A to Z of supplements

Find out the facts about vitamins, minerals and other food supplements, and the role they play in maintaining good health.

Learn more about where they come from; how and why they are used as food supplements; which foods they can be found in; and any known adverse effects or precautionary advice.

Simply search our A-Z by name or filter the list by type e.g. vitamin, mineral, botanical,  essential fat.

Description Globe artichoke is a member of the botanical family that includes thistles. It was first domesticated in the Mediterranean area, where most production still occurs.  It can reach up to 2 metres high and has large purple and green flower heads. The buds are cooked and eaten as a delicacy. Cynarin is the key active component.Not to be confused with the root vegetable, Jerusalem artichoke.
Function/ Used for Rich in a wide range of nutrients including Vitamin C, vitamin A, folic acid, biotin, manganese, potassium, niacin, riboflavin and thiamine. Artichoke has long been used to support the healthy functioning of the digestive system, in particular the gall bladder and liver.  It has been found to improve digestion and relieve nausea and flatulence.
Intake N/A
As a supplement It is available as extracts in tablet or capsule form, and as standardised leaf extract containing cynarin. Dose: usually 640mg, three times daily with meals.1
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications People suffering from obstructive gall bladder disease should consult their GP before taking artichoke extract because it increases bile secretion. A small number of people are allergic to artichoke.
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications None known2
Adverse effects Artichoke presents minimal risks, although some people may experience flatulence and mild gastro-intestinal upset.
References 1 Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 2 Mills, S. & Bone, K. Principles and practice of phytotherapy. Churchill Livingstone, 2000.  
 
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Description Beta-carotene is a precursor form of vitamin A.  It is converted to vitamin A in the body on an ‘as-required’ basis.
Function/ Used for In its unconverted form, beta-carotene acts as an antioxidant in the body, neutralising potentially damaging free radicals. If it is converted in the body then its actions are those of vitamin A.
Intake Recommended intake EU NRV: Not established.   UK average daily intake In the UK, the average adult diet provides 2.58 mg (beta-carotene) daily.1 Five portions of fruit and vegetables per day will usually provide about 6mg of beta-carotene. However, apples, bananas and onions provide almost no beta-carotene.
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Beta-carotene gives yellow and orange fruit and vegetables their colour. Therefore, rich sources include brightly coloured fruit and vegetables such as carrots, red pepper, spinach (and other dark green leafy vegetables), mango, peaches and apricots (60 per cent of the average UK intake comes from carrots). Levels are stable during cooking, but losses occur due to exposure to light and air.
Deficiency There are no known deficiency symptoms.
Precautions and contraindications High intakes are not recommended for smokers. Two large-scale studies have shown an association between beta-carotene supplementation (20mg/day) and an increased incidence of lung cancer in smokers and individuals with previous high-level exposure to asbestos.2,3 Safe Upper Level: 7mg/day4
Use in pregnancy and breastfeeding Beta-carotene is converted to vitamin A in the body on an ‘as required’ basis which reduces the risk of vitamin A toxicity. This makes it safe during pregnancy when high levels of vitamin A itself (retinol) should be avoided.
Interactions e.g. with other medications Beta carotene may interact with alcohol increasing the liver toxicity of alcohol5
Adverse effects Carotenoids are generally non-toxic. Intake of >30mg daily may lead to hypercarotenemia which is characterised by a yellowish colouration of the skin (including soles of feet and palms of hand). This is harmless and reversible.6
References 1 DEFRA. Family Food 2014.UK Purchases and expenditure on food and drink and derived energy and nutrient intakes. National Statistics, December 2015. https://www.gov.uk/government/statistics/family-food-2014 2 The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. New England Journal of Medicine 330, 1029-1035. 3 Omenn, G.S., Goodman, G.E., Thornquist, M.D., Balmes, J., Cullen, M.R., Glass, A., Keogh, J.P., Meyskens, F.L., Valanis, B., Williams, J.H., Barnhart, S., Hammer, S. (1996). Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. New England Journal Medicine 334, 1150-1155 4 Expert Group on Vitamins and Minerals, 2003. 5 Leo M. A & Lieber C.S. Alcohol, Vitamin A and βcarotene: adverse interactions including hepatotoxicity and carcinogenicity. American Journal of Clinical Nutrition. June 1999 vol 69:6 pp1071-1085 http://ajcn.nutrition.org.content/69/6/1071.full 6 Mason, P. Dietary Supplements. Pharmaceutical press, London, 2001
 
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Description Closely related to the blueberry, bilberry is a shrubby perennial bush that grows in the forests and on the moors of northern Europe. The main active ingredients are anthocyanins, chemical compounds with antioxidant and anti-inflammatory properties.
Function/ Used for Bilberry is widely used for supporting eye health. The antioxidant anthocyanidin compounds protect blood vessels, including the capillaries which help deliver oxygen rich blood to the eyes.
Intake N/A
As a supplement Bilberry is generally available as fresh or dried berries; and as bilberry extract usually standardised to 25% anthocyanidin. Dose: 160-480mg daily.1 Tablets providing 50-120mg of anthocyanins per day have been typically used in clinical trials2.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Very high doses should be avoided in patients with haemorrhagic (bleeding) disorders.
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy when consumed in dietary amounts, however safety is not known when used in larger quantities.
Interactions e.g. with other medications Warfarin and other anti-coagulant and anti-platelet (blood thinning) medication.3
Adverse effects None known
References 1 Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 2 Mills, S. & Bone, K. Principles and practice of phytotherapy. Churchill Livingstone, 2000. 3 Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005.
 
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Description Formerly known as Vitamin H or Co-enzyme R, biotin is a water soluble vitamin and a member of the B-vitamins group.
Function/ Used for Biotin works synergistically with other B vitamins. It is involved in energy production through the metabolism of carbohydrates, proteins and fats. It is also essential for the production of RNA and DNA and helps to maintain the mucous membranes, healthy skin and nails.
Intake Recommended intake EU NRV: 50µg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Biotin is found in many foods and is also synthesised by the microflora in the gut. The richest sources of biotin are liver, kidney, egg yolks, brewer’s yeast and soya beans. Meat, wholegrain cereals, wholemeal bread, milk and cheese are also good sources. Green vegetables contain very little biotin.
Deficiency Symptoms include patches of hair loss (alopecia), reversible baldness, depression, muscle pains and wasting. Also, dry, flaky skin, rash around the eyes, nose and mouth, brittle hair, tiredness and loss of appetite.
Precautions and contraindications Safe Upper Level: 970µg/day2
Use in pregnancy and breastfeeding Suitable to be used during pregnancy and breastfeeding.
Interactions e.g. with other medications Biotin may interact with anticonvulsant drugs. Long term treatment with anticonvulsant drugs may decrease blood levels of biotin. To avoid side effects, individuals taking anticonvulsants should supplement with biotin either alone or as part of a multivitamin. 3,4
Adverse effects None known.
References https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2 Expert Group of Vitamins and Minerals, 2003. 3 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4. Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
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Description Calcium is an essential mineral.
Function/ Used for The most abundant mineral in the body, calcium is essential for building and maintaining healthy bones and teeth. Calcium also plays a role in muscle contraction, including the heart muscle; facilitates nerve transmissions; is involved in energy production and cell division and is used in the blood clotting mechanism.
Intake Recommended intake EU NRV: 800mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include dairy products, canned fish such as sardines (when the soft, edible bones are consumed), dark green leafy vegetables, white bread, brown bread, sesame seeds and pulses.
Deficiency Long term deficiency leads to osteoporosis, muscle aches and pains, muscle twitching and spasm, muscle cramps; rickets (in children), osteomalacia (softening of bones), heart disorders, brittle nails and insomnia.
Precautions and contraindications Calcium supplements should be avoided in conditions associated with hypercalcaemia (high calcium levels in the bloods) and hypercalcuria (elevated calcium in the urine), and in renal (kidney) impairment (chronic).2 Safe Upper Level: 1500mg/day3
Use in pregnancy and breastfeeding No problems have been reported. Calcium supplements may be required during pregnancy and breast-feeding and should be combined with vitamin D to ensure effective absorption.4
Interactions e.g. with other medications Excessive alcohol intake may reduce calcium absorption. Aluminium- and magnesium-containing antacids may reduce calcium absorption. Calcium can decrease absorption of some antibiotics, biphosphonates (to treat osteoporosis) and anti-convulsants (to treat epilepsy). Loop diuretics increase excretion of calcium in the urine whereas thiazide-type diuretics may reduce calcium excretion. Calcium carbonate or calcium phosphate may reduce absorption of iron and should be given 2 hours apart.5
Adverse effects Reported adverse effects with calcium supplements include nausea, constipation and flatulence (usually mild).
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3.     Expert Group on Vitamins and Minerals, 2003. 4.     NHS Choices Vitamins, supplements and nutrition in pregnancy http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/vitamins-minerals-supplements-pregnant.aspx#Calcium 5.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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Description Chamomile comes from the dried daisy like flowers of the Matricaria recutita plant (sometimes called Matricaria chamomilla, Chamomilla recutita or German chamomile). Chamomile contains a number of active constituents including volatile oils and antioxidants.
Function/ Used for Chamomile is renowned for its health supporting properties which include relaxation, carminative (acting to soothe and support the digestive system), anti-inflammatory and anti-septic. It is widely used to promote general relaxation and to help calm the digestive system. It can also be topically applied to help soothe skin rashes and burns, including sunburn. It can be used as a mouth wash for inflammation of the mouth such as gingivitis and for bathing inflamed and sore eyes.
Intake N/A
As a supplement Unprocessed dried flowers are available to buy in bulk. Chamomile tea prepared in tea bags is also readily available.  It can be found in aqueous or alcohol extracts and as topical ointments and creams. Essential oil of chamomile is also widely available.As a general guide, 2-8grams dried flower per day, as an infusion (tea) or equivalent liquid extract is generally recognised as safe1.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Chamomile oil should not be taken internally.
Use in pregnancy and breastfeeding The American National Institute of Health advise that chamomile and essential oil of chamomile should not be used in pregnancy as it may stimulate uterine contractions.2
Interactions e.g. with other medications None known
Adverse effects Allergic reactions have been reported in those individuals sensitive to members of the Compositae family, i.e. daisies, ragweed, and crysanthemums.3
References 1 Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 2 "Roman chamomile: MedlinePlus". MedlinePlus. National Institutes of Health. 2012-02-16. Retrieved 15/02/2017 https://medlineplus.gov/druginfo/natural/752.html 3 Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005.
 
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Description Chromium is an essential trace mineral.
Function/ Used for Chromium is involved in the processes that make glucose available for energy. It is also important for the metabolism of amino acids (the ‘building blocks’ of proteins) and fats.
Intake Recommended intake EU NRV: 40μg (micrograms)1   UK average daily intake In the UK, the average daily intake of chromium from food was 100μg/day (1997 Total Diet Study).3
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include liver, kidney, yeast products, wholegrain cereal, nuts and legumes.
Deficiency Gross chromium deficiency is rarely seen in humans, but signs and symptoms of marginal deficiency include: Glucose intolerance (insulin resistant hyperglycaemia – high sugar levels in the blood, raised serum lipids and weight loss)2.
Precautions and contraindications Because of its effect on blood glucose levels, diabetics should only take chromium under medical supervision. Not suitable for epileptics.Safe Upper Level: 10mg1
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy at normal intakes.
Interactions e.g. with other medications Chromium supplements containing yeast should be avoided by people taking monoamine oxidase inhibitors for the treatment of depression. People taking any medication for diabetes (either injected insulin or oral antidiabetics) should seek medical advice before taking chromium. Absorption of beta-blockers and corticosteroids may be increased by chromium; people using these drugs should seek medical advice before taking chromium supplements.2
Adverse effects None known when taken orally.
References 1 Expert Group on Vitamins and Minerals, 2003. 2 Mason, P. Dietary Supplements. Pharmaceutical Press,  London, 2001 3. Manual of Nutrition 12th Ed. Dept. of Health, June 2012.  
 
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Description Co-enzyme Q10 (CoQ10), sometimes called Ubiquinone, is a naturally occurring vitamin-like substance produced by the body. It is found in the mitochondria of all cells in the body, but particularly in those of the heart, liver, kidneys and pancreas. Co-enzyme Q10 is produced in the body but the ability to synthesise CoQ10 reduces with age.
Function/ Used for CoQ10 is needed for the process that converts the energy from food into energy that can be used by the body. CoQ10 also works as an antioxidant, neutralising potentially damaging free radicals to stabilise cell membranes and protect both lipids (fats) and proteins. It also works to regenerate other antioxidants such as vitamin E. CoQ10 is also essential for the normal function of the heart muscle.
Intake N/A  
As a supplement CoQ10 is sold in capsules and tablets in strengths of 10–200 mg. Absorption is increased when capsules containing CoQ10 in an oil base are taken with meals.1
Found in (dietary sources) CoQ10 can be mainly found in organ meats such as liver and kidneys; fish and shellfish; and the germ portion of whole grains. It can also be found in smaller quantities in soya beans, nuts and vegetables, particularly spinach and broccoli.
Deficiency N/A
Precautions and contraindications CoQ10 should not be used to treat cardiovascular disorders without medical supervision.
Use in pregnancy and breastfeeding Safety in pregnancy and breastfeeding has not been established.
Interactions e.g. with other medications In patients on warfarin (an anti-coagulant) and heart medication (eg. Beta-blockers), high doses of CoQ10 should be used with caution. The synthesis of CoQ10 follows a similar biochemical pathway as cholesterol and, therefore, drugs which lower cholesterol such as statins also inhibit CoQ10 production in the body. Other drugs which may reduce levels of CoQ10 include hypertensive drugs (used to treat high blood pressure, e.g. clonidine, hydralazine, methyldopa), thiazide diuretics (e.g. hydrochlorothiazide) and tricyclic antidepressants (e.g. amitriptyline).2
Adverse effects CoQ10 appears to be safe and relatively well tolerated in doses of 10–200 mg daily. There are occasional reports of gastrointestinal discomfort, dizziness and skin rash, but these tend to occur with doses in excess of 200mg daily.1
References 1 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 2 Gaby A.R et al. A-Z Guide to Drug-Herb-Vitamin Interactions. Health Notes. Three Rivers Press. New York. 2006
 
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Description Cod liver oil is obtained from the liver of the cod. Cod liver oil and other fish liver oils are rich sources of vitamins A & D; they are also rich sources of the omega-3 essential fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Function/ Used for EPA and DHA are found in every cell membrane in the body and have a wide range of functions.  Their health benefits include1:
  • Reducing triglyceride levels in the blood
  • Heart health
  • Supporting brain function
  • Reducing blood pressure
  • Maintaining eye health
  EPA and DHA also inhibit the production of inflammatory chemicals in the body and have an anti-inflammatory effect in their own right.  Fish body oils and fish liver oils are widely used in the management of inflammatory joint conditions2.   EPA may also help to discourage the formation of blood clots and help assist the blood to flow freely around the arteries, maintaining the circulation. EPA may also help maintain a healthy heart.   DHA is important in infant development, particularly in prematurely born infants. It is believed to be necessary to early eye and brain development.  DHA is also thought to support brain development throughout childhood.   Omega 3 fatty acids also help maintain suppleness.
Intake The European Food Safety Authority3 makes recommendations for EPA and DHA intake, substances which are found in fish oils: ·         250mg of EPA/DHA per day for adults and children over the age of 2. ·         100mg DHA per day for infants and young children aged 7-24 months. ·         100-200mg DHA per day in addition to general adult requirements for pregnant and lactating women from fish body oils (fish liver oils should be avoided. See ‘use in pregnancy and breastfeeding’).
As a supplement Cod liver oil and other fish oil supplements are available as capsules and liquids. Food supplements generally provide 100–1500 mg combined EPA/DHA per dose. The dose is not established but doses of 1-3g daily may be adequate.
Found in (dietary sources) Cod liver oil is obtained from the liver of the cod.
Deficiency N/A
Precautions and contraindications Patients with blood clotting disorders or those taking anticoagulants such as warfarin should be monitored while taking cod liver oil or other fish oils.4
Use in pregnancy and breastfeeding Cod liver oil or other fish liver oil supplements should not be taken by women who are pregnant or planning a pregnancy because high amounts of vitamin A may be present. Fish body oils do not contain vitamin A and are safe to consume up to 3 grams a day.4
Interactions e.g. with other medications Taking cod liver oil or other fish oils with anticoagulants (such as warfarin), aspirin, dipyridamole (a vasodilator), ginkgo biloba or ginseng, may increase the risk of bleeding. Medical supervision in these cases is required.4
Adverse effects Fish liver oils contain vitamins A and D , fat soluble vitamins that can be toxic when consumed in excessive amounts.4 Reflux or “burping up” of fish oil may occur in some individuals. Take with food to avoid this occurring.
References 1EU Community Register of Nutrition and Health Claims http://ec.europa.eu/food/safety/labelling_nutrition/claims/register/public/?event=register.home 2 Natural Medicines Comprehensive Database, via the National Library of Medicines National Institutes of Health EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal 2010; 8(3):1461. [online] Available at: http://www.efsa.europa.eu/en/efsajournal/pub/1461.htm [Accessed February 2017]. 4 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Copper is an essential trace mineral.
Function/ Used for Copper is an essential component of several enzymes. Copper supports iron absorption and works with iron in the formation of red blood cells.  It acts as an antioxidant, supports the function of the immune system and is needed for connective tissues, bone growth, nerve function and energy release. It also helps to maintain skin and hair pigmentation.
Intake Recommended intake EU NRV: 1mg   UK average daily intake In the UK, the average daily intake of copper in 2000/01 was 1.2mg/per day from food.1
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include wholegrain products, liver, most seafood, dried beans and peas. In the UK many water pipes are made from copper and, therefore, tap water is an excellent source.
Deficiency Deficiency of copper is rare. Marginal deficiency may result in elevated cholesterol levels; impaired glucose tolerance; defects in pigmentation and structure of the hair; demyelination (loss of the myelin sheath that surrounds the neurons to protect nerves); and degeneration of the nervous system. In infants and children, copper deficiency can lead to skeletal fragility and increased susceptibility to infections, especially those of the respiratory tract.2
Precautions and contraindications Copper should not be taken by people with Wilson’s disease (the disorder may be exacerbated) or hepatic and biliary disease. Safe Upper Level: 10mg/day3
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy with normal intakes.
Interactions e.g. with other medications Penicillamine, Trientine, and large doses of Zinc and Iron may reduce absorption of copper and vice versa - give 2 hours apart. Vitamin C in large doses (> 1 g daily) may reduce copper status. Copper may reduce the absorption of ciprofloxacin, an antibiotic used to treat bacterial infections. Copper may enhance the anti-inflammatory effect of ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs).2,4
Adverse effects In excessive doses copper is toxic and can lead to nausea and vomiting, diarrhoea, abdominal pain, jaundice and metallic taste.
References 1 Manual of Nutrition 12th Ed., Dept. of Health, June 2012. 2 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3 Expert Group on Vitamins and Minerals, 2003. 4 Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.  
 
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Description A native American plant, closely related to the blueberry.
Function/ Used for Cranberries and cranberry juice contain substances that may help to maintain a healthy urinary tract.
Intake N/A
As a supplement Available as juice, fresh or frozen berries, cranberry concentrate, dried capsules and tablets. Between 3 to 10 grams per day of cranberry in tablet or capsule form is recommended for a healthy urinary tract1. A daily dose of up to 960ml juice is recommended for the prevention and treatment of urinary tract infections.2
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications None known
Use in pregnancy and breastfeeding Cranberry is suitable to be taken during pregnancy and breastfeeding at dietary doses1.
Interactions e.g. with other medications None known1
Adverse effects At high doses, gastrointestinal discomfort may occur1.
References 1.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2.       Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003
 
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Description Feverfew is a member of the botanical family that includes the daisy. It has yellow and white flowers and feathery green leaves. It is primarily the leaves which contain the active ingredient, parthenolide.
Function/ Used for Feverfew has been widely used to prevent the onset of migraines1. It is thought to prevent the sudden dilation of blood vessels, which is associated with the onset of migraine; however,  it does not work to relieve symptoms of a migraine once it has started. It has also long been used to relieve symptoms of menstrual cramps.
Intake N/A
As a supplement Feverfew is generally available in a tablet or capsule form, and is often standardised to contain 0.4% parthenolide. Dosage is 250mg of standardised extract per day for long term use.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Caution use in those with hypersensitivity to the Asteraceae (Compositae) or Daisy family, i.e. chamomile, ragweed, yarrow, etc.2
Use in pregnancy and breastfeeding Feverfew should not be taken during pregnancy as it may cause contractions of the uterus. It is also not recommended for breastfeeding women.3
Interactions e.g. with other medications Feverfew may inhibit blood clotting; people taking anti-coagulant or anti-platelet (blood thinning) medicines should consult their doctor before use.
Adverse effects Minor abdominal discomfort and diarrhoea has been reported. Dermatitis, soreness or ulceration of the mouth, and a mild tranquillising effect have also been reported.4
References 1Migraine Trust 2 Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 3 Mills, S. & Bone, K. Principles and practice of phytotherapy. Churchill Livingstone, 2000. 4. Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003
 
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Description Folic Acid, known as folate in its natural form, is a synthetic water-soluble vitamin and is part of the B-vitamins group. Folic acid is generally consumed in the form of food supplements or in fortified foods.
Function/ Used for Essential during pregnancy for efficient neural tube development which forms the brain and spinal cord. ‘Neural tube defects’, such as spina bifida, in babies appear to be linked to a ‘metabolic defect’ in folate metabolism in the mother. This means that, even though the mother may have an adequate dietary intake of folic acid, her body cannot use it efficiently. Taking extra folic acid at the time when the neural tube is forming can reduce the chance of the baby having a neural tube defect. However, the neural tube is formed very early during pregnancy - about a month after conception. Women are advised to take folic acid for 12 weeks prior to conception and to continue taking folic acid supplements until the 12th week of pregnancy.   In addition, folic acid is essential for the formation of red blood cells and has been shown to reduce the levels of an amino acid (homocysteine). This reduction may have a protective effect against heart disease.1
Intake Recommended Intake EU NRV: 200µg   Women of childbearing age (14-49 years) who are planning or who may become pregnant are advised to take a supplement containing 400µg folic acid every day.   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes2.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) ‘Folate’ can be found naturally in yeast extract, wholegrain cereals, liver, brussels sprouts, broccoli, leafy green vegetables, beans, oranges and beer. Levels of folate are unstable, unless the foods are refrigerated, and can also be destroyed by processing and cooking. ‘Folic acid’ can be sourced from fortified foods, such as breakfast cereals, marmite, bovril and fat spreads.
Deficiency Folate deficiency may lead to an increased risk of neural tube defect (spina bifida) in babies. Folate deficiency may cause macrocytic megaloblastic anaemia (enlarged but fewer red blood cells).5
Precautions and contraindications Safe Upper Level: 1000µg/day3
Use in pregnancy and breastfeeding No problems have been reported. Supplements are required during pregnancy and when planning a pregnancy.
Interactions e.g. with other medications Those taking anti-epileptic drugs should seek doctor’s advice. Prolonged use of oral contraceptives may cause folic acid depletion4. Adequate amounts of all B vitamins are required for optimal functioning. Deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another. Folic acid may reduce the absorption of zinc.
Adverse effects Folic acid is generally considered to be safe even in high doses, but it may lead to convulsions in patients taking anticonvulsants and  to neuropathy in patients with pernicious anaemia.5   Some gastrointestinal disturbance has been reported at doses of 15 mg daily. Allergic reactions (shortness of breath, wheezing, fever, erythema, skin rash, itching) have been reported rarely.5
References 1.       NHS Choices. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vitamins-minerals-supplements-pregnant.aspx#Folic 2.       https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 3.       Expert Group on Vitamins and Minerals, 2003. 4.       Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006. 5.       Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.
 
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Description Garlic is the fresh bulb of Allium sativum, which is related to the lily family (Liliaceae). Known for its pungent odour, garlic has been used as both a food and a medicine in many cultures for thousands of years. Construction workers who built the Egyptian pyramids were supposedly given huge rations of garlic to sustain their resistance against fevers2.
Function/ Used for Garlic is thought to have antibacterial properties. Modern research has focused on exploiting its potential to reduce the risk of heart disease which may be as a result of its antiplatelet effect and anti-oxidant properties. Garlic also has antimicrobial properties. To get the full benefits of fresh garlic, it should be eaten raw. Alliin, a substance present in fresh garlic, is converted into allicin, an important active ingredient, when the garlic bulb is crushed.
Intake N/A
As a supplement Garlic supplements come in many forms, including capsules, tablets, softgels and those made from garlic powder. Some are deodorised, and others have an enteric coating to prevent 'garlic breath'. Dosage range2 is: 2-5g fresh garlic daily (or 1-2 cloves); 0.4-1.2g dried powder daily; 2-5mg garlic oil daily. Some supplements may be standardised for allicin potential. One clove of garlic is roughly equivalent to 4000mcg allicin potential. However, allicin is now known not to be the only important active ingredient in garlic3.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Individuals with hypersensitivity to garlic should avoid it. Individuals with bleeding abnormalities should avoid doses greater than usual dietary intake.1,2
Use in pregnancy and breastfeeding Garlic is not recommended in doses greater than usual dietary intake, during pregnancy and breastfeeding.2
Interactions e.g. with other medications People who are taking drugs to prevent blood clots (anticoagulants, antiplatelets or aspirin) or to reduce high blood pressure (anti- hypertensives) should consult their doctor before taking as garlic may intensify the effects of these drugs.1, 2
Adverse effects Some people develop indigestion when taking high doses of garlic. Hypersensitivity reactions such as contact dermatitis and asthma have also been reported occasionally3.
References 1.   Mills, S. & Bone, K. Principles and practice of phytotherapy. Churchill Livingstone, 2000. 2.   Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 3. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Ginger is native to India, China, Jamaica and other tropical areas, where its use as a culinary spice spans at least 4,400 years. Ginger grows in fertile, moist, tropical soil.
Function/ Used for Ginger is a popular stomach-settler and has been used for thousands of years as a treatment for digestive problems ranging from mild indigestion and flatulence to nausea, vomiting, travel sickness, morning sickness in pregnancy and vertigo. It has also been used to relieve symptoms of colds and arthritis due to its anti-inflammatory properties.
Intake N/A
As a supplement Ginger is available in raw root form and in tablets and capsules. Tea can be made with fresh ginger root (up to four cups of ginger tea per day for colds). Ginger oil is sometimes mixed with a neutral oil to rub on to areas of muscular pain. Ginger may help to relieve morning sickness during the first two months of pregnancy1.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Large amounts of ginger should be avoided on an empty stomach. Chemotherapy patients should not take ginger on an empty stomach. Ginger in high doses is not recommended for children under 6years1.
Use in pregnancy and breastfeeding Up to 2grams per day of dried ginger root (or equivalent) is suitable to be taken during pregnancy and breastfeeding2.
Interactions e.g. with other medications Due to the anti-platelet activity of ginger,  doses above general dietary intake are not recommended to be taken alongside warfarin and other anti-platelet (blood thinning) medications3.
Adverse effects Gastric irritation, heartburn and bloating have been reported. Ginger oil may cause dermatitis in hypersensitive individuals1, 2.
References 1.       NHS Choices Nausea and Morning Sickness http://www.nhs.uk/conditions/pregnancy-and-baby/pages/morning-sickness-nausea.aspx 2.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 3.       C. A. Newall, L.A. Anderson, J.D. Phillipson. Herbal medicines – a guide for healthcare professionals. Pharmaceutical Press, 1996.
 
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Description Ginkgo is an extract from the dried leaves of Ginkgo biloba (maidenhair tree). Ginkgo biloba is one of the world’s oldest living tree species, and its existence can be traced back more than 200 million years. Ginkgo has been used therapeutically for many centuries and is now one of the most popular plants prescribed in Europe for cognitive disorders.
Function/ Used for The leaf contains substances that may help to support healthy circulation, particularly to the brain and extremities. Ginkgo is known to be a circulatory stimulant.
Intake N/A
As a supplement Ginkgo is available in liquid extracts, tablets and capsules. Dosage range: 9-10g dried herb daily (or equivalent)1.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Caution use in those with abnormal bleeding conditions1.
Use in pregnancy and breastfeeding Ginkgo should not be used during pregnancy or breast-feeding1.
Interactions e.g. with other medications Due to its anti-platelet effect, Gingko should not be taken if on aspirin, warfarin (an anti-coagulant drug) or platelet-inhibitor medication.1, 2
Adverse effects In a few number of cases, ginkgo has been reported to cause mild gastrointestinal upset, headaches and dizziness. There have been rare reports of severe allergic reactions, including skin reactions (e.g. itching, redness and blisters) and convulsions. 1, 2
References 1.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2.       Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Ginseng is extracted from the root of several different species of the Panax group of plants from East Asia (Panax Ginseng and Panax Japonicus) and North America (Panax quinquefolius), and has been used medicinally for more than 2000 years. Siberian ginseng (Eleutherococcus senticosus) is not considered to be true ginseng because it is not a species of the genus Panax. However, it is often promoted alongside Asian and American ginseng supplements.
Function/ Used for Used through the ages as a tonic, ginseng helps with stamina and stress resistance and is often referred to as an adaptogen. Adaptogens help the body to adapt to prevailing situations which could be stressful. Traditionally, people have claimed ginseng to be useful for memory and mental function, improving libido and sexual vigour, regulating blood pressure, preventing diabetes and improving immunity3.
Intake N/A
As a supplement Ginseng can be found in tablets and capsules, as well as in standardised extracts. Dosage: Short term (up to 20 days): 0.5-1g root daily. Long term: 0.4-0.8g root daily. Some experts recommend that people stop taking ginseng for one week every month and then resume their regular dose.1,2
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Ginseng is generally contraindicated in acute infections with fever and should be used with caution by people with cardiovascular disease including hypertension (high blood pressure); diabetes; asthma; schizophrenia; and disorders of the nervous system.1,3
Use in pregnancy and breastfeeding Not suitable for use if pregnant or breast-feeding.
Interactions e.g. with other medications Not to be taken if taking warfarin (an anti-coagulant), digoxin (used to treat heart conditions), tranquillisers or anti- depressants.1
Adverse effects Overuse may result in headaches, insomnia, and palpitations.1
References 1.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2.       Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 3.       Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.  
 
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Description Glucosamine is a substance which occurs naturally within the human body.  It is found within the fluid around joints and within other connective tissues.
Function/ Used for The body uses glucosamine to build and repair cartilage and it may help to maintain healthy joints. It has an anti-inflammatory action and has been used to relieve pain, stiffness and swelling of the knees, fingers and other joints, as well as arthritic back and neck pain. Glucosamine may also increase the production of cartilage components and has been used to speed up the healing of sprains and strengthen joints. A 2005 Cochrane review of 20 randomised controlled trials demonstrated the effectiveness of Glucosamine in the reduction of pain and improvement of joint function in osteoarthritis and also demonstrated its safety2.
Intake N/A  
As a supplement Glucosamine comes in capsule, tablet or powder forms. It is available as a synthetically manufactured food supplement in the form of glucosamine sulphate and glucosamine hydrochloride. A dose of glucosamine sulphate 500mg three times a day (1500mg daily) is generally recommended. A minimum of 4 weeks may be needed for the full benefit to be seen.1 Glucosamine is sometimes provided in supplements with chondroitin, an important component of cartilage, with which it may act synergistically.
Found in (dietary sources) Small amounts are provided in the diet by animal and fish products.
Deficiency  
Precautions and contraindications People who are allergic to shellfish should not take glucosamine supplements, unless taking the vegetarian form.
Use in pregnancy and breastfeeding No problems have been reported, but there have not been sufficient studies to guarantee the safety of glucosamine in pregnancy and breast-feeding.1
Interactions e.g. with other medications None known. Although insulin or oral hypoglycaemics used for the treatment of diabetes may be less effective. People with diabetes taking glucosamine should be aware of its potential influence on glucose metabolism1.
Adverse effects Glucosamine is relatively non-toxic, although some side-effects reported include constipation, diarrhoea, heartburn, nausea, drowsiness, headache and skin rash1.
References 1.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 2.     Towheed et al. Glucosamine therapy for treating osteoarthrtitis. Cochrane database, issue 2, 2005.
 
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Description Iodine is an essential trace element - only small amounts are needed to maintain good health.
Function/ Used for Iodine is used to form thyroid hormones (thyroxine and tri- iodothyronine), which regulate metabolic rate.
Intake Recommended intake EU NRV: 150µg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include saltwater fish and shellfish, kelp, seaweed, sea salt, iodised salt, and dairy products.
Deficiency Deficiency may lead to hypothyroidism. Symptoms include tiredness, muscle weakness, breast pain and tenderness, sudden or unexplained weight gain. A classic deficiency sign is goitre (enlargement of the thyroid gland in the neck in order to compensate for low levels of iodine intake). Infants born to severely deficient mothers are likely to suffer from cretinism (stunted physical and mental growth).
Precautions and contraindications Supplements usually only necessary on medical advice. Safe Upper Level: 500µg /day2
Use in pregnancy and breastfeeding Doses exceeding the NRV should not be used during pregnancy or breastfeeding (they may result in abnormal thyroid function in the infant)3.
Interactions e.g. with other medications Iodine may interact with thyroid medication3.
Adverse effects High iodine intake may induce hyperthyroidism (particularly in those over the age of 40 years) or hypothyroidism in autoimmune thyroid disease. Toxicity is rare with intakes below 5000µg daily and extremely rare at intakes below 1000µg daily. Hypersensitivity reactions including headache, rashes, symptoms of head cold, swelling of lips, throat and tongue, and joint pain have been reported.3
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Iron is an essential trace mineral.
Function/ Used for Iron is essential for the formation of haemoglobin which is present in red blood cells. Haemoglobin is being formed in the body all the time and is the substance in red blood cells that transports oxygen around the body.
Intake Recommended intake EU NRV: 14mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include liver, kidney, heart, red meat, beef, pork, canned pilchards/sardines, fish, shellfish, wholegrain cereals, eggs, spinach, chicken, leafy green vegetables and fortified breakfast cereals. Iron is most easily absorbed from animal sources. Vitamin C improves the absorption of iron from plant sources.
Deficiency Symptoms include anaemia, concave and brittle nails, sore tongue, cracking in the corners of the mouth, increased susceptibility to infection. Also, tiredness, muscle fatigue, skin itching, dizziness, headache, insomnia, brittle hair and hair loss.
Precautions and contraindications Iron supplements should be avoided in conditions associated with iron overload (e.g. haemochromatosis, haemosiderosis, thalassaemia), and gastrointestinal disease, particularly inflammatory bowel disease, diverticulitis and peptic ulcer1. Overdose of iron is dangerous, particularly in young children.   Safe Upper Level: 17mg2
Use in pregnancy and breastfeeding Iron supplementation is not generally required in pregnancy, but iron status should be monitored.
Interactions e.g. with other medications Antacids, tetracyclines (antibiotics), warfarin (anti-coagulant), calcium carbonate or calcium phosphate, and zinc may reduce the absorption of iron - they should be given two hours apart. Aspirin and NSAIDs such as ibuprofen may cause stomach irritation, bleeding and iron loss which may lead to deficiency. To avoid irritation take with food. Large doses of iron may increase the requirement for vitamin E.3,4
Adverse effects Iron supplements may cause gastrointestinal irritation, nausea and constipation, which may lead to faecal impaction (where dried, hard stools collect in the rectum and anus), particularly in the elderly. Patients with inflammatory bowel disease may suffer  worsening of diarrhoea. Liquid iron preparations may stain the teeth.3
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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Description Cultivated in Turkey and Greece, the liquorice plant is a member of the pea family. Its root contains glycyrrhizin, which is the main active ingredient and is also responsible for its sweet taste. There is another form of liquorice called DGL (deglycyrrhizinated liquorice), which has glycyrrhizin removed, and which can be used at higher intakes without raising blood pressure.
Function/ Used for Liquorice containing glycyrrhizin is used to help reduce inflammation and ease coughs, sore throats and other respiratory symptoms. Liquorice can also be used as a cream to help soothe irritated and inflamed skin. Liquorice has anti-ulcer activity and has been used clinically for ulcers, including stomach and mouth ulcers2. The DGL form of liquorice, which has the active ingredient glycyrrhizzin removed, helps combat indigestion.
Intake N/A
As a supplement Liquorice extract is available in tablets, capsules or liquid extracts, standardised to contain 22% glycyrrhizin. General dosage recommendation is 200mg, three times a day. Liquid extract: 2-5ml2.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Glycyrrhizin found in liquorice raises blood pressure and so should be avoided by people with heart, kidney or liver disease, or high blood pressure. People taking liquorice for more than a month should have their blood pressure monitored. DGL liquorice, however, has glycyrrhizin removed, and so does not cause blood pressure to be raised.
Use in pregnancy and breastfeeding Not suitable to be taken if pregnant or breastfeeding1.
Interactions e.g. with other medications Not suitable for people taking anticoagulant, antihypertensive, corticosteroid, digoxin (used to treat heart conditions), diuretic, or potassium medication1.
Adverse effects Oral intake of more than 20g/day of licorice can cause adverse effects, such as headache, lethargy, hypertension (high blood pressure), sodium and water retention, elevated potassium secretion, and sometimes even cardiac arrest. Symptoms usually manifest within one week if the daily ingestion of liquorice is over 100g. In addition, excessive intake of liquorice may affect the menstrual cycle and cause slightly premature childbirth. Note: DGL is virtually free of adverse side effects.1,2
References 1.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2.       Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003
 
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Description Magnesium is an essential mineral. It is the second most abundant nutrient stored in body tissue after calcium.
Function/ Used for Magnesium is needed for the formation of many enzymes in the body which release energy from food. It is also vital for the nervous system, muscle movement and for the formation of healthy bones and teeth.
Intake Recommended intake EU NRV: 375mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes.1  
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Magnesium is present in all green plants. The main sources are unrefined cereals and wholemeal bread, green leafy vegetables, and peanuts. Over 80 per cent of magnesium is lost in the removal of the germ and outer layers of cereal grains.
Deficiency Symptoms include loss of appetite, nausea, fatigue, weakness, insomnia, diarrhoea. Hypocalcaemia (low calcium levels in the blood) is common in moderate to severe magnesium deficiency. Obvious clinical signs of deficiency are uncommon.2
Precautions and contraindications Doses exceeding the Safe Upper Level are best avoided in renal (kidney) impairment. Safe Upper Level: 400mg/day3
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy and breastfeeding.
Interactions e.g. with other medications Excessive alcohol intake may increase the loss of magnesium in urine. Loop diuretics and thiazide diuretics can increase the loss of magnesium in urine and lead to magnesium depletion. Magnesium can reduce the absorption of the antibiotics tetracyclines, which should be taken at least two hours before or after a magnesium-containing supplement. People taking heart medication should consult their doctor or pharmacist before taking magnesium.2, 4
Adverse effects Doses of 3–5grams have a laxative effect.
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3.     Expert Group on Vitamins and Minerals, 2003. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.  
 
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Description Manganese is an essential trace mineral.
Function/ Used for Manganese activates  some enzymes  so they begin to work. It is also essential for the formation of certain enzymes, one of which is superoxide dismutase, a powerful antioxidant enzyme that neutralises potentially damaging free radicals.
Intake Recommended intake EU NRV: 2mg   UK average daily intake Intake of manganese is not routinely tracked by government data. The UK, average daily adult intake from food sources in 2000/01 was 3mg per day.1
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Nuts, pulses, wholemeal bread and cereals and green vegetables. Tea is a rich source of manganese and possibly the biggest source of manganese for many people in the UK.
Deficiency Manganese deficiency in individuals consuming mixed diets is very rare. Symptoms thought to be associated with deficiency include weight loss, dermatitis, hypocholesterolaemia (low levels of cholesterol in the blood), depressed growth of hair and nails and reddening of black hair2.
Precautions and contraindications Safe Upper Level: General  population: 4mg/day3 Older people: 0.5mg/day (older people may be more sensitive to manganese)
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications Oral contraceptives may interfere with the absorption of manganese. Manganese can reduce the absorption of Ciprofloxacin, an antibiotic used to treat bacterial infections.2,4
Adverse effects Long term intakes of daily doses of 4mg and over of manganese may lead to muscle pain and fatigue2.
References 1.     Manual of Nutrition 12th Ed., Dept. of Health, June 2012. 2.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3.     Expert Group on Vitamins and Minerals, 2003. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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Description Molybdenum is an essential ultratrace mineral.
Function/ Used for Mineral involved in the functioning of several important enzymes in the body. Aids in carbohydrate and fat metabolism and helps in iron utilisation.
Intake Recommended intake EU NRV: 50µg   UK average daily intake Estimated intake range between 50-400µg a day1
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) The richest sources of molybdenum include dairy products, liver and kidney, nuts, dark green leafy vegetables, wholegrains, peas and beans and brown rice.
Deficiency No known deficiency symptoms.
Precautions and contraindications The molybdenum intake from the UK diet (estimated maximum intake 230µg /day) is not expected to present any risk to health. However, there is insufficient evidence about the safety of molybdenum intakes in excess of those naturally occurring in the diet.2 Safe Upper Level: Current estimates indicate a safe upper level of 600µg a day for adults.1
Use in pregnancy and breastfeeding Safety of use during pregnancy and breastfeeding is unknown.
Interactions e.g. with other medications None reported.3
Adverse effects Molybdenum is a relatively non-toxic element. High dietary intakes (10–15mg daily) have been associated with elevated uric acid concentrations in blood and an increased incidence of gout3.
References 1.     http://www.efsa.europa.eu/sites/default/files/efsa_rep/blobserver_assets/ndatolerableuil.pdf 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Pantothenic acid is also sometimes referred to as Vitamin B5. It is water soluble and part of the B-vitamins group. Pantothenic acid and calcium pantothenate (a more stable form of pantothenic acid) are available in the form of tablets and capsules, but they are found mainly in multivitamin and mineral preparations.
Function/ Used for Pantothenic acid forms part of two substances, co-enzyme A and the acyl carrier protein. These have key roles in the release of energy from foods. Pantothenic acid is involved in the metabolism of protein and fat, and is also needed for healthy growth.
Intake Recommended intake EU NRV: 6mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Fortified breakfast cereal, wholegrains (such as brown rice and wholemeal bread), dairy products, liver, kidneys and eggs.
Deficiency Deficiency of pantothenic acid is extremely rare. Symptoms include poor muscle co-ordination, muscle cramps, numbness and tingling, painful burning feet, depression, fatigue, weakness, headache and loss of appetite.3
Precautions and contraindications None known. Safe Upper Level (Guidance Level): 210mg total dietary intake per day2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications Excessive alcohol intake may increase requirement for pantothenic acid. Oral contraceptives may also increase requirement for pantothenic acid. Adequate amounts of all B vitamins are required for optimal functioning as deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another.3
Adverse effects No adverse effects, except for occasional diarrhoea, have been reported in humans.
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
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Description The peppermint plant is a hybrid of spearmint and water mint. Its active ingredient is a volatile oil made up of more than 40 components, including menthol, flavonoids and phenolic acids.
Function/ Used for Peppermint is primarily used for indigestion relief. It is also used as an inhalant, for clearing congestion in coughs and colds. Peppermint soothes the digestive tract, helps relieve nausea, and sweetens breath. Peppermint oil may be effective in irritable bowel syndrome (IBS)2. Menthol and peppermint oil can be applied externally to treat headache2.
Intake N/A
As a supplement Peppermint can be found in its essential oil form (not to be taken internally), as a tea, or as enteric coated capsules containing 0.2ml oil. Dosage: powdered herb 2-4g up to 4 cups of peppermint tea per day 2 drops of peppermint oil in a steam bath to inhale up to 2 enteric coated capsules containing 0.2ml oil daily
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Peppermint oil acts as a relaxant on the muscles of the stomach and gastro-intestinal tract, and can aggravate acid reflux or the symptoms of hiatus hernia. Peppermint oil should not be put on the nostrils or chests of children under 5 years old. When taken internally, peppermint oil should be in enterically coated products to reduce possible irritation.3
Use in pregnancy and breastfeeding External use is suitable during pregnancy. However peppermint is not recommended to be taken internally during pregnancy, unless as a tea which may be taken to help relieve morning sickness.1
Interactions e.g. with other medications No significant interactions reported.1
Adverse effects When taken as a tea, peppermint is usually considered safe, although hypersensitivity reactions have been reported. Rare negative reactions to enteric-coated peppermint oil capsules may include skin rash, heartburn, slowed heartbeat, and muscle tremors. Menthol or peppermint oil applied topically could cause contact dermatitis or rash.1
References 1.       Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2.       Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 3.       National Center for Complementary and Integrative Health https://nccih.nih.gov/health/peppermintoil (September 2016)
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Description Next to calcium, phosphorus is the most abundant mineral in the body, making up about 1% of total body weight.
Function/ Used for Phosphorus is essential for bone health.   Calcium, which gives strength to bones and teeth, needs to be combined with another mineral, such as phosphorous, to become stabilised before it can be effective.   Phosphorus also helps to release energy from food as it plays an important role in the metabolism of carbohydrate, fat and protein.
Intake Recommended intake EU NRV: 700mg   UK average daily intake Unknown (in the UK)
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include red meat and poultry, dried milk and milk products, wheat germ, yeast, grains, hard cheeses, canned fish, nuts, potatoes, eggs and soft drinks.
Deficiency Symptoms include abnormal calcification of soft tissue, tetany (spasm and twitching of the muscles, particularly those of face, hands and feet), lethargy and anorexia. However, deficiency is unlikely as it is so widely distributed in food.
Precautions and contraindications Consuming high doses of phosphorus for a short time can cause diarrhoea or stomach pain.1 The long term over-consumption of foods high in phosphorus can deplete calcium resources and lead to reduced bone mass, which means that bones are more likely to fracture.2   Safe Upper Level (SUL): ·         Total intake of not more than 2,400mg/day1 ·         Supplemental intake should not exceed 250mg /day
Use in pregnancy and breastfeeding Safety of the use of phosphorus during pregnancy and breastfeeding is unknown.
Interactions e.g. with other medications No clinically significant interactions between phosphorus and conventional medications are known to have been reported in literature to date. Long term intake of aluminium hydroxide, an antacid, may deplete phosphorus levels.3,4
Adverse effects Phosphates can be toxic at levels over 1,000mg per day, leading to diarrhoea, calcification of organs and soft tissue, and preventing the absorption of iron, calcium, magnesium, and zinc.1
References 1.     Expert Group on Vitamins and Minerals, 2003. 2.     Calvo, MS.  Advances in Nutritional Research. 1994:9 pp183-207 ‘The effects of high phosphorus intake on calcium homeostasis’ 3.     Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia. 31st ed. London: Royal Pharmaceutical Society; 1996:1181-1182, 1741. 4.     Gaby A.R et al. A-Z Guide to Drug-Herb-Vitamin Interactions. Health Notes. Three Rivers Press. New York. 2006
 
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Description A probiotic is a live microbial food supplement that contains microbial substances normally found in the gut.
Function/ Used for Probiotics such as acidophilus and bifidus are consumed to improve digestion. Once in the gut they work by multiplying and restoring the balance of the normal bacterial population of the intestine. Probiotics may also help to support the health of the immune system.
Intake N/A  
As a supplement Available as bio-yoghurts or fermented milk based drinks. Also as capsules and tablets. To be effective, they should be consumed daily.  Many probiotics should be kept refrigerated and should be consumed before the expiry date. There is no established dose for these products.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications None known.
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications None reported1.
Adverse effects None known.
References 1.            Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Royal Jelly is a milky-white substance produced by the salivary glands of worker bees as a food source for the queen bee. It is an essential food for the queen bee.
Function/ Used for Royal jelly supplements are thought to assist general well-being.  It may have antiseptic properties and also act as a vasodilator (widening of blood vessels).
Intake N/A  
As a supplement Royal jelly is available in the form of tablets and capsules. The dose is not established. Dietary supplements provide 250-500mg daily1.
Found in (dietary sources) N/A
Deficiency N/A
Precautions and contraindications Not to be taken by asthma sufferers or those allergic to bee stings.
Use in pregnancy and breastfeeding No problems reported, but there is insufficient evidence to guarantee the safety of royal jelly in pregnancy and breastfeeding.
Interactions e.g. with other medications None reported
Adverse effects Allergic reactions, which can be severe.
References 1.            Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Selenium is an essential trace element.
Function/ Used for Selenium is part of an antioxidant system. It protects the body's cells from damage and helps maintain the body’s defence system. Selenium also works in conjunction with vitamin E and is a component of many enzymes.
Intake Recommended Intake EU NRV: 55µg UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include whole wheat, meat, eggs, offal, fish, shellfish and Brazil nuts. In plant foods, selenium content is affected by the selenium content of the soil in which the plants have been grown.
Deficiency Deficiency has been associated with muscle pain and tenderness and some cases of cardiomyopathy (a group of diseases that affect the heart muscle).
Precautions and contraindications Safe Upper Level: 350µg2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy from normal intakes.
Interactions e.g. with other medications Yeast-containing selenium products should be avoided by people taking monoamine oxidase inhibitors (used for the treatment of depression). The anti-psychotic drug Clozapine may reduce selenium levels. Oral corticosteroids, an anti-inflammatory drug, may increase loss of selenium in urine.3,4
Adverse effects Adverse effects reported include hair loss, nail changes, skin lesions, nausea, diarrhoea, irritability, metallic taste, garlic-smelling breath, fatigue and peripheral neuropathy (damage to the nerves in the extremities of the body such as feet and hands).2
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions.  HealthNotes 2006.
 
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Description Vitamin A is a fat-soluble vitamin stored mainly in the liver. Dietary Reference Values express the requirement for vitamin A in terms of retinol equivalents.
Function/ Used for Vital for maintaining good eyesight, particularly for the normal function of the retina and visual adaptation to darkness, and healthy skin. It is also important for growth in children.
Intake Recommended intake EU NRV: 800µg   Chief Medical Officer recommendations are that all children aged six months to five years should take a daily supplement containing vitamins A, C and D.   UK average daily intake Requirements vary depending on age and gender.  The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes.1
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) The richest natural sources are fish liver oils. It is also very concentrated in animal liver. Other sources include oily fish, egg yolk, fortified margarine, butter and full fat milk.
Deficiency Vitamin A deficiency is prevalent in young children in developing countries and is associated with general malnutrition in these countries.2,3 In the UK, deficiency is relatively rare (especially in adults). Deficiency symptoms include an increased susceptibility to infections, scaly skin, flaking scalp, brittle, dull hair; poor eyesight and night vision, loss of appetite.2,3
Precautions and contraindications Just before, or during the first three months of pregnancy, women are advised by the Department of Health that they should not eat liver, or take vitamin A supplements which contain more than the 800µg NRV unless under medical supervision. As vitamin A (retinol) is teratogenic, it may induce developmental abnormalities in a foetus if taken in high amounts just before, or during the first three months of pregnancy. However, too little vitamin A in pregnancy can also cause problems.3   Safe Upper Level: 1500µg/day2
Use in pregnancy and breastfeeding The Department of Health recommends that women who are (or may become) pregnant should not take dietary supplements that contain vitamin A (including fish liver oil), except on the advice of a doctor or antenatal clinic, and should also avoid eating liver and products containing liver (e.g. liver pate and liver sausage).4
Interactions e.g. with other medications People taking anticoagulants, retinoids, or statins should seek medical advice before taking Vitamin A. The weight-loss drug orlistat and cholesterol-reducing drugs may reduce the absorption of vitamin A and other fat-soluble vitamins (D, E, K).3,5
Adverse effects Acute toxicity may be induced by single doses of 300mg retinol in adults, 60 mg retinol in children or 30 mg retinol in infants. Signs and symptoms are usually temporary (usually occurring about 6 hours after ingestion of acute dose and disappearing after 36 hours) and include severe headache (due to raised intracranial pressure), sore mouth, bleeding gums, dizziness, vomiting, blurred vision, irritability and (in infants) bulging of the fontanelle. Signs of chronic toxicity may appear when daily intake is >15mg retinol in adults and 6 mg in infants and young children. Signs may include dryness of the skin, dermatitis, skin rash, skin scaliness, disturbed hair growth, bone and joint pain, headache, fatigue, irritability, insomnia, anorexia, nausea, vomiting, diarrhoea, and weight loss.2
References 1.       https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.       Expert Group on Vitamins and Minerals, 2003. 3.       Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.       NHS Choices. Foods to avoid in pregnancy. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/foods-to-avoid-pregnant.aspx#vitamin 5.       Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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Description Thiamin is water soluble and part of the B-vitamins group.
Function/ Used for Thiamin aids the nervous system and is essential for the functioning of some important enzymes. These enzymes have vital roles in the processes that make energy available in the body. Thiamin is essential for the transmission of certain types of nerve signal between the brain and the spinal cord.
Intake Recommended intake EU NRV: 1.1mg   Thiamin requirements depend on energy intake; values are therefore often given as mg/1000 kcal and also as total values based on estimated average energy requirements for the majority of people in the UK.   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Brown rice, peas, beans and other vegetables, fortified breakfast cereals, wholemeal breads and cereals, eggs, pork, bacon and liver.
Deficiency Thiamine deficiency may lead to beri-beri (rare in the UK) which affects the cardiovascular and nervous systems. Deficiency is associated with abnormalities of carbohydrate metabolism. Early signs of deficiency include depression, poor memory, muscle weakness and stiffness, nerve tingling, burning sensation and numbness, tiredness, headache, loss of appetite and nausea.3
Precautions and contraindications Known hypersensitivity to thiamin. Safe Upper Level: 100mg/day2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications Excessive alcohol intake induces thiamin deficiency. Prolonged use of oral contraceptives may induce thiamin deficiency. Adequate amounts of all B vitamins are required for optimal functioning; deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another.3
Adverse effects There appear to be no toxic effects (except possibly gastric upset) with high oral doses. There have, however, been rare reports of anaphylactic reactions (coughing, difficulty in breathing and swallowing, flushing, skin rash, swelling of face, lips and eyelids).
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Vitamin B12 is a water soluble vitamin and a member of the B-vitamins group.
Function/ Used for Vitamin B12 is essential in the functioning of the nervous and immune systems; red blood cell formation and RNA and DNA synthesis. It is also involved in energy production and works synergistically with vitamin B6 and folic acid in homocysteine (an amino acid) metabolism.
Intake Recommended intake EU NRV: 2.5µg (micrograms)   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Vitamin B12 is found only in animal products and certain foods fortified with the vitamin, therefore, vegans and strict vegetarians are at risk of deficiency. Good sources include meat, liver, kidney, poultry, fish, eggs, dairy products and fortified breakfast cereals.
Deficiency Deficiency of vitamin B12 leads to enlarged, but fewer red blood cells (megaloblastic anaemia). Other deficiency symptoms include mood changes, sore tongue, fatigue, weakness and lack of concentration.3
Precautions and contraindications None known. Safe Upper Level: 2000µg/day1
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy with normal intakes.
Interactions e.g. with other medications Excessive intake of alcohol may reduce the absorption of vitamin B12. Oral contraceptives may reduce blood levels of vitamin B12. Large doses of folic acid given continuously may reduce vitamin B12 in blood or may mask symptoms of megaloblastic anaemia. Vitamin C may destroy vitamin B12 (avoid large doses of vitamin C within one hour of taking oral vitamin B12).3,4   All B vitamins act synergistically and excess levels of one may lead to imbalance or deficiency in others.  It is advisable to take B vitamins as a complex rather than as single substance supplements.
Adverse effects Vitamin B12 may occasionally cause diarrhoea and itching skin. Megadoses may exacerbate acne.
References 1.       https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.       Expert Group on Vitamins and Minerals, 2003. 3.       Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.       Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
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Description Riboflavin is water soluble and part of the B-vitamins group.
Function/ Used for Riboflavin is essential for the formation of two substances: FAD (flavin adenine dinucleotide) and FMN (flavin mononucleotide). Both are vital for the processes that make energy available in the body. Riboflavin works effectively with iron, vitamin B6 and folic acid. It is important for the nervous system, skin and eye health.
Intake Recommended intake EU NRV: 1.4mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Liver, kidneys, fortified breakfast cereals, meat, milk, some green vegetables, eggs, cheese, yeast extracts. Riboflavin is degraded by heat and also exposure to light. This is significant with respect to milk, which is a major source of riboflavin (i.e. if milk is exposed to bright sunlight/light for long periods of time).
Deficiency Trembling, dizziness, poor concentration and memory. Also, blood-shot, red, tired or gritty eyes; Mouth ulcers or sores and cracks at the corner of the mouth; Red, inflamed tongue and lips and scaly eczema-like skin rash.3
Precautions and contraindications Safe Upper Level: 40mg/day2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications Excessive alcohol intake induces riboflavin deficiency. Prolonged use of oral contraceptives may induce riboflavin deficiency. Deficiency of riboflavin may impair iron metabolism and produce anaemia. Adequate amounts of all B vitamins are required for optimal functioning; deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another.3  
Adverse effects None known, although large doses may cause a yellow discolouration of the urine.
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2         Expert Group on Vitamins and Minerals, 2003. 3         Mason, P. Dietary Supplements
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Description Niacin is water soluble and is part of the B-vitamins group. Vitamin B3 comes in two common forms: Nicotinamide (the active form) and Nicotinic Acid.
Function/ Used for Niacin is vital for energy release in tissues and cells. It helps form NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate), two coenzymes which are involved in the release of energy from food. Niacin helps maintain healthy nervous and digestive systems. It is also essential for normal growth and for healthy skin.
Intake Recommended intake EU NRV: 16mg (nicotinamide)   Niacin requirements depend on energy intake; values are therefore given as mg/1000 kcal and also as total values based on estimated average energy requirements for the majority of people in the UK.   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.  
As a supplement Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Meat, oily fish, poultry, bread, potatoes and breakfast cereals. Niacin can be synthesised from tryptophan (an essential amino acid).
Deficiency Niacin deficiency (rare in the UK) may lead to pellagra which means ‘raw skin’. Early signs of deficiency are vague and non-specific and may include loss of appetite, headache, nausea, fatigue, mouth ulcers, dry skin, difficulty sleeping, poor memory and irritability. The severe deficiency state of pellagra is characterised by dermatitis (predominantly in the areas of skin exposed to sunlight), dementia (associated with confusion, disorientation, seizures and hallucinations) and  diarrhoea.3
Precautions and contraindications Large doses of niacin are best avoided in gout (may increase uric acid levels); peptic ulcer (large doses may activate an ulcer); and liver disease (large doses cause deterioration). Large doses should also be used with caution in diabetes mellitus.3   Safe Upper Level: 500mg/day2 (nicotinamide); 17mg/day2 (nicotinic acid).
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications Prolonged use of oral contraceptives may induce niacin deficiency. Adequate amounts of all B vitamins are required for optimal functioning; deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another.3
Adverse effects Doses of over 150mg of the nicotinic acid form may cause temporary flushing of the skin in some people.
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
 
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Description Vitamin B6 is also known as pyridoxine. It is a water soluble vitamin and member of the B-vitamins group.
Function/ Used for Vitamin B6 is important in the functioning of more than 60 enzymes including those responsible for energy production; protein metabolism; RNA and DNA synthesis and the production of red blood cells and antibodies which fight infections. It also supports healthy skin and is essential for maintaining a healthy nervous system. It may also be helpful in reducing the severity of pre-menstrual syndrome.
Intake Recommended intake EU NRV: 1.4mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Wholemeal bread, meat (especially liver and pork), fish, bananas, wheat bran and fortified breakfast cereals.
Deficiency Vitamin B6 deficiency is unusual. Symptoms include anaemia; cracks in the corners of the mouth; red and inflamed tongue; sensation of burning skin and poor blood sugar balance. Advanced deficiency may produce weakness, irritability, depression, dizziness, peripheral neuropathy and seizures. Diarrhoea, anaemia and seizures are particular characteristics of deficiency in infants and children.2
Precautions and contraindications Safe Upper Level: 10mg/day3
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy with normal intakes.
Interactions e.g. with other medications Oral contraceptives may increase requirement for vitamin B6.4 Deficiency of vitamin B6 may lead to vitamin C deficiency. All B vitamins act synergistically and excess levels of one may lead to imbalance or deficiency in others.  It is advisable to take B vitamins as a complex rather than as single substance supplements.
Adverse effects Adverse effects usually occur with large doses only.  Taking more than 200mg a day for a long time can lead to a loss of feeling in the arms and legs (peripheral neuropathy), unsteady gait, numbness and tingling in feet and hands, loss of limb reflexes, impaired or absent tendon reflexes, photosensitivity on exposure to sun, dizziness, nausea, breast tenderness, and exacerbation of acne.2
References 1 https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3 Expert Group on Vitamins and Minerals, 2003. 4 Gaby A.R. A-Z Guide to Drug-Herb-Vitamin Interactions. Health Notes. Three Rivers Press. New York. 2006
 
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Description Vitamin C, also known as ascorbic acid, is a water soluble vitamin.
Function/ Used for Vitamin C acts as an anti-oxidant, neutralising free radicals to protect cells. Vitamin C is involved in the synthesis of collagen and other constituents of bone, teeth and capillaries. It aids wound healing. It is also necessary for the function of several enzymes and it increases the absorption of iron in the gut. Vitamin C may have a role in protecting against the common cold as well as conditions such as cancer, cardiovascular disease, cataracts, diabetes and Parkinson’s disease.
Intake Recommended intake EU NRV: 80mg   Chief Medical Officer recommendations are that all children aged six months to five years should take a daily supplement containing vitamins A, C and D.   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Foods of plant origin, particularly citrus and soft fruits (such as oranges, strawberries, kiwi, blackcurrant, guava) and vegetables (such as kale, broccoli, brussels sprouts, peppers, potatoes, tomatoes) are major sources of vitamin C. Vitamin C is readily lost during storage and cooking.
Deficiency Vitamin C deficiency may lead to scurvy. Early symptoms in adults include fatigue, weakness, aching joints and muscles. In later stages, symptoms of scurvy include anaemia, swollen and bleeding gums and delayed wound healing. In children, bones, teeth and blood vessels develop abnormally and growth is affected. Low levels of vitamin C have been associated with poor wound healing and ulceration.3
Precautions and contraindications Vitamin C supplements should be used with caution by people with diabetes and by sufferers of disorders of iron metabolism or storage e.g. haemochromatosis and thalasaemia.3   Safe Upper Level: 1000mg/day2
Use in pregnancy and breastfeeding Long term intakes of large doses of vitamin C in pregnancy may result in increased requirements for the vitamin and scurvy in the offspring.
Interactions e.g. with other medications Vitamin C has an impact on how drugs are metabolized in the liver. Large doses of vitamin C may affect how drugs are absorbed and utilized. Prolonged use of oral contraceptives may reduce blood levels of vitamin C. Taking aspirin may lead to increased loss of vitamin C. Vitamin C may reduce the activity of the anti-coagulant warfarin (a blood-thinner). People taking warfarin should consult with their doctor before taking vitamin C supplements.3,4
Adverse effects There is no evidence of serious health risks associated with high doses of vitamin C but daily doses over 1g may lead to diarrhoea and gastric discomfort. Doses of 2g and above may result in increased risk of kidney stones.
References
  1. https://www.gov.uk/government/collections/national-diet-and-nutrition-survey
  2. Expert Group on Vitamins and Minerals, 2003.
  3. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.
  4. Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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Description A fat-soluble vitamin.
Function/ Used for Vitamin D helps the body to absorb and use calcium and phosphorus; which are essential for maintaining strong and healthy bones and teeth, as well as other body functions such as heart and muscle function. Vitamin D is also important for blood clotting, the immune system and muscle growth, development and function.
Intake Recommended intake EU NRV: 5µg (micrograms)   In July 2016 Public Health England published guidelines for vitamin D1: ·         Babies from birth to 1 year: 8.5-10µg/day all year round. ·         Children over 1 year and adults: 10 µg /day in the winter months ·         Pregnant and breastfeeding women and population groups at risk of vitamin D deficiency (those with minimal exposure to sunshine and those from minority ethnic groups with dark skin): 10 µg /day all year round   Chief Medical Officer recommendations are that all children aged six months to five years should take a daily supplement containing vitamins A, C and D.   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes2.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good food sources include full-fat dairy products, oily fish, egg yolks and fortified margarine. Food alone is unlikely to provide sufficient vitamin D. Vitamin D is also formed by the action of sunlight on the skin (from May to September in the UK).
Deficiency Vitamin D deficiency results in poor growth, bone pain and deformities (rickets in children and osteomalacia in adults), osteoporosis, gum disease, constipation and muscle weakness.3
Precautions and contraindications Vitamin D should be avoided in hypercalcaemia (high levels of calcium in the blood). Safe Upper Level: 25µg2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy at normal intakes.
Interactions e.g. with other medications Anticonvulsants (used to prevent epileptic seizures) may reduce the effect of vitamin D by accelerating its metabolism. The weight loss drug orlistat and cholesterol-lowering drugs can reduce the absorption of vitamin D and other fat-soluble vitamins (A, E and K). Calcium may increase risk of hypercalcaemia.3,4
Adverse effects There is no risk of vitamin D toxicity from prolonged exposure to sunlight. Excessive dietary intake may lead to hypercalcaemia, which can weaken the bones and damage the kidneys and heart.
References 1 https://www.gov.uk/government/news/phe-publishes-new-advice-on-vitamin-d 2 Expert Group on Vitamins and Minerals, 2003. 3 Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4 Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.  
 
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Description Vitamin E is a family of fat soluble vitamin substances which include both tocopherols and tocotrienols.
Function/ Used for Vitamin E acts as an antioxidant helping to neutralise potentially damaging free radicals in the body. Vitamin E is particularly important for the protection of cell membranes as well as maintaining healthy skin, heart and circulation, nerves, muscles and red blood cells.
Intake Recommended intake EU NRV: 12mg   UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Seed oils, and the outer germ of cereals are the richest sources of vitamin E as well as olive oil, avocado pear, muesli, nuts, leafy green vegetables, wholemeal bread, cereals and egg yolks. Vitamin E is not very stable and is readily lost during storage and cooking, particularly if there is significant exposure to heat and oxygen.
Deficiency None known.
Precautions and contraindications Vitamin E supplements should be avoided by patients  taking oral anticoagulants and by patients with iron deficiency anaemia and hyperthyroidism. Safe Upper Level: 540mg/day2
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy at normal intakes.
Interactions e.g. with other medications Prolonged use of oral contraceptives may reduce blood levels of vitamin E. The weight loss drug orlistat and cholesterol-lowering drugs can reduce the absorption of vitamin E and other fat-soluble vitamins (A, D and K). Vitamin E supplements may affect blood coagulation and should be avoided by patients taking oral anticoagulants such as warfarin (blood thinners).3
Adverse effects Vitamin E is relatively non-toxic. Large doses in excess of 1000mg daily for prolonged periods have occasionally been associated with increased bleeding tendency in vitamin K-deficient patients; and rarely, blurred vision, diarrhoea, dizziness, fatigue and weakness, headache and nausea.3
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Expert Group on Vitamins and Minerals, 2003. 3.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.  
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Description Vitamin K is a fat-soluble vitamin.
Function/ Used for Vitamin K is required for the formation of several of the proteins, called ‘clotting factors’ that regulate blood clotting, which means it helps heal wounds. Vitamin K is also required for the formation of some proteins which are important for the maintenance of healthy bones and teeth
Intake Recommended intake EU NRV: 75µg   UK average daily intake UK dietary intake is unknown.
As a supplement
Found in (dietary sources) Green vegetables such as kale and spinach, potatoes, liver, soya beans and vegetable oils. Vitamin K is also synthesised by gut bacteria and this contributes significantly towards the daily requirement of the vitamin.
Deficiency None known.
Precautions and contraindications Safe Upper Level: 1000µg/day1
Use in pregnancy and breastfeeding There is no evidence of adverse effects in pregnancy at normal intakes. New-born infants are routinely given vitamin K injections or supplements.
Interactions e.g. with other medications Those taking anti-coagulants (such as warfarin) should not take supplements containing over 100mg Vitamin K except on the advice of a doctor. Antibiotics can destroy vitamin K producing bacteria in the gut and may increase requirements for vitamin K. The weight-loss drug orlistat and cholesterol-reducing drugs may reduce the absorption of vitamin K and other fat-soluble vitamins (A, D, E)2,3
Adverse effects None known.
References 1.     Expert Group on Vitamins and Minerals, 2003. 2.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
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Description Zinc is an essential trace mineral.
Function/ Used for Zinc is an important part of many enzymes, some of which have key roles in the formation of new proteins - one of the processes involved in tissue growth. Zinc is required to aid growth of the immune cells plus maintenance of hair, skin and nails. Superoxide dismutase (a powerful antioxidant enzyme that neutralises potentially damaging free radicals) requires zinc. Zinc is also essential for reproduction.
Intake Recommended intake EU NRV: 10mg UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes1.
As a supplement Available as a single supplement. Also commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources) Good sources include red meat, liver, shellfish (especially oysters), egg yolks, dairy products, wholegrain cereals and pulses.
Deficiency Signs of mild to moderate deficiency include growth retardation, male hypogonadism (the testes produce few or no sex hormones), poor appetite, rough skin, mental lethargy, delayed wound healing and impaired taste. Severe zinc deficiency symptoms include alopecia (hair loss), diarrhoea, dermatitis, psychiatric disorders, weight loss, infection (due to impaired immune function), hypogonadism in males, and poor ulcer healing. Maternal zinc deficiency before and during pregnancy may lead to growth retardation and congenital abnormalities in the foetus.2
Precautions and contraindications Those people with liver damage or an intestinal disorder should consult their doctor before taking supplements containing zinc. Safe Upper Level: 25mg/day3
Use in pregnancy and breastfeeding Zinc is suitable to be taken at recommended daily doses during pregnancy and breastfeeding.
Interactions e.g. with other medications High doses of zinc upset absorption of iron and copper. Folic acid and iron reduce zinc absorption. Zinc may decrease the absorption of some antibiotics – they should be taken two hours before or four to six hours after taking a zinc supplement. Zinc can also reduce the absorption and action of penicillamine, a drug used to treat rheumatoid arthritis – they should be taken two hours apart. Long term use of oral contraceptives may reduce zinc levels.2,4
Adverse effects Signs of acute toxicity (doses >200mg daily) include gastrointestinal pain, nausea, vomiting and diarrhoea. Prolonged exposure to doses >50mg daily may induce copper deficiency and iron deficiency. Doses >150mg daily may reduce serum HDL-cholesterol levels, depress immune function and cause gastric erosion.2
References 1.     https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2.     Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 3.     Expert Group on Vitamins and Minerals, 2003. 4.     Gaby, A. R. A-Z Guide to Drug-Herb-Vitamin Interactions. HealthNotes 2006.
 
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