Some clinics would recommend patients to stop their vitamins and other dietary supplements when suffering from diarrhea. As diarrhea is a symptom of frequent defecation of watery stools, in take of vitamins and dietary supplements will be a waste of time since these will only be excreted. But, can this reason be true?
While vitamin (ascorbic acid and multivitamin) intake is doubled and even tripled for dengue fever management and supplements (Charantia, Taheebo) are recommended for diabetes, heart disease and other health conditions, the use of vitamins and other dietary supplements are temporarily terminated during chronic diarrhea. Clinic and pharmacy personnel would reason that taking vitamins won’t be helpful since these will only be flushed down along with the frequent bowel evacuation. Contrary to this, vitamins and supplements can actually be absorbed by the body.
The main concern here is there are vitamins and supplements that can make diarrhea worse. However, there are still those that can support diarrhea treatment.
Vitamins and dietary supplements to avoid during diarrhea
Have you ever wondered why magnesium is always with aluminum in most antacids? Creamil S, Maalox and Simeco are some examples of Aluminum-magnesium antacid combinations. While aluminum alone can cause constipation, magnesium alone can cause diarrhea. But, together they can work as an effective antacid.
Magnesium is a mineral that has been known to promote blood pressure. It is involved in energy metabolim thus also regulates blood sugar.
As a dietary supplement, magnesium is often in combination with other vitamins. Some examples of dietary supplements containing magnesium are Centrum, Enervon C and Calmag (Jamieson).
Ascorbic acid and sodium ascorbate can be essential supplements for rapid wound healing and recovery from an infection. However, drug directories cite that too much intake of vitamins C - ascorbic acid (Ceelin) or sodium ascorbate (Fern C) can lead to diarrhea. Thus, as vitamin C supplements can trigger diarrhea, these are not advisable to take during the illness.
Vitamin B 12
Vitamin B12 can be cyanocobalamin or methylcobalamin. While cyanocobalamin is more recognized for the red blood formation in treating pernicious or macrocytic anemia, methylcobalamin is noted for its use in the liver, brain and nervous system. Both vitamin B 12 forms can be found in multivitamin combinations, often with vitamin B6 and vitamin B1. However, cyanocobalamin and methylcobalamin can also be available as a single active constituent. GNC Cyanocobalamin (GNC) and Mega B-12 Dots (Twinlab) are some product examples of cyanocobalamin. On the other hand, Methylcobalamin Vitamin B 12 (Vitamin Research Products) and Source Naturals MethylCobalamin are some products of methylcobalamin.
Both cyanocobalamin and methylcobalamin has been warned for diarrhea side effects.
An abundant source of vitamin D comes from sunlight. Although, vitamin D can also be found in fortified milk and cereals; in salmon, tuna shrimp, herring; in beef, egg-yolk and chicken liver. As it helps the absorption of calcium, vitamin D is important for the teeth and bones to prevent rickets in children and osteoporosis for the adults. There are different types of vitamin D. Among these, vitamin D3 also known as cholecalciferol is recognized for pharmaceutical use.
As a supplement, vitamin D is often found in combination with other vitamins. Some examples of multivitamins contaning vitamin D are Calciday (Medisys Pharma) and Calvit (Multicare), both a combination of calcium carbonate and vitamin D3. Vitamin D supplement has been cited to cause diarrhea when taken in large doses.
Tocopheryl is another popular name for vitamin E. While vitamin E is advised as an aphrodisiac for couples who want children, vitamin E is more popular as a skin and hair supplement. Like vitamin C, vitamin E is an antioxidant. Not only is vitamin E revealed as a protectant for the heart, it can also improve the nerve functions. However, diarrhea is included as its common side effect. Vitamin E can be in single or in combination formulation.
Some popular vitamin E supplements in single forms are Evirose 400 (XL Lab), Myra E (Innovitelle) and Zyme E (Blooming Fields).
Aloe vera supplements are generally recommended for immune system support, healty skin and healty digestion which includes good bowel movement. More to this, aloe vera supplements are also being recognized for diabetes. While its latter use still lacks scientific studies, aloe vera has been used as a purgative. Aloe vera contains antraquinones and other glycosides that are responsible for its laxative effect. With this action, aloe vera supplements can make diarrhea worse.
Some common aloe vera supplements are Aloeride, Puritan’s Pride Aloe Vera and Catherine’s Choice Aloe Vera.
Vitamins and dietary supplements for diarrhea treatment support
Vitamin A is also known as retinol which is more recognized as the eyesight vitamin. It is also essential for anemia, measles, asthma and cystic fibrosis. Although, there are findings that cite vitamin A has minimal support for diarrhea, it is supplemented for infants and children in third world countries. This is to prevent and control diarrhea.
Vitamin A is often found in multivitamin preparation. Some examples are Clusivol (Wyeth), Conzace (Biomedis) etc. Vitamin A in single component forms includes Afaxin (Sanofi-Aventis) and Alici-A (Mallix).
Fiber supplements including methylcellulose types (Citrucel), psyllium (Cilium) and polycarbophil (Konsyl fiber) have been known to treat constipation. However, these fiber supplements are also indicated by doctors for simple diarrhea. These fiber supplements tend to absorb the excess water and by doing so, the frequency of defecation is reduced at the same time, the solidification of the watery stool is improved.
Calcium is an important supplement for strong bones and for prevention of osteoporosis. It can be in single component form (Calbone, Calci-Aid) and in combination with other vitamins (Calcid, Calciday). One side effect of calcium is constipation. With this, calcium can oppose and control diarrhea symptoms.
In some studies, the mineral zinc can cause diarrhea. Contrary to this, zinc sulfate has been known as an effective aid for diarrhea. As WHO and UNICEF has recommended the mineral zinc use with ORS or oral rehydration salt in 2004, most doctors have been prescribing zinc supplements particularly in children. Not only that zinc can lessen the severity of diarrhea, it can also prevent diarrhea for at least three months. In the Philippines, some common zinc supplements given for children are E-zinc (Unilab) and Immuzinc (Medlink).
Image by the author
Considerations and health care decisions
Including a supplement like zinc along with an ORS and an anti-amoeba drug in a prescription is common for infants and children. The physician or a pharmacy personnel will simply cite that zinc can be a good help for diarrhea. However, when the mother or the patient asks if it’s OK to continue the other vitamins or supplements while treating diarrhea, the doctor or the pharmacy personnel, can be expected to say no.
Even with the fact that most pharmacy and health care personnel know what vitamins or supplements can be bad or not, they make things simple by advising the patients to stop their dietary supplements. Most vitamins can be in combination types like Centrum which can have opposing ingredients. Another example is Calmag (Jamieson) which includes calcium, magnesium and vitamin D. While calcium can act as an aid for diarrhea, magnesium and vitamin D can make it worse.
This article is for information only.
© Phoenix Montoya @ May 25, 2012
- Wilson and Gisvold’s Textbook of Organic Medicinal and Pharmaceutical Chemistry 9th edition