It’s strange but true. People should look into their meds, even if cramps and spasms aren’t listed as a side effect. Also, if I get my vitamin D naturally, why do I need a supplement to help absorb calcium?

DEAR READER: That’s a great question. Calcium is vital for the formation and maintenance of strong bones and for normal bodily functions such as the development and maintenance of strong teeth. It is required for the contraction and expansion of blood vessels, the secretion of enzymes and hormones, and the transmission of impulses of the nervous system. Vitamin D is equally important for the absorption of calcium from the intestines. The combination is most often used to prevent deficiency and to treat it in those who are calcium deficient.

An adequate daily calcium intake is 1,000 milligrams for people between the ages of 19 and 50; and 1,200 for those 50 and older. Food sources include milk, cheese, yogurt, tofu, salmon, fortified cereals and instant breakfast drinks.

An adequate daily intake for vitamin D is 200 IU for people between the ages of 19 and 50; 400 IU for those between the ages of 51 and 70; and 600 IU for those 71 and older. This fat-soluble vitamin is found in fortified milk products and cereals, egg yolks, butter, salmon, sardines, herring and beef liver. Aside from food sources, sunlight exposure for about 15 minutes a day is reported to provide the necessary amount, but don’t get too much sun.

Side effects of too much calcium with D include drowsiness, weakness, dry mouth, irregular heartbeat, difficulty breathing, nausea or vomiting and constipation, but the list goes on and on. If any of these symptoms are experienced, a user should contact his or her physician promptly.

You don’t indicate your age, so I am unsure whether you have issues with such disorders as osteoporosis; however, if your diet is adequate, I don’t believe you require a supplement, but this can be determined by a blood test. You will continue to receive some benefit from the calcium you take, even if you discontinue the D. Perhaps the answer is to take a good one-a-day vitamin. Speak with your doctor regarding his or her views on the subject. In the interim, read labels at your local grocery store when selecting foods. That way, you can determine whether you satisfy the recommended requirements through diet alone. If not, the next step might be to select some of the foods recommended so you can increase your intake naturally.

To provide related information, I am sending you a copy of my Health Report “Vitamins & Minerals.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Twelve years ago, I had radial-nerve surgery, which was successful. I was able to use my arm and hand without any problems. However, if I engaged in an activity such as playing cards or knitting, where my hand was in the same position for any length of time, my hand cramped up and was painful. I tried the vitamin E capsule (400 IU) twice a day and very rarely have cramping anywhere in my body. If I do have a problem, I take an extra capsule immediately with the same result.

During a recent physical examination, I discussed this “remedy” with my doctor, who also reads your columns, and he said he thought you might be interested in this remedy. He said he had no idea why it works but since it does, to continue with the regimen, as this relatively small dose will not harm me. Because it is a blood thinner, I have been advised to stop taking it seven to 10 days prior to any surgery.

I am a 78-year-old Caucasian woman; however, I assume age and race have nothing to do with the results that I have had. I hope this will work as well for others.

DEAR READER: Vitamin E is a fat-soluble vitamin with antioxidant properties. It is used for the treatment and prevention of many health conditions. In fact, research remains ongoing regarding its value in treating heart conditions, Parkinson’s, diabetes, anemia, cancer and a host of other diseases and disorders. However, no conclusive studies are available for these and other conditions.

The recommended long-term daily allowance of E is between 15 and 20 IU daily; however, many experts claim it is safe when consumed in larger amounts.

Deficiency of E is rare with a proper diet that includes broccoli, spinach, kiwi, fortified cereals, whole grains, fruits, vegetables and vegetable oils, and also because it is stored in the body for extended periods of time.

There is concern regarding the safety of E in high doses because of the potential for an increased risk of bleeding, particularly in patients on anticoagulants or with a vitamin K deficiency. Excesses have been known to also cause headache, fatigue, blurred vision, diarrhea, flatulence and bloating.

If your physician thinks the 800 IU daily regimen is OK for you, stick with it, especially if it relieves your pain. Other readers should consider a modification in their diet and a discussion with their primary-care physician before taking the supplement. Medications, even those available over the counter, can interact adversely. The safest bet is to get the go-ahead first rather than backtrack after the fact.

To provide related information, I am sending you a copy of my Health Report “Vitamins & Minerals.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.