Using nutritional supplements

In today’s modern world we are fortunate to have access to nutritional supplements that may be helpful in supporting our health. Taking supplements may help to boost nutritional status, improve methylation, and may even have the capacity to help unwind chromatin from the DNA to improve overall functioning. There are, however, a number of factors that should be considered before taking supplements. Some things to consider in order to help maximise benefits and minimise harm include the following:

1) The vitamins and minerals in our bodies work synergistically. Supplementing with just one vitamin or mineral can sometimes disrupt the balance of other vitamins and minerals in the body over the longer term. Choline, for example, is considered to be part of the B vitamin group. Taking just one of the vitamins from this group can create imbalances in the body. It is therefore generally recommended that a B complex be taken along with the choline. This information holds true for all vitamins and minerals – if you are going to supplement with something, you need to be aware of what else you may need to include to ensure that imbalances don’t occur.

2) Some vitamins/ minerals compete with each other for absorption. For example, iron competes with zinc. It you take supplemental iron at the same time as you take zinc, then less zinc and iron will be absorbed. Some supplements need to be taken at different times of day to prevent this issue.

3) Some supplements are not appropriate for some people. For example, magnesium should be used with caution in people with renal impairment, and is contraindicated in people with advanced renal disease or renal failure.  Iron supplements should not be taken by children unless iron studies shows an iron deficiency, to avoid iron toxicity.  Fish oil should not be taken by people with platelet disorders such as ITP, as it increases the risk of bleeding,  These are just a few examples of many contraindications.  It is important to be aware of all contraindications before starting on any supplements.

4) Supplements can interact with prescription medications.  An awareness of all potential interactions is crucial to avoid negative or dangerous outcomes from supplementation.

5) Different forms of vitamins and minerals are available in supplemental forms. Some forms are more bioavailable than others, and some forms are more appropriate for certain conditions. For example, magnesium can be found in supplements as magnesium sulphate, magnesium citrate, magnesium oxide, magnesium orotate, magnesium chelate, magnesium chloride, magensium glycinate, magnesium lactate, magnesium malate and magnesium carbonate.   Magnesium citrate and magnesium oxide may be used for their laxative effects.  Magnesium malate is more suitable for supporting the production of cellular energy.  Magnesium taurate is considered to be the most effective for supporting heart health.  Magnesium glycinate is considered to be most useful for inducing relaxation, supporting sleep and helping with stress management.  It is important to know which form of supplement is the most suitable for the condition you are supporting.

6) Some forms of supplements should be avoided by some people due to their genetic makeup.  For example, it is generally recommended that people with MTHFR mutations do not take folic acid or the form of B12 called cyanocobalamin.  Rather, they should take folinic acid, or 5 -mthf, and B12 in the form of hydroxocobalamin or methyl b12.

7) The therapeutic dose for a vitamin or mineral is not the same as the recommended daily intake (RDI), and different therapeutic dosages are often needed for different conditions.   For example, the recommended daily intake for zinc is 14.0 mg  for adult males, and 8.0 mg for adult females (1) ).  The therapeutic dose for zinc for asthma is 30mg – 50 mg per day (2).   The therapeutic dose of zinc for for rheumatoid arthritis is 45mg – 80mg per day (3).

8) Dosages for children are different to dosages for adults, and should be calculated by weight or by using “Clark’s rule” or “Young’s rule”.

9) A poorly functioning gut will not absorb supplements (or food!) properly. Making sure the gut is functioning optimally is an important factor when using supplements. Otherwise you will be spending money on supplements that will be poorly absorbed, so you will not get maximum benefit from your money.  Gut health is essential for overall health and wellbeing, and should always be an important consideration in any treatment plan.

10) When starting on supplements designed to assist with methylation, you need to support the methylation pathways to open up, and make sure you aren’t going “too fast too soon”. Otherwise you may run into problems with overmethylation. I have personally experienced what it feels like to take too much too soon. It was NOT pleasant. I was super anxious. My heart was racing, I was grinding my teeth, and generally felt uncomfortable in my body.   Overmethylation might also show up as increased anxiety, or more meltdowns.  It is important to be able to recognise the signs of overmethylation, so that decisions about appropriate supplements and dosing can be made.

These are just some of the things that need to be considered when using dietary supplements.  It is recommended that people work with a professional (eg qualified nutritionist, naturopath, integrative GP etc) to determine the optimum supplement protocol and dosages, based on individual case history and individual goals.

I am not in any way trying to scare people off the use of supplements.  Dietary intervention and supplementation have been nothing short of miraculous for us.  When we don’t give Sophie her supplements, her teachers and therapists notice. I am sharing this information to advise caution, in the hope of helping people to avoid any negative consequences, and in the hope of ensuring that people get maximum benefit from any supplementation they do undertake.

Please bear in mind, as always, that I AM NOT a doctor or qualified nutritionist (yet!). I am an interested mother, with a background in research, who has been passionate about finding answers to help my own child and others. I am currently studying nutritional medicine but I am not yet qualified.  I would suggest that people work with a qualified biomedical doctor, integrative GP, nutritionist or naturopath to ensure that you are going to help and not harm when using supplements.

 

  1. National Health and Medical Research Council. (2014). Nutrients.  Retrieved from https://www.nrv.gov.au/nutrients
  2. Rerksuppaphol, S., & Rerksuppaphol, L. (2016). Zinc supplementation in children with asthma exacerbation.  Pediatric Reports, 8(4), 63-67. doi:  10.4081/pr.2016.6685
  3. Hechtman, L. & Costa-Bir, L. (2012). The musculoskeletal system.  In Hechtman, L., (Ed.), Clinical naturopathic medicine (1st ed., pp. 508-630). Chatswood: Elsevier Australia

Kabuki, growth and short stature

Short stature is common in people with Kabuki syndrome. Is there anything we can do about it?

Some of our kids have a lack of human growth hormone (hGH), which would of course contribute to short stature. But some of our kids have normal growth hormone levels and still have short stature. There are a number of factors that affect bone growth. Some are hormonal factors, and some are nutritional factors.   I have collated some information on some of the factors that may need to be considered for optimising growth.  This is not an exhaustive list, but it’s a start 🙂

Hormones that affect growth include:

IGF’s (insulin-like growth factors) – IGF is needed in childhood for optimal bone growth – this hormone promotes cell division at an area at the long end of bones that contains growing bone (an area called the epiphyseal plate). Production of this hormone is stumlated by hGH and can be impaired by undernutrition. IGF1 can actually be increased by increasing protein intake.

hGH (Human growth hormone) – this is a hormone that stimulates growth, cell production and cell regeneration in humans. Please note that HgH is not just responsible for growth – it is considered to be a very complex hormone and many of its functions are still unknown. Recent studies are showing that it can have an effect on mental and emotional wellbeing, as well as helping to maintain energy levels. It has many other functions such as increasing protein synthesis, increasing calcium retention but I wont go into all that here because this post isn’t just about hGH – that needs a book!

Thyroid (T3 &T4) hormones – works in synergy with HgH to promote bone growth. if your child is having issues with growth, then their thyroid hormone levels shoudl be checked, as well as their hGh. Please note that not all blood tests for thyroid hormone are as useful as others – as well as looking at T3 and T4, it is also useful to look at FREE T3 and T4, and reverse T3.

Calcitonin and parathyroid hormone– These are two other hormones made by the thyroid (not measured by looking at T3 and T4). Calcitonin hormone participates in calcium and phosphorous metabolism and help to increase the activity of osteoblasts. Osteoblasts are cells that help to make bone. Parathyroid hormone also helps to regulate the activity of osteoblasts.

Sex hormones at puberty also stimulate a growth spurt.

There are a number of diet related factors that impact on bone growth. To ensure your child has the best chance of growing to their optimal height, the following minerals and vitamins should be available in adequate amounts in your child’s diet (and of course your child’s gut needs to be well enough to ensure that these minerals and vitamins can actually be absorbed and utilized by the body).

•Calcium & phosphorus – directly related to bone growth

•Manganese – helps prevent loss of bone

•Vitamin C – for collagen formation (collagen forms part of the bone matrix)

•Vitamin D – If you don’t have sufficient Vitamin D, then you can’t absorb calcium from food – calcium is required for bone growth and strength

•Vitamins K and B12 – for protein synthesis – protein makes up roughly 50% of the volume of bone and one third of it’s mass.

If you are going to supplement your child with any vitamins and minerals, please remember that our bodies are complex and vitamins and minerals work together.
Sometimes if you add a supplement, you need to add something else to make sure the balance in the body is correct. Some supplements are not suitable for some people depending on their medical history and other medications they may be taking. And some supplements can actually interfere with uptake of other supplements (for example calcium and iron should not be taken at the same time of day, because calcium interferes with iron absorption). So to be sure you aren’t going to do any harm, and that you aren’t going to be spending money on supplements that won’t be absorbed properly, please consult with a professional. I’d suggest that a naturopath ,a nutritionist who has studied nutritional medicine or a biomedical doctor will probably the best practitioners to offer support in this area.

As always – this is just information from an interested mother – I’m not a doctor, I’m not providing advice or suggesting what you should do. Just sharing my own understanding on the factors that are related to growth.

I know this post covers a few different areas, and may be a little technical in parts. But I think it can be good to take a wider view when looking at our (complex) kids, so we can have the best chance of figuring it all out! +