Transcription:

Melanie Cole (Host): There are so many vitamins and minerals that can do a body good, however, when you’re looking at supplementation or whether you should get these vitamins from your food, it can be very confusing. We’re talking today, with Trigg Thielke. He’s a pharmacist with Aspirus Health System. Welcome to the show, Trigg. When we’re talking about vitamins and supplements, first just explain a little bit about the vitamin and supplement industry and which vitamins you think are so important that we might need.

Trigg Thielke (Guest): Right, so first of all, regarding the industry, I think it’s important that people understand that over-the-counter supplements and vitamins are not regulated in the same way that prescription medications are. While I’m not here to promote any specific brands, I would recommend to listeners to talk with the pharmacist or provider to discuss what a high-quality brand would be because not everything is created the same regarding over-the-counter supplements.

As far as the importance of the supplements – or rather, of minerals and vitamins through the diet -- I typically suggest a three-step strategy for trying to obtain the necessary amounts of minerals, vitamins, and nutrients. The first step is to consume as many whole, unprocessed foods as possible while avoiding refined and processed foods. The reason is, refined and processed foods actually use up the body’s store of minerals and vitamins that can result in deficiencies.

The second step would be to use an unrefined salt with a sea vegetable, such as kelp flakes or dulse, and that would be to provide trace minerals and iodine. The unrefined salt provides the trace minerals. The kelp or dulse, which are basically like seaweed, help to provide the body with iodine, which is necessary for proper function of the thyroid, as well as other glandular tissues of the body. Refined table salt is a processed food that, when regularly consumed, can lead to trace mineral deficiencies, so I don’t recommend people use refined table salt.

The third step then would be to use targeted supplementation for those minerals and vitamins still lacking, which actually brings us to those three items that we’re going to discuss today, magnesium, vitamin D3, and vitamin K2.

Melanie: So then let’s start with vitamin D3. People hear about vitamin D and the lack of it -- we’re getting tested now in our blood tests for it, and they found that’s due to not being outside as much and even sunblock -- maybe we’re a little vitamin D deficient as a society. When we need vitamin D – obviously we’ve heard from the sun, but now we’re not supposed to be out in the sun so much without sunblock on -- so where do you want us to get our vitamin D?

Trigg:  Well, I would say that sensible exposure to the sun is not necessarily a bad thing. There are some other factors that go into how much vitamin D our skin makes in a certain period of time. Having to do with the season – in the winter, specifically in the northern hemisphere, even if it’s a sunny day, we’re so far from the sun that the sun’s rays don’t have the strength to necessarily make the vitamin D. In addition, the older you are, the less you make. Your skin color – the darker your skin, the slower it makes vitamin D. Then you already mentioned the use of sunscreen, which actually blocks vitamin D production, and then people being indoors as a lifestyle, for the most part, all of these things add up to vitamin D deficiency. In a perfect world, if we could expose our full bodies to the sun for 15, 20, 30 minutes a day, that would be ideal, but in reality, I think that’s difficult for most people, if not everybody, to achieve. That’s where I feel a supplement is important to make sure that people don’t have vitamin D deficiency.

Now, food sources, there are some foods -- relatively few that have higher levels of vitamin D. Those would include blood sausage, which I don’t imagine a lot of people consume regularly, also high vitamin cod liver oil and then also fatty fishes such as salmon, mackerel, tuna, and sardines. And then, albeit in smaller amounts, vitamin D is also found in egg yolks and beef liver, but unless people are consuming large amounts of those on a regular basis, a supplement is a way to go. As far as –

Melanie: So how much should we take? In the supplement, how much?

Trigg: Right, how much? That’s a good question. I would say there’s two answers to that. Number one would be if you have a provider that’s willing to run the lab for you, you could have the lab test done, and they can be very specific then with what the proper dose is. Aside from that, the research that I am familiar with actually suggests that it takes a dose of approximately 1000 International Units for every 20 pounds of body weight to achieve an optimal level. That works out for a person – like an adult who weighs 150 pounds, who could work out to 7500 units a day, which sounds very high. Again, I would encourage listeners to work through a provider, but the fact of the matter is, right now, the recommended daily value of vitamin D is about 800 International Units ages four and up, but there are a lot of providers that feel this is too low for adults specifically. The fact that a four-year-old would require 800 units, versus a 44-year-old also requiring 800 units, just based on body size alone has you scratching your head a little bit.

Melanie: And Trigg, what about magnesium? We hear it’s very important, especially for women, where do we get it and how much do we need if we have to supplement?

Trigg: Sure. Food sources of magnesium include dark green leafy vegetables, nuts, seeds, legumes, which are like beans, and unprocessed whole grains. As far as how much a person needs, again, this is a little up for debate. Right now, the recommended daily value for magnesium is about 420 milligrams ages four and up. For a 150 pound adult, that works out to about 6 milligrams per kilogram body weight, but there are some providers who suggest even up to 15 milligrams per kilogram body weight would be better, so I would say anywhere from 400 milligrams up to even 1000 milligrams. That’s very difficult to get through your diet alone. In fact, four out of five people have been shown to be magnesium deficient or don’t get enough of their daily value.

In terms of supplementation, not all magnesium supplements are created equal. Magnesium oxide, which is commonly used actually has very poor absorption, and for that reason, I don’t typically recommend it. Rather, I would recommend supplementing with magnesium citrate, magnesium chloride, or chelated magnesium products because they have a lot better absorption. Chelated means the magnesium is attached to an amino acid. And then there are also topical products that people can use including Epsom salts, which is magnesium sulfate, that you can soak in or magnesium oils that you can rub into the skin.

Melanie: Let’s move on to vitamin K. We hear that you can get too much of it, that it’s not one that is excreted and that -- it’s a clotting mechanism, and it can be dangerous in large amounts. Tell us about vitamin K and what we need to know.

Trigg: Well, the first thing is there’s actually different forms of vitamin K and so the one that we’re talking about here today is vitamin K2, which should not be confused with vitamin K1. Vitamin K1 is involved in the blood clotting process, but vitamin K2 has a little bit different role in the body. In fact, one of its main functions is to activate the proteins that take Calcium out of the blood can't put it into our bones and teeth. Without Vitamin K2, those proteins are stuck in the off position, and one of the consequences of that is if we can’t get Calcium into the bones, we end up with weak bones and possibly osteoporosis. A second consequence is if we have too much Calcium in the blood, it can start to form plaques and these are the same plaques that can lead to heart attacks or strokes. Vitamin K2 helps to keep the arteries clean and the bones strong, so it’s very important, and I don’t feel it’s probably got the attention it should, although I feel that’s going to change in the next few years.

Melanie: Well, it certainly hasn’t, and that was an excellent explanation of the two different kinds. How do you want people to get Vitamin K2?

Trigg: Great, well food sources include something called Natto, which I’ll mention more on in a minute. Also, hard cheeses like Gouda, soft cheeses like brie, egg yolks from chickens that are allowed to go out in the pasture, and butter and fat from grass-fed cows. That’s quite the list, cheese, egg yolks, butter, fats – it sounds like all of the stuff we’ve been told to stay away from. Of course, the devil’s in the details and in this case the keywords are pasture and grass-fed. That’s important because the animals who provide these foods, if they are not allowed to consume green grasses that actually have the vitamin K1 – which then their bodies convert to the K2 – if they don’t get those foods, then they don’t make a lot of K2. The conventionally raised – or industrial agriculture practice of feeding animals high amounts of grains actually means that those products are not high in vitamin K2, so the take-home point here is what’s good for the animals is good for us.

Melanie: That is a good take-home point. Wrap it up for us, Trigg, if you would, with these three important vitamins, what you want the public to know about looking at the supplements on the shelf at the pharmacy, speaking to our pharmacist, and what you want them to know about the available sources.

Trigg: Well, the first thing I would say is that everything that we’ve talked about, there are potential health conditions or contraindications for each of these, which I would encourage patients, before they try to start any of these supplements, to first talk with their provider or a pharmacist to make sure that based on their own health conditions that it’s appropriate.

The second thing is to echo what we started with; all supplements are not created equal. I would encourage again, talking with a provider or a pharmacist who has a lot of experience with over-the-counter supplements and can recommend a reputable brand. There are independent labs that do testing of over-the-counter supplements, and you can find out which ones generally test true for what they advertise. I think it’s important to remember what we started with, which is focus on the high quality, unprocessed foods. Make that your basis of your own personal healthcare and then use targeted supplementation where necessary.

Melanie: Thank you, so much, Trigg, for being with us today. You’re listening to Aspirus Health Talk, and for more information, you can go to Aspirus.org, that’s Aspirus.org. This is Melanie Cole. Thanks, so much, for listening.