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waruna01

Good multivitamin for PD patients

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Unless you are deficient in a specific nutrient, it's usually best to get a general all-purpose multivitamin/mineral. Adults over age 50 are advised not to take iron supplements unless they are iron-deficient. And people with PD are advised the same, as abnormal iron deposits are found in the brain. People with PD using levodopa should use caution with large amounts of vitamin B6, as well as iron, as both may interfere with levodopa absorption. Here are the two tested by ConsumerLab that meet those requirements:

 

Dr. Mercola Whole Food Multi Plus (8 tablets once daily) (no iron, 4 mg B6)

Nutrilite Double X (no iron, 15 mg B6) Dist. by Amway

 

I was hoping there would be more, but other approved brands contain very large amounts of B6.

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It appears to be fine; it's just that I looked only at brands approved by ConsumerLab, and this one was not among them. That doesn't mean it isn't a good choice. ConsumerLab does not test every product made by every company that is on the market.

 

And, if one is not sensitive to large amounts of B6, then that opens up more choices. Regarding iron, we must always bear in mind that anemia can develop among people with PD (and does); if so, then the doctor will need to prescribe the correct type and dose of supplement, and monitor results.

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There isn't complete agreement on whether methylcobalamin is a better choice than cyanocobalamin. However, some people with PD (and the general population as well) have utilized 23andMe and discovered they have a gene mutation that does not complete the methylation process properly. For these people, methylcobalamin may be a better choice. Other than that, I'm not aware so far that cyanocobalamin would be a concern with PD.

 

I don't think any ingredients would be directly harmful. I prefer d-alpha tocopherol (the natural form) to dl-alphatocopherol; and the entire range of tocopherols and tocotrienols to either form, as these support each other and are present in foods that naturally contain vitamin E. Polyethylene glycol is the active ingredient in Miralax, a laxative, but there may not be sufficient quantity to make a difference one way or the other. Most of the polysyllabic ingredients are forms of the various minerals included, such as molybdenum, boron, and vanadium, and so far as I am aware, are safe -- always bearing in mind that very few substances have been studied with specific reference to PD, making it difficult/impossible to determine their effectiveness or safety.

 

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One more question on above Costco brand. It has 50mg or 13% of Magnesium from Magnesium Oxide. Does that mean you are getting 13% of your Magnesium RDA or its even less than 13% since its coming from Magnesium Oxide?

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As written, it means you will receive 50 mg of magnesium from the magnesium oxide, but only about 4% is likely to be absorbed.

 

That is why magnesium (and calcium) are provided as separate supplements. The amount required by the RDA is impossible to fit into a multivitamin-mineral tablet.

 

If you don't require supplementation of magnesium, this multivitamin is fine; but if you do need supplements, you need to obtain a separate magnesium supplement.

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Your questions are very good, and it's good to be concerned, especially if there is a family history of cardiovascular disease.

 

It's not an easy question to answer, however. Study results are mixed, and confusing; researchers do not by any means all agree; not all the studies included measurement of vitamin D intake, and different population groups were studied, thus there is no exact answer.

 

By far the best approach is to get as much calcium from foods as possible, as it is difficult to overdo calcium via diet if you eat a balance of grains, vegetables, fruits, protein sources, and dairy foods. If you have a family history of cardiovascular disease, or if your doctor has stated that you are at risk for atherosclerosis or other cardiovascular disease, ask if it would be best to limit calcium intake to 1000 mg per day.

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Isnt magnesium and calcium, Vitamin D are the most important vitamins/minerals that most people lack in a regular diet and therefore needs supplements? If that's the case, aren't we better off using separate pills for magnesium and (Calcium + Vitamin D) than using a Multivitamin that has hardly anything of value when it comes to magnesium and calcium, Vitamin D? I feel you are better off taking Magnesium and (Calcium + Vitamin D) pills daily than taking a multivitamin. 

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Magnesium and calcium are important, but I would not say they are the most important nutrients missing from a regular diet.  Vitamin B12, for example, is less well absorbed as we age, and older adults can become deficient in B12. It is one of the few nutrients that is better absorbed from pills than from food. Folic acid is crucial during pregnancy, so it is included. Selenium, a trace mineral, is often stripped away from processed foods, so people who eat mainly highly-processed foods can be deficient in selenium, and multivitamins generally contain the RDA for selenium; ditto copper, manganese and other trace minerals. A multivitamin is (usually) designed to provide at least the RDA for most nutrients, so that people who don't eat an adequate diet can prevent deficiency.

 

But size is a factor for a multinutrient pill, and calcium and magnesium each require a pretty large pill, far too large to be combined in a single multivitamin pill. So if you require supplements of either of these, you will definitely need to purchase separate supplements, as a multivitamin will not be able to supply the RDA for either one. It can and usually does supply the RDA for vitamin D.

 

Whether you need to take a multivitamin as well as calcium and magnesium is entirely an individual concern. It depends on the quality of one's diet, state of health, age, gender, lack of stomach acid, and many other factors.

 

I know this isn't the simple and quick answer you are probably hoping for; but nutrition is very complex and has innumerable complicating factors. So if I need to clarify further, don't hesitate to ask -- you are asking very intelligent questions, it's just that the answers aren't always simple.

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Arent most multivitamins contain cyanocobalamin for B12 therefore only a small fraction gets absorbed similar to using Magnesium Oxide for magnesium?

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For most people cyanocobalamin is quite adequately absorbed, and can be taken orally, which is why it is found in so many supplements. For a few people, such as smokers, or who have a genetic mutation which can interfere with B12 metabolism, other forms of B12 are needed, some of which are given via intramuscular injection or intravenously and thus are more expensive.

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