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Table 2 Potential adverse events of vitamin and mineral supplement use based on comparison of nutrient levels to Dietary Reference Intakes and database searches for reported adverse events for individual vitamins and minerals used

From: Nutrient- and non-nutrient-based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events

Vitamin/mineral ULa % > ULa(95% CI) LOAELb % > LOAELb(95% CI) Effect at the LOAELb
Vitamins and Minerals with ULs a and LOAELs b
Vitamin B3 or niacin - mg 35c 28 (19 to 38) 50 19 (11 to 28) Vasodilation causing flushing of the skin
Vitamin B6 or pyridoxine - mg 100 8 (4 to 16) -- -- --
Vitamin B9 or folate - mcg 1000c 17 (10 to 25) 5000 0% Precipitate or exacerbate neuropathy in vitamin B12 deficient individuals
Vitamin Dd – mcg and Vitamin Ed - mg D: 100; E: 1000e 3 (1 to 9) D: 50; E: 39,545 and 18,000f 0% Vitamin D: Hypercalcemia. Vitamin E: Increased tendency to hemorrhage seen in rats
Calcium - mg 2500 6 (2 to 13) 5000 0% Hypercalcemia, renal insufficiency
Iron - mg 45 7 (3 to 14) -- -- --
Magnesium - mg 350c; g 6 (2 to 13) 360 6 (2 to 13) Diarrhea
Zinc - mg 40 mg 6 (2 to 13) -- -- --
Manganesed - mg 11 mg 8 (4 to 16) -- -- --
Vitamins and Minerals (without ULs a and LOAELs b )
Product names % (95% CI) Adverse Events Reported in the Literature h
Pantothenic acid, vitamin B5, pantethine, pantothenol, or D-pantothenate and Potassiumi 37 (28 to 49) Forms of pantothenic acid: Diarrhea seen with 10 to 20 grams/day of calcium D-pantothenate [28]. Case report of eosinophilic pleuropericardial effusion in an elderly woman taking 10 mg of biotin and 300 mg of pantothenic acid daily for two months [29]. Nausea and heartburn, have been reported with pantethine [30]
Potassium: Supplementation of potassium only is generally prescribed to treat hypokalemia while preventing hyperkalemia and medication interactions. Mild effects include nausea, vomiting, abdominal discomfort, and diarrhea [28]
  1. aTolerable Upper Intake Level.
  2. bLowest Observed Adverse Effect Level: The lowest intake (or experimental oral dose) at which an adverse effect has been identified.
  3. cThe UL for niacin, folate, and magnesium apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two.
  4. dNutrient analysis software for food intakes of vitamin E, vitamin D and manganese have less than 50% coverage for nutrient; thus prevalence estimates of nutrient intakes exceeding the UL are conservative.
  5. eThe UL for vitamin E applies to any form of supplemental α-tocopherol, fortified foods, or a combination of the two.
  6. fLOAEL for vitamin E is based on 500 mg/kg of α-tocopherol.
  7. gThe UL for magnesium is based on gastrointestinal effects from consumption of 350 mg or more of the synthetic form.
  8. hBased on database searches of MEDLINE, EMBASE, PsychINFO, the Cochrane Library, CINAHL, NAPRALERT, MedEffect™ Canada, International Pharmaceutical Abstracts, CISCOM, and HerbMed.
  9. iPotassium in multi-vitamin and mineral supplements are limited to 99 mg per day. Reported frequency here includes only supplementation of potassium as the single nutrient as adverse effects have only been reported with this.