Wednesday, April 16, 2003

Choosing supplements can be tricky

Health pharmacy

By Richard Harkness
Enquirer contributor

Question: My Citracal supplement says it contains 200 mg per tablet. As I understand from your recent column, only 21 percent of that is elemental calcium. That means each tablet contains only 42 mg of the 1,500 mg of calcium I should have each day. If so, I'd have to take 36 tablets. Is this so?

Answer: Thankfully, you won't have to take that many tablets. The column you refer to was about the best ways to get calcium, a mineral necessary for building bone and preventing the bone-weakening disorder osteoporosis.

I believe the Citracal you mention contains 940 mg of calcium citrate. As I wrote, about 21 percent of that amount is calcium, which translates to the 200 mg of calcium you refer to. That makes the number of tablets you need to take manageable, especially since the body can absorb only about 500 mg of calcium at one time. Knowing this, you could take 2 tablets (400 mg calcium) 4 times daily for a total daily intake of 1,600 mg.

Q: My husband had an angioplasty and takes the B vitamins mentioned in your column that were found to benefit angioplasty patients. Is it OK also to take vitamin E?

A: Some evidence suggests that vitamin E taken with other antioxidants should be avoided, at least until his arteries have fully healed after angioplasty.

According to a trial presented at the Canadian Cardiovascular Congress 2000, a combination of vitamin E, vitamin C and beta-carotene was tried in the hope it might help prevent reopened arteries from clogging again, a common problem after angioplasty. The vitamins showed no benefit, and, furthermore, seemed to interfere with the normal healing process after the procedure. Whether vitamin E alone might do this is not known. Check with the physician about this.

Q: My two brothers have had bypass surgery and take vitamin E as recommended by their doctors. Based on this, I'm taking 800 IU of vitamin E daily. I am 67 years old, male, and have been blessed with no known heart problem. Should I continue the vitamin E or change to a B supplement or take both?

A: Probably take both, but confirm this with your physician. Though supplemental vitamin E alone appears to be a dud in helping prevent heart disease, it does show promise in a variety of other conditions, so there seems to be no reason to give it up.

Interestingly, a combination of vitamins E and C does appear to be beneficial. A 2000 trial in people who smoked found that, in men but not women, this combination slowed plaque buildup in the main artery leading to the brain. It may be that the two vitamins complement each other. Researchers think this plaque-slowing benefit might apply generally.

The B vitamins folate (folic acid), B6 and B12 appear to exert heart-healthy benefits by holding down blood levels of homocysteine. To get extra amounts, you could take a standard multivitamin supplement, which typically provides the adult recommended daily intake of folate (400 mcg), as well as 2 mg of vitamin B6 and 6 mcg of vitamin B12.


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