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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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