Most people consuming standard diets do not take in enough of the right kinds of nutrients on a daily basis.
Some of this is obviously related to food choices, but another significant factor is due to soil depletion in large-scale farming, which results in unbalanced trace minerals in the soil and subsequently the food grown in it.
That’s one compelling reason to buy your produce from small local farms and, whenever possible, from small organic farms that are responsibly managed.
But even if you are diligent about purchasing only organic foods, this may not solve the problem. Large-scale organic operations may yield crops that are just as depleted, or even more so, than non-organic varieties.
We spent one winter camping in Mexico with Raffi, soaking up the sun. During that time, we observed some growing practices that I’m sure hold true for large-scale farming anywhere in the world.
For one, many of the big farms were growing their produce in sandy soil.
I can’t imagine that these foods contained all the vitamins and minerals that would be found if they had been grown in nutrient-rich soil. (Have you noticed how much of the produce available in the United States comes from Mexico?)
If you’re using Cronometer, your Food Diary page will display all the nutrients along with how well you are meeting the minimum daily requirements.
Cronometer is linked to vetted databases, so the information is as accurate as it can be given the issues with soil depletion.
If you want even more information about the nutrients in a wide variety of brand-name products, visit the searchable USDA Food Composition Database (https://ndb.nal.usda.gov) and click on the food you are interested in to view the nutrient report.
This provides you with detailed data, not only for vitamins and minerals, but also for individual fatty acids and amino acids.
Vitamins and Minerals: Key Considerations
Ideally, you should receive all of the vitamins and minerals you need from the foods that you eat. But the sad reality is that even if you’re eating organic or locally grown food, you may still fall short, especially if you are restricting total calories or if your food intake is low for other reasons.
You need to either ensure your average nutrient intake is adequate by faithfully tracking everything you consume (with a tool like Cronometer) or take supplements—at least in the beginning as you are adjusting to so many other changes in your life.
Most vitamins serve critical roles in a variety of biological functions and activities. For example, B vitamins are cofactors in enzymatic reactions that support healthy metabolism and brain function; others, such as C and E, act as antioxidants.
Vitamin D has an unusual structure that is similar to steroid hormones like estrogen, and in many ways it acts more like a hormone than a vitamin in the body.
If you find you are not getting all the nutrients you need from food, consider adding a good vitamin supplement, along with a few key minerals, to cover your bases. Thankfully, there are many good options available.
Choosing Multivitamins and Minerals
When I work directly with clients, I dig into the specifics of their health history and food preferences to help me to individualize their plan and suggest supplements where needed.
Here, however, I’m simply providing a broad overview. Do your homework and be sure to discuss your choices with your medical team. They may have reasons why they don’t want you to take a certain supplement right now.
I should also note that there are cancer researchers who believe that defective mitochondria in tumor cells benefit from supplemental vitamins. This is definitely something that needs research!
Vitamin A
Vitamin A is recognized as an antioxidant. It is fat soluble, so there is a danger of toxicity if you consume too much preformed vitamin A, such as that found in liver and some fish oils, including cod liver oil.
However, plant-based provitamin A is a precursor that does not carry this risk.
Most multivitamins contain either provitamin A itself or provitamin A along with a low level of preformed vitamin.
(There are many different vitamin A precursors, and to complicate matters further, dosages can be given in either micrograms [mcg] or international units [IU].)
Vitamins B
You’ll need to be careful here, as there are a lot of low-quality B vitamins in the marketplace. Pass over those and look for one that provides most of the B vitamins in more bioavailable forms (for example, B12 [cobalamin] as methylcobalamin or hydroxycobalamin instead of cyanocobalamin, and B9 [folate] as methylfolate instead of folic acid).
These forms may provide more benefit because they have already undergone some of the reactions that move them closer to their “active” forms. Caution: People with active cancer need to be mindful about the potential downside of hypermethylation.
Consult with an integrative doctor before you decide to supplement with methylated forms of these vitamins.
Vitamin C
It doesn’t take much effort to meet the minimum requirement for vitamin C. In the past, I’ve recommended against taking oral vitamin C supplements because I believed they could interfere with ketosis.
However, in my conversations with Dr. Jeanne Drisko at the University of Kansas Integrative Medical Center, I have learned that vitamin C (taken orally as ascorbic acid) will not raise blood glucose levels.
But the controversy regarding the impact of vitamin C on glucose levels also reflects confusion between the effect of vitamin C taken orally and its effect when delivered intravenously, at a much higher concentration that can be consumed.
Because the chemical structures of glucose and vitamin C are very similar, a home blood glucose meter will erroneously indicate a very high glucose level following an intravenous infusion of the vitamin.
(Imagine your surprise at seeing glucose at 260 ml/dL or higher, despite tight adherence to your plan!) This is simply an artifact of testing. In fact, home meters are routinely used as a quick check of vitamin C saturation following an intravenous treatment.
Intravenous infusions of vitamin C are sometimes recommended as a prooxidant cancer treatment, usually as an adjunct to conventional prooxidant therapies, such as radiation and some chemotherapy drugs.
Prooxidative therapies exert their effect by creating intense oxidative stress that overwhelms dysfunctional cancer cells.
If you are supplementing with high-dose oral vitamin C, it’s likely because you’ve read that it has a powerful antioxidant effect.
But despite extensive research, oral vitamin C supplementation has not been shown to improve outcomes in cancer. In fact, it could work against you.
(This is the subject of much controversy and confusion, so it’s good to understand the difference in action between oral and intravenous vitamin C.)
But that still leaves us with an unresolved issue: Is there a “safe” amount of oral vitamin C supplementation? I’ve posed that question to my colleagues, and the answer ranges from “no supplementation beyond food sources” to “it’s likely safe to supplement up to bowel tolerance” (in other words, up to the dose that induces diarrhea).
Ultimately, we may learn that, as is the case with most other therapies, the safe amount is likely to be situation-specific and vary greatly between individuals.
A Word about Vitamin D
I’ve singled this vitamin out because almost everyone who doesn’t supplement is deficient to some degree. Vitamin D is essential not only for bone health but also for immune modulation, which is so critical in cancer and most other chronic diseases.
Unfortunately, most conventional health care practitioners don’t yet understand how important it is to assess blood levels of this vitamin, and those that do may accept 30 ng/mL as an acceptable threshold. But this is far from optimal!
The RDA for vitamin D is quite low (600 to 800 IU, depending on age) and is met by almost all multivitamins, but this amount does not provide any real health benefit apart from preventing rickets in children.
Food sources don’t cover our needs either, and people routinely overestimate the amount of vitamin D synthesis from sun exposure (most of the United States is at too high a latitude to activate synthesis for a good part of the year).
Other factors, such as darker skin color and advancing age, also lower the amount of vitamin D synthesis. Add to that the fact that most Americans block the sun’s rays with sunscreen or UV-resistant clothing and it’s no wonder that blood levels of vitamin D throughout this and most other developed countries are dismal.
A February 2016 fact sheet from the government Office of Dietary Supplements suggests that oral supplementation with 4,000 to 5,000 IU of vitamin D3 (cholecalciferol) should be safe for most adults.
I suggest that you ask your provider to test your blood level of 25-hydroxyvitamin D (calcidiol, the prehormone form the vitamin takes following metabolism by the liver), then supplement accordingly.
In my world, optimal calcidiol levels are thought to be in the range of 50 to 70 ng/mL, though government guidelines suggest keeping levels at or below 60 ng/mL.
Depending on your age, skin color, and degree of sun exposure, maintaining those blood levels of calcidiol may require supplementation of anywhere from 2,000 to 5,000 IU of oral vitamin D3 daily (taken at the same time as calcium- and magnesium-containing foods or supplements).
Since vitamin D is fat-soluble, take it as a capsule suspended in oil (such as coconut oil).
If your baseline levels are deficient (less than 20 ng/dL) or insufficient (less than 30 ng/dL), consider working with a doctor who can prescribe and monitor a therapeutic loading dose.
Vitamin E
Vitamin E is actually made up of several plant-derived vitamins, some of which are potent antioxidants that help to protect the lipid component of cell membranes from oxidation.
Only one form, alpha-tocopherol, is known to be necessary for human health, while others show good evidence of benefit even if they are not considered “essential.”
(Your oncologist may not want you taking this as an antioxidant supplement while you are receiving chemotherapy, so do check before adding this to your regimen.)
Vitamin K
Vitamin K is needed to move calcium from blood into bone. It can be derived either directly from the diet or by being converted in the body from vitamin K1. As a supplement, it should be taken as menaquinone-7.
Even if you are taking in enough K1 through diet, that’s no guarantee that you will convert it efficiently to K2, and low levels of K2 can negatively impact bone health.
Fermented vegetables are a source of K2 but you can’t assess the dosage accurately. If you are on certain types of anticoagulant therapy (e.g., warfarin), you should adhere to any food or supplement advice from your medical team, as K2 affects blood-clotting factors.
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