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78 HEALTH VITAMINS MINERALS AND SUPPLEMENTS FROM PAGE 77 Often, those using VMS are looking for an easy fix to a more complex problem. Their GP may have told them they have vitamin deficiencies they should address, or perhaps they’ve read about those claims of ‘miracle cures’. Whatever the reason, pharmacists play an important role in giving consumers evidence-based advice on complementary medicines. Accredited practising dietitian and spokeswoman for Dietitians Australia Dr Anika Rouf tells Retail Pharmacy that from a dietitian’s perspective, VMS products definitely have a place and are useful for people with a deficiency. “There’s no doubt pharmacists are well placed to raise awareness of this, while always making sure patients have checked their vitamin and mineral levels before taking \\\\\\\\\\\\\\\[VMS\\\\\\\\\\\\\\\] products,” she said. According to the PSA position statement on complementary medicines, “pharmacists can assist consumers make informed decisions regarding complementary medicines to promote quality use of medicines and responsible self-medication”. “When discussing the use of complementary medicines,” the statement continued, “the pharmacist must ensure the consumer is provided with the best available information about the current evidence for efficacy, as well as information on any potential side effects, drug interactions and risks of harm.” This advice should include making consumers aware VMS products sold in Australia are regulated through the TGA, while products sold on international websites may not meet the standards of safety or quality enforced through the TGA. As such, by buying these products, consumers may be exposing themselves to risk. People who are advised by their doctor that they need to take vitamin supplements should be encouraged to consult an accredited dietitian, which is an opportunity for community pharmacists to provide, as an in-store professional service, dietary advice related to the person’s situation. How much is enough? Our bodies are capable of some incredible things but creating all the vitamins and minerals we need isn’t among them. Instead, we must consume them, ideally getting the essential vitamins and minerals from foods before turning to supplements. Vitamin supplements are frequently misused and taken without professional advice. They’re often used as a form of medicine to treat ailments such as colds, or to counteract lifestyle issues such as being time-poor or stress. Contrary to popular belief, vitamins aren’t drugs or miracle cures. They are organic compounds that contribute to various important metabolic functions. Simply taking a vitamin pill is not an instant fix for feeling run down or lacking in energy. It’s the combination of a whole range of compounds in foods that gives us the protection. Proper balance and adequate levels of essential nutrients including vitamins and minerals are important for a range of complex processes that help us maintain a healthy body. However, taking large doses of some vitamins can be harmful. For most people, it’s best to source the vitamins needed for our bodies by eating a healthy variety of unprocessed foods, because taking vitamins as supplements introduces them into the body at levels that could never be achieved by eating even the healthiest of diets. When a vitamin is absorbed from foods, it has many additional companion vitamins that optimise the body’s processes. For example, when absorbed from food, vitamin A (beta-carotene) is accompanied by hundreds of its carotenoid relatives along the way. Vitamins and minerals taken as supplements can result in large doses of a single item being eaten unaccompanied. Being absorbed in a manner completely out of context can mean the item may not be as effective and, in the case of some vitamins, can have negative effects. While a healthy diet and lifestyle are the preferred source of our vitamins and minerals, there are people either unable or unwilling to address their deficiencies through diet and exercise. For them, VMS products are an important alternative. The Victorian government’s Better Health Channel states that “people on long-term restrictive weight loss diets or those with malabsorption problems, such as diarrhoea, coeliac disease, cystic fibrosis or pancreatitis, can benefit from supplements. “Folic acid supplements are strongly recommended for women planning a pregnancy to reduce the risk of having a baby with neural tube defects, like spina bifida. Also, people who follow vegan diets, especially if pregnant, may benefit from vitamin B12 supplements.” Dr Rouf added: “Products such as the type of supplements taken during pregnancy are a must, and most women recognise the need to take some kind of supplements during pregnancy. Anyone who is vegan would also typically find supplements are necessary in some form. “Also, despite living in a sunny country, one in four Australians don’t get enough vitamin D, a figure that gets a little worse during the winter months. So, we know vitamin D is something many people are missing out on.” Improving the effectiveness of vaccines Every moment of the day, vitamins and minerals are playing a vital role in the thousands of chemical reactions driving processes in our bodies. They help heal wounds, boost our immune system, convert food into energy and are indispensable part of our make-up. Experts suggest that if you need to take a supplement, it’s best to take multivitamins at the recommended dietary level, rather than single nutrient supplements or high-dose multivitamins. However, understanding the effects of the individual vitamins and minerals is important. As we progress through a period of national vaccination against Covid-19, it’s worth considering how vitamins may assist in raising the effectiveness of the vaccination, especially among older people, who are known to have weaker immune responses and typically respond less well to vaccines than younger adults. While this is thought to be partly associated with increased frailty, deficiencies in vitamins and minerals are also believed to play a part. For the immune system to fight off infection or generate good protection against a disease following vaccination, it requires a variety of micronutrients. While there is no conclusive research, it is thought this will be true for those receiving the Covid vaccine. A recent study at the UK’s Cambridge University led to the suggestion that, with malnutrition being common among elderly people, raising their vitamin and mineral levels before they RETAIL PHARMACY • MAY 2021