researchers found that daily doses of 450 mg of linoleic acid and
600 mg of calcium raised prostaglandin E2 levels. Only 9.3 per cent of
women taking the supplements developed preeclampsia compared
with 37.2 per cent of the control group. Moreover, these women also
delivered babies who weighed, on average, 124 g more than those born
to women on placebo treatment (Obstet Gynecol, 1998; 91: 585–90).
Animal research also suggests that CLA supplementation can reduce
body fat (Am J Physiol, 1998; 275: R667–72; Lipids, 1997; 32: 853–8) and
limit food-allergy reactions (Lipids, 1998; 33: 521–7). It may also
prevent atherosclerosis (Artery, 1997; 22: 266–77; Atherosclerosis, 1994;

108: 19–25) and improve glucose tolerance (Biochem Biophys Res
Commun, 1998; 244: 678–82). As with the cancer research, however, the
effects of CLA on these conditions in humans remains unclear.
CLA is seen as an immune system regulator, and may be useful for
chronic conditions such as multiple sclerosis, ME/CFS (myalgic
encephalomyelitis/chronic fatigue syndrome), hayfever and arthritis.

Dietary sources
CLA is found mainly in dairy products, and also in beef and poultry,
eggs and corn oil. Bacteria that live in the body’s intestines can
produce CLA from linoleic acid, but supplementation with the free
fatty acid form of linoleic acid did not increase blood levels of CLA
in one human study (Am J Clin Nutr, 1998; 67: 332–7).

Supplement dosage
A suggested maintenance daily dose is 1000 mg/day, although dosages
as high as 2–3 g/day have been used in the current research.

The side-effects of CLA are unknown because of the limited research
in humans. However, the free fatty acid variety has proved irritating to
the digestive system, particularly among people with digestive system
disorders. The glyceride variety is often better tolerated.

Part 4
V itamin and mineral suppliers come in all shapes and sizes. In
this industry, you get what you pay for. The cheaper deal is
certainly not always the best.
Ideally, you should buy products from suppliers who carry out
recognised quality-control tests on their products, and have evidence
of these tests as certificates from independent labs. The companies that
can’t deliver such information are the ones to avoid. The better-known
and respected suppliers are likely to be up-front about these data as
they’ll have spent good money in the process of getting it, and will
want to use such information as part of their marketing programmes.
Reputable homoeopathic chemists and other good outlets also vet
their suppliers. After all, their reputation depends on them stocking
well-tested products, the claims for which have been validated.
Wholesalers distribute large numbers of varied brands to Boots
and other pharmacy chains as well as to supermarkets. It goes without
saying that they will check their suppliers thoroughly by a process of
due diligence on any products they may sell to make sure that they’re
safe—they’ll have done their homework.
Good Manufacturing Practice (GMP) or ISO2001 accreditation is
expected everywhere these days. But, apart from normal manufac-
turing standards of quality, supplements are classed as foods, which
means they are not required to be produced at medicinal manu-
facturing sites and, therefore, not subject to the UK Department of
Health’s Medicines Control Agency inspections. However, some of
these sites may be dual-purpose manufacturing sites and, as such, they
will be inspected by environmental health inspectors.
Most of the big suppliers offer a wide range of products. Solgar, for
example, lists around 460 products in its catalogue. Lamberts also

offers a large product selection. However, chains like Boots will stock
the popular brands, but won’t sell any specialised products. They’ll
have vitamin C, but not olive leaf extract (similar to Echinacea), which
a specialised pharmacist is likely to supply. Recently, Boots has
decided to forego certain alternative products, considering them to be
not commercially worth their while.
A new idea is a ‘partnership’ arrangement between suppliers and
outlets, like the team-up between The Nutri Centre, a specialised
supplier of vitamin and supplement products, and Tesco.

BioCare Limited
Lakeside, 180 Lifford Lane, Kings Norton, Birmingham B30 3NU
Tel: 0121 433 3727

The company and what it sells

Birmingham-based BioCare is a privately owned and financially
independent British company. It has a quality reputation for product
development and manufacturing. The company’s product range
embraces everything from vitamins to probiotics, and from herbal
extracts to nutriceutical combinations. In so doing, it caters for the
needs of vegetarians, vegans and those wishing to avoid animal-
based products.
The company, which is ISO2000 and ISO2001 accredited, also carries
out full-time research in collaboration with various universities as well
as a programme of product-information seminars for practitioners.

Ethos and production

BioCare manufacturing uses the company’s patented DriCelle system
to microencapsulate and water-solubilise nutritional oils and fatty
acids in the form of a dry powder. Encapsulation is preferred because
it allows a minimal use of excipients. Its Natrafill process fills the
capsules with only the active ingredient. A large freeze-drying plant

complements its full-capsule filling facilities so that natural products
can be processed without the need for chemicals or other additives.
Microbiologists carry out quality-control checks on every product
batch in the company’s analytical laboratory. It also claims to be the
only company to vacuum-pack supplements to protect them against
oxidative damage.
Although not cheap, BioCare’s quality and attention to detail ensure
an absolutely top-notch range of products.

Bioforce (UK) Limited

2 Brewster Place, Irvine KA11 5DD, Scotland
Tel: 01294 277 344

The company and what it sells

Founded in 1963 by Swiss naturopath and herbalist Dr Alfred Vogel,
the Roggwil, Switzerland-based company claims to be “Europe’s lead-
er in herbal medicine”. Echinaforce (made from Echinacea purpurea) is
their main product, although Bioforce has a range of herbal remedies,
food products and supplements as well as bodycare products.
The UK company was established in 1987, and distributes in the UK
and Ireland. Based in Irvine, Scotland, it also operates a very active
clinical research department—claimed to be the first of its kind in the
UK—which carries out trials and runs an ‘information exchange’ for
healthcare professionals.

Ethos and production

Vogel created natural remedies for his patients from herbs organically
grown in his garden. Even then, he refused to test his products on
animals. So, organically grown from genetically pure seeds, whole
herbs (such as Echinacea, Ginkgo, and Hypericum) are processed in
alcohol while still fresh. The company is also proud of the way it uses
modern manufacturing techniques to produce to quality standards.

There’s no doubt that these are high-standard products. But
PROOF! was somewhat disappointed by the low dosage of its leading
Echinacea product Echinaforce.

Higher Nature
The Nutrition Centre, Burwash Common East Sussex TN19 7LX
Tel: 01435 882 880

The company and what it sells

Higher Nature was founded in 1994 by the current joint managing
directors, Brian and Celia Wright, who’d been running their own nutri-
tion company since 1979. Higher Nature started with nine employees,
all of whom became shareholders and contributed a great deal to the
setting up of the business. The company now employs 80 people and
sells 116 supplement, healthcare and beauty products, including a
range from nutritionist Patrick Holford.

Ethos and production

The company insists that all of its manufacturers work to GMP (Good
Manufacturing Practice). Further quality assurance is conducted by
Surrey University’s department of chemistry. The herbs and plants
used are organic where possible, and freshly dried and powdered. In
some cases, it uses standardised extracts which guarantee potency.
It also uses materials which are bioidentical, or in a form which the
body recognises as part of its own chemistry. The company avoids
genetically modified sources and other synthetic processes.
Higher Nature is known for embracing the latest innovative
products and for attempting to produce an affordable range. Just
occasionally, however, PROOF! has found that the lower potency of
some products means the value for money isn’t always as high as it

Holland & Barrett
Tel: 0870 606 6606

The company and what it sells

Holland & Barrett is the UK’s leading retailer of vitamins, minerals
and herbal supplements—there are more than 1000 products in its
portfolio. Its stores are a familiar sight in almost every major city and
town across the UK.
The healthfood retailer’s origins date back to the 1920s. Samuel
Ryder, of golf-trophy fame, ran a market garden based in St Albans
with his brother James that specialised in herbs. The business soon
diversified into a mail-order company under the name of Heath &
Heather Limited. The Ryder brothers expanded to open a chain of
herbalists and introduced a range of healthfoods. By 1946, Heath &
Heather had 46 shops and supplied other healthfood retailers and
chemists as well.
In 1968, the company was sold to the Byfleet, Surrey-based
Associated Health Foods. At that time, additional vitamin supple-
ments and other healthfood lines were included in the product mix.
Associated Health Foods was then sold to Booker McConnell in
1970. The health stores under its wing were renamed Holland & Bar-
rett in 1971, the name coming from a small grocery chain that Booker
owned, which had ceased trading some years before.
A period of steady growth followed under Booker’s ownership
until, when Lloyds Chemist plc acquired the company in May 1991,
there were 181 company-owned stores and seven franchises. Lloyds
immediately began an aggressive expansion programme, with new
stores opening in major cities and towns up and down the country—
from Penzance to Aberdeen.
In February 1997, Holland & Barrett was bought out by GEHE as
part of its purchase of Lloyds Chemists plc. Not wishing to diversify
from its pharmaceutical base, GEHE decided to sell Holland & Barrett
to American food-supplement manufacturer NBTY in August 1997.

This transatlantic alliance has allowed Holland & Barrett to continue
to expand and, today, there is a network of stores across the UK,
including the first Holland & Barrett stores in Northern Ireland that
started opening in October 2000.
In June 2001, Holland & Barrett acquired Naturesway, a chain of
12 healthfood stores with a mail-order and Internet business, based in
the Republic of Ireland. This will serve as a base from which to expand
Holland & Barrett’s presence in Ireland through further development
of green-field sites and other business acquisitions.

Ethos and production

Holland & Barrett’s products are produced by NBTY in accordance
with strict GMP guidelines (it uses the CRN and HFMA guidelines as
a model). The company has greatly improved its range of own-label
products, and can now offer them direct from the factory at what it
claims are the lowest possible prices. Summer 2000 saw the opening
of a brand-new purpose-built warehouse and distribution centre in
Burton-upon-Trent, which the company also hopes to expand.
Holland & Barrett has a mail-order division that operates out of the
new Burton-upon-Trent centre, as well as a website and a consumer
information telephone line. Again, the emphasis is on affordability.

Lamberts Healthcare
1 Lamberts Road, Tunbridge Wells, Kent TN2 3EQ
Tel: 01892 552 121

The company and what it sells

Established in 1982, the Lamberts’ manufacturing business was
acquired by the Peter Black group in 1997, then a publicly owned
company, which later acquired Ferrosan UK and became private again
in February 2001 under the chairmanship of the Black family.
Peter Black Healthcare produces a full range of vitamins, minerals,

supplements and herbal remedies. The company’s brand names
include Healthcrafts, Red Kooga, Natracalm, Natrasleep and Gerard
House, which are distributed to supermarkets, chemists and health-
food stores. The group also supplies vitamins, minerals and supple-
ments to Superdrug, Tesco, Sainsbury’s and Safeway.
Lamberts Healthcare is essentially a no-frills supplier which
distributes a range of 120 quality products—including vitamins, min-
erals, herbs, multiple formulas and digestive aids, as well as more
specialised products such as glucosamine and coenzyme Q10.
Its technical department provides a variety of the usual support
material for health professionals and operates a special telephone
advice service.

Ethos and production

The only information the company has given us concerning its
manufacturing processes is that its factory is one of the most modern
and technically advanced in Europe, and operates to “stringent phar-
maceutical standards of good manufacturing practice” and is
approved by the Medicines Control Agency. Lamberts says it will only
develop those products which are supported by a “valid scientific
The products themselves offer a quality high-potency range for
customers who require a comprehensive supplements programme.

Nature’s Answer
75 Commerce Drive, Hauppage New York 11788, USA
Fax: 001 631 951 2499

The company and what it sells

One of America’s largest and oldest manufacturers of liquid herbal
extracts (since 1972, and now celebrating 30 years in the business) and
alcohol-free extracts (which it feels it pioneered), this family-owned

and -operated company makes an extensive range of herbal remedies,
vitamins and minerals.
It’s a remarkable garage-to-riches story. Founder and now CEO
Frank D’Amelio was managing a construction business while study-
ing natural healing, botany and chemistry. His wife Josephine played
the role of business partner. Both worked out of a garage-sized
manufacturing plant, filling bottles and applying labels by hand. By
1980, they’d opened an 18,000 sq ft facility in Hauppage, New York,
which has now grown into a 140,000 sq ft state-of-the-art plant with
an in-house research and development lab, quality-control depart-
ment, advanced manufacturing facility and modern warehousing
The company is now run by Frank’s son, Frank Jr, and the product
line has expanded from liquid herbal extracts to include a compre-
hensive line of herbal and vitamin capsules, children’s formulas,
homoeopathic creams and, most recently, dental health products.

Ethos and production

Nature’s Answer owns and operates one of North America’s most
extensive pharmaceutically licensed, high-quality herbal-manufac-
turing and quality-controlled plants, and houses one of the largest
herbariums in the US.
The company adheres to good manufacturing standards. Products
are continually compared with previous batches for colour, taste,
consistency and chemical properties to ensure that they all meet the
same consistent quality and label claims (including monitoring of
volume and weight). Samples are also drawn every 15 minutes and
tested for microbiological contamination. These samples are then
kept for five years.
Nature’s Answer also says its formulations are free of synthetic
ingredients and are unconditionally guaranteed.

The Nutri Centre / The Nutri Centre @
The Hale Clinic, 7 Park Crescent, London
Tel: 0800 912 1163

The company and what it sells

The original Nutri Centre is in London’s West End and was founded in
1991 by pharmacist Rohit Mehta, who opened The Hale Clinic (of
which The Nutri Centre is part) in 1988. Mehta also founded—and is
still an extremely active patron of—The Foundation for Integrated
Medicine, which brings together the leaders of the medical royal
colleges and research bodies, and those practising complementary
medicine to exchange information and challenge each other’s practice.
Mehta has also been at the forefront of efforts to bring comple-
mentary medicine and natural health products into the mainstream
since he founded the London-based retail chain of pharmacies and
health stores, trading under the ‘Sloane’ name in the 1980s.
The Nutri Centre was the UK’s first Natural Medicines Dispensary,
integrating a hitherto fragmented supply network of specialised
professional products and expanding to source products from all over
the world. It currently has a stocklist of 22,414 products—what it
claims is the largest inventory of nutritional supplements worldwide.
It also has a strong focus on its customers, actively encouraging them
to seek advice from its many pharmacists and nutritionists. It also
provides information and telephone advice to those unable to come in
person to the Centre.
The Natural Medicines Dispensary at the Centre operates a national
and international mail-order service, with over 90 per cent of orders
dispatched within 24 hours.
The Nutri Centre also has a partnership with the University of
Westminster, and receives Department of Trade and Industry funding
towards the development of an Adverse Reaction Reporting System in
Complementary Therapies.

Ethos and production
On 7 August 2001, Tesco bought a controlling share in The Nutri
Centre. This now forms the basis of a new concept—The Nutri Centre
@ Tesco, where a full range of natural health products is available to
Tesco shoppers, initially in 50 stores and now available in 200.
Currently, there is a range of 100 products at The Nutri Centre @ Tesco,
while others can be obtained by its customers via The Nutri Centre’s
website. A free catalogue and factsheets, covering many common
health problems or concerns, are also available.
There is also a dedicated helpline, with trained staff to provide
professional advice on key aspects of natural health. Tesco produces
its own Natural Health Guide booklet, which covers complementary
therapies and remedies, aromatherapy, herbal medicine, homoeopathy,
and vitamin, mineral, antioxidant and nutritional supplements.

Ortis Laboratories
Hinter der Heck 46, 4750 Elsenborn, Belgium
Tel: +32 80 44 00 55
UK importer and distributor: Cedar Health Limited
Pepper Road, Bramhall Moor Lane, Hazel Grove, Cheshire SK7 5BW
Tel: 0161 483 1235

The company and what it sells

Ortis is based in the Hautes-Fagnes, an environmentally protected
region of Belgium. Ortis’ founder Adolphe Horn (who died in 1982)
began his working life as a baker. But after World War II, he changed
career to become a timber merchant. In 1958, he was forced to leave
the wood business, which enabled him to pursue his long and deeply
held interest in natural healthfoods. With his wife Irene’s help, it took
him only a few months to create his first product, based on royal
jelly—Api Regis.

They used the family farm’s dairy as a workshop, and their first
deliveries to customers were made by public transport to a limited
clientèle of some 15 chemists and healthfood shops scattered across
the length and breadth of Belgium. Nevertheless, by 1964, Ortis had
expanded to supply markets in France and the UK and, now, 75 per
cent of the 75 food supplements manufactured in the company’s plant
in Elsenborn are sold in 35 countries. Irene died in 1999, and Adolphe
and Irene’s two sons, Michel and Philippe, and Michel’s wife Solange,
now run the company.

Ethos and production

The company is proud of its ‘green’ credentials as well as its humble
beginnings. The company says it successfully combines intimacy and
family feeling with the managerial efficiency needed to run a modern
enterprise. It also insists it conforms to GMP, and every legal require-
ment concerning the quality and purity of food products (HACCP).
The company encourages tours of its manufacturing plant and, at
the end of June 2001, it opened the gates to a new medicinal herb
garden. Here, the medicinal herbs and plants are laid out thematically.
Ortis’ video also provides a basic introduction to the company and
the herbs it sells for those who don’t know much about them.

Quest Vitamins Limited

8 Venture Way, Aston Science Park, Birmingham B7 4AP
Tel: 0121 359 0056

The company and what it sells

The three directors involved with the business when it started in 1983
are still there—namely, Dr Hassam, Naushad Mehrali and Eamonn
Regan. Quest sells an extensive range of vitamins, minerals and herbal
supplements—in all, 85 formulas plus a homoeopathic range of
products—to specialist healthfood stores.

Ethos and production
Its ethos is simple: to produce the finest quality nutritional supple-
ments, backed by research. Manufacturing is carried out at Quest’s
own facility in Birmingham’s Aston Science Park. It is licensed by the
UK Department of Health’s Medicines Control Agency, has ISO9002
quality accreditation and is an Investor in People company.
Quest says it has developed new manufacturing and laboratory
methods to produce products that are free of hydrogenated fats (com-
monly used in supplement manufacture as lubricants and time-release
agents) and genetically modified derivatives, and guarantee product
purity and stability. Quest claims it’s the first company to analyse and
guarantee the potency of the active ingredients used in herbal tablets.
The company also organises training programmes for stockists,
including the QPAA (Quest Product Adviser Award), and for the
public through its questhealthlibrary website.
The company says most of its products are free from artificial
preservatives, colours and flavours, added starch, sucrose, lactose or
yeast. The products also don’t contain wheat and are therefore gluten-
free. Wherever possible, the company uses ingredients that are not
derived from animals, making the majority of its range suitable for
vegetarians and vegans.
Where appropriate, Quest adds what it believes to be complemen-
tary nutrients to its products to enhance the formulation and recreate
the balance found in nature (for example, bioflavonoids are added to
vitamin C, vitamins B and C are found with iron, and copper has
added zinc).
Quest’s product range is often in the middle-potency range, with an
emphasis on affordability.

Solgar Vitamin and Herb

Aldbury, Tring, Herts HP23 5PT

The company and what it sells
Tel: 01442 890355

Founded in 1947, the US vitamin giant is one of the few supplement

companies to actually conduct its own research, manufacturing and
distribution. From ingredients to manufacturing to packaging, the
company is known for its excellence. It’s owned by Wyeth Consumer
Healthcare, a division of Wyeth. Solgar’s headquarters and major
manufacturing facility is in Leonia, New Jersey. It sells an extensive
range of vitamins, minerals, herbs and other supplements—468 of
them, including non-GMO (genetically modified organisms), kosher,
organic and vegetarian products as well as those available in varied
dosages and absorbable forms.
The company also invented Vegicaps, a two-piece capsule made
from all-vegetarian sources.
It created its own independent research lab in 1978—the Solgar
Nutritional Research Center (SNRC)—under Richard Passwater. The
SNRC brought vitamin E research on heart disease to the attention
of the scientific community and, in 1992, two studies by Harvard
researchers supported Passwater’s findings (published in 1976).

Ethos and production

The company’s products go through extensive quality-control tests.
Solgar maintains that its Formula VM-75 multivitamin, for example,
must pass 100 tests before approval for sale. The company also claims
that most of its offerings shouldn’t cause allergic reactions as the
majority are free of corn, yeast, wheat, soy and dairy products, and no
preservatives, artificial flavours or colours are used.
For purity, Solgar says it prepares its products in isolated rooms. It’s
also proud of its packaging. The company uses recyclable amber-
coloured glass bottles to maintain the potency of its nutrients. It does
not use plastic bottles or Styrofoam cushioning, so its packaging is
better for the environment.
Solgar is one of the few companies to control its own network of

distribution centres in five locations around the world, and so can
guarantee prompt delivery to retailers—usually 48 hours. Solgar
consistently scores high on value for money in PROOF! road tests.

Viridian Nutrition Limited

31 Alvis Way, Daventry, Northants NN11 5PG
Tel: 01327 878050

The company and what it sells

This friendly, Daventry-based company was founded by John Steen-
son (formerly Solgar’s UK sales director) and his partner Cheryl
Thallon (a former editor of Natural Food Trader and Solgar’s marketing
director), and is a four-year-old family business that operates its own
manufacturing facility on pharmaceutically licensed premises in North
The company produces a 60-product range of vitamins, minerals,
amino acids and nutritional oils (including eight, certified by the Soil
Association as being 100-per-cent organic), and runs an active
technical support department for independent retailers. The company
says it now supplies to the UK, Ireland, Iceland and South Africa.

Ethos and production

Viridian is the colour that can be seen surrounding the Earth from
outer space, so it probably comes as no surprise that the company has
gained a reputation for being ethical, with a strong commitment to
minimising its impact on the environment. It operates a ‘green’ recycl-
ing programme (you get 25 p back on the empty bottle), and each year
gives away 50 per cent of its available profit to charity. It donated
£15,000 to a selection of environmental, children’s and other charities
in 2001. Since 1999, it has donated around £30,000. Viridian is also
vehemently opposed to animal testing of food supplement products
and their ingredients, and will not use suppliers who do.
The company says that the raw materials it uses are the best avail-

able and organic, where possible, to avoid the use of chemical sprays
and artificial fertilisers. The company uses a naturally beneficial blend
of spirulina, bilberry and alfalfa as the base for its capsules.
As with BioCare and Solgar, Viridian is wedded to high potency and
its products often represent good value.