Taking vitamins is part of the daily routine of millions of people worldwide.

Though directions for safe dosing are listed on most supplement bottles, its common practice to take more than whats recommended.

Consumers are bombarded with health information telling them that taking high doses of certain vitamins can benefit their health in many ways. However, taking too much of some nutrients can be dangerous.

This article reviews the safety of taking vitamins, as well as the side effects and potential risks associated with consuming high doses.

The 13 known vitamins are divided into 2 categories fat-soluble and water-soluble (1).

Water-soluble vitamins are readily excreted from the body and not easily stored in tissues. There are more water-soluble vitamins than there are fat-soluble ones (2).

Water-soluble vitamins include vitamin C, plus eight B vitamins:

Because water-soluble vitamins arent stored but rather excreted through urine, theyre less likely to cause issues even when taken in high doses.

However, taking megadoses of some water-soluble vitamins can lead to potentially dangerous side effects.

For example, taking very high doses of vitamin B6 can lead to potentially irreversible nerve damage over time, while taking large amounts of niacin typically in excess of 2 grams per day can cause liver damage (3, 4).

Unlike water-soluble vitamins, fat-soluble vitamins do not dissolve in water and are easily stored in your bodys tissues (2).

There are four fat-soluble vitamins:

Given that fat-soluble vitamins can accumulate in the body, these nutrients are more likely to lead to toxicity than water-soluble vitamins.

While rare, taking too much vitamin A, D, or E can lead to potentially harmful side effects (5).

Alternatively, taking high doses of non-synthetic vitamin K seems to be relatively harmless, which is why an upper intake level (UL) has not been set for this nutrient (6).

Upper intake levels are set to indicate the maximum dose of a nutrient thats unlikely to cause harm for nearly all people in a general population (7, 8).

Water-soluble vitamins are readily excreted from the body, while fat-soluble vitamins can be stored in tissues. Fat-soluble vitamins are more likely to cause toxicity, although water-soluble vitamins can do so as well.

When consumed naturally through foods, these nutrients are unlikely to cause harm, even when consumed in large amounts.

Yet, when taken in concentrated doses in supplement form, its easy to take too much, and doing so can lead to negative health outcomes.

When taken in excess, some water-soluble vitamins can cause adverse effects, some of which can be dangerous.

However, similarly to vitamin K, certain water-soluble vitamins have no observable toxicity and hence no set UL.

These vitamins include vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B5 (pantothenic acid), vitamin B7 (biotin), and vitamin B12 (cobalamin) (9, 10, 11, 12, 13).

Its important to note that while these vitamins have no observable toxicity, some of them may interact with medications and interfere with blood testing results. Therefore, caution should be taken with all nutritional supplements.

The following water-soluble vitamins have set ULs, as they can cause adverse side effects when taken in high doses:

Note that these are side effects that healthy people may experience when taking large doses of these vitamins. Individuals with health conditions can experience even more serious reactions to taking too much of a vitamin.

For example, though vitamin C is unlikely to cause toxicity in healthy people, it can lead to tissue damage and fatal heart abnormalities in those with hemochromatosis, an iron storage disorder (19).

Because fat-soluble vitamins can accumulate in your bodys tissues, they can cause much more harm when taken at high doses, especially over long periods.

Aside from vitamin K, which has a low potential for toxicity, the remaining three fat-soluble vitamins have a set UL due to their potential to cause harm at high doses.

Here are some side effects related to the overconsumption of fat-soluble vitamins:

Although vitamin K has a low potential for toxicity, it can interact with certain medications, such as warfarin and antibiotics (6).

Both water- and fat-soluble vitamins can cause side effects when taken in high doses, with some causing more severe symptoms than others.

Although its extremely rare to die from a vitamin overdose, there have been reported instances of death related to vitamin toxicity.

For example, hypervitaminosis A can be caused by taking one large dose of over 200 mg of vitamin A, or chronic use of more than 10 times the recommended daily intake (23).

Vitamin A toxicity may lead to serious complications, such as increased spinal fluid pressure, coma, and potentially fatal organ damage (23).

Additionally, taking megadoses of vitamin D more than 50,000 IU daily over long periods can lead to high blood levels of calcium (hypercalcemia), which can lead to death (24).

Overdosing on other vitamins can likewise cause potentially fatal side effects, such as liver damage.

A case report found that taking very high doses of over 5 grams of extended-release niacin can lead to metabolic acidosis, a buildup of acid in body fluids, as well as acute liver failure both of which can be fatal (25).

Keep in mind that these potentially deadly side effects are associated with taking exceptionally high doses of vitamins. Even so, caution should always be taken when consuming any dietary supplement.

In rare cases, taking extremely high doses of certain vitamins may lead to fatal complications.

The best way to get the nutrients you need is by consuming a well-rounded diet. However, many people need to supplement with vitamins for a variety of reasons.

Age, genetic disorders, medical conditions, and diet are all factors that can increase the need for certain nutrients.

Fortunately, vitamins are typically safe to take as long as they are used responsibly.

The following chart outlines both the recommended daily intake (RDI) and tolerable upper intake levels (UL) for fat-soluble and water-soluble vitamins (6, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 22):

Due to potential toxicity, its not recommended to consume more than the tolerable upper intake levels set for the nutrients listed above.

Keep in mind that in certain circumstances, your healthcare provider may recommend that you take more than the UL for certain nutrients to correct a deficiency.

For example, vitamin D deficiencies are often treated with high-dose vitamin D injections or supplements that deliver over 50,000 IU of vitamin D, which is much more than the UL (26).

Though most supplement bottles provide recommendations regarding how much of a vitamin to take per day, needs can vary from person to person.

If you have questions regarding vitamin dosing, its best to consult a medical professional.

Some vitamins have set ULs to prevent potential toxicity. Its best to consult your healthcare provider if have questions regarding proper vitamin dosing.

Although vitamin supplements are safely consumed by many people on a daily basis, its possible to take too high of a dose, which can result in adverse side effects.

Overdosing on certain vitamins can lead to serious complications and, in rare circumstances, even death.

For these reasons, its important to use vitamins responsibly and consult a trusted health professional if you have questions about proper dosing.

See the article here:
Can You Overdose on Vitamins? - Healthline

Pregnancy marks a special time in every womans life, but it is not without its complications. There are a number of natural processes that take place in the mothers body that could lead to serious complications later, if not kept in check. Many specialists across the world call this period as a natural stress test for the body. During this time, some of the changes that occur include a significant rise in blood flow that leads to extra pressure on the heart, often causing temporary strikes in blood pressure or blood sugar levels. These are healthy and natural changes that take place in order to provide nourishment to the growing fetus. These are completely normal, and for many women, these issues die down post-delivery. But for a growing number of women, these changes could lead to an increased chance of cardiovascular disease, and even diabetes. If they remain unchecked, chances of passing on these issues to fetus increase drastically. While facing heart trouble during pregnancy, expecting mothers may experience symptoms similar to a heart attack. These include:-An increased heart rate-Shortness of breath-Chest pain-Fatigue-Dizziness

To avoid these conditions, or make them more manageable, the pregnant women must take care not to overexert themselves, while following a healthier lifestyle. Some of the ways of doing this is by adopting a balanced meal plan and carrying out regular exercise.

Foods to include:Zinc - While meat and shellfish are great sources of zinc, vegetarians and vegans must especially ensure they receive the necessary amount of zinc through their diets, as they are generally low in protein, which is necessary for zinc to bind with. Legumes like chickpeas, lentils, and beans, along with seeds and nuts, are great alternative sources of zinc.

Folic Acid - All women who are of childbearing age require 400 micrograms (0.4 mg) of folic acid every day, found in eggs, nuts, beans, citrus fruits, leafy vegetables, fortified breakfast cereals, and specific vitamin supplements. Besides helping reduce the risk of birth defects of the brain and spinal cord, Folic acid is also extremely necessary during the first 28 days after conception, when risks of neural tube defects are the highest.

Iron - Having a healthy iron intake helps build iron stores in the body to prepare it for the needs of the fetus during the pregnancy. Meats, poultry, fish, legumes, and leafy green vegetables are rich in iron and must be included in a pre-pregnancy diet.

B Vitamins B vitamins are miraculous supplements that are essential for the healthy development of the fetuss mind and body. These are eight different vitamins that help the body in a variety of ways; some of which include healthy growth and function of organs, promotion of healthy skin, nerves, and digestion, breaking down of carbohydrates to generate energy, creation of red blood cells and reduction of birth defects. Foods like whole grains, green vegetables, chicken, egg yolks, milk and fish are good sources of B Vitamins and should be included in the diet.

Exercise:In a healthy pregnancy, regular physical activity is allowed and encouraged. Physical activity does not increase the risk of miscarriage, low birth weight, or early delivery. However, it is important for expecting mothers to discuss exercise with their obstetrician during their early prenatal visits. If the health care professional gives the OK to exercise, they can discuss what activities they can do safely. Exercise is important, as it provides the following benefits to both mother and child:

-Decreases back pain-Alleviates constipation-May lessen the risk of gestational diabetes, preeclampsia, and cesarean delivery-Boosts healthy weight gain during pregnancy-Enhances overall general fitness and strengthens heart and blood vessels

Read this article:
Foods and exercises to avoid heart problems during pregnancy - Times of India

Each dog is unique and can vary in size even within their breeds. The "average" weight for a cockapoo is impossible to determine. Each breed has its own unique physical characteristics. While the breed standard weight of two breeds could be 45 pounds, the breeds could side by side look completely different. The only way to know if your dog is at a healthy weight is knowing their bodyweight and their Body Condition Score. Designer dogs have no known breed standards and one mutt is as loved as another and even within litters, some dogs favor one parent or the other. Vets use a weight target formula that covers all breeds and size of dogs by knowing their body weight and their body condition score (BCS). Your Schnoodle may not be even fat, he may just be fit for a full-size Schnauzer bone structure if you look under the fur and check his BCS in comparison to his weight.

The Body Condition Score is widely used to determine a dog's percentage of body fat to lean mass. The BCS for dogs is evaluated on a 9-point scale. A healthy body condition is defined as having a BCD+S between 5 or 6. If a dog is outside this range, a dog is considered underweight or overweight. Dogs scoring only 3 or less are considering underweight and are lacking the minimal fat and necessary lean muscle mass for health. 6- and 7-point earning canines are overweight. Dogs can even be obese and score an 8 or 9. The morbidly obese dog is very rare but not unseen in vets offices and a morbidly obese dog can achieve a score above nine.BCS evaluates the dog's physical conditioning based on the criteria of the canine waistline, the abdomen, and ribs using both touch and visual appearance.An owner should be able to feel a dog's ribcage with soft pressure. The ribs should be covered by a thin layer of fat. When viewing the dog from directly above and using a birds-eye, a dog should have a visible waistline. The waistline is seen as slight indentation inward on a curve behind the ribcage. A healthy body condition in a dog is also shown with the dog having a visible upwards curvature of the midsection behind the ribs. This is called the "abdominal tuck." For very furry dogs or dogs with long hair, it can be harder to see these but these curves should be able to be felt when gently running your hands over your dog's body to determine the BCS if you did not get a number from the vet or are doing a BCS calculation or update at home.Dogs that are overweight have ribs that the ribs cannot be felt at all or only one or two may be felt at all due to fat being underneath the skin there. Obese dogs have a protruding rounded or drooping belly instead of an abdominal tuck and there will be no indentations or visible waistline. A fat pup can even protrude in the sides and be wider in the middle than at the ribcage in that area when viewed from above.An underweight dog has a skeletal appearance and the bones of the body are also easily felt. They feel like loose thin fur over bones. The ribs are easily seen with a low BCS dog, but the pelvic bones, hip, and knee joints and the spinal vertebrae are visible and able to be palpated (felt) in an underweight dog. There will be a strong obviously exaggerated abdominal tuck and waistline

Once you have your dog's BCS and have used the numbering charts available from multiple pet care resources, you can use that BCS number to calculate the target weight for your individual dog. The University of Liverpool and Royal Canin created the mathematical formula used.

The following example is how to calculate the ideal weight of a morbidly obese dog. The dog weighs 50 lbs. and scored 9 on his BCS.

Target Weight: 35.7 pounds

If a dog's BCS changes, the weight changes. If your dog is not anywhere near the target number, then making an appointment with your vet and consulting the experts for professional care and advice is the responsible thing to do, along with annual well-pet visits and always protecting your pet with up to date vaccines and spaying and neutering non-breeding animals. Flea, tick, and worm infestation prevention are also necessary for your pet's safety.Vet visits for underweight pets can help make sure that there is treatment provided to a medical cause such as a metabolic or chronic health condition that has led to. Dental disease can also make eating very painful and avoided. Parasites can likewise contribute to weight loss and need to be treated. Even a new spouse, new house or stress can cause a dog to lose their appetite.If you have a chubby puppy, the vet can check for metabolic issues and help you provide a balanced and complete nutrition diet and increased activity to help your dog lose weight safely and gradually. By having a target weight, you can reduce your dog's calories but still ensure they get the macro and micronutrients needed. Monthly visits to have a dog weighed are usually free veterinary services.Knowing how to calculate your companion animals BCS to calculate their target weight and doing so protects your dog's health and allows you to enjoy a better and quality of time with your pet.

2 Paws Up Inc Pet Sitters offer pet sitting, dog walking, overnight/house-sitting and concierge services in the following neighborhood cities of Snellville, Lilburn, Grayson, Loganville, Lawrenceville, Stone Mountain, Tucker, Conyers, and Covington.Contact Us at 770.695.3096.Visit our website at https://2pawsupinc.com/.

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Finding Your Dogs Healthy Weight - Patch.com

American College of Physicians, Washington, DC (R.B., K.R.)

Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, Oregon (T.G.C.)

Louisiana State University Health Sciences Center, New Orleans, Louisiana (L.S.E.)

Financial Support: Financial support for the development of this position paper came exclusively from the ACP operating budget.

Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at http://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2410.

Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.

Corresponding Author: Renee Butkus, BA, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.

Current Author Addresses: Ms. Butkus and Ms. Rapp: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.

Dr. Cooney: Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239.

Dr. Engel: Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112.

Author Contributions: Conception and design: R. Butkus, K. Rapp.

Analysis and interpretation of the data: R. Butkus, K. Rapp, T.G. Cooney, L.S. Engel.

Drafting of the article: R. Butkus, K. Rapp, L.S. Engel.

Critical revision of the article for important intellectual content: R. Butkus, T.G. Cooney, L.S. Engel.

Final approval of the article: R. Butkus, K. Rapp, T.G. Cooney, L.S. Engel.

Continued here:
Reducing Barriers to Care and Addressing Social Determinants of Health - Annals of Internal Medicine

In 2019, Massive Science covered some ground. We wrote about climate change killing off biodiversity, galaxies eating one another, parakeet mate selection, and on and on. We polled the Massive staff for their favorite stories of the year, both in what we worked on and in the outside world. But first, our top five most popular articles of the year:

#5

After another devastating intergovernmental report on wildlife loss, Cassie Freund wrote this urgent call for action. It's the very real end of the world, why isn't anyone acting?

#4

Neuroscience is Massive's bread-and-butter, so Claudia Lopez-Lloreda's story on fish giving up and the brain cells responsible checked a lot of boxes. Next time you quit on something, you'll know who's at fault.

#3

"Unexpected science" is another angle our writers have gotten serious mileage out of, and Darcy Shapiro's article on gorilla teeth, snacks, and how that changes human history is a classic of the genre.

#2

Definitely another "unexpected science" entry, Molly Sargen's story combined math, bridge building, and breakfast food. Now we know our audience likes that and more breakfast food science will be coming in 2020.

#1

It's got it all: space and a vague sex angle. What more could you want? You might say that Mackenzie Thornbury's article went viral. We won't though.

Sometimes though, what we think is cool and what you all think is cool doesn't match up. We're not mad about though, we know disagreement is natural. Not mad at all. Here are our personal faves that we think you should give a second shot. No pressure though!

Or, as it was more affectionately known in the Slack channel: Babies...in...SPAAAAAAACE.

Another Cassie Freund work on the actual human effort to get around conservation efforts that other humans are employing to save the planet.

"Connecting brains" is a sub-genre of our normal neuroscience work and Jordan Harrod wrote one of the best ones we've ever seen.

Yeah, the science is cool, the writing is great, but you know what really spiced up Luyi Cheng's debut article? The gifs.

We love all Our Science Heroes equally, but there's something about du Chtelet. If a man had had her adventurous, influential life that included standing on Newton's shoulders and having Voltaire as a kept man, there'd be movies made about that man's life. This is our pitch for a du Chtelet biopic. Hollywood, please call us.

Go here to read the rest:
Solitary confinement is bad for the heart too - Massive Science