Inexpensive vitamin C, B-complex, and niacin supplements have been readily available to consumers for only the past 30 to 40 years. I don’t believe that my generation (I’m in my forties) is doing a good job teaching the next generation about how to make the best use of vitamin supplements. I’m going to try to do better.
Vitamins are essential for life. Deficiency causes death. In addition to maintaining health, vitamins are frequently used tools during the process that constructs an adult from an egg and sperm. This means vitamin supplements are more useful to children to children than to adults.
Even the healthiest children can be challenged by the environment during critical phases of growth and development. Good examples include elevated levels of heavy metals in blood and tissues, and cold and flu viruses that have evolved novel mechanisms to elude an ordinary robust human immune response. To me, this means that all children should take vitamin C, B-complex, niacin, and multivitamin supplements as a precaution. During difficult moments, food is not enough.
What doses of vitamin supplements should children take? The Food and Nutrition Board has been studying vitamins since its inception in 1949. The toxicity of vitamins is remarkably well understood. Vitamins can cause a wide variety of discomforts. Even when users ignore the discomforts caused by vitamins supplements (whether by mistake, in order to achieve a benefit, or in a deliberate attempt to sicken themselves), a full recovery is almost always achieved when the supplements are discontinued. Cases of lasting harm are genuine oddities, akin to being struck by lightening. That’s why B-complex vitamins, vitamin C, and niacin are all classified as generally recognized as safe (GRAS), the gold standard for over-the-counter supplements sold to maintain or improve health.
I believe the question for parents is, “How much risk of temporary discomfort should I take in return for the potential (and unknowable) benefits of improving the growth and development of my children?” All parents will rightfully arrive at a different answer. As time passes, fewer and fewer parents will choose none.
The work of the Food and Nutrition Board is helpful. The Board has identified the maximum daily doses of Vitamin C, B-complex, and niacin supplements that can be taken with no known risk of toxicity (discomfort). These levels are known as UL’s. The UL for vitamin C is 2000 mg/day. The UL for vitamin B3 (niacin plus niacinamide) is 35 mg/day. The UL for vitamin B6 is 100 mg/day. The UL for folic acid is 1000 ug. There is insufficient data (meaning not enough reliable reports of discomfort from long term use of supplements) to set UL’s for the rest of the B-complex vitamins (B1, B2, B12, biotin, and pantothenic acid).
The UL’s provide a good starting point for a supplement program for children. For my kids, I chose daily doses of 2,000 to 4,000 mg/day of vitamin C, one-tenth of a B-100 B-complex vitamin supplement, 30 mg of niacin, and two complete multivitamin/mineral supplements containing 1 RDA of most of the vitamins and minerals. When the kids were old enough to swallow pills, I switched to 100 mg time-release niacin supplements two times per week to maintain an average dose of almost 30 mg/day.
The vitamin C dose is only slightly above the 2,000 mg UL, so it is unsurprising that my kids did not experience any discomfort. Between the multivitamin, the B-complex, and the niacin supplements, my kids averaged 130 mg/day of vitamin B3. This is almost four times higher than the UL. The UL for vitamin B3 supplements is based on the experiences of adults, not children. I believe the UL for vitamin B3 will prove to be higher for children, but will end up close to 100 mg/day because one of my two children experienced one day of discomfort on several occasions at the 130 mg/day dosage.
My children got 12 mg/day of vitamin B6, well below the Board’s UL of 100 mg/day. Vitamin B6 can cause a neuropathy which can take months to completely disappear so I was happy to keep my children well below it.
The other B vitamins are so safe at the doses in available supplements that they have no UL yet. I would have liked to give my children more, and I would like to take more myself. Currently, however, it is not a practical option. I have not identified a B-complex vitamin formulated with a higher ratio of vitamins B1, B2, biotin, and pantothenic acid to vitamins B3 and B6. I take too many supplements already and am not going to try to manage extra bottles of vitamins B1, B2, biotin, and pantothenic acid.
Adults who want to improve their health can safely explore vitamin supplements at doses far above the UL’s once they have carefully read and understood the side effects. Go ahead and take 10,000 mg/day of vitamin C, 250 mg/day of time-release niacin, and a B-50 B-complex tablet for several weeks. I you have benefits and no side effects, keep on going for several months. Then fall back to the UL’s. If the extra vitamins have enabled your body to heal, the problems that resolved won’t reappear. If you have benefits that depend upon maintaining these doses, then the underlying health problem is unlikely to heal quickly and may be permanent. If you have no benefits and no side effects, then vitamins are highly unlikely to provide any benefits and likely to cause discomfort. Falling back to the UL’s before side effects emerge is sensible. If you have side effects and no benefits, falling back to the UL’s is the only sensible option.
If you are seriously ill, 100 g/day doses of vitamin C combined with the best modern medicine has to offer should be considered. Situations where IV vitamin C causes dangerous interactions with modern medicine are rare. If current reports of the ability of vitamin C to make mainstream medical treatments more effective continue to be reproduced, IV vitamin C and vitamin C injections will become mainstream medicine.
Vitamin supplements are difficult to master because growth and development and healing processes are often slow, difficult to perceive, and irreversible (nothing bad happens when vitamin supplements are stopped). Vitamin side effects are often immediate and easy to perceive (irritating and/or painful). So, it’s not surprising that vitamin supplements are still underutilized. I hope this essay has clarified the opportunities and challenges, and proves useful to readers.
Steve,
Your suggestion to use the Food and Nutrition Board’s “Upper Limits” as a safe starting point is outstanding. I will now use this as a recommendation.
I do believe that supplementation is of great value, even when there is no immediate perceivable response. This is certainly true in regards to forestalling the chronic conditions that afflict our society.
Rusty,
I can’t tell you how much I appreciate your support. Writing this blog can be lonely work.
I hope it is clear that I also believe that supplementation is of great value even when there is no immediate perceivable response. Hopefully readers see that I am advising supplementation every day from birth to death using the UL’s as the minimum.