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#1
terabyte

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Guys I want to ask if I should take supplements particularly, multi-vitamins? I am a 25 year old fairly active male diagnosed with T2 about a month back. My BG is already in control with fasting always under 100 and post meal numbers always under 120.

The reason I want to take multi-vitamins is because of certain vitamins like B12 which I have heard repairs nerves/nervous system and hence ensures that diabetic complications associated with nervices such as neuropathy does not occurs or its chances are minimized.

At the moment I am taking in around 2000 calories each day and burning almost 400 of them via exercise which means 1600 net calories. Average daily carbs are around 200g, fats 40g and protein 100g. I eat a variety of stuff including a couple of fruits, veggies, meat and even bread etc.

I am concerned about risks of taking multi-vitamins. I have heard that they are more suitable for old people like 60+ who have a very specific diet and are not active etc. How true is that? Will I benefit from taking these multi-vitamins? Any risks associated with taking more than daily RDI(Recommended daily intake)?
DX 15 August 2011 with 314 FBG & 12.4 HBA1C
25 year old male, 253 pounds, BMI 35+
Current Diet: Medium carb / Medium fat / 2500 calories per day max
Current Exercise: 5km walk & 15 mins on elliptical trainer
Goal: HBA1C under 5.5 in 3 months
Meds: Metformin 850mg twice a day

#2
foxl

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short answer: only if taking them does not give you a false sense of comfort.

1) they do not provide enough Vitamin D, and often not the right type (look for D3 or Cholecalciferol).

2) they do not provide enough B12 if you are on metformin.

3) Looks like you are already paying attention to macronutrients, keep doing that.
Linda


[B]Jan A1c 6.3/B]
Jul 09 ... C-pep 1.3, GAD-65 > 30
Mar 10 C-pep 2.8 (20 g carb); GAD 3.2
dx 02/09 in DKA


Levemir 12U per day; novolog PRN TDD ca 16U
MetforminXR 1000 mg BID
Ramipril 5 mg
T4 112 mcg
Chia oil
Vitamin D3, 4000 IU
Eating 20 - 45 g carb per day ovo-lacto-vegetarian
Walking 30 min 6x week

#3
shyam

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Since you are a meat eater, why have you kept that restricted to 40gm ? A P:C:F ratio of 1:2:0.4 is not right IMHO. Is it Ornish ?
DX Type II Nov 2007 (219 fasting)
Diet/Exercise since Aug 2010
1stAug10 : BG 178 Fasting / A1C : 8.00, Oct'10 6.9 / Jan'11 6.4
Apr'11 6.0 / June'11 5.9 / Oct'11 5.8 / Jan'12 5.6 / Apr'12 5.3
Now between 70-125 all the time
;)

#4
foxl

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Yeah I am a vegetarian and eat more protein than that!
Linda


[B]Jan A1c 6.3/B]
Jul 09 ... C-pep 1.3, GAD-65 > 30
Mar 10 C-pep 2.8 (20 g carb); GAD 3.2
dx 02/09 in DKA


Levemir 12U per day; novolog PRN TDD ca 16U
MetforminXR 1000 mg BID
Ramipril 5 mg
T4 112 mcg
Chia oil
Vitamin D3, 4000 IU
Eating 20 - 45 g carb per day ovo-lacto-vegetarian
Walking 30 min 6x week

#5
NickP

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I agree with Foxl on the vitamin recommendations. A multiple-vitamin is good, but not enough.

However, (IMHO) you are eating way too many Carbs and not nearly enough fat. I try to eat 70% fat, 20% protein and the rest in Carbs. It is called a ketgenic diet.

And yes, absolutely NO WHEAT for me. Grains are inflammatory and disrupt your digestion. Check out the newest book by Dr William Davis titled "Wheat Belly"
Nick
Feb 17, 2010 - Initial A1C 9.3 Weight 238
May 26, 2010 - A1C 6.0
Aug 20, 2010 - A1C 5.6
Nov 19, 2010 - A1C 5.8
Mar 1, 2011- A1C 5.7 (No Meds)
Jun 3, 2011 - A1C 5.7 (No Meds)
Oct 31, 2011 - A1C 5.3
Nov 6, 2012 - A1C 5.3
Feb 18, 2014- A1C 5.6 Weight 199

Current Meds:
Metformin 500mg x 2

#6
jillybean

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If you don't want to go low carb, that's fine, but I would agree with others that yo try to increase your fat. 40g for a semi-active male is really very low even for general health. The body NEEDS fat for lots of things, and, if you're worried about vitamins, the body cannot efficiently absorb or utilize vitamins A, D, E, and K without sufficient fat intke (they are the fat-soluble vitamins).

I also agree that vit D and B12, both very important and often gone low without detection due to not being tested, won't be found in sufficient amounts/forms in a standard multivitamin. Ditto for calcium and iron.

Can you get a full set of labs run by your doc? They usually don't have a problem doing this once a year or so. At a minimum, I would ask for the following to be run just so you have a solid extensive baseline to work from:

vit A (NOT carotene)
vit D (D-25 hydroxy, not just D2)
vit E (typically shown on lab results as "tocopherols")
vit K (there are 2 types - K1 and K2 - one has to do with clotting and one works with aiding the absorption of calcium)
Comprehensive Metabolic Panel (CMP - this will include a glucose level, calcium, potassium, sodium, protein, and a handful of other things)
CBC - this will essentially take a snapshot of blood and liver conditions
lipid panel (cholesterol)
vitamin B1
vitamin B6
vitamin B12
iron
ferritin
PTH

If you have weight concerns, I would also add in a TSH for good measure.

*Jill*
Diagnosed Type 2 May 21, 2008, A1C 9.5, Fasting Glucose 214
Had Duodenal Switch (DS) surgery to resolve diabetes on March 27, 2009.
Most recent A1Cs prior to surgery: 8.1 and 7.9 while on 2500mg metformin and 50mg Januvia (sitagliptin) :(
A1C on 7/10/2009: 5.4 :)
A1C on 12/3/2010: 4.9 (off all meds) :cool:
6/9/2011: A1C of 4.6, fasting: 70, fasting insulin: 2 :D:D:D
A1C on 10/13/11: 4.8 :) (fasting: 60)
A1C in August 2012: 4.9 :)
A1C on 3/11/2013: 4.8 :)

#7
jwags

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Many times diabetics don't metabolise food well, so we don't always get all the vitamins and minerals we need. First I would try to eat lots of brightly colored veggies to get your vitamins and minerals. On top of that I do take a One a day vitamin. But I also take extra Calcium, zinc, B 12 and CoQ10 and chromium.
HbA1c 5.3 3/11 , HbA1c 5/12 6.1
metformin 2550 mg
Moderate carb diet 40-75 carbs a day
3 T of Coconut Oil daily

Vit D, CoQ10, Melatonin, Multi vitamin, zinc, B 12
Chia Seeds , Flaxseeds

Exercise- Tennis - 2 hours/week, Power Walking- 2 miles most days, Hiking in the summer on trails and in the mountains

diagnosed Feb 2007
Age 64

#8
diaboki

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I would be more concerned with the amount of carbs you are eating in a day. And if those carbs include bread and other grains that include phytates and other antinutrients, then you absolutely need a multivitamin to try to counteract all the malabsorbtion of nutrients you are experiencing.

#9
UltraStimp

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However, (IMHO) you are eating way too many Carbs and not nearly enough fat. I try to eat 70% fat, 20% protein and the rest in Carbs. It is called a ketgenic diet.


Yes, I thought the same thing when this came up in another thread (the thread about Reactive Hypoglycemia), however, through some kind of medical miracle, this guy is having no bg issues at all on a 200 g of carbs per day diet. And, this normalcy began only days after being diagnosed with an A1C over 12. It makes no sense to me, but he is posting non-diabetic numbers, so somehow whatever he is doing is working for him.

#10
psb

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... and, if you're worried about vitamins, the body cannot efficiently absorb or utilize vitamins A, D, E, and K without sufficient fat ...


Jill,

You are awesome. You are a wealth of info on vitamins. I'm glad you are here and not just for your encyclopedic vitamin knowledge ;)

#11
terabyte

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short answer: only if taking them does not give you a false sense of comfort.

1) they do not provide enough Vitamin D, and often not the right type (look for D3 or Cholecalciferol).

2) they do not provide enough B12 if you are on metformin.

3) Looks like you are already paying attention to macronutrients, keep doing that.


Thats strange. The nutrient info on the packaging states that it provides 100% of the RDI for most vitamins and minerals including B12 and D and I am pretty sure I am taking in at least 30-40% myself as a part of my regular diet. So whats the verdict? Should I go ahead?

Also I have never seen any other young person take multi-vitamins. I know I am different as I am diabetic but why does it matters?

Since you are a meat eater, why have you kept that restricted to 40gm ? A P:C:F ratio of 1:2:0.4 is not right IMHO. Is it Ornish ?


I don't know what ornish is. Today I ate (according my log maintaing at MyFitnessPal) 341g carbs, 107g fat, 75g protein for a total of 2,121 calories. Why isn't is right? I am eating healthy and eating fruits/veggies/meat. In fact I feel much much better on this diet compared to my pre-diagnosis diet which used to be 4000 calories+ and only included white breads, meat, soft drinks and ice creams. I rarely ate any fruits or veggies back then.

Yeah I am a vegetarian and eat more protein than that!


I am avoiding taking protein because excessive protein intake has its side effects. Nowadays, I am still getting a little bit foam in my urine so I am concerned about my kidneys. Also I have done a protein diet a couple of years back. While it massively helped with weight loss (which I eventually regained :( ) it caused hair loss and disturbed my test results (LFTs if I remember correctly)

I agree with Foxl on the vitamin recommendations. A multiple-vitamin is good, but not enough.

However, (IMHO) you are eating way too many Carbs and not nearly enough fat. I try to eat 70% fat, 20% protein and the rest in Carbs. It is called a ketgenic diet.

And yes, absolutely NO WHEAT for me. Grains are inflammatory and disrupt your digestion. Check out the newest book by Dr William Davis titled "Wheat Belly"


Good but not enough? So it means I am okay to take multi-vitamins? (as in it should help a little bit compared to taking nothing, right? )

I don't know about wheat. I am avoiding it too but still taking small portions, especially bran bread.

If you don't want to go low carb, that's fine, but I would agree with others that yo try to increase your fat. 40g for a semi-active male is really very low even for general health. The body NEEDS fat for lots of things, and, if you're worried about vitamins, the body cannot efficiently absorb or utilize vitamins A, D, E, and K without sufficient fat intke (they are the fat-soluble vitamins).

I also agree that vit D and B12, both very important and often gone low without detection due to not being tested, won't be found in sufficient amounts/forms in a standard multivitamin. Ditto for calcium and iron.

Can you get a full set of labs run by your doc? They usually don't have a problem doing this once a year or so. At a minimum, I would ask for the following to be run just so you have a solid extensive baseline to work from:

vit A (NOT carotene)
vit D (D-25 hydroxy, not just D2)
vit E (typically shown on lab results as "tocopherols")
vit K (there are 2 types - K1 and K2 - one has to do with clotting and one works with aiding the absorption of calcium)
Comprehensive Metabolic Panel (CMP - this will include a glucose level, calcium, potassium, sodium, protein, and a handful of other things)
CBC - this will essentially take a snapshot of blood and liver conditions
lipid panel (cholesterol)
vitamin B1
vitamin B6
vitamin B12
iron
ferritin
PTH

If you have weight concerns, I would also add in a TSH for good measure.


Wow thanks for the detailed reply! Well I am trying to go low carb and I have actually reduced my carb intake to less than half of my pre-diagnosis intake. But I will not be going the low carb route of less than 100g carbs. I will try to cap my daily carb intake at 200g and since its working for me (my numbers are great lately) I don't feel the need to go low carb.

High fat? I don't know about that. I feel it can lead to heart issues, you know cholestrol etc. Moreover, I already have more than rnough fat on my body which needs be utilized :)

I had my lipids done at dx and my cholesterol numbers were bad. I will retest in 10 days and post both results here. Thanks for listing the required tests. I will see that if they are cheap, I will get them done asap.

Many times diabetics don't metabolise food well, so we don't always get all the vitamins and minerals we need. First I would try to eat lots of brightly colored veggies to get your vitamins and minerals. On top of that I do take a One a day vitamin. But I also take extra Calcium, zinc, B 12 and CoQ10 and chromium.


I am a bit confused about being a diabetic. If our BG is in control, would we still face issues like the metabolism one you mentioned? Why is that?
Thanks for the tip on colored veggies. I am trying to eat a salad each day.

I would be more concerned with the amount of carbs you are eating in a day. And if those carbs include bread and other grains that include phytates and other antinutrients, then you absolutely need a multivitamin to try to counteract all the malabsorbtion of nutrients you are experiencing.


Thanks! I guess I will get the tests done as mentioned by Jill and that will help me make a final decision

Yes, I thought the same thing when this came up in another thread (the thread about Reactive Hypoglycemia), however, through some kind of medical miracle, this guy is having no bg issues at all on a 200 g of carbs per day diet. And, this normalcy began only days after being diagnosed with an A1C over 12. It makes no sense to me, but he is posting non-diabetic numbers, so somehow whatever he is doing is working for him.


This is what I ate today, and the highest reading I got today was 120.

Attached File  1.jpg   88.51KB   45 downloads

EDIT: I just realized that my protein intake was more than 75g today. The 3 Chicken Seekh Kebabs I ate today were made of Chicken so they had to have protein while the log shows 0. I don't know how many gs of protein they had but must be more than 50g
DX 15 August 2011 with 314 FBG & 12.4 HBA1C
25 year old male, 253 pounds, BMI 35+
Current Diet: Medium carb / Medium fat / 2500 calories per day max
Current Exercise: 5km walk & 15 mins on elliptical trainer
Goal: HBA1C under 5.5 in 3 months
Meds: Metformin 850mg twice a day

#12
psb

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...
This is what I ate today, and the highest reading I got today was 120.
...


Just wondering, what website are you plugging in your meal info into in order to get this nice chart?

#13
jillybean

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High fat? I don't know about that. I feel it can lead to heart issues, you know cholestrol etc. Moreover, I already have more than rnough fat on my body which needs be utilized :)

I had my lipids done at dx and my cholesterol numbers were bad. I will retest in 10 days and post both results here. Thanks for listing the required tests. I will see that if they are cheap, I will get them done asap.

Fat is only unhealthy WITH carbs - when limiting carb intake, high fat does not cause dangerous health effects. Most folks here can attest to having both their weight AND their cholesterol go DOWN while eating high in fat and low in carbs. I know I can personally make that claim. My last total cholesterol reading was 102.

Lab tests should be convered by insurance as part of an annual physical. When you run into trouble is when you start trying to have tests too close together without a necessary diagnosis code to support more frequent labs (for example, a normal person having frequent A1C readings might not be covered because it would be viewed as unnecessary more than once a year, but since you have a T2 diabetes diagnosis code, they would be covered).

*Jill*
Diagnosed Type 2 May 21, 2008, A1C 9.5, Fasting Glucose 214
Had Duodenal Switch (DS) surgery to resolve diabetes on March 27, 2009.
Most recent A1Cs prior to surgery: 8.1 and 7.9 while on 2500mg metformin and 50mg Januvia (sitagliptin) :(
A1C on 7/10/2009: 5.4 :)
A1C on 12/3/2010: 4.9 (off all meds) :cool:
6/9/2011: A1C of 4.6, fasting: 70, fasting insulin: 2 :D:D:D
A1C on 10/13/11: 4.8 :) (fasting: 60)
A1C in August 2012: 4.9 :)
A1C on 3/11/2013: 4.8 :)

#14
gphx

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B12 doesn't metabolize well in pill form. It's especially hard to absord. Personally I use a liquid, applied with a dropper under the tongue. This is known as a sublingual form. For some reason the flesh beneath the tongue absorbs B12 particularly well. Perhaps we best get our B12 not from swallowing but while still chewing our food.

#15
jillybean

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B12 doesn't metabolize well in pill form. It's especially hard to absord. Personally I use a liquid, applied with a dropper under the tongue. This is known as a sublingual form. For some reason the flesh beneath the tongue absorbs B12 particularly well. Perhaps we best get our B12 not from swallowing but while still chewing our food.

It depends on the individual. B12 swallowed (in pill form, for example) requires an additional checmical in the stomach called Intrinsic Factor. If you are producing sufficient IF, then regular supplements will work fine. However, if you find that regular pills are not working to bring your B12 level up, then sublingual forms are available (either liquid as mentioned - though the liquids I see are more commonly B complexes, not just B12 - or a little dissolvable B12 tablet that you hold under your tongue). I do the sublingual supplements because I had the outser curvature of my stomach removed, and that is where the majority if IF is produced.

There are also now sublingual forms of vitamin D available (I believe they are usually oral sprays) if regular supplements don't seem to be working particularly well to bring someone's D level up.

*Jill*
Diagnosed Type 2 May 21, 2008, A1C 9.5, Fasting Glucose 214
Had Duodenal Switch (DS) surgery to resolve diabetes on March 27, 2009.
Most recent A1Cs prior to surgery: 8.1 and 7.9 while on 2500mg metformin and 50mg Januvia (sitagliptin) :(
A1C on 7/10/2009: 5.4 :)
A1C on 12/3/2010: 4.9 (off all meds) :cool:
6/9/2011: A1C of 4.6, fasting: 70, fasting insulin: 2 :D:D:D
A1C on 10/13/11: 4.8 :) (fasting: 60)
A1C in August 2012: 4.9 :)
A1C on 3/11/2013: 4.8 :)

#16
NickP

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It is your life and your call, but (IMHO) your carb count is too high. I realize that you think your BG readings are good, but how often are you testing? Have you found out where you really are spiking? When is your next A1C?

If you can eat 300 Carbs a day and keep your A1C in the low 5's, then good for you! But, very few of us can handle that. Plus, for weight loss, eating that many Carbs would put more weight on my body.

Eating a high fat diet has allowed me to lose 50 pounds!

If eating this way works for you, then stick with it! I will be anxious to see how your next A1C comes out....Good Luck!
Nick
Feb 17, 2010 - Initial A1C 9.3 Weight 238
May 26, 2010 - A1C 6.0
Aug 20, 2010 - A1C 5.6
Nov 19, 2010 - A1C 5.8
Mar 1, 2011- A1C 5.7 (No Meds)
Jun 3, 2011 - A1C 5.7 (No Meds)
Oct 31, 2011 - A1C 5.3
Nov 6, 2012 - A1C 5.3
Feb 18, 2014- A1C 5.6 Weight 199

Current Meds:
Metformin 500mg x 2

#17
terabyte

terabyte

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It is your life and your call, but (IMHO) your carb count is too high. I realize that you think your BG readings are good, but how often are you testing? Have you found out where you really are spiking? When is your next A1C?


Well I am testing 6-10 times each day. I am spiking randomly and it does not makes sense to me. But even the spikes, thankfully, are under 140 on the higher reading Accu-Chek Performa. You can view my daily readnigs here

http://www.diabetesf...html#post709041

My next A1C is in 2 months

If you can eat 300 Carbs a day and keep your A1C in the low 5's, then good for you! But, very few of us can handle that. Plus, for weight loss, eating that many Carbs would put more weight on my body.

Eating a high fat diet has allowed me to lose 50 pounds!


Well at the moment it seems to work out. Regarding weight loss, I have lost 4 inches off my waist and lost 14 pounds since 15th August (i.e. since 28 days) on my current diet. This is way more weight loss than I expected in such a short time.

If eating this way works for you, then stick with it! I will be anxious to see how your next A1C comes out....Good Luck!


It surely seems to be working except for some rare spikes. Thanks!
DX 15 August 2011 with 314 FBG & 12.4 HBA1C
25 year old male, 253 pounds, BMI 35+
Current Diet: Medium carb / Medium fat / 2500 calories per day max
Current Exercise: 5km walk & 15 mins on elliptical trainer
Goal: HBA1C under 5.5 in 3 months
Meds: Metformin 850mg twice a day




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