Vitamins and Supplements Belong in the “Medications” Conversation

When your doctor asks you what medications you’re taking, do you mention your vitamins and supplements? If the answer is no, you’re far from alone. Since most vitamins and supplements are available over the counter at the local supermarket, many women don’t think to include them when discussing medications with their physician. But, like prescribed medications, vitamin and supplement use is vital information to share with your provider so it can be safely incorporated into your overall health care.
A 2013 study published in the Journal of the American Medical Association (JAMA) found 49 percent of adults report using a dietary supplement. The study also found the vast majority of supplements being used – a reported 77 percent – were based on personal choice, not the recommendation of a health care professional. Certainly, there are times in every woman’s life when specific vitamins or supplements are recommended. For example, if you are a woman of childbearing age or you are planning a pregnancy, a prenatal vitamin that has 0.4 mg of folic acid is recommended.
Folic acid deficiency is linked to birth defects in the developing fetus. Depending on your medical history and any medications you are currently taking, you may require additional supplementation. Also, women over the age of 65 and those who are pregnant or breastfeeding may be at risk of a vitamin D deficiency and require a supplement. Vitamin D plays a critical role in calcium absorption, helping to build and maintain strong bones, among other important functions.
The Institute of Medicine recommends 600 IU (international units) daily for children and for adults up to age 70, and 800 IU daily for people age 71 and older. Vitamin D supplementation beyond these levels can cause increased calcium absorption and increased risk for kidney stones. Recently, the role of calcium in preventing bone fractures has been called into question. There does not appear to be any benefit beyond the recommended 1,000 mg to 1,200 mg intake of calcium per day for women (the higher dose for women age 51 and older), most of which can be consumed through diet. In fact, too much calcium carries an increased risk of kidney stones, intestinal side effects and heart attacks.
For those drawn to herbal supplements and their claims of potential benefits, keep in mind that, like traditional supplements, they may have harmful interactions with other medications and should also be discussed with your doctor. My recommendation for women: start with the basics – a healthy diet, regular exercise and some sunlight exposure, a natural source of vitamin D. If you think you need additional supplements, talk with your doctor about what’s right for you, the potential risks and benefits, appropriate dosages and possible interactions with other medications you’re taking or any medical conditions you may have. The next time your doctor asks, “What medications are you taking?” don’t forget your vitamins!