What are the common side effects of Alive Women’s Energy. How can users minimize potential risks. What are the benefits of taking this multivitamin supplement. When should you consult a doctor about side effects.

Understanding Alive Women’s Energy: A Comprehensive Multivitamin

Alive Women’s Energy is a multivitamin and mineral supplement designed specifically for women. This product aims to provide essential nutrients that may be lacking in a typical diet. As with any supplement, it’s crucial to understand both the potential benefits and risks associated with its use.

Common Side Effects of Alive Women’s Energy

While many users may not experience any adverse effects, some common side effects have been reported:

• Upset stomach
• Nausea or vomiting
• Diarrhea
• Constipation
• Headache
• Unusual or unpleasant taste in the mouth

These side effects are generally mild and often subside as the body adjusts to the supplement. Taking the vitamin with food can help reduce gastrointestinal discomfort.

Severe Side Effects and When to Seek Medical Attention

While rare, some users may experience more severe side effects that require immediate medical attention. These include:

• Signs of an allergic reaction (rash, hives, itching, swelling of face/throat, difficulty breathing)
• Severe stomach upset or persistent vomiting
• Severe diarrhea
• Extreme constipation
• Muscle weakness
• Numbness and tingling sensations

If you experience any of these symptoms, discontinue use and seek medical help immediately.

Long-Term Considerations and Potential Risks

Long-term use of multivitamins is generally considered safe when taken as directed. However, there are some potential risks to consider:

• Excessive intake of certain minerals (e.g., iron, calcium) can lead to toxicity over time
• Some vitamins may interact with medications or medical conditions
• Overconsumption of fat-soluble vitamins (A, D, E, K) can accumulate in the body

To minimize these risks, always follow the recommended dosage and consult with a healthcare provider before starting any new supplement regimen, especially if you have pre-existing health conditions or are taking medications.

Benefits of Alive Women’s Energy Multivitamin

Despite potential side effects, multivitamins like Alive Women’s Energy can offer several benefits:

• Filling nutritional gaps in the diet
• Supporting overall health and well-being
• Boosting energy levels
• Promoting healthy hair, skin, and nails
• Supporting bone health
• Enhancing immune function

It’s important to note that while supplements can be beneficial, they should not replace a balanced diet and healthy lifestyle.

How to Minimize Side Effects

To reduce the likelihood of experiencing side effects from Alive Women’s Energy, consider the following tips:

1. Take the supplement with food to minimize stomach upset
2. Start with a lower dose and gradually increase to the recommended amount
3. Stay hydrated by drinking plenty of water throughout the day
4. Avoid taking the supplement close to bedtime, as some ingredients may interfere with sleep
5. Do not exceed the recommended dosage

If side effects persist despite these measures, consult your healthcare provider for guidance.

Interactions and Precautions

Alive Women’s Energy may interact with certain medications or medical conditions. It’s essential to be aware of potential interactions and take necessary precautions:

• Inform your doctor about all medications and supplements you’re taking
• Use caution if you have a history of allergies or sensitivities to vitamins or minerals
• If you’re pregnant or breastfeeding, consult your healthcare provider before use
• Some ingredients may affect blood clotting, so use caution if you’re taking blood thinners
• Certain medical conditions may require adjustments in vitamin and mineral intake

Always read the product label carefully and follow the recommended guidelines for use.

Can Alive Women’s Energy interfere with prescription medications?

Yes, certain ingredients in multivitamins can interact with prescription medications. For example, calcium and iron supplements may reduce the absorption of some antibiotics, while vitamin K can interfere with blood-thinning medications. It’s crucial to inform your healthcare provider about all supplements you’re taking to avoid potential interactions.

Are there any specific populations that should avoid Alive Women’s Energy?

While Alive Women’s Energy is generally safe for most adult women, certain groups should exercise caution or avoid the supplement:

• Pregnant women (unless recommended by a healthcare provider)
• Women with certain medical conditions (e.g., hemochromatosis, which causes iron overload)
• Those with known allergies to any ingredients in the supplement
• Individuals taking multiple medications that may interact with the vitamins or minerals

Always consult with a healthcare professional before starting any new supplement regimen, especially if you have pre-existing health concerns.

Understanding Dosage and Administration

Proper dosage and administration of Alive Women’s Energy are essential for maximizing benefits and minimizing side effects:

• Follow the recommended dosage on the product label or as advised by your healthcare provider
• Take the supplement at the same time each day to establish a routine
• If you miss a dose, do not double up; simply resume your regular schedule
• Store the product in a cool, dry place away from direct sunlight
• Keep the supplement out of reach of children

Remember that more is not always better when it comes to vitamins and minerals. Excessive intake can lead to adverse effects and potential toxicity.

How long does it take to see benefits from Alive Women’s Energy?

The time frame for experiencing benefits from a multivitamin can vary depending on individual factors such as diet, lifestyle, and overall health. Some people may notice improvements in energy levels and general well-being within a few weeks, while others may take longer to see noticeable effects. Consistent use over several months is typically recommended to fully assess the supplement’s impact on your health.

Comparing Alive Women’s Energy to Other Multivitamins

When considering Alive Women’s Energy, it’s helpful to understand how it compares to other multivitamin options:

• Formulation: Alive Women’s Energy is specifically designed for women’s nutritional needs
• Ingredient quality: Look for supplements that use high-quality, bioavailable forms of vitamins and minerals
• Additional components: Some multivitamins include herbal extracts or probiotics for added benefits
• Dietary considerations: Check if the product is suitable for specific dietary needs (e.g., vegetarian, gluten-free)
• Cost and value: Compare the price per serving and the overall nutrient profile

While Alive Women’s Energy may be an excellent choice for many, it’s essential to select a multivitamin that aligns with your individual health goals and dietary preferences.

Are there any alternatives to taking a multivitamin supplement?

Yes, there are alternatives to taking multivitamin supplements:

1. Eating a varied, nutrient-dense diet rich in fruits, vegetables, whole grains, and lean proteins
2. Focusing on specific nutrient-rich foods to address particular deficiencies
3. Incorporating fortified foods into your diet
4. Working with a nutritionist to develop a personalized meal plan
5. Considering individual vitamin or mineral supplements based on specific needs

While these alternatives can be effective, some individuals may still benefit from a multivitamin supplement, especially if they have restricted diets or increased nutritional needs.

Monitoring Your Health While Taking Alive Women’s Energy

To ensure that Alive Women’s Energy is benefiting your health without causing adverse effects, consider the following monitoring strategies:

• Keep a journal of any changes in energy levels, mood, or overall well-being
• Note any side effects or unusual symptoms that occur after starting the supplement
• Schedule regular check-ups with your healthcare provider to discuss your supplement use
• Consider periodic blood tests to check vitamin and mineral levels, especially if you have pre-existing deficiencies
• Be aware of any changes in your menstrual cycle or hormonal balance, as some nutrients can influence these factors

Regular monitoring can help you and your healthcare provider determine if Alive Women’s Energy is meeting your nutritional needs effectively.

How can users determine if they’re getting too much of certain vitamins or minerals?

Detecting an excess of vitamins or minerals can be challenging, as symptoms may be subtle or nonspecific. However, some signs that you may be getting too much of certain nutrients include:

• Nausea, vomiting, or persistent stomach discomfort
• Headaches or migraines
• Skin issues, such as flushing or rashes
• Changes in urine color or frequency
• Bone pain or joint discomfort
• Irregular heartbeat or changes in blood pressure

If you suspect you may be getting excessive amounts of vitamins or minerals, consult your healthcare provider. They may recommend blood tests to check your nutrient levels and adjust your supplement regimen accordingly.

The Future of Women’s Multivitamins: Trends and Innovations

The field of nutritional supplements, including women’s multivitamins, is continually evolving. Some emerging trends and innovations include:

• Personalized nutrition: Tailored supplement formulations based on individual genetic profiles and health needs
• Improved bioavailability: Development of new delivery systems to enhance nutrient absorption
• Sustainable and eco-friendly packaging: Increasing focus on environmentally responsible product packaging
• Integration with digital health: Apps and wearable devices to track nutrient intake and health metrics
• Incorporation of adaptogens: Inclusion of herbs and botanicals to help manage stress and support overall well-being

As research in nutrition and women’s health advances, we can expect to see continued improvements in multivitamin formulations and delivery methods.

How might future developments in multivitamins address current limitations or side effects?

Future developments in multivitamin supplements may address current limitations and side effects through several innovative approaches:

1. Targeted delivery systems to reduce gastrointestinal side effects
2. Improved nutrient forms with enhanced bioavailability to lower required doses
3. Integration of probiotics or enzymes to support digestion and nutrient absorption
4. Time-release formulations to maintain consistent nutrient levels throughout the day
5. Advanced screening techniques to identify individual nutritional needs and potential sensitivities

These advancements could potentially lead to more effective and better-tolerated multivitamin supplements, reducing the likelihood of side effects while maximizing health benefits.

Alive Women’s Energy Side Effects: Common, Severe, Long Term

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Generic name: multivitamin with minerals

Medically reviewed by Drugs.com. Last updated on Jul 3, 2023.

Note: This document contains side effect information about multivitamin with minerals. Some dosage forms listed on this page may not apply to the brand name Alive Women’s Energy.

Applies to multivitamin with minerals: oral tablet. Other dosage forms:

• oral capsule, oral liquid, oral tablet, oral tablet chewable
• oral capsule
• oral miscellaneous
• oral wafer

Serious side effects

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your
doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing;
  tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue,
  or throat.
• Very upset stomach or throwing up.
• Severe diarrhea.
• Very bad constipation.
• Muscle weakness.
• Numbness and tingling.

Other side effects

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical
help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach or throwing up.
• Diarrhea.
• Constipation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical
advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

More about Alive Women’s Energy (multivitamin with minerals)

• Check interactions
• Compare alternatives
• Dosage information
• Drug class: vitamin and mineral combinations

Patient resources

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Professional resources

• Prescribing Information

Related treatment guides

• Vitamin/Mineral Supplementation and Deficiency

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

Alive Women’s Gummy – Side Effects, Interactions, Uses, Dosage, Warnings

Reviewed: February 25, 2022

This medicine is a combination of many different vitamins and minerals that are normally found in foods and other natural sources.

Multivitamins and minerals are used to provide substances that are not taken in through the diet. Multivitamins and minerals are also used to treat vitamin or mineral deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, certain medications, and many other conditions.

Multivitamins and minerals may also be used for purposes not listed in this medication guide.

uses

What is Alive Women’s Gummy (Oral) used for?

• Vitamin/Mineral Supplementation

warnings

What is the most important information I should know about Alive Women’s Gummy (Oral)?

Multivitamins and minerals can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medicine than directed on the label or prescribed by your doctor.

Ask a doctor or pharmacist if it is safe for you to use multivitamins and minerals if you have other medical conditions or allergies.

Ask a doctor before using this medicine if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy. Some vitamins and minerals can be harmful if taken in large doses. You may need to use a specially formulated prenatal vitamin.

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Side Effects

What are the side effects of Alive Women’s Gummy (Oral)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling.

When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Common side effects may include:

• upset stomach;
• headache; or
• unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Alive Women’s Gummy (Oral) if I’m pregnant or breastfeeding?

Ask a doctor before using this medicine if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy. Some vitamins and minerals can be harmful if taken in large doses. You may need to use a specially formulated prenatal vitamin.

Interactions

What drugs and food should I avoid while taking Alive Women’s Gummy (Oral)?

Avoid taking more than one multivitamin product at the same time unless your doctor tells you to. Taking similar products together can result in an overdose or serious side effects.

Avoid the use of salt substitutes in your diet if your multivitamin and mineral contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement.

Do not take this medicine with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain minerals.

Dosage Guidelines & Tips

How to take Alive Women’s Gummy (Oral)?

Use Alive Women’s Gummy (Oral) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Alive Women’s Gummy (Oral)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Overdose Signs

What happens if I overdose on Alive Women’s Gummy (Oral)?

Overdose symptoms may include increased thirst or urination, severe stomach pain, vomiting, bloody diarrhea, black and tarry stools, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, severe back pain, blood in your urine, pale skin, easy bruising or bleeding, severe drowsiness, slow heart rate, shallow breathing, weak and rapid pulse, confusion, muscle weakness, cold and clammy skin, blue lips, and seizure (convulsions).

If you think you or someone else may have overdosed on: Alive Women’s Gummy (Oral),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Alive Women’s Gummy (Oral), call 911

911

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Medical Disclaimer

Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Healthy lifestyle articles

Vitamin and mineral complexes in modern clinical practice | Gorokhovskaya G.N., Zimaeva Yu.O., Petina M.M.

Vitamin and mineral complexes in modern clinical practice

March 07, 2008

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• Gorokhovskaya G. N.

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• Zimaeva Yu.O.

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• Petina M.M.

For citation: Gorokhovskaya G.N., Zimaeva Yu.O., Petina M.M. Vitamin and mineral complexes in modern clinical practice. breast cancer. 2008;5:345.

The term “vitamin” comes from the Latin “vita” – life. The role of vitamins in the life of the body is extremely large. By the second half of the 19th century, it was known that the nutritional value of food products is determined by the content of proteins, fats, carbohydrates, mineral salts and water in them. It was believed that if a person’s food includes certain amounts of all these nutrients, then it fully meets the biological needs of the body. This opinion was firmly rooted in science and was supported by such authoritative physiologists of that time as Pettenkofer, Voit, and Rubner [10]. However, practice has not always confirmed the correctness of ideas about the biological usefulness of food. Budd stated in 1842 that malnutrition was the cause of some diseases. His concept sharply contradicted the views established in the 19th century. In his monograph, he wrote: “There are three different forms of disease that are the result of malnutrition. The first and most famous of these is scurvy; a manifestation of the second form is the formation of ulcers on the cornea; the third form is most often manifested in increased bone flexibility and rickets” [1].

An important step towards the discovery of vitamins was made by the Russian scientist N.I. Lunin (1853–1937). In 1890, he conducted an experiment, which consisted in feeding mice with food containing in a purified diet all the necessary nutrients known by that time – proteins, fats, carbohydrates and mineral salts. However, most of the mice died after a while. Only two mice fed exclusively milk remained healthy for 2 months (until the end of the experiment). N.I. Lunin came to the conclusion that healthy natural food contains, in addition to these components, some vital substances, still unknown to science. The scientist argued that studies on the role of these components in the diet are of great interest to science. The need for other nutritional components in the diet, in addition to protein, carbohydrates, fats and mineral salts, has become obvious. Only at 19In 11, the Polish scientist Casimir Fuk isolated a crystalline substance from rice bran, which, when added in negligible amounts to the feed of sick beriberi pigeons, cured them. In the rice grains themselves, this substance was absent. During chemical analysis, K. Fook found nitrogen in its composition, so the isolated substance was called by the researcher a vitamin, that is, a “vital amine” [2]. The first half of the 20th century was marked by the discovery of all currently known vitamins. It turned out that vitamins are a heterogeneous group of organic substances, and some do not contain nitrogen, i.e. are not amines. However, the concept of vitamins has remained unchanged: vitamins are organic components required in small quantities by most living organisms for normal growth and vital activity and performing specific physiological functions. Currently, about 20 different vitamins are known, their chemical structure has been established; this made it possible to organize the industrial production of vitamins not only by processing the products in which they are contained in finished form, but also artificially, by means of their chemical synthesis.
The human body does not synthesize vitamins or synthesizes in insufficient quantities (for example, nicotinic acid) and must necessarily receive them with food. Vitamins have a high biological activity. Unlike other essential nutrients, vitamins are involved in metabolism as catalysts and regulators of certain biochemical and physiological processes.
It is customary to distinguish between water-soluble and fat-soluble vitamins. Water-soluble include ascorbic acid (vitamin C) and B vitamins – thiamine (vitamin B1), riboflavin (vitamin B2), pyridoxine (vitamin B6), vitamin B12 (cyanocobalamin), niacin (vitamin PP), folacin (folic acid), pantothenic acid and biotin. The group of fat-soluble vitamins includes vitamins A, D, E, K. They enter the body as part of fat-containing products; their absorption also requires the presence of fat [3].
Along with vitamins, the need for which for humans and animals is indisputable, there are substances in food, the deficiency of which does not lead to pronounced manifestations, but they also have a certain biological activity. These substances can be classified as vitamin-like compounds. These usually include bioflavonoids, choline, inositol, carnitine, lipoic, orotic, pangamic and para-aminobenzoic acids.
Some analogues and derivatives of vitamins are antivitamins. Penetrating into cells, these substances enter into competition with vitamins. Having taken the place of a vitamin in the structure of the enzyme, the corresponding antivitamin cannot perform its function due to differences in structure, and therefore the phenomena of vitamin deficiency develop. Some antivitamins have antibacterial as well as carcinostatic activity. For example, sulfa drugs are antagonists of para-aminobenzoic acid, which is necessary for the growth of microorganisms. Folic acid antagonists aminopterin and amethopterin (methotrexate) are used in the treatment of malignant neoplasms [4].
The need for vitamins depends both on the state of the body (internal factors) and on the influence of the environment (external factors). At the same time, the age of a person, the nature and intensity of labor have a significant impact. The need for vitamins increases significantly during pregnancy and lactation, increases significantly in the conditions of the North, when working in hot shops, underground, with strong neuropsychic stress. Thus, people in hazardous professions are advised to take additional vitamins due to their increased consumption under the influence of harmful production factors.
Inadequate intake of one or another vitamin with food leads to its deficiency in the body and the development of the corresponding vitamin deficiency disease, which is based on violations of biochemical, most often enzymatic, processes from this vitamin [9].
There are two degrees of vitamin deficiency: beriberi and hypovitaminosis. Vitamin deficiency is understood as a deep deficiency of one or another vitamin with a detailed picture of a disease state of deficiency: with a deficiency of vitamin C – scurvy, vitamin D – rickets, vitamin B1 – beriberi disease, vitamin PP – pellagra, vitamin B12 – pernicious anemia. Hypovitaminosis includes states of moderate deficiency with erased nonspecific manifestations, such as loss of appetite, fatigue, irritability, and individual microsymptoms: bleeding gums, pustular skin diseases, peeling and dry skin, brittle hair, etc. In these cases, biochemical tests, such as certain concentrations of vitamins, the activity of vitamin-dependent enzymes, already reveal a deficiency of a particular vitamin, but there is still no detailed clinical picture of its deficiency. Along with a deficiency of one vitamin, polyhypovitaminosis is common, in which the body is deficient in several vitamins. However, even under these conditions, the deficiency of one of the vitamins, as a rule, is leading, and the rest are concomitant. The main cause of hypo- and avitaminosis is insufficient intake of vitamins from food. In such cases, hypo- and beriberi are called primary, or exogenous. Along with this, vitamin deficiency can occur with sufficient intake from food. In this case, deficiency develops due to a violation of their utilization in the body or a sharp increase in the need for vitamins. Such hypo- and beriberi are called secondary, or endogenous. A special group of such conditions are congenital, genetically determined metabolic disorders and vitamin functions. The intake of a number of vitamins in doses significantly exceeding the physiological need can produce undesirable side effects, and in some cases lead to serious pathological disorders – hypervitaminosis [11].
The most common deficiency of vitamins C, A, insufficient intake of vitamins B1, B2, folic acid and vitamin B6. Insufficient intake of vitamins, which does not even lead to pronounced clinical manifestations of beriberi, adversely affects human health: worsens health, reduces efficiency, resistance to cold infectious diseases, increases the negative impact on the body of harmful working conditions and the environment, exacerbates the course of diseases, prevents their successful treatment , which leads to an increase in the loss of working time and unproductive expenses for payment of temporary disability.
Insufficient intake of ascorbic acid correlates with the incidence of high blood cholesterol (hypercholesterolemia) and coronary heart disease, hypertension.
Deficiency of vitamin A and carotenoids, as well as some B vitamins, is a factor predisposing to the development of a number of malignant neoplasms. Insufficient supply of vitamins to pregnant and lactating women, whose need for these nutrients is significantly increased, causes great damage to the health of the mother and child, can be the cause of congenital deformities, malnutrition, prematurity, impaired physical and mental development of children. Long-term insufficient intake of vitamins in childhood and adolescence adversely affects the indicators of general physical development, endurance, prevents the formation of a healthy body, contributes to the gradual development of metabolic disorders and chronic diseases. Finally, insufficient intake of vitamins is a factor that predisposes to alcoholism and enhances the destructive effect of alcohol on the health and psyche of a person. Hypovitaminosis status, characteristic of a large number of healthy people, is significantly aggravated in various diseases. Hypovitaminosis aggravates the course of the underlying disease, complicates and reduces the effectiveness of therapeutic measures, complicates the outcome of surgical interventions and the course of the postoperative period. In this regard, the treatment of almost any disease should include the correction of an existing or possible vitamin deficiency by including multivitamin preparations in complex therapy.
Important elements that are involved in a variety of biological processes, a variety of physiological and biochemical reactions, are minerals. Of the 92 natural elements, 81 are found in the human body. All elements enter the human body from the external environment. 36 elements are of clinical importance for the state of the human body, while 15 of them are “essential” – a decrease in their content in the body or absence is accompanied by a characteristic clinical picture [12].
Modern vitamin-mineral complexes contain the necessary amount of vitamins, minerals and antioxidants to fully provide the body with nutrients. The formulas of these complexes always contain a complete set of vitamins and minerals needed by the body, as well as enzymes that contribute to better absorption of nutrients. The development of hypo- and beriberi can be prevented by periodically taking vitamins and minerals. Vitamin-mineral complexes can be narrow, “directional” action, used to correct the lack of a particular vitamin or trace element. There are also vitamin complexes containing vitamins and minerals based on the needs of the “average adult” in nutrients. There are complexes that take into account age (vitamins for children, vitamins for the elderly), health status (vitamins for pregnant women, vitamins for diabetics), lifestyle features (vitamins for those who play sports or experience increased physical activity). Of course, such complexes also have different compositions.
It is known that vitamins are characterized by such types of drug interactions as pharmaceutical, pharmacokinetic, pharmacodynamic.
Pharmaceutical action is the result of physicochemical reactions of vitamins among themselves. For example, thiamine hydrochloride (vitamin B1) is oxidized under the action of riboflavin (vitamin B2), turning into thiochrome with the formation of chloroflavin. Both of them can precipitate. The interaction between them is enhanced by the action of nicotinamide, which, in turn, significantly enhances the interaction between cyanocobalamin and thiamine. Nicotinamide triples the solubility of folic acid and riboflavin. Ascorbic acid restores folic acid, which is an essential cofactor. To perform its function, folic acid must be in the reduced tetrahydrofolate form, and this state is provided and maintained in the presence of ascorbic acid. Riboflavin enhances the aerobic degradation of ascorbic acid, which in solution reduces the half-life of thiamine [5,13,14].
The chemical interaction of vitamins is more pronounced in liquid dosage forms than in solid ones. A large amount of scientific data has been accumulated on the negative and positive interaction of vitamins and minerals during absorption in the gastrointestinal tract and the implementation of physiological functions in the internal environment of the body. Even a small amount of ions of elements such as iron, cobalt, copper, magnesium, nickel, lead, cadmium has a catalytic effect on the oxidative destruction of many vitamins.
The relationship between the elements is not easy: some of them compete with others on the pathways of absorption, some are in antagonistic relationships at the level of receptors. Competition for the target can lead to both synergism and antagonism in terms of the final result of the physiological effect [15].
Vitamin C protects vitamin E and b-carotene from destruction by free radicals. Vitamin C is a protector of folic acid reductase and is involved in the distribution and accumulation of iron. The antioxidant effect of vitamin E is potentiated when combined with ascorbic acid, retinol, flavonoids. The metabolism of vitamin E is closely related to selenium. The action of these antioxidants is synergistic. Vitamin B1 has a C-vitamin-saving function and creates more favorable conditions for the use of vitamin C by the enzyme systems of the body. Riboflavin is necessary for the conversion of tryptophan to nicotinic acid and pyridoxine. Biotin is a synergist of vitamins B2, B6, A, nicotinic acid. A classic example is the interaction between calcium and vitamin D3 [6].
An example of micronutrient antagonism in the internal environment is vitamin B12, which can exacerbate allergic reactions caused by vitamin B1. Vitamin C, especially in the presence of iron, copper, vitamin B1, can oxidize vitamin B12 and turn it into useless or antagonistic counterparts. One of the negative effects of these analogues is the destruction of the “intrinsic factor” IF [7,16]. Thus, vitamin B12 must be taken separately from vitamin C, it is desirable to take vitamin C at different times with iron, copper and vitamin B1. When taken separately (as part of different tablets), the maximum concentrations in the blood of these antagonists are reached at different times, which reduces the likelihood of developing negative reactions. So, calcium competes for absorption with copper, magnesium, lead, iron; magnesium – with calcium and lead; copper – with zinc, manganese, calcium, cadmium [18]. Phosphates impair the absorption of calcium, magnesium, copper, lead. Iron is a zinc antagonist, competing for absorption with cadmium, copper, lead, phosphate, and zinc. Of the listed substances that can reduce the absorption of iron, calcium ion pays special attention. This is due to the fact that it has a high biological activity, is included in a significant amount in staple foods and, as a rule, is present in one multivitamin tablet with iron. First of all, it must be said that the cellular mechanisms of absorption, that is, the entry of iron and calcium ions from the intestinal lumen into the bloodstream through intestinal enterocytes, are different. Numerous studies have shown that various cellular transporters are involved in this process [Hoenderop J. et al., 2005]. In addition, there is evidence that calcium reduces the intake of heme into the body [Hallberg, 1991] and non-heme iron. Taken together, it indicates that calcium can affect the bioavailability of iron, exerting an inhibitory effect either on its transport in the gastrointestinal tract or on binding to receptors located on the apical membrane of erythrocytes [17]. Experimental data have shown that the intake of calcium and iron with an interval of 4 hours eliminates the effect of inhibition [Gleeprup A. et al., 1993]. In addition, while taking an iron supplement, you should refrain from eating any foods containing calcium. In this case, it is convenient to use vitamin and mineral complexes, which provide for the separate use of iron and calcium in advance.
However, more often, while performing their biological function in the internal environment, vitamins and minerals do not compete, but act in concert. The best-known examples of positive interactions in the internal environment are the restoration of the oxidized form of vitamin E by vitamin C and the maintenance of calcium and phosphorus by vitamin D.
Based on all of the above data, the question arises of the advisability of simultaneously taking all the necessary elements in one tablet. Dividing the daily dose of the elements necessary for the body into several tablets, taking them during the day, observing the time interval, will avoid unwanted interactions and enhance the beneficial effects. In addition, vitamin-mineral complexes contain the daily intake of all vitamins and most minerals, but the antagonist substances are separated into different tablets, and the synergists are combined in one. Sequential taking of the pills at intervals of 4–6 hours ensures that the antagonists do not “meet” and the synergists do not “separate”. Currently, both doctors and patients prefer vitamin complexes that dominate the pharmaceutical market. The current trend in the production of multivitamin and vitamin-mineral complexes is justified, on the one hand, by improving the patient’s quality of life, and on the other hand, by the possibility of a complex effect on various stages of metabolism [8].
As already noted, a sufficient amount of information has now been accumulated that allows us to reliably state that there are a number of synergistic interactions between vitamins and macroelements, without which it is impossible to create vitamin-mineral complexes effective in the treatment of certain pathologies. Understanding the mechanisms of this interaction allows the practitioner, in the conditions of a large number of drugs present on the modern pharmaceutical market, to most rationally choose a vitamin-mineral complex for the prevention and / or treatment of a certain pathological condition.