April newsletter – are you taking the right supplements?

Welcome to my April newsletter

In this month’s newsletter, I’m going to talk about the controversial subject of supplements. Controversial as many feel they are a waste of time and money. Is there a real need for them in 21st century living? With the threat of many being banned in the coming years, should it be under the control of our GP to prescribe vitamins or should our health be in our own hands? Should we be allowed to choose?
The phrase you don’t need vitamins if you eat a “balanced diet” really grates on my nerves! As many people don’t have a clue what a real balanced diet is, essentially it’s a meaningless concept. As long as you’re not eating burgers and chips every day, you’ll be fine, right? Everything in moderation? To a certain degree, that last comment is correct. However, in the twelve years I’ve been doing this job, I see people who are eating appalling diets which may not only be making them ill but may be exacerbating the symptoms of their illness in the first place. Together with the fact that misjudged media hype means people might very well be eating things they believe to be good for them but are actually a waste of time and money.

Diseases from lack of vitamins

Scurvy. If we think of vitamins on a basic level, most people know that we cannot make Vitamin C, and have to obtain it from food. We also know that lack of Vitamin C can give us scurvy – that’s why limes and lemons were bought on ships in the 1700s. Scurvy leads to the formation of spots on the skin, spongy gums, and bleeding from the mucous membranes.The spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. In advanced scurvy there are open, suppurating wounds and loss of teeth. However, it was not until 1747 that James Lind formally proved that scurvy could be treated and prevented by supplementing the diet with citrus fruit. James Cook succeeded in circumnavigating the world (1768-71) without losing a single man to scurvy.

Beriberi (meaning I cannot, I cannot in Sinhalese) is caused by a lack of thiamine (vitamin B1). Thiamine occurs naturally in unrefined cereals and fresh foods, particularly whole grain bread, fresh meat, legumes, green vegetables, fruit and milk. Beriberi is therefore common in people whose diet excludes these particular types of nutrition e.g. as a result of famine. Beriberi may be found in people whose diet consists mainly of polished white rice, which is very low in thiamine because the thiamine-bearing husk has been removed. It can also be seen in chronic alcoholics with an inadequate diet (Wernicke-Korsakoff syndrome), as well as being a rare side effect of gastric bypass surgery. If a baby is mainly fed on the milk of a mother who suffers from thiamine deficiency, then that child may develop beriberi as well. The disease was often found in Asian countries (especially in the 19th century and before), due to those countries’ reliance on white rice as a staple food.

Is this relevant today? In the western world no one could have scurvy, or beriberi could they? Well, I have heard and seen incidences of mild scurvy in young adults. Thankfully not with beriberi, although I have however seen many people with mild B vitamin deficiencies which can lead to:

split lips, cracks at the corners of the mouth, photosensitivity, anxiety, palpitations, mental health issues, etc.

B12 anemias, I believe, are on the increase as many women have given up red meat and offal, like liver and kidneys. These are now out of fashion. In these situations I think it’s vital to supplement until the diet is sorted out.

How many vitamins should I be taking?

I often see patients bringing in rucksacks (literally) of vitamins and, in a Ready Steady Cook way, emptying them out on my desk – my maximum to date was 47 pots of vitamins and herbs.This is worrying and happens when people self prescribe or they have been told by a friend that it will help a certain condition. People often ask me what I take on a daily basis. Some are surprised when I say nothing for several months. However, at the moment, I’m taking probiotics and vitamin B complex. That’s because I know my body and at the moment I know they are supporting me. It’s important to know exactly what you need, get any defiencies tested, and know the reason why you are taking them. On average (and this does vary hugely) about 4 or 5 a day is plenty if your diet is really good. However It is entirely dependent on the individual and their needs, no two people are the same.

What vitamins can I get tested?

The vitamin and mineral tests you can get from your GP are: iron, ferritin, calcium, zinc, Vitamin B12, magnesium, Vitamin D and folate. Nutritional tests (done at specialist labs) include: red cell magnesium, Esential Fatty Acids, CoQ10, B complex, chromium and all the vitamins and minerals. (The list of what is available is too long for this newsletter – please do call me if you would like further information on this on 01323 737814). There are deficiency symptoms of all the major vitamins and minerals, particularly so with magnesium, calcium, vitamin B, chromium, iron and B12. Below are some of the major deficiency symptoms of some vitamins and minerals (if you read this and have some of the symptoms, please dont panic and self medicate as there are other causes as well!)

Calcium
Brittle Nails
Delusions
Depression
Hypertension
Insomnia
Irritability
Limb Numbness
Muscle Cramps
Nervousness
Osteomalacia
Osteoporosis
Palpitations
Pins and Needles
Periodontal Disease

Pantothenic Acid -Vitamin B5
Alopecia
Burning feet
Depression
Faintness
Fatigue
Hypotensions
Muscle spasms
Nervousness
Tachycardia
Weakness

Zinc
Acne
Anorexia
Brittle nails
Depression
Fatigue
Growth impairment
Impaired wound healing
Paranoia
White spots on the nails
Memory impairment

Folic Acid
Anaemia
Apathy
Digestive disturbances
Fatigue
Headaches
Memory impairment

Iron
Anaemia
Brittle nails
Confusion
Depression
Dizziness
Palpitations
Fatigue
Inflamed tongue

Magnesium
Anxiety
Confusion
Depression
Hypotension
Irritability
Muscle pains
Nervousness
Tachycardia
Weakness

Niacin – Vitamin B3
Confusion
Depression
Dermatitis
Diarrhoea
Fatigue
Indigestion

Why we might need vitamins?

The nutrients most people tend to be low on are magnesium and the B vitamins, so I will list here the most common sources found in food:

Vitamin B1 (thiamine): dried brewers yeast, yeast extract, brown rice, wheat germ, nuts, wheat bran, Soya flour, oat flakes, wholegrains, liver and wholemeal bread.

Magnesium: Soya beans, nuts, dried brewers yeast, whole-wheat flour, brown rice, dried peas, shrimps, rye flour, seafood, dried fruit, vegetables, meat and green vegetables.

You can see how easy it would be for some people to be deficient in these two vital nutrients. Let’s think of a person of school age who lives on fizzy drinks and chips and then we are shocked that they are suffering from anxiety, depression, acne and IBS before they leave school? A couple of years ago, I was asked to help a boy of ten who had learning difficulties and would only eat white food. This meant he would only eat potato, meringue, chicken, white bread, and the outside of an egg – there are no white fruits or vegetables and he wouldn’t drink milk. On doing blood tests, I found he was deficient in nearly every mineral, particularly zinc and magnesium and the only way forward was to give him liquid vitamin supplements which were hidden in his food. A couple of months later, he started to pick up, was less boisterous in class and his concentration levels soared, as did his marks at school. – I suspect he is not alone.

How our diet has changed

The way we shop today has changed so dramatically that it could be said that highly processed foods tend to offer a reduced level of important nutrients and are more enriched with salt and fat. Only 15-18% of men and women in this country are eating five portions of fruit and vegetables per day. Buying organic is not top priority any more as we are clutching to our purse strings in tough financial times. Foods grown in the UK tend to deliver lower levels of zinc and selenium, while magnesium intakes are being reduced through processing and adverse food choices. When we boil vegetables as well, many of the nutrients are lost, so the way we cook our food is important. The “Good Life” is a dream for many time- and energy-poor people.

If you’re an “average” person with no ill health, average amounts of stress and an average diet (whatever that is) then a strong daily multivitamin is a good idea – make sure it has at least 10-15 mg of zinc. If you’re under the weather, with more coughs and colds than usual, I’d suggest 1g of vitamin C, echinacea and probiotics for a month. If you are a stressy, nervy type who worries, concentrate on your B vitamins, calcium and magnesium.

I don’t particularly want to get political or controversial but it’s vital that we are allowed to use vitamins and minerals ourselves without intervention from the government. It’s difficult to estimate how many people take responsibility for their own health and take a daily vitamin and mineral supplement. On the whole, no harm is done and there are more side effects from pharmaceutical drugs than there are vitamins. Sadly it is the occasional story hitting the news that can cause scaremongering.

It is of vital importance that you do not self-prescribe – it could be doing you more harm than good. Often, you might be taking too much of a supplement which could be interacting with other medications you are on, which could have an impact on your health or, more frustratingly, you could be taking not enough and wonder why it’s not working and wasting a lot of money in the bargain.

If you would like me to go through your supplements, I offer a half hour tailored made service for £30. This will assess your individual needs. Please call me on 01323 737814.

In Season – Crab

Crabs first evolved in the Jurassic period (the horseshoe crab dates back over 200 million years) and have been caught and eaten throughout human history. Crab is a good source of a number of trace minerals including selenium which counteracts cancer and chromosome damage, as well as increasing our resistance to viral and bacterial infections. It contains useful amounts of B vitamins, iron and zinc.

Purchasing a live crab will ensure maximum freshness. Whole cooked crabs or fresh crab meat from a trusted supplier are perfectly adequate alternatives. Live crabs should be refrigerated and cooked on the day of purchase. Cooked fresh crab meat will be fine in the fridge for 3 or 4 days and can be frozen.

The RSPCA publishes detailed instructions on how to humanely kill crabs and other crustacea (dropping into boiling water is not recommended, some research suggests that crabs feel pain). Cook crabs by boiling – 20 minutes for crabs up to 1kg and 10 minutes per kg after that.

Once cooked and cool enough to handle, twist off the claws and legs. Knock the underside of the body on the chopping board and push your thumbs on the crab’s back to prise the body section away from the shell. Remove and discard the stomach sac (just behind the mouth) and the soft gills (dead man’s fingers) – these are readily identifiable and will come away easily. Use a teaspoon to scoop out the brown meat from inside the shell, not forgetting the crevices where the claws and legs join the body. Crack the legs and claws with a rolling pin or nutcracker and prise out the white meat using a skewer.

Crab Pate -Serves 4

2 cups canned crab meat
4 tbs butter, diced
2 tbs low fat mayonnaise
2 tbs tomato puree or ketchup
1/2 tsp Worcestershire sauce
2 stalks celery, finely chopped
3 tbs finely chopped chives
Organic sea salt and freshly ground black pepper

1.Place crab meat, butter, mayonnaise, tomato puree and Worcestershire sauce in a food processor bowl.
2.Blend until smooth.
3.Season with salt and pepper and stir in chopped celery and chives.
4.Mix well to blend flavours.
5.Transfer to a loaf shaped container and even the surface with a flat knife or metal spatula.
6.Cover with kitchen foil and chill for at least 4 hours.
Serve on oat cakes or crusty bread.

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