Heathy Body

[The lady who signed below is a Budget Analyst out of the Federal Washington D.C. office. ]

Did you ever wonder how much it costs a drug company for the active Ingredient in prescription medications?

Some people think it must cost a lot, since many drugs sell for a lot of money by the tablet. As we have revealed in past issues of Life Extension, a significant percentage of drugs sold in the United Statescontain active ingredients made in other countries.

In our independent investigation of how much profit drug companies really make we obtained the actual price of active ingredients used in some of the most popular drugs sold in America. The chart below speaks for itself.

Celebrex 100 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%

Claritin 10 mg
Consumer Price (100 tablets): $215.17
Cost of general active ingredients: $0.71
Per cent markup: 30,306%

Keflex 250 mg
Consumer Price (100 tab lets): $157.39
Cost of general! active ingredients: $1.88
Percent markup: 8,372%

Lipitor 20 mg
Consumer Price (100 tablets): $272.37
Cost of general active ingredients: $5.80
Percent markup: 4,696%

Norvasc 10 mg
Consumer price (100 tablets): $188.29
Cost of general active ingredients: $0.14
Percent markup: 134,493%

Paxil 20 mg
Consumer price (100 tablets): $220.27
Cost of general active ingredients: $7.60
Percent markup: 2,898%

Prevacid 30 mg
Consumer price (100 tablets): $44.77
Cost of general active ingredients: $1.01
Percent markup: 34,136%

Prilosec 20 mg
Consumer price (100 tablets): $360.97
Cost of general active ingredients $0.52
Percent markup: 69,417%

Prozac 20 mg
Consumer price (100 tablets) : $247.47
Cost of general active ingredients: $0.11
Percent markup: 224,973%

Tenormin 50 mg
Consumer pr ice (100 tablets): $104.47
Cost of general active ingredients:$0.13
Percent markup: 80,362%

Vasotec 10 mg
Consumer price (100 tablets): $102.37
Cost of general active ingredients: $0.20
Percent markup: 51,185%

Xanax 1 mg
Consumer price (100 tablets) : $136.79
Cost of general active ingredients: $0.024
Percent markup: 569,958%

Zestril 20 mg
Consumer price (100 tablets) $89.89
Cost of general active ingredients $3.20
Percent markup: 2,809%

Zithromax 600 mg
Consumer price (100 tablets): $1,482.19
Cost of general active ingredients: $18.78
Percent markup: 7,892%

Zocor 40 mg
Consumer price (100 tablets): $350.27
Cost of general active ingredients: $8.63
Percent markup: 4,059%

Zoloft 50 mg
Consumer price: $206.87
Cost of general active ingredients: $1.75
Percent markup: 11,821%

Since the cost of prescription drugs is so outrageous, I thought everyone I knew should know about this. P lease read the following and pass it on. It pays to shop around. This helps to solve the mystery as to why they can afford to put a Walgreens on every corner.

On Monday night, Steve Wilson, an investigative reporter for channel 7 News
in Detroit, did a story on generic drug price gouging by pharmacies. He found in his investigation, that some of these generic drugs were marked up as much as 3,000% or more. Yes, that's not a typo.....three thousand percent!

So often, we blame the drug companies for the high cost of drugs, and usually rightfully so. But in this case, the fault clearly lies with the pharmacies themselves.

For example, if you had to buy a prescription drug, and bought the name brand, you might pay $100 for 100 pills. The pharmacist might tell you that if you get the generic equivalent, they would only cost $80, making you think you are "saving" $20. What the pharmacist is not telling you is that those 100 generic pills may have only cost him $10!

At the end of the report, one of the anchors asked Mr. Wilson whether or not there were any pharmacies that did not adhere to this practice, and he said that Costco consistently charged little over their cost for the generic drugs.

I went to the Costco site, where you can look up any drug, and get its online price. It says that the in-store prices are consistent with the online prices. I was appalled.

Just to give you one example from my own experience, I had to use the drug, Compazine, which helps prevent nausea in chemo patients. I used the generic equivalent, which cost $54.99 for 60 pills at CVS. I checked the price at Costco, and I could have bought 100 pills for $19.89.

For 145 of my pain pills, I paid $72.57. I could have got 150 at Costco for $28.08. I would like to mention, that although Costco is a "membership" type store, you do NOT have to be a member to buy prescriptions there, as it is a federally regulated substance. You just tell them at the door that you wish to use the pharmacy, and they will let you in (this is true, I went there this past Thursday and asked them).

I am asking each of you to please help me by copying this letter, and pasting it into your own email, and send it to everyone you know with an email address

Sharon L. Davis
Budget Analyst
U.S. Department of Commerce
Room 6839
Office Ph: 202-482-4458

Doctors and scientists are learning how emotions are connected to our physical health By Michael D. Lemonick

Posted Sunday, January 12, 2002; 8:31 a.m. EST
If you close your eyes and think about it for a while, as philosophers have done for centuries, the world of the mind seems very different from the one inhabited by our bodies. The psychic space inside our heads is infinite and ethereal; it seems obvious that it must be made of different stuff than all the other organs. Cut into the body, and blood pours forth. But slice into the brain, and thoughts and emotions don't spill out onto the operating table. Love and anger can't be collected in a test tube to be weighed and measured.

Rene Descartes, the great 17th century French mathematician and philosopher, enshrined this metaphysical divide in what came to be known in Western philosophy as mind-body dualism. Many Eastern mystical traditions, contemplating the same inner space, have come to the opposite conclusion. They teach that the mind and body belong to an indivisible continuum. In the past, doctors and scientists have tended to dismiss that view as bunk, but the more they learn about the inner workings of the mind, the more they realize that in this regard at least, the mystics are right and Descartes was dead wrong.

Mind and body, psychologists and neurologists now agree, aren't that different. The brain is just another organ, albeit more intricate than the rest. The thoughts and emotions that seem to color our reality are the result of complex electrochemical interactions within and between nerve cells. The disembodied voices of schizophrenia and the feelings of worthlessness and self-hatred that accompany depression, although they seem to be based on reality, are no more than distortions in brain electrochemistry. Researchers are learning how these distortions arise, how to lessen their severity and, in some cases, how to correct them.

Scientists are also learning something else. Not only is the mind like the rest of the body, but the well-being of one is intimately intertwined with that of the other. This makes sense because they share the same systems—nervous, circulatory, endocrine and immune. What happens in the pancreas or liver can directly affect brain function. Disorders of the brain, conversely, can send out biochemical shock waves that disturb the rest of the body. The pages that follow, our annual special report on health, take you to the cutting edge of mind-body research, where scientists, having left Descartes's great mistake far behind, are exploring how the brain works, how it malfunctions, and what can be done when it goes awry.

• How Your Mind Can Heal Your Body: The risk of dying from cardiovascular disease after having a heart attack is four to six times greater if you also suffer from depression, TIME's Michael Lemonick reports in TIME's 47-page package on Mind and Body. Heart disease is one of a long list of illnesses that worsen with depression. People with such afflictions as cancer, diabetes, epilepsy and osteoporosis all appear to run a higher risk of disability or premature death when they are clinically depressed. The effect is potentially so significant that the medical profession has begun to focus serious attention and resources on trying to understand what's going on. TIME's 5th annual Health Special Issue examines new ways to beat the blues, as well as:

--Women, men and depression - by TIME's Jeffrey Kluger
--Can Freud make a comeback? - by TIME's Lev Grossman
--Meditation - by Dr. Mehmet Oz, director of Columbia Presbyterian Hospital's Heart Institute
--Alternative treatments for anxiety! and depressio! n - by Dr. Andrew Weil
--Is happiness in your genes? - by Steven Pinker, M.I.T. psychology professor
--The making of a disorder - by TIME's John Cloud
--The aggressive child - by TIME's Alice Park
--Anti-depressants - by Dr. Sanjay Gupta
--The Year in Medicine: Your guide to the major advances

We spoke with TIME sciences writer Michael Lemonick, who has written over 40 cover stories for TIME, about this week's cover story.

QUESTION: What is the most important thing readers should learn from this TIME cover story?

LEMONICK: They should learn that a prejudice of Western medicine for at least the past 300 years--that mind and body are two separate parts of the human organism--is dead wrong. Not only is the brain just another (although very special) organ, made of the same flesh and blood as the heart or liver or kidneys, but states of mind, including mental illness, can directly affect the functioning of the body. And the opposite is also tru! e: physical wellness or illness have a powerful influence on ! our state of mind.

LEMONICK: Two things. First, the amount of research into mind-body interactions has exploded over the past few years, as medical scientists have begun to understand how important the phenomenon is, and how many different aspects it has. Second, and always a powerful impetus for a TIME cover story, mind-body medicine overturns longstanding and widely-held beliefs about how we function. It's seems obvious to just about everyone that the mind--memory, consciousness, mood--has a reality beyond the physical. And when the deeply obvious turns out not to be true at all, that's news.

QUESTION: Are there other health conditions, beyond heart disease and osteoporosis, that are strongly affected by depression, but the research is limited?

LEMONICK: Absolutely. The data are best on heart disease; it turns out that people with that condition who are also suffering from depression are six t! imes more likely to die from the heart disease than those who aren't. But there's also evidence that depression will worsen the risk of serious complications or death, not just from osteoporosis, but also from diabetes, cancer, epilepsy and many other diseases.

QUESTION: Are there specific study results that you are looking forward to seeing in the next year or two?

LEMONICK: If you have a couple of hours, I'd be glad to fill you in. The truth is that now that medical science has begun to take this problem seriously (the National Institutes of Health held a meeting to try and understand the scope of depression-disease link back in November), there are literally hundreds of studies that have been launched or refocused to put actual numbers to the phenomenon. Results will be literally pouring in over the next few years, as doctors not only try to get a handle with the mental disease/physical disease link, but try to figure out how to deal with it.

-----Original Message-----
From: Rita El-Hage [mailto:newform@ghana.com]
Sent: Thursday, February 07, 2002 11:24 AM
To: A. G. Kenicer
Subject: VERY IMPORTANT!!!!!

Subject: VERY IMPORTANT PLEASE READ: RECALL of MEDICINES
Date: Wed, 6 Feb 2002 09:21:16 -0000

Hey guys,
You know I do not send joke and I certainly hate to receive them. This is not a joke, we actually use some of this stuff. Please read throughthe whole text......ram
IMPORTANT!!!
All drugs containing Phenylpropanolamine are being recalled. You may want to try calling the 800 number listed on most drug boxes and inquire about a REFUND.

Please read this CAREFULLY, as I know that some of you may USE some of these drugs (Alka Seltzer Plus for one).

Also, please pass this on to everyone you know. STOP TAKING anything containing this ingredient. It has been linked to increased hemorrhagic stroke (bleeding in brain) among women ages 18-49 in the three days after starting use of medication.
Problems were not found in men, but the FDA recommended that everyone (even children) seek alternative medicine.

The following medications contain Phenylpropanolamine:

Acutrim Diet Gum Appetite Suppressant Plus Dietary Supplements
Acutrim Maximum Strength Appetite Control
Alka-Seltzer Plus Children's Cold Medicine Effervescent
Alka-Seltzer Plus Cold medicine (cherry or orange)
Alka-Seltzer Plus Cold Medicine Original
Alka-Seltzer Plus Cold & Cough Medicine Effervescent
Alka-Seltzer Plus Cold & Flu Medicine Effervescent
Alka-Seltzer Plus Cold & Sinus Effervescent
Alka Seltzer Plus Night-Time Cold Medicine Effervescent
BC Allergy Sinus Cold Powder
BC Sinus Cold Powder
Comtrex Deep Chest Cold & Congestion Relief
Comtrex Flu Therapy & Fever Relief
Day & Night Contac 12-Hour Cold Capsules
Contac 12 Hour Caplets
> > > Coricidin D Cold, Flu & Sinus
Dexatrim Caffeine Free
Dexatrim Extended Duration
Dexatrim Gelcaps
Dexatrim Vitamin C/Caffeine Free
Dimetapp Cold & Allergy Chewable Tablets
Dimetapp Cold & Cough Liqui-Gels
Dimetapp DM Cold & Cough Elixir
Dimetapp Elixir
Dimetapp 4 Hour Liquid Gels
Dimetapp 4 Hour Tablets
Dimetapp 12 Hour Extentabs Tablets
Naldecon DX Pediatric Drops
Permathene Mega-16
Robitussin CF
Tavist-D 12 Hour Relief of Sinus & Nasal Congestion
Triaminic DM Cough Relief
Triaminic Expectorant Chest & Head Congestion
Triaminic Syrup Cold & Allergy
Triaminic Triaminicol Cold & Cough

> > > I just found out and called the 800# on the container for Triaminic and they informed me that they are voluntarily recalling the following medicines because of a certain ingredient that is causing strokes and seizures in children:

Orange 3D Cold & Allergy Cherry (Pink)
3D Cold & Cough Berry
3D Cough Relief
Yellow 3D Expectorant

They are asking you to call them at 800-548-3708 with the lot number on the box so they can send you postage for you to send it back to them, and they will also issue you a refund. If you know of anyone else with small children,
PLEASE PASS THIS ON. THIS IS SERIOUS STUFF. DO PASS ALONG TO ALL ON YOUR MAILING LIST so people
are informed. They can then pass it along to their families.

To confirm these findings please take time to
check the following URL: www.fda.gov/cder/drug/infopage/ppa/default.htm

Courtesy of Ihsan Bou Sauder: Wash soda cans before drinking from them...

I received the following in email with first search on the net it confirms it's validity...

PLEASE READ

THIS IS NOT A JOKE

A stock clerk was sent to clean up a storeroom at their Maui, Hawaii location. When he got back, he was complaining that the storeroom was really filthy, and that he had noticed dried mouse or rat droppings in some areas. A couple of days later, he started feeling like a stomach flu, achy joints, headache, and he started throwing up. He went to bed and never really got up. Within two days he was so ill and weak. His blood sugar count was down to 66 and his face and eyeballs were yellow. He was rushed to the emergency room at Pali Momi, where they said he was suffering from massive organ failure. He died shortly before midnight. None of us would have ever made the
connection between his job and his death, but the doctors specifically asked if he had been in a warehouse or exposed to dried rat or mouse droppings at any time. They said
there is a virus (much like Hanta virus) that lives in dried rat and mouse droppings. Once dried, these droppings are like dust, and can easily be ingested if a person is not careful to wash their hands and face thoroughly, or wear protective gear. An autopsy was conducted to verify the doctors' suspicions. This is why it is extremely important to ALWAYS carefully rinse off the tops of any canned sodas or foods, and wipe off pasta packaging, cereal boxes, etc. Almost everything you buy in a supermarket was stored in a warehouse at one time or another, and stores themselves often have rodents. Most of us remember to wash vegetables and fruit but never think of boxes and cans. The ugly truth is that even the most modern, upper-class, super store has rats and mice. And their warehouse most assuredly does! Whenever you buy any canned soft drink, PLEASE make sure that you wash the top with running water and soap, or if not available, drink with a straw. A brief investigation by the Center for Disease Control in Atlanta, of soda cans, discovered that the top of soda cans can be encrusted lith dried rat's urine which is toxic and lethal! Canned drinks and other food stuffs are stored in warehouses and containers that are usually infested with rodents and then get transported to the retail outlets without being properly cleaned. PLEASE FORWARD THIS MESSAGE TO WHOM YOU CARE ABOUT
Check one of many sites you can see when you search for "Hanta virus"

We all have seen some loved ones get sick, go to the doctor, and spend a lot of money and time to get well. On occasions, we watched helplessly while they suffered with their sickness. Some got better and triumphed over their aliments, and on other occasions, they got sicker and died.

Usually, our wake-up call comes in after we discover that we are sick and there is something seriously wrong with our bodies. That is when we would pay attention and religiously follow doctors’ orders and take strong medications at the precise time prescribed. We would do anything for our loved ones to get them well. The sad thing is that by then it is beyond our control. It is in the hands of the doctors and God. Why wait until something bad happens. Now, while we and our loved ones are healthy, we can do something to maintain our health and significantly reduce our chances of getting sick.

Proper Vitamins, Minerals and Supplements play a vital role to boost our immune system. There are thousands of articles and many books on the subject that at times can be intimidating or overwhelming.

Recently, I watched Barbara Walters interview some well known character on 20/20. His "wake-up" call came when his friend was suddenly diagnosed with cancer and died within a short time. He decided to take a blood test which revealed that he also had prostate cancer. He promptly focused his energy and resources to combat this ailment. He made drastic changes in his diet and life style and so far has succeeded in improving his chances to be in remission and extending his life.

Some time ago, I had my blood and my hair analyzed. The doctor gave me recommendations to take supplements that the tests showed I was deficient in and I paid him a few hundred dollars. I did what many of us do when we see a doctor, be passive, let the doctor give us a brief explanation (that usually goes over our heads), give us the prescription and remain in the dark about our condition. We need to make the extra effort to familiarize ourselves with some basics in order to have more meaningful discussions with our doctor and healthcare practitioner. For example, I should have asked for copies of the tests and really go over the results with the doctor and educate myself about supplements. This has prompted me to take a PRO ACTIVE role, learn at least the basics of some very important health issues, take preventative measures where possible and share my findings with the people I love and care about. I was amazed how simple it was. My primary objective is to raise enough awareness in order to make informed decisions. Here’s a summary of what I learned:

Basically, a well balanced diet is the best primary source of nutrients. Since it is impractical to get all necessary nutrients from food, we need to take supplements. There are about two dozens important Vitamins, Minerals and other nutrients that our bodies need to supplement the food we eat. The key is to take the right potency of each to suit our personal condition. More than a dozen Vitamins and Minerals are included in one Multi Vitamin/Mineral (Multi) tablet. Others are not important enough to warrant taking them as a supplement. That leaves 4-8 supplements that we need to take in addition our Multi tablet to achieve optimum dosage.

Since I am not a doctor or nutritionist, I cannot prescribe or tell others what supplements to take. I can share with you what I learned from the experts, research, copies of worthwhile articles, and charts to help you arrive at the best supplement combination for you. After you have educated yourself with all this information, it is always recommended to discuss your results with a nutritionist or a doctor who is familiar with your medical background, nutritional supplements and alternative healing. Some people could be allergic to certain supplements or are taking medications that could have a negative effect if mixed with a certain supplement. For example, although Vitamin E is considered one of the most beneficial vitamins, (see items A & E herein), someone who is taking a particular heart medication should not take large doses of vitamin E. Also, those who have kidney stone condition should not take large doses of calcium.

Aside from supplements, regular EXERCISE (including WALKING, JOGGING, AEROBICS, SWIMMING, YOGA AND MEDITATION), MASSAGE, INOCULATION (including annual flu shots, hepatitis, tetanus, etc.), ACUPUNCTURE, CHIROPRACTIC and a well balanced DIET all play an important role to achieve OPTIMUM HEALTH.

I hope you will find the enclosed helpful and start a healthier path for you and your family.

THE REAL VITAMIN & MINERAL BOOK (Book). No book is complete or addresses all health issues, however, this is one of the best books that gives a good overview on the subject. It has easy to follow charts. Areas of importance in the book include:

Book: Daily Supplement Schedule: A chart to identify supplements in addition to Multi

Aside from mail order, drugstores and health food stores carry most of the vitamins and supplements. On the West Coast, Trader Joe’s (most famous for great wine, cheese and beer selections and values) has an excellent array of the important quality supplements at good prices under the name of Trader Darwin’s. One of the best and well rounded supplement combo, daily packets (5-7 tablets/ packet/ day), 30 day supply for men or women for about $10. (Compare the contents to the ODI Charts).

If you may be allergic to one or more of the items included in the multi tablets, then you could design a supplement to suit your individual needs. Costco has a great selection of Vitamins, Minerals & / or Multis under the Kirkland label. For example: a 500 one a day Multi tablets for about $12. That sure beats my previous Multi of 210 one a day tablets for $38 from a fancy Vitamin store. Of course they do not have the same potency, Costco’s has less of some and more of others. But, overall, it would make an excellent basic or main Multi. Complement it with a B-50 Kirkland Complex (which includes minerals) makes a great combination. The other primary items to add would be C, E, Calcium and magnesium. You may end up with several bottles of different tablets to take in the morning and/or evening. Label or group each accordingly. It may be a hassle to juggle all these bottles each day, open a bottle, take one tablet and close it. An easier way would be to place in one bottle the combination of tablets that you plan to take a.m., in another bottle for p.m. Put enough of each to last for 7, 10, 14 or 30 days depending on the bottle’s capacity. Place a sample tablets of the morning and/or evening supplements in clear plastic and tape it to each respective bottle. This way you would only open one bottle to take your supplements each morning and evening .

After you have calculated and written down your ODIs on the ODIs & Multi Comparison Sample Worksheet, buy a good Multi and write its potency in the next column of the chart and compare it to your ODIs. Mark down the items where there is a significant difference of important items to warrant adding them as supplements to the main Multi. (See sample worksheets for ODIs and Multi Comparison [pp 262-264] and Daily Supplement Schedule in Addition to Multi [265-266]). I included an extra chart of each just in case you change Multi or make an error. In addition to the Multi, buy the important supplements that your Multi is lacking and any additional supplements that you feel would be beneficial to you based on your own research or the info you read. Note: Just like the Multi, try to find tablets that contain several of the needed nutrients and potency in one tablet.

Not all Multi Vitamins are the same
Read the Vitamin Label to find out how they differ

What do they do? Multiple vitamin-mineral (MVM) supplements contain a variable number of essential and/or non-essential nutrients. Their primary purpose is to provide a convenient way to take a variety of supplemental nutrients from a single product, in order to prevent vitamin or mineral deficiencies, as well as to achieve higher intakes of nutrients believed to be of benefit above typical dietary levels.

Potassium is an unusual case, as adequate amounts of potassium cannot, by law, be sold in nonprescription products. Thus potassium, when included in an MVM formula, represents only a trivial amount. MVMs may contain iron, but these should be taken only by people who have been diagnosed as having, or being at high risk of, iron deficiency, or who have a history of frequent iron deficiencies.

Some nutrients may be beneficial at levels above what is possible to obtain from diet alone, and an MVM formula can provide these levels as well. Nutrients that may be useful to most people in larger amounts include vitamin C, folic acid, and calcium. Vitamin E has long been thought to protect against heart disease beginning at 100 IU per day, but a recent study has suggested that amounts of vitamin E available in MVM formulas may not be effective (see Atherosclerosis). Large amounts of vitamin B1, vitamin B2, vitamin B3, and pantothenic acid are often included in MVM formulas. Some people claim to experience improvements in mood, energy, and/or overall well-being when taking higher-than-RDA amounts of B vitamins. However, there is little scientific research to support those observations.

The common inclusion of the non-essential nutrient beta-carotene in MVMs remains speculative. The synthetic beta-carotene found in most MVMs clearly does not prevent cancer and may increase the risk of lung cancer in smokers. Therefore, the inclusion of synthetic beta-carotene in MVM formulas is of questionable value, and it should be avoided by smokers. This concern is validated by the results of a large study which found that male smokers who use multivitamins had a higher death rate from cancer than male smokers who did not use a multivitamin, presumably due to the synthetic beta-carotene content.¹ On the other hand, because beta-carotene can be converted to vitamin A without causing vitamin A toxicity, some manufacturers use beta-carotene as a source of vitamin A. However, natural beta-carotene and several other carotenoids may be helpful in preventing certain diseases, including some cancers.² ³ ⁴ Increasingly, natural beta-carotene and several other carotenoids are found in higher quality MVMs.

Another class of non-essential nutrients is the flavonoids, which have antioxidant and other properties and have been reported by some,⁵ though not all,⁶ researchers to be linked with a reduced risk of heart disease. MVM supplements also frequently include other nutrients of uncertain benefit in the small amounts supplied, such as choline, inositol, and various amino acids.

Preliminary⁷ and double-blind⁸ trials have shown that women who use an MVM containing folic acid beginning three months before becoming pregnant and continuing through the first three months of pregnancy, have a significantly lower risk of having babies with neural tube defects (e.g., spina bifida) and other congenital defects.

In one double-blind trial, schoolchildren received, for three months, a daily low-dose vitamin-mineral tablet containing 50% of the USRDA for most essential vitamins and the minerals, iron, zinc, chromium, manganese, molybdenum, selenium, and copper.⁹ The subjects were “working class,” primarily Hispanic, children, aged 6 to 12 years. Dramatic gains in certain measures of IQ were observed in about 20% of the supplemented children. These gains may have been due to the correction of specific nutrient deficiencies (for example, iron) found in these children. However, it was not possible in this study to identify which nutrients caused the increases in IQ.

Use of a multivitamin has been associated with reduced death rates from cardiovascular disease.¹⁰

What about “one-per-day” multiples? One-per-day multiples are primarily B-complex vitamins, with both vitamin A and vitamin D included either at high or low potency, depending on the supplement. The rest of the formula tends to be low potency. It does not take much of some of the minerals—for example, copper, zinc, and iron—to offer 100% or more of what people normally require, so these minerals may appear at reasonable levels in a one-per-day MVM.

One-per-day MVMs do not provide sufficient amounts of many nutrient supplements shown to benefit people eating a Western diet, such as vitamin E, calcium, magnesium, and vitamin C. One-per-day MVMs should therefore not be viewed as a way to “cover all bases” in the way that high-potency MVMs, requiring three or more pills per day, are viewed.

How much is usually taken? The following table shows the USRDA for nutrients as well as suggested optimum amounts of each vitamin and mineral that should be present in a daily MVM supplement for healthy people. Some people may want to take larger amounts because of specific health concerns. They should read the individual nutrient sections to learn about safe upper ranges of supplementation.

Nutrient	Daily Value (includes diet)	Suggested Daily Optimum in an MVM Supplement
Biotin	300 mcg	300 mcg
Calcium	1,000 mg	800–1,000 mg
Chromium	120 mg	120–200 mcg
Copper	2 mg	1–3 mg
Folate	400 mcg	400 mcg
Iodine	150 mcg	150 mcg
Iron	18 mg	People should avoid iron supplements unless they have been diagnosed with having, or being at high risk of, iron deficiency.
Magnesium	400 mg	250–400 mg
Manganese	2 mg	2–5 mg
Molybdenum	75 mcg	75 mcg
Niacin	20 mg	20 mg
Pantothenic acid	10 mg	10 mg
Riboflavin	1.7 mg	1.7 mg
Selenium	70 mcg	100–200 mcg
Thiamine	1.5 mg	1.5 mg
Vitamin A	5,000 IU	5,000 IU (as natural beta-carotene)
Vitamin B6	2 mg	10 mg
Vitamin B12	6 mcg	50 mcg
Vitamin C	60 mg	100–200 mg
Vitamin D	400 IU	400 IU
Vitamin E	30 IU	100–400 IU
Vitamin K	80 mcg	80 mcg
Zinc	15 mg	15–25 mg

Because one-per-day formulas typically do not contain even the minimum recommended amounts of some of the nutrients above, multiples requiring several capsules or tablets per day are preferable. With two- to six-per-day multiples, intake of pills should be spread out over the day, instead of taking them all at one sitting. The amount of vitamins and minerals can be easily increased or decreased by taking more or fewer of the multiple.

Which is better—capsule or tablet? Multiples are available as a powder inside a hard-shell pull-apart capsule, as a liquid inside a soft-gelatin capsule, or as a tablet.

Most multiples have all the ingredients mixed together. Occasionally the B vitamins react with the rest of the ingredients in the capsule or tablet. This reaction, which is sped up in the presence of moisture or heat, can cause the B vitamins to “bleed” through the tablet or capsule, discoloring it and also making the multiple smell. While the multiple is still safe and effective, the smell is off-putting and usually not very well tolerated. Liquid multiples in a soft-gel capsule—or tablets or capsules that are kept dry and cool—do not have this problem.

Capsules are usually not as large as tablets, and thus some people find capsules easier to swallow.

Some people prefer vegetarian multiples. While some capsules are made from vegetarian sources, most come from animal gelatin. Vegetarians need to carefully read the label to ensure they are getting a vegetarian product.

One concern people have with tablets is whether they will break down. Properly made tablets and capsules will both dissolve readily in the stomach.

What about timed-release? Some multiples are in timed-release form. The theory is that releasing vitamins and minerals slowly into the body over a period of time is better than releasing all of the nutrients at once. Except for work done on vitamin C—some of which showed timed-release C was better absorbed than non-timed-release—research on this question has been lacking. It is possible that some nutrients, especially minerals, will be poorly absorbed from timed-release multiples. Also, some doctors have concerns about the safety of ingesting the chemicals that are used in tablets or capsules to make them timed-release.

What about nutrient interactions? Another area of controversy is whether all of the nutrients in a multiple would be better utilized if they were taken separately. While certain nutrients compete with each other for absorption, this is also the case when the nutrients are supplied in food. For example, magnesium, zinc, and calcium compete; copper and zinc also compete. However, the body is designed to cope with this competition, which should not be a problem if multiples are spread out over the day.

What about chewables? Unfortunately, multiples do not taste very good. In order to make chewable multiples palatable, whether for children or adults, some compromises must be made. First, bad-tasting ingredients must be reduced or eliminated. Second, the rest of the ingredients must be masked with a sweetener.

Unless an artificial sweetener like aspartame (NutraSweet®) or saccharin is used, the only sweeteners available are sugars. Generally, consuming sugar is undesirable, and not having it in a chewable dietary supplement would be preferable. Xylitol, a natural sugar rarely used in chewables because it is relatively expensive, would be an ideal choice since it does not cause tooth decay or other known problems.

Some chewables, such as vitamin C, contain more sugar than any other ingredient. In such products, the sweetener should be listed as the first ingredient, but often is not. Care needs to be exercised when reading labels about chewable vitamins. If it tastes sweet, it contains sugar or a synthetic sweetener.

When is the best time to take a multiple? The best time to take vitamins or minerals is with meals. Multiples taken between meals sometimes cause stomach upset and are likely not to be as well absorbed.

References:
1. Watkins ML, Erickson JD, Thun MJ, et al. Multivitamin use and mortality in a large prospective study. Am J Epidemiol 2000;152:149–62.
2. Shekelle RB, Lepper M, Liu S, et al. Dietary vitamin A and risk of cancer in the Western Electric Study. Lancet 1981;2:1185–90.
3. Giovannucci E, Ascherio A, Rimm EB, et al. Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst 1995;87:1767–76.
4. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. JAMA 1994;272:1413–20.
5. Hollman PC, Katan MB. Absorption, metabolism and health effects of dietary flavonoids in man. Biomed Pharmacother 1997;51:305–10 [review].
6. Hertog MGL, Sweetnam PM, Fehily AM, et al. Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study. Am J Clin Nutr 1997;65:1489–94.
7. Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal mulitivitamin use. Am J Epidemiol 2000;151:878–84.
8. Czeizel AE. Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. Am J Med Genet 1996;62:179–83.
9. Schoenthaler SJ, Bier ID, Young K, et al. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med 2000;6:19–29.10. Watkins ML, Erickson JD, Thun MJ, et al. Multivitamin use and mortality in a large prospective study. Am J Epidemiol 2000;152:149–62.

Learn more about Healthnotes, the company.

Learn more about the authors of Healthnotes.

The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 20

			Multi Vit'n	Sellers	Compare ODV	Compare ODV	and supplement
Nutrient	ODV Range	Nutrient Benefits	Dr. Whittaker	Trader Joes	to Multi 1	to Multi 2	accordingly

Vitamin A	10,000-100,000	Antioxidant, Immune	20,000	25,000
Complex B	25-200	Immune - Fights Cancer	80	100
Folic Acid	400-2000	Cell Growth - Reproduct	400	400
C	1000-4000	AntiOx, Hair, skin, Bone	1,300	1,000
D	400-800	Bones - Osteoperosis	400	400
E	100-800	AntiOx, Hair, skin,Heart	800	400
Calcium	800-1800	Diabetes, Osteo, Nerves	1000	1,000
Chromium	100-400	Heart, Adrenal, Diabetes	200	200
Iodine	100-260	Thyroid, Metabolism	150	150
Iron	15-30	Hemoglobin, Fatigue		18
Magnesium	200-800	Nerve Relax, Kidney stones	500	500
Manganese	25-Oct	Metab, Cancer, Diabetes	10	10
Selenium	50-300	AntiOx, Skin & Fertility	200	10
Zinc	20-50	Immune, Prostate, Skin	30	22.5
Other worthwhile supplements
Echinacea *	400-800	Immune, Cold, Flu, Infect	600
Garlic	200-800	Immune, Cold,Heart, Chol.	600
Ginko Biloba	60-120	Memory, Mood, Circulation	120
Gingseng *	400-1000	Fatigue, Stress, Energy	500+
Green Tea	100-300	Cancer Prevention	100-300
Kava *	150-800	Anxiety, Valium Substitute	500
St John's Wort	300-1000	Depression	600
Saw Palmetto	300-1000	Prostate	320
Valerian Root	100-200	Natural Restful Sleep	75

DHEA	25-100	Anti Aging - Longevity	W50, M100
Coenzyme Q10	50-400	Heart, Muscle Function	50-360
Melatonin	3 - 6 mg	Restful Sleep	3-6 mg

* Cyclical - Not every day