Genesis

The requirement for vitamin B6 is dependent on protein intake, which makes a deficiency more likely among those who have a high protein diet. (7) Other factors that may increase the requirement for this vitamin include certain food colourings (tartrazine), certain drugs, oral contraceptives and alcohol. Good food sources for this vitamin include whole grains, legumes, seeds and nuts. (8)

Conditions which respond well to vitamin B6 supplementation include pre-menstrual syndrome (PMS), carpal tunnel syndrome, depression and morning sickness. (8)

Vitamin B6 and magnesium enjoy a special relationship, as both nutrients require each other’s presence for optimal function and absorption. Vitamin B6 deficiency has been found to intensify magnesium deficiency as both nutrients act as co-factors for a number of enzymes.  One study showed that simply adding extra vitamin B6 as a daily food supplement could raise intracellular magnesium levels. (9)

Other B vitamins (B1 and B2)
The B vitamins play an important role in the metabolism of all cells and are particularly important in the processes involving energy production

Vitamin B2 is also required to convert vitamin B6 to its active form.

Vitamin D

Vitamin D acts on intestinal cells to increase the absorption of dietary calcium. Although the major supply of vitamin D is from synthesis in the skin during exposure to sunlight, the process may be limited during winter months or when skin exposure is limited.(10) Vitamin D deficiency is increasingly recognised as a common problem among older adults (11)

Magnesium

Magnesium is a mineral which often is in short supply in processed and refined foods. This mineral plays a particularly important role during times of stress, as it is used up much faster.  With increased demands on most of us, in an increasingly more competitive environment, and an intake of this mineral below government recommendations in the UK (13), many are likely to require supplementary magnesium to help the body function more optimally.

The mineral magnesium is the forth most abundant cation in the body overall and the second most common mineral found intra-cellularly after potassium. The major holding store for magnesium in the body is bone, which comprises approximately 60% of the overall body content. The rest is found within the soft tissue cells, where it functions mainly to stabilise the structure of ATP (Adenosine triphosphate) in ATP-dependent enzyme reactions. Approximately 300 metabolic enzyme reactions require magnesium including those involved in glycolysis and the Krebs cycle, essential for energy production. Others include various phosphatases and reactions in protein and nucleic acid synthesis. Magnesium (Mg2+) also plays a role either in opposition or in tandem with calcium in neuromuscular functions. (14, 15)

The more metabolically active a cell, the higher its magnesium content. In addition magnesium is required for the conversion of essential fatty acids into hormone-like substances that have many controlling functions within the body. (16)

When physical or mental demands are high, magnesium loss is accelerated. The adrenal glands, which play a key role in the body’s ability to cope with stress, release adrenaline, an excitatory hormone. Magnesium is required as a co-factor for the metabolic pathway that produces adrenaline. A suboptimal magnesium status has also been shown to cause the release of stress hormones, a process, which in turn depletes tissue magnesium levels. (17) These hormones stimulate the release of fatty acids which, when complexed with magnesium, reduce the bioavailability of this mineral. (18)

Zinc

This mineral is found in every body cell and is a component of over 200 enzymes. It is required for the proper action of various body hormones, including insulin, growth- and sex hormones. Tissues high in zinc concentration include the bone, skin, kidney, liver, pancreas, retina and prostate. (19)

Zinc is required for the body to produce stomach acid (hydrochloric acid) (20). When the pH- value in the stomach is too low, i.e. stomach acid is insufficient, protein cannot be digested properly. When amino acids are in short supply hormone and enzyme production suffers and the repair and building of new tissues may be impaired. Absorption of vitamin B12 and a whole range of minerals also suffers when there is a lack of acidity in the stomach, thus a vicious cycle ensues. Zinc is also required for proper immune function (21).

The mineral zinc is of particular relevance for male reproduction and is found in particularly high concentration in the prostate. Zinc deficiency has been found to lead to hypogonadism whilst milder zinc deficiency has been linked with male sterility, which could subsequently be corrected by zinc supplementation. (22)

Selenium

The soil level of selenium can vary tremendously even within the same country, thus affecting the overall availability of this trace mineral (23). From food analysis, regularly carried out by the Ministry of Agriculture Fisheries and Foods, it appears that the selenium content in food consumed in the UK has fallen dramatically over the past 20 years. (24) For this reason it may be beneficial for most people to take selenium from a food supplement form.

The primary role of selenium is in the production of glutathione peroxidase, an antioxidant enzyme. (25) This enzyme plays an important part in the protection of the body’s cells from free radical damage. Free radical activity is increased during times of stress, disease, excessive exercise and exposure to pollution. Free radical damage has been implicated in the etiology of degenerative disease such as heart disease and arthritis (26). In addition, selenium is involved in the production of thyroid hormone.

Selenium is antagonistic to heavy metals like lead, mercury, aluminium and cadmium. (27)

Apart from its antioxidant role, selenium also restores and increases immune function by increasing the resistance to viral infections, stimulating production of different white cells, increasing production of antibodies plus others. (28)

Selenium also plays a role in spermatogenesis. (29)

Chromium

The trace mineral chromium is an essential component of Glucose Tolerance Factor (GTF), which assists the pancreatic hormone insulin in depositing blood glucose and other substances into the cells (30). Chromium is mainly obtained from unrefined and unprocessed foods, which are in short supply in the diets of most people. Many also consume too much sugar, which constantly stresses the body’s system that deals with sugar metabolism. As a result of these factors it seems sensible to supplement this mineral.

Iodine

Iodine is a trace mineral needed to make thyroid hormones, which are necessary for maintaining normal metabolism in all cells of the body.  The key to good thyroid function is adequate, but not excessive iodine intake.
Iodine is found in seafood, iodized salt, and seaweed.

Copper

Superoxide dismutase (SOD), which forms part of the enzymatic antioxidant system of the body, and ceruloplasmin depend on the trace element copper for proper function. Supplementation of copper has been shown to increase SOD levels in humans. (31)

Ceruloplasmin exerts an antioxidant effect in its own right and in addition is required for the flow of iron from storage sites. (32) Lysyl oxidase, a copper dependant enzyme, is secreted by connective tissue cells to aid in the cross-linking of elastin and collagen, which is essential to connective tissue and blood vessel maintenance. Cytochrome oxidase, the terminal component of the electron transport chain in all mammalian cells is another copper dependent enzyme.

Manganese

This trace element is associated with a large number of enzymes in many areas of metabolism. These are involved in the Krebs cycle for energy production and the mitochondrial form of superoxide dismutase, an antioxidant enzyme. (33)

Potassium

Potassium is an essential mineral needed to regulate water balance, levels of acidity, blood pressure, and neuromuscular function. This mineral also plays a critical role in the transmission of electrical impulses in the heart.

People with low blood levels of potassium who are undergoing heart surgery are at an increased risk of developing heart arrhythmias and an increased need for cardiopulmonary resuscitation. (34) Potassium is also required for carbohydrate and protein metabolism.

Iron

It plays a key role in the haemoglobin synthesis, being the oxygen-carrying component of the blood. Low levels of iron can lead to fatigue and tiredness. Iron is also involved in enzyme activity for energy production.

Supplementation is recommended for women of child-bearing age because of the ongoing blood loss during menstruation. (35)

Supplementing the vitamins A and C with iron, help the absorption of iron better than if taking iron supplements alone. (36,37)

References:

1. Ministry of Agriculture, Fisheries and Foods, The Dietary and Nutritional Survey of British Adults - Further Analysis, HMSO, 1994

2. T. Barringer et al., Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life, Annals of Internal Medicine, (2003), 138 (5) pp365-371

Vitamin A
3. Stephensen CB, Vitamin A, infection and immune function. Annu Rev Nutr 2001; 21:167-92
4. Linder MC (Editor), Nutritional Biochemistry and Metabolism with Clinical Applications, Prentice-Hall International Inc. 1991

Vitamin C
5 Frei B et al, Ascorbate: the most effective antioxidant in human blood plasma. Adv Exp Med Biol 1990; 264:155-63

6. Linder MC (Editor), Nutritional Biochemistry and Metabolism with Clinical Applications, Prentice-Hall International Inc. 1991

Vitamin E
7 Stephens NG et al, Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347(9004):781-6

Vitamin B6
8. Mildred S. Seelig, Nutritional Status and Requirements for Magnesium, Mag.- Bull. 8, 1986, pp 170-185

9. M. T. Murray, Encyclopedia of Nutritional Supplements, Prima Publishing, 1996

10. G. E. Abraham, Effects of vitamin B6 on plasma and red blood cell magnesium levels in premenopausal women, Ann Clin Lab Sci, 1981, Vol. 11, (4), pp 333-6

Vitamin D
11. Eastell R, Lambert H. Diet and healthy bones. Calcif Tissue Int, 2002;70:400-404.

12. Allain TJ, Dhesi J. Hypovitaminosis D in older adults. Gerentology, 2003;49: 273-278.

Magnesium
13. MAFF, National Food Survey 1994, Annual Report on Household, Food Consumption and Expenditure, HMSO, 1995

14. M. C. Linder (Ed.), Nutritional Biochemistry and Metabolism with Clinical Application – Second Edition, Prentice-Hall International Inc., 1991

15. M. F. Ryan, The role of magnesium in clinical biochemistry: an overview, Ann. Clin. Biochem, 1991, 28: pp 19-26

16. Dr Robert Erdmann & Meirion Jones, Minerals the Metabolic Miracle Workers, The Guernsey Press Co. Ltd, 1988

17. Y. Itokawa, J. Durlach, (Eds.), Magnesium in Health and Disease, John Libbey & Co. Ltd., 1989, pp 271-278

18. M. S. Seelig, Consequences of magnesium deficiency on the enhancement of stress reactions; preventive and therapeutic implications (a review), Journal of the American College of Nutrition, 1994, Vol. 13, (5), pp 429-46

Zinc
19. M. T. Murray, Encyclopedia of Nutritional Supplements, Prima Publishing, 1996

20. Earl Mindell, The Vitamin Bible, Arlington Books (Publishers) Ltd., 1995

21. Dr Robert Erdmann & Meirion Jones, Minerals the Metabolic Miracle Workers, The Guernsey Press Co. Ltd, 1988

22. E. Favier, The Role of Zinc in Reproduction, Biological Trace Element Research, 1992, Vol. 2, pp 363-382

Selenium
23. Dr Eric Trimmer, Selenium The Trace Element for Health and Life  Extension, Thorsons Publishing Group, 1988

24. MAFF Joint Food Safety and Standards Group, Food Surveillance Information Sheet, Number 126, October 1997

25. Barry Halliwell, Human Health and Disease A radical look, Biological Sciences Review, March 1995

26. Hans Larsen, Antioxidant update, International Journal of Alternative and Complementary Medicine, October 1995

27. M. T. Murray, Encyclopedia of Nutritional Supplements, Prima Publishing, 1996

28. Kiremidjian-Schumacher L, Stotzky G, Selenium and Immune Responses. Env Res 1987; 42:277-303

29. Wallace E., Calvin H. I, Ploetz K., Cooper G. W., Functional and developmental  studies on the role of selenium in spermatogenesis, Selenium in biology and medicine, Combs G. F., Levander O.A. Spallholz J.E. Oldfield J. E. eds., Vol. A. New York: AVI, 1987; 181-96

Chromium
30. Dr Robert Erdmann & Meirion Jones, Minerals the Metabolic Miracle Workers, The Guernsey Press Co. Ltd, 1988

Copper
31. Jones AA et al, Copper supplementation of adult men: effects on blood copper enzyme activities and indicators of cardiovascular disease risk. Metabolism 1997;46:1380-3.

32. M.T. Murray, Encyclopedia of Nutritional Supplements, 1996, Prima Publishing, pp 199-217

Manganese
33. Maria C. Linder (Editor), Nutritional Biochemistry and Metabolism with Clinical Applications, Prentice-Hall International Inc., 1991

Potassium
34. Wahr JA, Parks R, Boisvert D, et al. Preoperative serum potassium levels and perioperative outcomes in cardiac surgery patients. JAMA 1999;281:2203–10.

Iron
35. Ross E.M., Evaluation and treatment of iron deficiency in adults. Nutr Clin Care 2002; 5(5):220-4

36. Mejia LA, Chew F. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. Am J Clin Nutr 1988;48:595–600.
37. Ajayi OA, Nnaji UR. Effect of ascorbic acid supplementation on haematological response and ascorbic acid status of young female adults. Ann Nutr Metab 1990;34:32–6.