DEAR READER: You certainly appear to have done your homework. I could not find confirmation for some of your claims, such as multi-B at bedtime causing insomnia; however, each of us responds differently to medication, even over-the-counters. Remember that vitamins and minerals are essential nutrients, but the body typically only requires small amounts of them. Readers should speak with their physicians before beginning a regimen, because a well-balanced, nutritious diet rich in fresh fruits and vegetables will likely be all that is required to maintain good health.

Furthermore, read labels to determine whether a medication or supplement should be taken with food or without, or in the morning or at bedtime.

To provide related information, I am sending you a copy of my Health Report “Vitamins and 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.

I have enclosed some article from different sources on the importance of vitamin D and hope that you will re-evaluate your position on the necessary amount of the essential vitamin.

DEAR READER:
Thank you for including the back-up information. My position on the amount of necessary vitamin D in the daily diet is directly related to various government sources that indicate 400 IU is adequate for healthy individuals. However, this does not mean that current research is incorrect.

As more studies are done, several sources have found that vitamin D deficiency is on the rise among infants, children, teens, adults and seniors. Further studies need to be done to determine why this is happening and what steps we can take to prevent future generations from developing this deficiency.

Interestingly, the body stores vitamin D but it cannot be activated for use until exposed to ultraviolet B. Simply being outside for 15 minutes in the sun everyday can provide dramatic results.

I do not recommend that patients increase their vitamin D intake but I can encourage them to see their physicians to discuss the issue. A simple blood test may be all that is needed to determine if a deficiency is present. If it is, simple supplementation may be all that is required but a referral to an endocrinologist or other specialist may be advised to determine if there is a more serious underlying cause.

Vitamin D deficiency can lead to several problems, the most common of which is weak, brittle bones. This can lead to fractures which can take extended periods of time to heal because unhealthy bone does not heal as quickly or as well as normal bone. It has also been linked with thyroid disease, cancer, diabetes, stroke, asthma, heart failure and more.

Several physicians who specialize in bone health have begun recommending the recommended daily intake be increased to about 1000 IU, which is currently more than double the standard. Until further studies have shown that this will benefit a majority of the population without serious side effects, I must stick to the old guidelines but am willing to change my opinion when more definitive results are available.

To give you related information I am sending you copies of my Health Reports “Osteoporosis” and “Vitamins and Minerals”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Eight years ago I was told by the leading retina expert in my area that I was going blind due to the condition. I immediately moved my office to my home, figuring I would not be able to drive.

A close friend of mine who is an optometrist suggested I try a multi-vitamin specifically designed for the eyes. He read of a discovery that was producing good results. Well, the results were astounding. Although I still have the condition, my right eye tests 20/30 and my left tests 20/40. I lead a normal life.

The multi-vitamin only helps the dry form of the condition. Unfortunately, the eye industry does not accept this multi-vitamin, probably because they can’t make any money with the treatment.

The product, put out by Science-Based Health is Ocula RX. Their phone number is 1-888-433-4726. Perhaps this will help some of your readers and will offer yet another option to their recovery.

DEAR READER:
Long-standing tests have linked lower than normal levels of zinc and vitamin E serum with the development of age-related macular degeneration.

In my original column I did indicate there is no current treatment available to reverse dry macular degeneration. I should have indicated there are methods to potentially halt its progression. I also went on to state that most eye specialists recommend high doses of antioxidants and zinc to reduce its progression and recommended patients speak with their physicians about adding the supplements. In doing so, I felt I covered the issue of vitamins. However, I am grateful you offered an alternative option.

Eyes are precious. I am extremely pleased you have been able to lead a normal life and halt the progression of this devastating condition. I recommend other readers so diagnosed to speak with their ophthalmologists about the possibility of vitamin therapy.

To give you related information, I am sending you a copy of my Health Report “Fads: Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Now my hair is turning a brassy yellow color on the top layer. I worked outside all summer in my garden as I am a farmer, but I wore a hat. I’ve tested our well water at the state office and find no problem there, except for a higher than normal arsenic count, common here near the Snake River in Idaho.

I am not on any new medications, but am at my wit’s end about the brassy color my hair has taken on. I’ve spoken with three beauticians but didn’t get any help there. Can you advise me?

DEAR READER:
Melanin contains metals such as iron, zinc and magnesium and is a natural pigment that gives hair, skin and the choroid of the eye color. Its production slows as we age, causing hair to turn grey. Other causes can be a vitamin B12 deficiency or a thyroid imbalance.

Hair that takes on a yellow tone can be linked to smoking or to air pollutants. Perhaps someone in your home smokes, or you may have been exposed to elements in the air while working out of doors.

Try using a purifying shampoo once a month or so to prevent a buildup. Also, shampoos with a blue/ash or silver tone will combat those yellow tones. There are also natural rinses, such as lemon juice, that might be worth pursuing.

When you visit your physician next, ask about the possibility of a B12 deficiency or thyroid imbalance. Simple laboratory testing can rule out both disorders. Further, B12 deficiency is so commonly overlooked for countless disorders that Sally Pacholok wrote a book entitled “Could It Be B12?” a few years ago. The information it contains might be helpful to you.

To give you additional related information, I am sending you a copy of my Health Report “Fads: Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Vitamin B6 is an extremely important water soluble vitamin required for more than 100 enzymes associated with protein metabolism. Our nervous and immune systems require the vitamin to function properly, it helps make hemoglobin and is needed for the conversion of an amino acid known as tryptophan to niacin within the body. It helps maintain blood sugars and convert stored carbohydrates and other nutrients to sugar when inadequate calories are consumed.

B6 is found in many foods, including fortified breakfast cereals, salmon, tuna, pork, chicken, peanut butter, beans, bananas, and many vegetables. In fact, ¾ cup of fortified breakfast cereal alone contains 100% of the recommended daily allowance. Therefore, a proper B6 balance in the system is most often found through diet alone

Deficiency is rarely seen but can occur in individuals who have extremely poor diets. Signs include depression, confusion, glossitis (painful tongue), and dermatitis. Since some of the symptoms mentioned can also result from medical conditions unrelated to a B6 deficiency, any issues should be discussed with a physician to determine the cause and the most appropriate medical care to be administered.

Alcoholics and older adults are more likely to have inadequate B6 intake because of their limited dietary intake. Alcohol can also lead to the destruction of B6 within the body.

Some controversy surrounds B6 therapy. For example, the vitamin has been used for a number of years for carpal tunnel syndrome, even though there are no scientific studies available to indicate its effectiveness. Amounts of 100 mg per day are the upper tolerable limit recommended for adults.

It has been used for symptoms of premenstrual syndrome (PMS), despite any known evidence to support significant benefits with its use. In fact, one study found that neuropathy (nerve damage) was present in almost 40% of those tested who took B6 for PMS. Oddly enough, this could be the result of too much B6 present in the system.

It would appear you are adequately controlled with your daily supplement. I would recommend you not rock the boat by making any changes, but would suggest you have your levels tested on a periodic basis. Your physician can monitor your numbers and make appropriate recommendations if necessary.

To give you related information, I am sending you a copy of my Health Report “Fads: Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
While no formal studies have been conducted, there are reports of pregnant women who have taken prenatal vitamins and have noticed an increase in hair thickness and growth.

Prenatal vitamins differ from regular multi-vitamins in that they contain elevated amounts of calcium, iron and folic acid. An increase in calcium is required because a woman needs stronger bones to be able to carry the additional weight of a baby to full-term. Additional iron is necessary because it helps the body make new blood to carry oxygen and nutrients to the fetus. Folic acid has been proven to prevent spina bifida, a neural tube defect.

Folic acid is one of the B complex vitamins available in many hair-growth formulas on the market today. It is reported to cause hair to grow faster, and the strands to become thicker. According to several hair loss experts and dermatologists there are various ways to treat hair loss. Rogaine is an excellent choice but if you choose to go a more natural route, they recommend that blood tests be done to rule out anemia, vitamin B12 deficiency and copper deficiency. Biotin, B vitamins, iron, and omega 3 fatty acids (such as omega 3 oil) are all necessary for proper hair, skin and nail health. Saw palmetto has shown promise in treating benign prostatic hyperplasia which is caused by the some of the same hormones that cause hair loss.

If you choose to try a vitamin regimen I recommend you use a multi-vitamin since you are not pregnant. If you want to read more about natural hair loss treatments, I recommend you go to www.WebMD.com/skin-problems-and-treatments/hair-loss/features/treating-hair-loss-naturally?page=1. Let me know how you make out.

To give you related information, I am sending you a copy of my Health Report “Fads: Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Chromium picolinate is a combination of chromium and picolinic acid. Chromium is a naturally occurring mineral with minimal amounts found in meat, poultry, whole-grain breads and fish. The addition of the picolinic acid assists the body with the absorption of chromium and is popular on the market today.

Depending on the source of your information, it is purported to burn calories, control appetite, increase muscle tone, increase energy and lifespan, prevent acne, and more. On the reverse side, some scientific evidence states this supplement is ineffective. It is found in many herbal weight-loss remedies, but because it is a nutritional supplement and not a prescription drug, the FDA cannot take a stand on claims presented. Therefore, I must defer to your primary care physician.

To give you related information, I am sending you a copy of my Health Report “Fads: Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

You have repeatedly recommended niacin instead of statins for lowering cholesterol. I will be going to my doctor soon for my routine physical and plan on asking if this is an appropriate option for me as I realize every case and body is different.

My concern, however, is that many people have told me that some vitamins and supplements can cause anal leakage. I would like to know what you think of this and, if it is true, to what vitamins it applies.

DEAR READER:
To the best of my knowledge, vitamins and supplements do not cause anal leakage (also known as bowel or fecal incontinence). This is not to say that there is no possibility for problems from the medication, just that it is highly unlikely because most vitamins and supplements are naturally occurring in foods and are necessary for normal body functions and metabolism.

The body only needs a small amount of niacin which is used in the formation of certain coenzymes. When used in higher doses is can lower cholesterol in some individuals. It is also a vasodilator, meaning it opens blood vessels, which causes the more notorious (and annoying) side effect, flushing. This is an appropriate option for lowering cholesterol when diet and exercise alone do not produce adequate results.

Bowel incontinence can be caused by many things but always occurs when there is a malfunction of the nerves or muscles or when there is decreased sensation. Women and the elderly are most often affected. The reason for this is simple; women who give birth can damage the muscles and nerves of the rectum and the elderly often have decreased sensation within the colon and weakened muscle control.

Any surgery on the intestine, prostate or rectum has the possibility of nerve damage. Emotional problems and stress can also cause problems. Chronic constipation, diarrhea or laxative use (because of irritable bowel syndrome, eating disorders, or other bowel disorders) often lead to muscle weakness or stiffness. Even lactose intolerance and certain other food allergies can play a role.

Certain medications, including sedatives, antacids, laxatives, narcotics, and more can cause leakage or incontinence. Orlistat (better known as Alli), Olean and sugar substitutes can also cause problems in many people.

Luckily, for people with chronic bowel incontinence or leakage, there are several treatment options. Based on the cause of the problem, treatment can include diet modifications, bowel retraining, medication, surgery, implants or transplants.

As you can see there are many factors that come into play and perhaps everyone who claims to have problems with vitamins and other supplements is really suffering from something else. Perhaps even one of the inactive ingredients is causing the problems; is there a sugar substitute, such as sorbitol, to make the pill more palatable?

Anyone suffering from bowel incontinence should be seen by a gastroenterologist who can determine the cause and provide appropriate treatment.

To give you related information, I am sending you copies of my Health Reports “Dr. Gott’s Compelling Home Remedies”, “Vitamins and Minerals” and “Irritable Bowel Syndrome”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title(s).

DEAR READER:
B vitamins are essential to help release energy from carbohydrates, fat and protein. I can understand why your physician cannot give an explicit answer to your question because the human body stores several years worth of B12, so a deficiency is quite rare unless a condition such as pernicious anemia or a strict vegetarian or vegan diet leads to a deficient state. B12 is also harmless in larger quantities (up to 1000+ mcgs) and is given as an energy boost to some individuals, (working more as a placebo). B6 is obtained from diet or through supplements. The recommended daily allowance is 1.5 mg per day. You don’t indicate if your have dietary restrictions, although you purchased a vegetarian supplement. Without knowing this, I cannot determine if you even need supplements or if you are obtaining adequate amounts through your diet.

I can only recommend that when taking complete B complex vitamins or any other supplement, be guided by the recommendations on the label since packaging by different manufacturers can vary. Centrum Silver has 100% of the daily recommended value of thiamin, riboflavin, niacin, 125% of folic acid, 150% of B6 and 417% of B12 in each tablet.

DEAR READER:
There are several known causes for a loss of smell or taste, including sinus infection, allergies, epilepsy, Alzheimer’s disease, diabetes, and stroke. Some medications such as antidepressants, antihistamines, anti-inflammatories, muscle relaxants, and chemotherapy have been linked to a loss of smell. Then, there’s zinc, an essential nutrient in the body. A zinc deficiency is marked by a loss of smell and taste, poor appetite, abnormal weakness, slowed growth, slow wound healing, and a greater risk of infection.

Several conditions can develop with a zinc deficiency, including Hodgkin’s, cystic fibrosis, ulcers, heart attack, and liver disease.

Diet plays an important role in all vitamins and minerals and zinc can readily be consumed in adequate amounts when meats, eggs, seafood, nuts, peanut butter, milk, whole grain cereals and vegetables with pods are consumed.

If a deficiency remains, a zinc supplement in amounts not to exceed 50 mg daily can be taken. The supplement should also contain copper, as more than 15 mg daily can lead to a depletion of that nutrient.

I am unaware of why you lost your sense of taste 38 years ago. You can certainly request to have your zinc level tested to determine if there is a deficiency. You might be pleasantly surprised if it works.

To give you related information, I am sending you a copy of my Health Report “Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.