HSR'S ANNUAL GUIDE TO VITAMINS

HSR'S ANNUAL GUIDE TO VITAMINS

Making its third appearance, HSR's Annual Guide to Vitamins is chock full of valuable information that can help you, the retailer, educate your customers on the benefits, research and safety of some of the most popular vitamins. Each article is designed to be photocopied for easy distribution to your customers. You have our permission to do so.

This year, we have added another vitamin to the guide, which now includes the following articles:

Vitamin A
B Vitamins
Vitamin C
Vitamin E
Vitamin K

Next Month

Be sure to check out the third edition of HSR's Annual Guide to Herbs with consumer-targeted articles on the most popular herbs including kava, garlic, hawthorn, and more. This second wave of supplement education articles can be a very useful educational tool for retailers.

Vitamin A

Vitamin A, the first vitamin to be officially identified, is necessary for good vision, keeping epithelial tissues healthy, developing cells into specialized forms for reproduction and growth, and protecting the immune system. It is available in two forms, retinol, a preformed Vitamin A, and provitamin A, which are carotene pigments.

Without the proper balance of vitamin A in the body, many problems can occur. Eye disease is the foremost consequence of a vitamin A deficiency. Xerophthalmia, a condition in which eyes become dry, ulcers develop on the cornea and the eyelids become dry and sticky, can lead to blindness. The leading cause of blindness in developing countries is a vitamin A deficiency, the most prevalent symptom of which is night blindness. The three groups most affected by this deficiency are the elderly, teenagers and alcoholics. Alcoholics' lack of vitamin A produces a variety of symptoms, including night blindness, skin problems, cirrhosis of the liver and susceptibility to infection. In the general population, lack of vitamin A can cause growth retardation, defective teeth and gum formation, a weakened immune system and fatigue. This deficiency can also lead to lower levels of active thyroid hormone, difficulty with weight loss, lower body temperature, depression and headaches.

Vitamin A is fat-soluble and is stored for long periods of time in the liver. Because of this, there is a potential for toxicity. It is very unlikely that a person would take in toxic levels through diet alone, but supplements do pose a risk. Vitamin A toxicity symptoms include headache, chapped lips, dry skin, fatigue, emotional instability, and bone and joint pain. More severe symptoms include hair loss, vertigo, vision problems, poor appetite, loss of weight, vomiting, liver damage and amenorrhea. Also, pregnant women with too much vitamin A in their system run the risk of birth defects in the fetus. Vitamin A acne cream used during pregnancy may also contribute to birth deformities.

Supplemental vitamin A is mostly used in the treatment and prevention of vitamin deficiency. It is also widely known for its use in helping with vision problems. Additionally, it is frequently used in developing countries to prevent or treat measles and other viral infections, as well as vision infirmities. Drops can be used in the treatment of blurred vision, cataracts, glaucoma, conjunctivitis and dry eyes. Vitamin A has also been used in the treatment of asthma, sebaceous cysts, fibrocystic breast disease and premenstrual syndrome.

Good food sources of vitamin A include fish and liver oils, egg yolks and all milk products. Supplemental vitamin A is often made from cod liver oil, synthetic vitamin A palmitate and vitamin A acetate. Preformed vitamin A, often retinal or retinol, are from food or animals origins. Provitamin A is the name of about 50 compounds in a group of plant pigments called carotenes. Provitamin A is converted to vitamin A in the body as it is needed. Cooking does not damage the vitamin A content in food. Recommended Dietary Intake (RDI) for vitamin A for adult men is 1,000 mcg and for women is 800 mcg.

For vitamin A to be successfully absorbed into the body, fat and bile must be present in the intestines where it joins with fatty acids and other substances before being transported to the liver. Beta carotene is absorbed into the walls of the intestinal lining where it is converted into vitamin A as the body needs it. It is available as a supplement, generally in pill form, as eye drops and as a topical skin cream to help treat acne.

Beta carotene is not a vitamin, as is often assumed, but it works with Vitamin A. Enzymes in the body convert beta carotene into vitamin A. Beta carotene also serves as an antioxidant, protecting the body against free radicals and other harmful substances within the body that can damage cells and tissues. It also has been shown to reduce the risk of cardiovascular disease and multiple forms of cancer.

Beta carotene is an orange-colored pigment found in vegetables and fruit, particularly dark leafy vegetables, broccoli, carrots, squash, pumpkins, sweet potatoes, cantaloupe, apricots and pink grapefruit. Cooking does not diminish beta carotene in foods. Supplements are available from algae and palm oil. Beta carotene can also be stored in the liver, lungs, kidneys, skin and fat, but is nontoxic. Because beta carotene is not classified as an actual vitamin, it has no official RDI and it not recognized as an essential nutrient, though approximately 3,000-4,500 mcg are suggested.

More information has become available and many studies have been conducted focusing on the effects of vitamin A and Beta carotene:

• Vitamin A is often added to lowfat milk because it is removed in the process of lowering fat content.
• Vitamin A necessity may increase in instances of trauma, fatigue, anxiety, stress, smoking and alcohol use.
• Population studies suggest links between low vitamin A levels and various types of cancer, particularly in the lungs, head and neck and it may also increase the risk of breast cancer. ¹
• In 1997, a study done in Spain suggested that low levels of vitamin A may contribute to heart disease. Vitamin A levels were 25 percent lower in cases of people with heart disease than in case of people with no heart disease.²
• Low levels of vitamin A have also been found in rheumatoid arthritis and systemic lupus erythematosus sufferers.
• A study in 1995 by the Boston University School of Medicine researched vitamin A consumption in pregnant women, through food and supplements. Women that consumed more than 4500 mcg before the seventh week of pregnancy were more than three times as likely to have a baby with birth defects as opposed to women that only consumed 1500 mcg.³
• Vitamin A metabolism may be altered in cases of diabetics.

References: 1 Zhang, S., et al. "Measurement of retinoid and carotenoids in breast adipose tissue and a comparison of concentrations in breast cancer cases and control subjects." American Journal of Clinical Nutrition 66:3, 626-32 (1997). 2 Ruiz, R., et al. "Plasma levels of vitamins A and E and the risk of acute myocardial infarction." Rv Cln Esp 197:6, 411-6 (1997). 3 Rothman, K., et al. "Terogenicity of high vitamin A intake." New England Journal of Medicine 333:21, 1369-73(1995).

Vitamin B

Although the water-soluble B vitamins each have their own unique, individual properties, they possess similar coenzyme functions and are commonly found together in foods. They are very important for the normal functioning of the nervous system and are often helpful in bringing relaxation or energy to individuals who are stressed or fatigued. Additionally, B vitamins help provide energy by acting with enzymes to convert carbohydrates to glucose and also are important in fat and protein/ amino acid metabolism. These nutrients also influence the health of skin, hair, eyes and liver.

However, because the B vitamins are not easily digested and absorbed, deficiencies of one or more B vitamin is not uncommon, particularly during times of fasting or dieting. Because of these deficiencies and no known toxicity associated with their use, modest excesses should not be cause for concern. When the amount of B vitamins taken exceeds the body's needs, the excess is easily excreted in the urine.

Vitamin B1

Vitamin B1, also known as thiamin, was the first of the B vitamins to be discovered and is essential for nearly every cellular reaction in the body. This is due to its involvement in energy production and carbohydrates.

Thiamin is important in the health of the nervous system because of its role in the synthesis of the neurotransmitter acetylocholine. This vitamin also helps prevent the accumulation of fatty deposits in arteries which helps prevent the progression of atherosclerosis.

Thiamin-rich foods include organ meats, dried beans, peas, soybeans, peanuts, poultry, egg yolks and fish. Other sources include plums, raisins, asparagus, broccoli and oatmeal. Cooking destroys some thiamin in food, as does exposure to ultra-violet light, sulfates, nitrites and live yeast.

Thiamin deficiency is rare in developed countries, because most flours and cereal are fortified with the vitamin. However, there is a risk of deficiency for young children, teenagers, stressed adults, heavy exercisers, alcoholics and pregnant women. The most common deficiency is called beriberi and it affects the gastrointestinal, cardiovascular and peripheral nervous systems. Symptoms include loss of stamina, depression, irritability, reduced ability to concentrate, fatigue, muscle cramps, indigestion, constipation, insomnia, heaviness in the legs and various other pains.

The Recommended Daily Intake (RDI) for thiamin is 1.5 mg for men and women and 1.7 mg for pregnant and lactating women, though the amounts vary depending on desired effect.

Vitamin B2

Vitamin B2, also known as riboflavin, was the second B vitamin to be discovered. In its pure form, it is a yellow-orange, water-soluble compound. Riboflavin is part of two enzymes essential for tissue respiration and the generation of energy from the metabolism of carbohydrates, amino acids and fats. This vitamin is vital for the normal reproduction, growth, repair and development of body tissues including skin, hair, nails, connective tissue and the immune system. There has been recent research that shows vitamin B2 may be helpful in reducing migraines.

A B2 deficiency, though severe deficiency is rare in developed countries, is possible because of antibiotic use, oral contraceptives and alcohol, all of which deplete or interfere with absorption and use of riboflavin. Symptoms of severe riboflavin deficiency include depression, loss of appetite, decreased sensitivity to touch, as well as red, swollen lips, mouth and tongue. This deficiency can lead to vitamin B2 anemia, thought to occur because red blood cell production is inhibited or because it causes cells to die too early.

Foods with high levels of riboflavin include organ meats, milk, yeast, cheese, oily fish, eggs and dark, green, leafy vegetables, as well as nuts, broccoli, currants and avocados. Riboflavin levels remain stable when food is cooked, but is destroyed by light, therefore making supplements the easiest way to obtain the proper amount of riboflavin into a diet.

The RDI for vitamin B2 is 1.7 mg per day for men and women and 2 mg per day for pregnant and lactating women.

Vitamin B3

Vitamin B3 is also known as niacin. In its pure form, it is a white powder, water-soluble and is more resistant to damage than the other B vitamins. This vitamin is one of the better known ways to help treat high cholesterol, and has other cardiovascular functions. Niacin can be used in treating anxiety, circulatory problems and emotional or physical stress.

Deficiency is rare, but one of the first signs of niacin deficiency is pellagra. The skin becomes sensitive to light, then becomes dark, rough, thick and dry. Other symptoms include weakness and fatigue, anorexia, indigestion and skin eruptions. Deficiency of niacin can be caused by alcoholism, severely malnourished people, as well as people with cancer, protein, deficiencies and women taking oral contraceptives. The RDI for niacin is 20 mg per day for men and women.

Vitamin B3 is found in beef, pork, fish, milk, cheese, whole wheat, potatoes, corn and carrots. Because only small amounts of vitamin B3 in foods is pure niacin it is best to steam, bake or stir-fry vegetables to save as much of the vitamin as possible.

Vitamin B5

Vitamin B5, also known as pantothenic acid (PA), is important for the release of energy from food, growth, reproduction and normal physiological functions. PA assists in the manufacturing of coenzyme A, which plays a crucial role in the breakdown of fats and carbohydrates, it is also necessary for building cell membranes and the production of some neurotransmitters essential for normal nervous system function. PA also aids in antibody synthesis and is involved in wound healing.

A pantothenic acid deficiency has not been found naturally in human beings, but has been induced experimentally. This deficiency causes adrenal glands to shrink, causing fatigue, headache, nausea, abdominal cramps, depression, sleep problems and personality changes. More severe symptoms include numbness, tingling of hands and feet, muscle cramps, impaired coordination, immune problems, dermatitis and itching. Toxicity is rare and the only reported overdosing symptom is diarrhea.

The RDI is 5 mg per day, but intakes can vary between 4 and 10 mg per day. Good sources of PA include yeast, liver, eggs, wheat germ, bran, peanuts, peas, meat, milk, poultry, whole grains, broccoli, mushrooms and sweet potatoes. Most fruits and vegetables contain small amounts of PA, but heat, food processing and canning destroys B5 in food.

Vitamin B6

Vitamin B6, or pyridoxine, is a family of chemically related compounds including pyridoxamine and pyridoxal which are found in animal products and pyridoxine, which is found in plants. The most common form found in foods and supplements is pyridoxine.

Necessary for the proper functioning of over 60 enzymes, vitamin B6 helps in the synthesis and breakdown of amino acids, in the conversion of amino acids to carbohydrates or fat and in the conversion of one type of fat to another.

Vitamin B6 deficiencies are most commonly found in adolescents, the elderly, those on restricted diets and alcoholics. Deficiency is frequently caused by exposure to radiation, tobacco use, air pollution, stress and the use of oral contraceptives. Symptoms of deficiency include irritability, weakness, drowsiness, depression and lack of appetite. It can cause convulsion in young children and it can affect the development of a baby's nervous system if the mother is vitamin B6 deficient during pregnancy. This vitamin is nontoxic but should be used carefully by diabetics as it has been shown to lower blood sugar. Vitamin B6 is used to treat asthma, cardiovascular disease, mood disorders and premenstrual syndrome.

Sources of vitamin B6 include chicken, fish, liver, kidneys, pork, eggs, milk, wheat germ and brewer's yeast. Long storage, canning, roasting or stewing can destroy vitamin B6. The most commonly available supplemental forms of this vitamin is pyridoxine hydrochloride and pyridoxine phosphate, which may be better absorbed. The RDI of vitamin B6 is 2 mg per day for men and women and 2.5 per day for pregnant or lactating women.

Vitamin B12

The last B vitamin to be identified is B12, also known as cobalamin, and is the only vitamin that contains an essential mineral, cobalt. This vitamin is essential for the metabolism of nerve tissue, fats and carbohydrates and the synthesis of proteins and for the health of the entire nervous system. Vitamin B12 is also important in the transport and storage of folate in cells and for conversion to its active form.

The body stores vitamin B12 in the liver, heart, kidneys, pancreas, brains, testes, blood and bone marrow making a deficiency very difficult, though possible over many years. Vitamin B12 deficiency disease is called pernicious anemia and is often accompanied by weight loss, weakness, pale skin and psychological disturbances. This deficiency is most commonly found in alcoholics, the elderly and strict vegetarians (as B12 is primarily found in animal products). No toxic effects from vitamin B12 have ever been reported.

Vitamin B12 can be consumed through oral supplementation, most widely found as cyanocoblalmin and hydroxycobalamin in a vitamin B12 injection, used in cases of B12 malabsorption. High levels of vitamin B12 are found in animal protein foods including oily fishes, crabs, oysters, eggs, milk products and meat. Because B12 is stored, the majority of 94 percent men and 83 percent of women meet the RDI guidelines - the highest percentage of all nutrients. 10 to 20 mcg per day of vitamin B12 is considered enough to maintain proper levels.

Other B Vitamins

All other vitamins in the vitamin B family are known by their chemical names: biotin, choline, folic acid, inositol and para-aminobenzoic acid (PABA). Biotin, choline and inositol and PABA have similar functions while folic acid is more closely related to those of vitamin B12.

Biotin is synthesized in the gut and helps incorporate amino acids into protein, synthesize sugar and fat molecules and plays an important role in carbohydrate metabolism. This B vitamin supports healthy bone marrow, sweat glands, nerve tissue, hair and skin, and it aids in cell growth and metabolism of fats and proteins. Biotin is also essential for the utilization of other B- complex vitamins.

Choline is a rare vitamin in that it crosses the blood-brain barrier into spinal fluid to be directly involved with chemical metabolism. This vitamin is important for disorders of the nervous system, such as Parkinson's disease and tardivedyskinesia, as well as for utilizing fats in the body, supporting weight loss in the process. Choline also assists in gallbladder regulation and liver function, nerve transmission, lecithin formation, hormone production, fat and cholesterol metabolism and it minimizes excess fat in the liver.

Inositol is vital for hair growth, lecithin formation and fat cholesterol metabolism. Also, it helps prevent hardening of the arteries and removes fats from the liver. Additionally, this vitamin plays a role in cell membrane structure and integrity and may help brain cell nutrition. Healthy inositol levels in the body can be reduced by high caffeine consumption.

The B vitamin PABA is important for its nourishment of the hair, its stimulation of cell growth and tissue repair and its usefulness as a sunscreen. It also contributes to the release of energy from carbohydrates, the synthesis of sugar molecules and the synthesis and breakdown of fatty acids. PABA, a part of the folic acid molecule, is found in many foods, including liver, rice and eggs. It is stored in body tissues and is synthesized by the natural bacteria in the intestines.

Folic acid has been found to have excellent effects when used preventively as well as therapeutically. Folic acid has been proven to help increase plasma folic acid levels and reduce homocysteine levels. Folic acid is critical in the prevention of spinal birth defects and pregnant women are urged to eat specially fortified foods or take supplements to protect against spina bifida.

The best source for folic acid is green, leafy vegetables such as spinach, kale, asparagus, broccoli and beats. Whole wheat bread and milk contain some folic acid, but exposure to light, heat, any type of cooking or an acid pH below 4 will destroy folic acid in food. The RDI for folic acid is 400 mcg per day for men and women, 800 mcg per day for pregnant women and 600 mcg per day while lactating.

References: 1 Haas, E. Staying Healthy with Nutrition: The Complete Guide to Diet and Nutritional Medicine. Berkeley: Celestial Arts, 1992.

Vitamin C

Vitamin C became a vital part of nutrition early in the 16th century, though no one knew exactly what they were dealing with. It was determined that certain fruits and vegetables played a large role in curing and preventing scurvy. In 1928, Vitamin C was discovered officially and was shown to be the leading cause in preventing and curing scurvy. In its pure form, it is known as absorbic acid and is found in a water-soluble white powder. Vitamin C is a major player in the health and well being of the human body, as it is involved in hundreds of vital processes.

This wonder antioxidant vitamin is helpful in numerous processes in the body. It is helpful in the prevention of the common cold and flu, as it is involved in antibody production and helps in the function and activity of white blood cells. It aids in the production of interferons, antiviral and anticancer substances. Vitamin C helps synthesize adrenal hormones, which produces the body's adrenaline and helps deal with stress, mineral balances and inflammation. It helps maintain and improve collagen in the body, which is responsible for making skin, bones, teeth and connective tissues strong. Vitamin C even helps in the aging process, as it is vital to skin health. It helps in the creation of neurotransmitters and carnitine, a substance necessary for the production of energy from fatty acids in cells, mostly notably, cardiac and skeletal muscle cells. Vitamin C is important in the process of metabolizing drugs, is necessary in iron absorption and it helps convert cholesterol to bile acids for excretion. Many benefits of combining vitamin C and E have been shown as they work synergistically, having a greater effect together than apart, extending antioxidant activity.

Vitamin C is found in many foods, including citrus fruit, strawberries, kiwifruit, black currants, papaya, red peppers, broccoli and brussels sprouts. Cooking and storage does not appear to damage the levels of vitamin C in foods, but bruising, overcooking and reheating seem to diminish them, possibly due to oxidative damage. Slicing fruits and vegetables and exposing them to heat and light can lead to some loss of vitamin C. Vitamin C is found naturally in foods and synthetically in supplements, found in the form of pills, powders, effervescent tablets, syrups and pastilles.

The Recommended Daily Intake (RDI) for vitamin C varies. According to the National Academy of Sciences, men should take around 60 mg (milligrams), women should take 60 mg, pregnant woman should take 70 mg and lactating women should take 95 mg. Overall recommendations vary greatly, ranging anywhere from 100 mg to 10,000 mg per day.

If a body is lacking in vitamin C, many things begin to happen. The most serious consequence is scurvy, though it is extremely rare in developed society. Scurvy weakens the capillary walls, which can lead to clotting and in turn, can lead to strokes and heart attacks. Symptoms of a vitamin C deficiency are bleeding (due to the breaking open of small blood vessels), reddening and bleeding of the gums, loose teeth, joint pain, dry, scaly skin and blood vessel damage. Other symptoms can include general weakness, fluid retention, depression and anemia. These symptoms can lead to wounds healing slowly, an increased susceptibility to infection, male infertility and increased genetic damage to sperm cells, which can lead to birth defects. Men, the elderly, smokers, diabetics, people with high blood pressure and sometimes those using oral estrogen-containing contraceptives have lower levels.

Vitamin C is absorbed into the intestines and used in the body within about two hours of initial consumption, generally leaving the body three to four hours after ingestion. Because of this, it is recommended that vitamin C is consumed at regular intervals throughout the day or be taken in a time release method once a day.

Due to the increased use of vitamin C in recent times, many studies and developments have come into view:

• In 1996, a population study published in the American Journal of Epidemiology showed that low levels of vitamin C have been linked to an increased risk in cardiovascular disease.¹
• A study published in 1993 showed an increased risk in death from ischemic heart disease, narrowing of the blood vessels causing inadequate blood flow to the heart, in people with low vitamin C levels. ²
• A study in the American Journal of Clinical Nutrition showed that people suffering from high cholesterol are also affected by low levels of vitamin C.³
• An eye study proved that there is 20 times more vitamin C in the eyes than in blood. Because of this, those with higher vitamin C levels are at less risk of cataracts.⁴
• There is some evidence that low levels are linked to high blood pressure.
• Vitamin C is helpful to anyone that smokes, is under physical and emotional stress, drinks alcohol, lives in a polluted area, is exposed to toxic chemicals, has recurrent infections and has an increased risk of cancer.
• It is very helpful to women taking birth control pills, elderly people, pregnant women and those with absorption difficulties.
• Smoking and alcohol consumption are the most noted killers of vitamin C in the body.
• Fever, viral illness, antibiotics, cortisone, aspirin, DDT, a pesticide, and carbon monoxide are also known to decrease levels of vitamin C in the body.

References 1 Sahyoun, N., et al. "Carotenoids, vitamins C and E, mortality in an elderly population." American Journal of Epidemiology 144:5, 501-11 (1996). 2 Gey, KF et al. "Poor plasma status of carotene and vitamin C is associated with higher mortality from ishemic heart deisease and stroke. Basel Prospective Study. Clincial Investigation 71:1, 3-6 (1993). 3 Ness, AR et al. "Vitamin C status and serum lipids." Eurpoean Journal of Clinical Nutrition 50:11, 724-9 (1996). 4 Mares Perlman, JA et al. "Diet and nuclear lens opacities." American Journal of Epidemiology 141:4, 322-24 (1995). 5 Haas, E. Staying Healthy with Nutrition: The Complete Guide to Diet and Nutritional Medicine. Berkeley: Celestial Arts, 1992.

Vitamin E

Surveys show that a majority of Americans are familiar with the term "antioxidant," which is a substance that has the ability to delay or prevent oxidation in the human body. Oxidation is caused by free radicals--damaged molecules missing an electron--that crash into stable molecules in an attempt to right themselves. This continuous process damages proteins and cell membranes, compromises cells' natural defenses, disrupts cells' genetic DNA, and makes the body more susceptible to cardiovascular disease, cancer and numerous other diseases. Free radicals also contribute to the aging process by causing cells to become inefficient, mutated or even to die.

Although free radical oxidation cannot be eliminated, antioxidants such as vitamin E can keep the process form running haywire throughout the body. Vitamin E is a fat-soluble vitamin that is most significantly found in the lipids of cell membranes and in circulating low-density lipoproteins. It is able to become localized in cell membranes, and as free radical formation occurs, vitamin E "quenches" free radicals before they damage cellular structures.

Researchers continue to find evidence that vitamin E's antioxidant activity reduces the risk of heart disease and cancer. In addition, vitamin E keeps LDL "bad" cholesterol from turning into even worse cholesterol (oxidized LDL), which initiates a buildup of arterial plaque that can ultimately lead to heart disease. Two epidemiological studies published in the New England Journal of Medicine show that both men¹ and women² who supplement with at least 100 IU of vitamin E per day for at least two years have a 37- to 41-percent decrease in the risk of heart disease. In a highly publicized clinical trial, the Cambridge Heart Antioxidant Study (CHAOS), vitamin E supplementation of 400 or 800 IU per day decreased the risk of non-fatal heart attack in a double-blinded, placebo-controlled trial of 2,002 patients with coronary disease who were treated with vitamin E or placebo and followed for a medium of 510 days.³

In addition to heart disease research, dozens of studies have been conducted on the potential of vitamin E to prevent numerous types of cancer. Evidence also indicates that the nutrient may be useful in the treatment of existing cancer. For Example, when vitamin E was given to cancer patients in a clinical trial, the nutrient appeared to protect normal cells from the effects of chemotherapy without protecting the cancer cells.

Studies have indicated a range of other health benefits form vitamin E. Because vitamin E improves heart and muscle respiration, it may help improve stamina and endurance. The nutrient also promotes normal blood clotting, aids in preventing cataracts ⁴ and strengthens capillary walls. However, one of the most exciting areas for vitamin E is in its role as an anti-aging agent that promotes the longevity of the skin.

According to VERIS, an information service for health professionals, researchers and nutrition and health communicators, the surface of skin is vulnerable to damaging free radicals, which are implicated in skin aging and in the development of such conditions as skin cancer. The epidermis of the skin contains a number of natural antioxidants including vitamin E. The May 1997 VERIS research summary stated that these antioxidants remove free radicals and counteract their damaging effects. Thus, it is possible to reduce or prevent skin damage (and subsequently, skin aging) associated with free radicals by using antioxidants formulated in topical skin care products.

The rays of the sun can have devastating consequences on the skin, often making a person look many years older that he or she actually is. UV radiation also increases risk of skin cancer. Studies have shown that UV rays reduce antioxidants in the skin, and decrease in skin vitamin E concentrations occurs after UVB irradiation. This appears to be a response to increased oxidative stress due to free radical generation initiated by UV irradiation, according to the VERIS research summary. Animal and human studies have indicated that topical vitamins E and C can protect and treat skin damaged by UV rays. This and other effects have been shown to improve the appearance of the skin. For example, in a study of 20 women between the ages 42 and 64, more than 50 percent of the women treated with vitamin E-containing cream for four weeks. The researchers concluded that the results clearly show that topical vitamin E induces smoothing of fine lines and wrinkles in sensitive areas of the face.⁵

Topical vitamin E has other benefits for the skin besides forestalling the effects of aging. Animal studies have raised the possibility that vitamin E improves healing of wounds and reduces scar formation.

In recent years, controversy has arisen over the best form of vitamin E to take. Most of the debate has centered around natural vitamin E vs. the synthetic form. The names of all types of vitamin E begin with either "d" or "dl," referring to different chemical structures. The "d" form is natural and the "dl" form is synthetic. Research has increasingly indicated that natural vitamin E is more bioavailable and thus, more active.

Vitamin E is naturally found in wheat germ oil, nuts, seeds, vegetable oils, whole grains, egg yolks and leafy green vegetables. Severe vitamin E deficiencies are rare, but the larger issue is whether or not people are getting optimal amounts of vitamin E to have positive health effects. The most commonly recommended dose of supplemental vitamin E is 400 IU, though the Optimum Daily Vitamin E is relatively nontoxic. However, people taking blood-thinning or anticlotting drugs should consult with a physician before taking supplemental vitamin E. Also, those with high blood pressure should not take large amounts of the vitamin.

References 1 Rimm, E., et al. "Vitamin E consumption and the risk of coronary heart disease in men." N Engl J Med 328: 1450-6 (1993). 2 Stampfer, M., et al. "Vitamin E consumption and the risk of coronary heart disease in women." N Engl J Med 328:1444-9 (1993). 3 Stephens, N., et al. "Randomized controlled trial of vitamin E in patients with coronary heart disease." The Lancet 347:781-6 (1996). 4 Rouhiainen, P., et al. "Association between low plasma vitamin E concentration and progression of early cortical lens opacities." American Journal of Epidemiology 144:496-500 (1996). 5 Mayer, P., et al. "The effects of vitamin E on the skin." Cosmetics and Toiletries 108:99-109 (1993).

Vitamin K

Vitamin K, first discovered in 1929, has been a staple in maternity units for many years, but growing concerns about osteoporosis and blood clotting has provoked mainstream consumer interest. Vitamin K consists of a group of three vitamins: K1, phylloquinone, made by plants; K2, menaquinone, made by animals, birds and bacteria in human intestines; and K3, menaphtone or menadione, a synthetic compound. While it has been assumed that the body makes the proper amounts of vitamin K, this may not be the case.

Recommended Dietary Intake (RDI) for Vitamin K varies with age, but adult men should consume 80 micrograms (mcg) per day and adult women should consume 60 mcg per day. Pregnant women should consume 65 mcg per day and 95 mcg while lactating for the first 6 months and 90 mcg while lactating for the last 6 months.

In order for vitamin K to be successfully absorbed into the body, it requires the presence of fats and bile in the gut. It is then absorbed from the small intestine and is transported to the liver for storage.

Vitamin K is best known for its role in blood clotting. It is vital to the creation of prothrombin and also helps prothrombin convert to thrombin, an important protein in clotting. In bone health and metabolism, it is necessary in the process of activating osteocalcin to regulate the function of calcium in bone turnover and mineralization. Vitamin K is also necessary for a protein called MGP, found in bones, teeth and cartilage, to function and is thought to play a role in bone production.

In the liver, vitamin K helps in the conversion of glucose to glycogen for storage. It even plays a role in the production of urinary protein involved in preventing the formation of kidney stones.

A lack of vitamin K in the body can cause a number of problems. Blood clotting is the most severe of the problems: the condition can affect people of all ages, but most dangerously in newborns. Often, the mother's breast milk does not contain enough vitamin K and the infant does not yet have the intestinal bacteria to create it within his own body to provide an adequate amount to prevent hemorrhagic disease. Most infants are given a shot shortly after birth to prevent serious bleeding problems.

In adults, lack of vitamin K can be a contributing factor to defective blood clotting. Though it is very rare, severe cases of deficiency are caused by chronic pancreatitis and diarrhea, fat malabsorption, intestinal bypass, liver disease, obstructive jaundice, malabsorption problems (such as celiac disease), and prolonged sulfa and antibiotic drug therapy. Researchers believe lack of K may be a contributing factor to osteoporosis. Symptoms of a vitamin K deficiency include dizziness, flushing, prolonged clotting time, easy bleeding and bruising, frequent nosebleeds, bloodstained urine and bleeding from the gut.

Vitamin K is present in many foods that are part of a normal, everyday diet. Dark leafy greens, spinach, broccoli, brussels sprouts and olive, canola and soybean oils are the best dietary sources. There is some found in cabbage, carrots, avocados, cucumbers, leeks, tomatoes, dairy, meats and cereals. Freezing can destroy the vitamin in foods, but it remains fairly stable when heated.

Aside from the vitamin K already produced by the human body, additional supplements are sometimes used. It is administered to women with a high risk of premature delivery. Patients are often given supplements before major surgery to help limit blood loss. Vitamin K can be received through diet, as a supplement, a shot, or topically. It is available in pill form, most often as a multi-vitamin. Intravenous injections may cause flushing, sweats, chest pain and constricted breathing. Intramuscular injections may cause pain, swelling and eczema. Topical creams have few side affects, mostly redness or rashes due to an allergy. K3, if taken in large doses, can cause hemolytic anemia and liver damage and should not be used therapeutically.

The newest application of vitamin K is in topical skin care. It can remove redness from varicose veins, alleviate bruising, can relieve burn and sun burn pain. This type of vitamin K is applied to the skin, absorbed through the dermal layer of skin, helping oxygen penetrate the skin and increasing cell replenishment.

In recent years, more information has become available and studies have been conducted concerning vitamin K and its effects:

• Vitamin K can be destroyed in the body by mineral oil laxatives, impaired absorption of fats in the digestive tract, certain liver disorders, cholestyramine, anticonvulsant phenytoin, x-rays and aspirin.
• Long term use of antibiotics may cause a deficiency because as the bad bacteria are being attacked, the good bacteria that creates the vitamin K is also being destroyed.
• The vitamin has proven useful in the treatment of heavy menstrual bleeding.
• Infants that take formula as opposed to breast milk have less chance of becoming vitamin K deficient because formula is fortified with vitamin K. Pregnant women may wish to take supplements to increase the amount of vitamin K in breast milk.
• Vitamin K can have harmful reactions with other medications, over-the-counter drugs, cough and cold medicines, nose drops, diet pills, laxatives and caffeine.
• In 1997, a Japanese study researched the relationship between vitamin K level, bone mineral density and other biological factors in bone metabolism. The study showed that women with reduced bone density had lower levels of vitamin K (K1 and K2) compared with normal bone density. ¹
• Four studies were conducted in the early 90s to determine if vitamin K injections after birth have increased the risk of childhood cancers. Two studies, published in the British Medical Journal in 1998, showed no association between K injections and cancer. One did not exclude the possibility and the fourth suggested a possible increased risk of leukemia. However, the results were inconclusive.²

References 1 Kanai T et al. "Serum vitamin K level and bone mineral density in post-menopausal women." Int J Gyn Obstet, 1997 Jan, 56:1, 25-30 2 Mylifepath.com "Bone Up of Vitamin K, Reduce Risk of Fractures." Blue Shield of California, 1999. 3 Recommended Dietary Allowances. "Recommended Dietary Intakes." Copyright 1989 National Academy of Sciences