By Leanne Chrisman Khawam, MD
Vitamins and minerals are crucial for women to maintain a healthy body and mind. These can be found in fruits and vegetables, and are vital to body processes.
Vitamin D and Calcium
Women are at risk for osteoporosis, especially those who are ethnically Caucasian or Asian, but more true for all women than men. Smoking and being overweight add to a person’s risks of developing the disease. Another risk is inadequate intake of calcium and Vitamin D.
Women’s peak bone mass increases up to about the age of 18; after this peak, it is slowly declines. Therefore, taking enough calcium and Vitamin D early in life is important (especially for those living in the Northern Hemisphere, where individuals are often Vitamin D deficient).
Active forms of Vitamin D work together with calcium to protect your bones. New evidence also suggests potassium, magnesium and Vitamin K found in vegetables and fruits also support bone as well as tooth health.
Before and After Baby
Folate is an important vitamin for women of childbearing age that helps prevent neural tube defects in the unborn. It is most important at the time before conception and up to 12 weeks of gestation as these structures form early in the pregnancy. For this reason, women who plan to get pregnant are encouraged to get prenatal vitamins and pre-conception counseling from their physician.
Folate, or folic acid, along with other B vitamins not only impact the formation of red cells (oxygen carrying cells), they also have been implicated in heart health. Around 400 micrograms is recommended for most women, while 600 mcg is recommended for pregnant women.
For women in their childbearing years, heavy or even regular monthly bleeding can result in the loss of iron stores. This results in anemia, or low red blood cell levels. Iron replacement can be difficult as it may be hard to absorb.
Vitamin C can help with iron absorption and may be taken as a supplement at 250 mg or found in a fair dose in oranges and other citrus fruits and their juices. The usual starting dose of iron is 300 to 325 mg of regular-release ferrous sulfate orally once a day.
The maintenance dose of regular-release ferrous sulfate: 325 mg orally three times a day. Alternatively, 300 mg orally four times a day may be given. Extended-release ferrous sulfate: 160 mg orally one to two times a day.
Those women in their childbearing years also should consume 1,300-1500 mg of calcium in multiple doses daily and with 600 IU Vitamin D daily. After menopause, women should take a minimum of 1,500 mg of Calcium daily in three doses with 800 IU of Vitamin D.
Food sources of calcium include milk, yogurt and cheese. Nondairy sources include vegetables, such as Chinese cabbage, kale and broccoli. (Spinach is known to have calcium that is not well absorbed.)
Some individuals need much higher doses of Vitamin D to combat chronic deficiency, and should have their levels measured if they have symptoms of fatigue, tiredness, depression or muscle weakness.
Also, calcium supplements should be consumed in three separate doses and preferably with food to promote absorption. Inadequate absorption occurs when taken at high doses all at once, therefore taking multiple doses at once is not helpful.
In fact, children ages 4 and younger should get from their diet and/or supplements a total of 1,000 mg calcium daily with 600 IU Vitamin D daily. Those ages 9 and older should get 1,300 mg of calcium/600 IU Vitamin D per day.
Getting Your B Vitamins
B12 vitamin deficiency can also have broad body impacts including anemia, nerve problems known as “neuropathy” with tingling in the arms and legs, and other central nervous problems such as depression, trouble thinking and concentrating, as well as memory loss. Anemia may also cause fatigue, tiredness and weakness.
B6 vitamins have been associated with peripheral neuropathy and a syndrome, with dandruff, sores in the mouth and cracks at the corners of the mouth. In adults, B6 deficiency may cause depression, confusion and even seizures.
Food sources of Vitamin B6 include chickpeas, avocados, banana, beans and legumes, meats, oatmeal poultry and fortified cereals. B complex vitamins will supplement the B vitamin needs for most individuals who do not consume enough in their diet or have health problems putting them at risk for deficiency. Some individuals must receive the Vitamin B injections.
Individuals with special diets, such as vegans, those who are pregnant or breastfeeding or who suffer with certain conditions such as osteoporosis, inflammatory bowel disease or take specific medications such as those for seizures or heartburn may need vitamin supplementation and should ask their doctors.
Dr. Chrisman Khawam works as the program director for the Family Medicine residency at MetroHealth. Visit metrohealth.org