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.

DEAR READER: There are 13 vitamins that your body needs, all essential for maintaining good health. These are broken down into two categories, water soluble and fat soluble. The water-soluble vitamins include the B complex, which is comprised of eight vitamins — 1, 2, 3, 5, 6, 12, biotin and folic acid — and C. The fat-soluble vitamins are A, D, E and K.

B1 (thiamin) works with the nervous system and helps the body use carbohydrates for energy. When deficiency occurs, it can cause impaired growth, muscle weakness, mental confusion and more.

B2 (riboflavin) helps the body process protein, carbohydrates and fats. It works to support good vision, healthy skin and the production of red blood cells. Deficiency can cause fatigue, slowed growth, swollen/sore throat and more.

B3 (niacin) assists the body in processing proteins and fats. It also helps the skin, digestive tract and nervous system to remain healthy. Deficiency can result in diarrhea, weakness, skin disorders and pellagra. Excesses can cause stomach upset, skin flushing and itching, and rash. The most common cause of too much niacin is from supplemental niacin taken to reduce cholesterol levels; therefore, it should be introduced gradually to prevent unwanted side effects.

B5 (pantothenic acid) helps the body process nutrients and synthesizes hormones and cholesterol. Deficiency is uncommon.

B6 (pyridoxine) aids in the formation of red blood cells and maintains brain function. Deficiency can cause kidney stones, anemia and nausea. Excess can cause leg pain and more.

B12 (cyanocobalamin) maintains red blood cells, is important for metabolism and the maintenance of the central nervous system, and helps to make DNA. Deficiency can result in pernicious anemia and tingling of the fingers and toes.

Biotin helps metabolize fats and carbohydrates. Deficiency is rare.

Folic acid/folate prevents birth defects and makes DNA and new red blood cells. Deficiency can cause anemia, diarrhea and other symptoms.

C (ascorbic acid) is an antioxidant necessary for the growth and repair of tissues. It helps repair bones, teeth and cartilage. Excesses can cause kidney stones, upset stomach and an increase in iron absorption.

A (retinol) is necessary for good vision, bone and tooth development and several other functions. Excesses can result in nausea, headache, blurred vision, vomiting and an increased risk of developing osteoporosis.

D (calciferol) helps teeth and bones stay healthy. Deficiency can result in osteoporosis, fractures and rickets (in children). Excesses can cause diarrhea, constipation, weakness and other problems.

E (tocopherol) acts as an antioxidant that helps the body utilize vitamin K and works to form red blood cells. Deficiency is rare because E is stored naturally in the body for extended periods of time. Excesses include possible hemorrhage and impairment of blood clotting.

K helps with the formation of bone and aids blood clotting. Low levels can lead to excessive bleeding. Excesses can cause liver damage.

People who maintain a well-balanced, healthful diet should not experience deficiency or excesses of vitamins unless there is an underlying condition that alters metabolism. Problems caused by excess consumption come into play primarily when supplements are used inappropriately or unnecessarily. Deficiency is most common in people who don’t eat properly, take medications that reduce a vitamin’s efficiency, or are vegetarian or vegan.

To provide more extensive 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 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.

DEAR READER: You ask an extremely important question, and your doctors are correct in what they tell you. In some respects, the most appropriate time of day to take vitamins and other medications is when you are least likely to forget, such as the first thing each day.

Thyroid medication should be taken on an empty stomach a half-hour before breakfast. If you are a swing-shift employee, judge accordingly and plan to take the medication at an appropriate time.

Vitamins can be taken at almost any time of the day, so just before or following a meal is satisfactory. Be sure to read the recommendation printed on each vitamin bottle to determine what the manufacturer believes is most appropriate. There are some supplements that work better when taken on an empty stomach. For example, if B-complex vitamins upset your stomach, take them with food. Iron supplements should be taken on an empty stomach. And, whenever vitamins are consumed, do not wash them down with alcohol.

Calcium comes in two forms — calcium carbonate, which is more readily available and inexpensive, or calcium citrate. Either form should be taken at least four hours apart from any thyroid medication. This also holds true for calcium antacids, iron supplements and many drugs prescribed or recommended as antacids. Calcium carbonate should be taken with meals; calcium citrate can be taken either with meals or on an empty stomach. Calcium should be taken in 500-milligram doses or less at one time. Therefore, if your supplement is a 1,000-milligram tablet, split it into two doses, because it can hamper the absorption of some medications, including those for high blood pressure and antibiotics, so a timing modification might be required. Speak with your physician for his or her recommendations.

I do not believe there are any specific requirements for omega-3 fish oils. To the best of my knowledge, they can be taken at any time of day and either on an empty stomach or a full one.

Drugs, whether prescription or over-the-counter, can interfere with other medications. Their effect can be reduced, and they can also lead to gastrointestinal issues and a number of other problems. Make sure that your physician knows what supplements you are currently taking so he or she can guide you accordingly.
It appears to me you are diligently attempting to do the right thing at the right time.

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 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.

DEAR READER: The USANA Corporation is based out of Salt Lake City, Utah. The company makes nutritional, weight management, and personal skin products, selling through a sales network marketing system of more than 140,000 independent distributors similar to Amway, Avon and other companies. USANA also produces skin and hair care products under a different brand name. I am unfamiliar with their “exorbitant” prices for the merchandise they manufacture, but am advised the company reported sales of almost $375,000,000 dollars in 2006.

I presume part of the expense of their product line is that they might deliver to your front door through a distributor. Consider that a product is manufactured, packaged, shipped to a sales person, and ultimately delivered to your home through a distributor. That’s a lot of middle men getting a piece of the financial pie. With clever advertising, attractive packaging and promises of a better product, any company can feel justified in charging what the market will allow.

Are the products better? I don’t know but I suggest you review the ingredient panel of one of the vitamins you have already purchased from USANA. Then visit your local chain pharmacy or department store to compare ingredients. Are they the same except for the dramatic differential in price? After all, aspirin is aspirin, and many vitamins are — you guessed it — vitamins. You can purchase a well-known brand name or a generic store brand. You’re still getting aspirin or vitamins that give similar results. The decision is up to you. If you are willing, experiment with vitamins containing the same ingredients that cost substantially less and still provide good results. You will be ahead of the game financially. If, on the other hand, you feel you have to spend more to get better results, then stick with a more costly brand.

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.