Assortment of vitamin pills

By Dr. Peter Kadile

A review of supplements and vitamins that I commonly use in my practice. Consult with your physician if you are currently taking any prescription medication before trying any over the counter supplements.

Dear Dr. Kadile, what is a good dose for melatonin? – Ann, La Quinta

Ann, melatonin is a natural hormone supplement that can assist with sleep. It is not meant to be like a traditional “sleeping pill”. Melatonin is naturally produced in your brain and tells your body that it’s nighttime and time to go to bed and sleep. It works best for frequent travelers, shift workers or anyone that knows they are going to have a major shift in their sleep schedule.

Unlike sleeping pills, the higher the dosage of melatonin does not necessarily improve one’s sleep. I typically see over the counter dosages of melatonin ranging from 3mg to 10mg. Patients will frequently complain to me that they have taken the maximum available dosage and still have difficulty sleeping. The widely available over the counter doses are way too high. Melatonin should actually be started at the lowest possible dose, I recommend starting at 0.3mg to 1mg. Higher doses of melatonin may actually disrupt sleep and may also cause headaches, nausea, dizziness, or irritability.

Dr. Kadile, when I was looking to buy some vitamin D, there are some brands that simply say “Vitamin D” and some that say “Vitamin D3”. Is there a difference? – Charlie, Rancho Mirage

Well Charlie, if the supplement simply says, “Vitamin D”, you will have to look closer at the label to see if it specifies either vitamin D2 (ergocalciferol) or vitamin D3(cholecalciferol).

There is a difference between vitamin D2 and vitamin D3.Vitamin D2 is manufactured by plants or fungus and is fortified in foods, such as juices, milk or cereals. Vitamin D3 is the form of vitamin D that is produced when the body’s skin is exposed to sunlight. Vitamin D3 is considered the more ‘natural form” of vitamin D. It can also be obtained when eating animal products. Vitamin D3 is more potent than D2. Vitamin D3 has been shown to raise and maintain serum D levels greater than vitamin D2. Clearly vitamin D3 is the preferable form of vitamin D.

As I have mentioned previously, if you are concerned about your vitamin D level, have your doctor check it with a lab test. If you don’t know your level, I recommend supplementing with vitamin D3 1,000-2,000IU a day 

Dr. K, I am confused on how much fish oil I should take, what’s a good dose? – Lloyd, Desert Hot Springs

Most of the over the counter available omega-3 fish oil will state “1,000mg” or “1,200mg” on the label, but you should turn the bottle around to look at the rest of the label to determine how much EPA and DHA are in the capsule. Fish oil is rich source of two essential omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). EPA is good for the heart and DHA is good for the brain, so the more EPA and DHA contained per fish oil capsule, the better. Not all fish oil brands are the same so it is very important to look at the label and make sure you pay attention to the serving size. What may seem like a good dose of EPA/DHA could be a serving size of 6 capsules! I generally recommend taking a product that provides at least 700-1,000mg of EPA and 200-500mg DHA daily in the smallest amount of pills. Higher dosages are available in liquid form. Molecularly distilled fish oils are naturally high in EPA and DHA and low in contaminants.

Dr. Peter, should I get a B12 shot? – Mark, Palm Springs 

Mark, vitamin B12 is found in every cell of the human body and is very important for energy production. It contributes to skin health, immune and nervous system functions and muscle function. Unfortunately, individuals may not be getting enough vitamin B12 in their diet or may have a problem absorbing it. Meat is a good source of vitamin B12, thus vegetarians may be lacking in vitamin B12, Taking over the counter and prescription antacids regularly, can interfere with vitamin B12 absorption. If you are low in vitamin B12, your body is not getting enough fuel for energy.

Vitamin B12 is a water soluble vitamin, so if your body doesn’t need it, it will flush away the excess. Since lack of vitamin B12 may be due to a gut absorption problem, injections or under the tongue would be the preferred routes for supplementation.

Vitamin B12 benefits

–              important for energy production, can decrease fatigue

–              healthy regulation of the nervous system, reduces depression, helps with stress

–              essential for healthy skin, hair and nails.

You can consult with your doctor and get a blood test to check your B12 level to see if you are deficient or you can try supplementing with vitamin B12 with daily sublingual (under the tongue) tablets or injections every 1-4 weeks and see if you feel any better.