This document discusses nutritional supplements, alternative medicines, vitamins, minerals, and herbal remedies. It covers the medical indications for supplements, identifies key vitamins and minerals, describes common alternative medicines and herbal uses, and provides guidance on safety, regulation, and educating patients about compliance and interactions with prescription drugs. The goal is to discuss nutritional balance, common deficiency symptoms, and side effects of supplements while promoting the safe and appropriate use of alternative treatments.

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CHAPTER 19
Nutritional Supplements and Alternative
Medicines
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LEARNING OBJECTIVES
 Discussing medical indications for nutritional
supplements.
 Identifying fat-soluble and water-soluble vitamins.
 Identifying minerals that are used as supplements and
for electrolyte replacement.
 Discussing common home remedies used as
alternative medicinal forms.
 Describing the use of herbal medicines.

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LEARNING OBJECTIVES (CONT’D.)
 Understanding over-the-counter (OTC) nutritional
supplements and their interactions with therapeutic
prescription medications.
 Describing cultural differences and the use of herbals
and alternative medicines.
 Providing patient education for compliance with
medications used as nutritional supplements and
alternative medicines.

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 Intellectual impairment
 Muscle wasting
 Obesity
 Emaciation
 Loss of hair
 Delayed healing of
wounds
NUTRITIONAL IMBALANCE
COMMON SIGNS AND SYMPTOMS
 Nonspecific complaints
 Abnormal bone function
 Neurological damage
 Inability to build, repair
tissue
 Change in energy level

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NOURISHMENT
The human body requires food, and especially
vitamins, that are not produced by the body.
Vitamins are normally obtained from fluids and plant
and animal products that we ingest.
Nutrients might be “natural,” but they can still have
side effects on the human body when:
 introduced in large amounts
 taken indiscriminately
 interacting with other supplements or drugs

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COMMON SIDE EFFECTS OF VITAMINS,
MINERALS, AND HERBS
 Irritability
 Anorexia
 Headaches, flushing
 Indigestion, nausea, diarrhea, constipation
 Abdominal cramping and pain
 Discolored stools
 Insomnia
 Hypotension

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VITAMINS
 General term for number of organic substances or
nutrients necessary for normal:
 growth
 development
 metabolism
 release of energy from food
 Needed in trace amounts; required amounts vary in
children, elderly, pregnant, or lactating women

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VITAMINS
 Most American diets contain adequate vitamin
amounts.
 Fat-soluble vitamins are stored for long periods.

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VITAMINS: PATIENT EDUCATION FOR
COMPLIANCE
 Vitamin supplements - taken in addition to dietary
sources; could be useful during certain times in life
cycle
 Healthy, nonsmoking, nonpregnant adults do not need
vitamin supplements.
 Fortified/enriched foods have synthetic
vitamins added during processing.

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VITAMINS: PATIENT EDUCATION FOR
COMPLIANCE
 Overcooking vegetables leads to vitamin loss.
 Over-the-counter vitamins typically have lower vitamin
content than prescription vitamins.
 Humans need 10 to 15 minutes of sunlight exposure
per day, 3 times a week, for normal absorption of
vitamin D.

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VITAMINS
 Vitamin A highly teratogenic

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FAT-SOLUBLE VITAMINS

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WATER-SOLUBLE VITAMINS

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WATER SOLUBLE VITAMINS

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VITAMINS

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MINERALS
 Inorganic solid substances
 Usually component of earth’s crust
 Needed in small amounts for body to function
normally
 4% of body weight
 Mineral supplements are needed during rapid growth
periods, for clinical situations (anemia), or during
certain drug therapies (diuretics)

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MINERALS
 Acid—hydrogen ion released in a solution, reacts
with metal to form salts
pH < 7
 Base—combines with hydrogen to form salt
pH > 7 or alkaline
 Salt—any compound of acid and base

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MINERALS
 Electrolytes can conduct electrical charge, form
charged particles (ions).
 Water = solvent; electrolytes = solute
 Together they form an isotonic (0.9%) salt solution.

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MAJOR MINERALS
 Calcium (Ca+)
 needed for bone and tooth formation, muscle contraction
and relaxation, blood clotting, nervous system
transmission, insulin secretion
 calcium carbonate (Tums) and Os-Cal good sources
 postmenopausal women need vitamin D for effective
calcium absorption

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MAJOR MINERALS
 Phosphorus (P+)
 needed for bone and tooth formation, energy
 helps in storage of fats and metabolism

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MAJOR MINERALS
 Magnesium (Mg+)
 helps synthesize proteins, stimulates muscle contraction
and nerve transmission, activates enzymes, aids in bone
formation
 supplements found in combinations with other minerals
(calcium)
 Slow Mag, MOM, Epsom salts

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MAJOR MINERALS
 Sodium (Na+)
 regulates body fluid and acid-base balance
 found in table salt

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MAJOR MINERALS
 Potassium (K+)
 maintains cell structure by regulating levels of intracellular
fluid
 regulates muscle function, especially cardiac muscle
 K-Lyte or K-Dur
 Chloride (Cl-)
 serves as buffer, enzyme activator, component of gastric
HCl

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TRACE MINERALS
 Iron (Fe+)
 essential component of blood hemoglobin;
used in antibody formation
 ferrous sulfate darkens stools, causes constipation
 liquid iron preparations should be ingested through a straw
to prevent tooth discoloration
 never mix iron and antacids

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TRACE MINERALS (CONT’D.)
 Zinc (Zn+)
 essential component of DNA and RNA
 necessary for sexual development, wound healing, normal
taste and smell
 Fluorine/Fluorides (Fl)
 protect against dental caries, contribute to bone formation
 present in fluorinated water, tea, seafood
 do not take fluoride drops with milk or dairy products

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USE OF MINERAL SUPPLEMENTS
 Take with care and only under physician advice.
 A healthy person who eats a balanced diet will obtain
sufficient minerals to counteract normal losses of minerals.
 Excessive amounts could easily become toxic,
causing:
 hair loss
 changes in blood, muscles, blood vessels

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ALTERNATIVE MEDICINES
 Products lacking scientific evidence of safety and
efficacy
 some herbal preparations
 copper bracelets for arthritis
 Complementary medicine—alternative techniques
proven effective by scientific research
 acupuncture
 massage therapy
 biofeedback

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HOME AND FOLK REMEDIES
 Treatment devised at home without professional
medical advice
 Passed down from generation to generation
 Questionable therapeutic value
Many home and folk remedies coexist with modern
pharmacological therapy.
In the United States, most cultural groups use some
form of complementary or alternative therapies.

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HOME AND FOLK REMEDIES

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SAFETY AND REGULATION OF HERBAL
SUPPLEMENTS
 Considered dietary supplements; not regulated by
FDA
 Always ask patients about their use of herbal
supplements
 Instruct patients to purchase herbs from a reputable
source
 Inform physician of herbal therapy to avoid drug
interactions

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LEADING USES FOR HERBAL PRODUCTS
• Different parts of the herb are used for
medicinal purposes.

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EXAMPLES OF HERBS WITH A POTENTIAL FOR TOXIC
EFFECTS