Count: 90 capsules
Dosage: One capsule three times daily with meals.
| Ingredient | Amount Per Serving | %DV |
|---|---|---|
| Vitamin A (as retinyl palmitate) | 10,000 IU | 200% |
| Vitamin C (as ascorbic acid) | 120 mg | 200% |
| Vitamin D-3 (as cholecalciferol) | 400 IU | 100% |
| Vitamin E (as d0alpha tocopheryl succinate) | 15 IU | 50% |
| Thiamine (B-1)(as thiamin HCI) | 10 mg | 667% |
| Riboflavin (B-2) | 10 mg | 588% |
| Niacin (as niacinamide) | 100 mg | 500% |
| Vitamin B-6 (as pyridoxine HCI) | 10 mg | 500% |
| Folate (as folic acid) | 360 mcg | 90% |
| Vitamin B-12 (as cyanocobalamin) | 50 mcg | 833% |
| Biotin | 25 mcg | 8% |
| Pantothenic Acid (B5)(as calcium-d-pantothenate) | 40 mg | 400% |
| Calcium (as calcium proteinate) | 200 mg | 20% |
| Iron (as ferrous fumarate) | 15 mg | 83% |
| Iodine (from Atlantic sea kelp) | 150 mcg | 100% |
| Magnesium (as magnesium amino acid chelate) | 100 mg | 25% |
| Zinc (as zinc amino acid chelate) | 15 mg | 100% |
| Selenium (as selenium I-methionine)) | 25 mcg | 36% |
| Manganese (as manganese sulfate) | 20 mg | 1000% |
| Chromium (as TRAAC® chromium nicotinate glycinate chelate)) | 20 mg | 17% |
| Chloride (from potassium chloride) | 90 mg | 3% |
| Potassium (as potassium chloride) | 99 mg | 3% |
| Hesperidin Complex (from orange [Citrus sinensis] peel extract)[contains min. 40mg of Hesperidin) | 100 mg | * |
| Choline Bitartrate | 75 mg | * |
| Inositol | 75 mg | * |
| Pancreatin (from pancreas concentrate) | 60 mg | * |
| Lysine (as L-lysine hydrochloride) | 50 mg | * |
| Methionine (as dl-methionine) | 50 mg | * |
| Borage Oil | 50 mg | * |
| RNA (plant derived) | 50 mg | * |
| PABA (Para-aminobenzoic acid) | 30 mg | * |
| L-Glutamic Acid | 30 mg | * |
| Proprietary Blend (rose hips, alfalfa (leaf) 5:1 extract, parsley (leaf), and raw stomach substance | 24 mg | * |
| Rutin | 25 mg | * |
| Bile Salts | 5 mg | * |
Other Ingredients: gelatin (capsule), rice flour
Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose call a doctor or poison control center immediately.
Multi Caps, a high potency multiple vitamin and mineral formula, should be used in all maintenance schedules. Provides 100% or more RDA of 13 vitamins and minerals plus a host of amino acids and enzymes.
Vitamin A deficiency is rare in the United States, and the optimal way to support vitamin A status is to assess one’s intake of vitamin A rich foods. Because vitamin A is fat soluble, the body stores excess amounts, primarily in the liver, and these levels can accumulate. It is strongly recommended to have vitamin A levels tested prior to supplementation and to discuss supplementation with your healthcare provider. A food first approach is best with vitamin A. Potential drug interactions:
Retinoids Synthetic retinoids derived from vitamin A are used orally as prescription medicines. Examples include the psoriasis treatment acitretin (Soriatane®) and bexarotene (Targretin®), used to treat the skin effects of T-cell lymphoma. Retinoids can increase the risk of too much vitamin A when taken in combination with vitamin A supplements.
Vitamin C has low toxicity and is not believed to cause serious adverse effects at high intakes. The most common potential side effects are diarrhea, nausea, abdominal cramps, and other gastrointestinal disturbances. Vitamin C supplements have the potential to interact with several types of medications:
Chemotherapy and radiation. The safety and efficacy of the use of vitamin C and other antioxidants during cancer treatment is controversial. Individuals undergoing chemotherapy or radiation should consult with their oncologist prior to taking vitamin C or other antioxidant supplements, especially in high doses.
3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). Vitamin C, in combination with other antioxidants, may reduce the increase in high-density lipoprotein levels resulting from combination niacin–simvastatin (Zocor®) therapy. Health care providers should monitor lipid levels in individuals taking both statins and antioxidant supplements.
Excess amounts of vitamin D are toxic. Signs and symptoms of toxicity are unlikely at daily intakes below 250 mcg (10,000 IU). Vitamin D supplements may interact with several types of medications:
Orlistat. The weight-loss drug orlistat (Xenical® and alli®), together with a reduced-fat diet, can reduce the absorption of vitamin D from food and supplements.
Statins. Statin medications may reduce vitamin D synthesis. High intakes of vitamin D, especially from supplements, might reduce the potency of atorvastatin (Lipitor®), lovastatin (Altoprev® and Mevacor®), and simvastatin (FloLipid™ and Zocor®).
Steroids. Corticosteroid medications, such as prednisone (Deltasone®, Rayos®, and Sterapred®), may impair vitamin D metabolism.
Thiazide diuretics. The combination of thiazide diuretics (e.g., Hygroton®, Lozol®, and Microzide®) might lead to hypercalcemia.
Research has not found any adverse effects from consuming vitamin E in food, however, high doses of alpha-tocopherol supplements can cause hemorrhage and interrupt blood coagulation in animals. Doses of up to 1,500 IU/day of the natural form or 1,100 IU/day of the synthetic form in adults appear to be safe. Vitamin E supplements have the potential to interact with several types of medications. Discuss with your health professional about supplementing with vitamin E if you take any of the following medications:
Anticoagulant and antiplatelet medications. Vitamin E can inhibit platelet aggregation and interfere with vitamin K-dependent clotting factors. As a result, taking large doses with anticoagulant or antiplatelet medications, such as warfarin (Coumadin®), can increase the risk of bleeding, especially in conjunction with low vitamin K intake. The amounts of supplemental vitamin E needed to produce clinically significant effects are unknown but probably exceed 400 IU/day.
The body excretes excess amounts of thiamin in the urine. There is no upper limit set for thiamin. Thiamin is not known to interact with any medications.
Adverse effects from high riboflavin intakes from foods or supplements (400 mg/day for at least 3 months) have not been reported. There are no upper limits established for riboflavin. Riboflavin is not known to have any clinically relevant interactions with medications.
The type of niacin used in this formulation does not cause flushing. Nausea, vomiting, and signs of liver toxicity can occur with nicotinamide intakes of 3,000 mg/day. Niacin can interact with certain medications, and several types of medications might adversely affect niacin levels:
Isoniazid and pyrazinamide. Isoniazid and pyrazinamide (together in Rifater®), used to treat tuberculosis can interrupt the production of niacin.
The amount of vitamin B6 you need depends on your age. Taking high levels of vitamin B6 from supplements for a year or longer can cause severe nerve damage. Other symptoms of too much vitamin B6 include painful, unsightly skin patches, extreme sensitivity to sunlight, nausea, and heartburn. The upper limit for vitamin B6 is 100 mg/day. Vitamin B6 supplements can interact with several medications:
Cycloserine (Seromycin®). An antibiotic used to treat tuberculosis, and worsen any seizures and nerve cell damage that the drug might cause.
Certain epilepsy drugs. Could decrease vitamin B6 levels and reduce the drugs’ ability to control seizures.
Theophylline (Aquaphyllin®, Elixophyllin®, Theolair®, Truxophyllin®, and many others). For asthma or another lung disease can reduce vitamin B6 levels and cause seizures.
It’s important to take this supplement as directed as there is a potential for large amounts of folate to cause or worsen anemia and cognitive symptoms associated with a vitamin B12 deficiency. Folate supplements can interact with several medications:
Methotrexate (Rheumatrex®, Trexall®). Used to treat cancer and autoimmune diseases.
Antiepileptic medications, such as phenytoin (Dilantin®), carbamazepine (Carbatrol®, Tegretol®, Equetro®, Epitol®), and valproate (Depacon®). Used to treat epilepsy, psychiatric diseases, and other medical conditions.
Sulfasalazine (Azulfidine®). Used primarily to treat ulcerative colitis.
There is no established upper limit for vitamin B12 because of its low potential for toxicity. Even at large doses, vitamin B12 is generally considered to be safe because the body does not store excess amounts. Vitamin B12 has the potential to interact with certain medications:
Gastric acid inhibitors. Include proton pump inhibitors, such as omeprazole (Prilosec®) and lansoprazole (Prevacid®), and histamine 2-receptor antagonists, such as cimetidine (Tagamet®) and ranitidine (Zantac®). These medicines can interfere with vitamin B12 absorption from food.
Metformin. Used as first-line treatment for prediabetes and diabetes, might reduce the absorption of vitamin B12 and significantly reduce serum vitamin B12 concentrations.
There is no established upper limit for biotin because there is no evidence in humans that biotin is toxic at high intakes. Biotin can interact with certain medications, and some medications can have an adverse effect on biotin levels:
Anticonvulsants. Including carbamazepine (Tegretol®, Carbatrol®, Epitol®, Equetro®), primidone (Mysoline®), phenytoin (Dilantin®, Phenytek®), and phenobarbital (Luminal®, Solfoton®) as well as combinations of these medications may reduce biotin status and absorption.
There are no established upper limits for pantothenic acid because there are no reports of pantothenic acid toxicity in humans at high intakes. Pantothenic acid is not known to have any clinically relevant interactions with medications.
Calcium has the potential to interact with certain medications, and several types of medications might adversely affect calcium levels:
Dolutegravir (Dovato, Tivicay). Is an HIV integrase inhibitor. The combination of these medications and calcium can reduce blood levels of dolutegravir substantially. Labels approved by the FDA for dolutegravir advise patients to take dolutegravir 2 hours before or 6 hours after taking calcium supplements.
Lithium. Long-term use of lithium (Eskalith, Lithobid), a treatment for bipolar disorder, can lead to hypercalcemia, and use of both lithium and calcium supplements could increase this risk.
Quinolone antibiotics. Use of calcium supplements and quinolone antibiotics together, such as ciprofloxacin (Cipro), gemifloxacin (Factive), and moxifloxacin (Avelox), can reduce the absorption of quinolones. Take the antibiotic 2 hours before or 2 hours after calcium supplements prevents this effect.
Supplements containing 25 mg iron or more can reduce zinc absorption and plasma zinc concentrations. High-dose iron supplements can also cause gastrointestinal effects, including gastric upset, constipation, nausea, abdominal pain, vomiting, and diarrhea. Take iron supplements with food to help minimize these adverse effects. The Food and Nutrition Board have established ULs (45 mg for adults 18 +) for iron from food and supplements based on the amounts of iron that are associated with gastrointestinal effects following supplemental intakes of iron salts.
Levodopa. Iron supplements may reduce the absorption of levodopa (found in Sinemet® and Stalevo®), used to treat Parkinson’s disease and restless leg syndrome.
Levothyroxine: Levothyroxine (Levothroid®, Levoxyl®, Synthroid®, Tirosint®, and Unithroid®). Used to treat hypothyroidism, goiter, and thyroid cancer. The simultaneous ingestion of iron and levothyroxine can result in clinically significant reductions in levothyroxine efficacy in some people. It is advised on the labels of some products to not take levothyroxine within 4 hours of iron supplements.
High intakes of iodine can cause some of the same symptoms as iodine deficiency—including goiter, elevated TSH levels, and hypothyroidism, Studies have also shown that excessive iodine intakes cause thyroiditis and thyroid cancer. The Food and Nutrition Board have established iodine ULs for food and supplement intakes of 1,100 mcg for adults 18+. In most people, iodine intakes from foods and supplements are unlikely to exceed the UL. Possible drug and medication interactions:
Anti-thyroid medications. Such as methimazole (Tapazole®), are used to treat hyperthyroidism. Taking high doses of iodine with anti-thyroid medications could cause hypothyroidism.
High doses of magnesium from dietary supplements can result in diarrhea that can be accompanied by nausea and abdominal cramping. Several types of medications have the potential to interact with magnesium supplements or affect magnesium status:
Bisphosphonates. Magnesium-rich supplements or medications can decrease the absorption of oral bisphosphonates, such as alendronate (Fosamax®), used to treat osteoporosis. Use of magnesium-rich supplements or medications and oral bisphosphonates should be separated by at least 2 hours.
Antibiotics. Take antibiotics at least 2 hours before or 4–6 hours after a magnesium-containing supplement.
Diuretics. Chronic treatment with loop diuretics, such as furosemide (Lasix®) and bumetanide (Bumex®), and thiazide diuretics, such as hydrochlorothiazide (Aquazide H®) and ethacrynic acid (Edecrin®), can increase the loss of magnesium in urine and lead to magnesium depletion.
Proton pump inhibitors. Prescription proton pump inhibitor (PPI) drugs, such as esomeprazole magnesium (Nexium®) and lansoprazole (Prevacid®), when taken for prolonged periods (typically more than a year) can cause hypomagnesemia. FDA advises health care professionals to consider measuring patients’ serum magnesium levels prior to initiating long-term PPI treatment and to check magnesium levels in these patients periodically.
High zinc intakes can cause nausea, dizziness, headaches, gastric distress, vomiting, and loss of appetite. If used for weeks, doses of 50 mg zinc or more—typically from supplements can interfere with copper absorption (which can cause low copper status), reduce immune function, and lower HDL cholesterol levels. Zinc has the potential to interact with certain medications:
Antibiotics. Take antibiotics at least 2 hours before or 4–6 hours after the zinc supplement minimizes this interaction.
Penicillamine. Zinc can reduce the absorption and action of penicillamine, a drug used to treat rheumatoid arthritis and Wilson disease. To minimize this interaction, people should take zinc supplements and penicillamine at least 1 hour apart.
High intakes of selenium can cause a garlic odor in the breath, metallic taste in the mouth and hair and nail loss or brittleness. Other signs and symptoms include nausea, diarrhea, skin rashes, mottled teeth, fatigue, irritability, and nervous system abnormalities. Brazil nuts contain very high amounts of selenium (68–91 mcg per nut) and could cause selenium toxicity if consumed regularly. The FNB has established ULs for selenium from food and supplements based on the amounts of selenium that are associated with hair and nail brittleness and loss at 400 mcg. Selenium can interact with certain medications, and some medications can have an adverse effect on selenium levels:
Cisplatin. A chemotherapy agent, is used to treat ovarian, bladder, lung, and other cancers can reduce selenium levels in hair and serum but whether these reductions have a clinically significant impact is not known.
The Food and Nutrition Board established manganese ULs (11 mg for adults 18+) for healthy individuals based on levels associated with whole-blood manganese concentrations above the normal range of 4 to 15 mcg/L and risk of neurotoxicity.
The Food and Nutrition Board concludes that no adverse effects have been linked to high intakes of chromium from food or supplements and has not established an UL. They do caution that data is limited and that high intakes of chromium could have adverse effect, especially for those with renal and liver disease susceptible to adverse effects from high chromium intakes. Potential drug and medication interactions:
Insulin. Chromium might increase insulin sensitivity. Taking chromium with insulin could increase the risk of hypoglycemia.
Metformin and other antidiabetes medications. Some studies indicate that chromium supplementation might lower blood glucose levels and increase the risk of hypoglycemia.
Chloride is not known to have any clinically relevant interactions with medications.
Potassium supplements can cause minor gastrointestinal side effects. Interactions with drugs and medications:
ACE inhibitors and angiotensin receptor blockers (ARBs). ACE inhibitors, such as benazepril (Lotensin®), and ARBs such as losartan (Cozaar®) reduce urinary potassium excretion, which can lead to hyperkalemia. It is recommended to monitor potassium status in people taking ACE inhibitors or ARBs, especially if they have other risk factors for hyperkalemia, such as impaired kidney function.
Potassium sparing diuretics. Such as amiloride (Midamor®) and spironolactone (Aldactone®), reduce the excretion of potassium in the urine and can cause hyperkalemia. It is recommended to monitor potassium status in people taking these medications, especially if they have impaired kidney function or other risk factors for hyperkalemia.
There is limited information to know if hesperidin is safe when taken for longer than 6 months. Potential side effects include stomach pain and upset, diarrhea and headaches. Potential drug and medication interactions:
Celiprolol. Hesperidin may reduce how much celiprolol the body absorbs. This might decrease how well celiprolol works. Do not take hesperidin with celiprolol.
Diltiazem. Hesperidin may reduce how much diltiazem the body absorbs. This might decrease how well diltiazem works. Do not take diltiazem with hesperidin.
Antihypertensive drugs. Hesperidin might decrease blood pressure. Taking hesperidin along with medications used to lower high blood pressure might cause your blood pressure to go too low.
P-Glycoprotein Substrates. Some medications are moved by pumps in cells. Hesperidin might make these pumps less active and increase the amount of some medications that get absorbed by the body. This might increase the amount of some medications in the body, which could lead to more side effects. But there is not enough information to know the degree of concern.
Anticoagulant / Antiplatelet drugs. Hesperidin might slow blood clotting. Taking hesperidin along with medications that also slow blood clotting might increase the risk of bruising and bleeding and others.
High intakes of choline are associated with a fishy body odor, vomiting, excessive sweating and salivation, hypotension, and liver toxicity. The upper limit has been established at 3000 mg. Choline is not known to have any clinically relevant interactions with medications.
Inositol might lower blood sugar levels. Taking inositol along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Pancreatin may cause diarrhea, abdominal pain/cramps, or nausea. If any of these effects last or get worse, speak with your health professional.
Lysine is possibly safe for most people when taken in doses up to 3000 mg daily for up to one year. It can cause side effects such as stomach pain and diarrhea. Potential drug and medication interactions:
Gastrointestinal agents (5-HT4 agonist). Lysine might reduce the effects of some gastrointestinal drugs called 5-HT4 agonists.
Common side effects associated with methionine tend to be mild and include nausea, vomiting, drowsiness, and irritability. Certain populations should avoid using methionine or at least discuss it with their healthcare provider before taking it. If you have the methylenetetrahydrofolate reductase (MTHFR) deficiency, a hereditary disease, you should avoid using methionine. People with MTHFR deficiency cannot convert homocysteine, a potentially dangerous compound, to methionine. For people with MTHFR deficiency, taking methionine supplements may cause homocysteine levels to become too high. If you have high homocysteine levels in your blood, you should avoid using methionine supplements. High blood homocysteine can lead to heart disease and other complications.
Possible drug and medication interactions with borage oil:
Medications such as Carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin). And others increase the breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers) interact with borage. Medications that cause the liver to break down borage seed oil might enhance the toxic effects of chemicals contained in borage seed oil.
Anticoagulant / Antiplatelet drugs. Borage seed oil might slow blood clotting in some people. Taking borage seed oil along with medications that also slow clotting might increase the chances of bruising and bleeding. Medications include: aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Phenothiazines. Taking supplements containing gamma linolenic acid, such as borage, with phenothiazines might increase the risk of having a seizure in some people. Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others.
RNA is LIKELY SAFE when consumed in the amounts found in food.
Para-aminobenzoic acid (PABA) can decrease the effectiveness of certain antibiotics called sulfonamides. PABA should not be taken when using sulfonamide (sulfa) drugs.
L-Glutamic Acid is likely safe when used in doses up to 40 grams daily. Side effects are generally mild and might include bloating, nausea, dizziness, heartburn, and stomach pain.
Rutin is usually well tolerated in doses at 600 mg daily or less. Side effects might include headache or stomach upset. There isn't enough evidence to know if rutin supplements are safe to use when pregnant or breast feeding. Rutin might lower blood sugars. Taking rutin along with blood sugar lowering modifications might cause blood sugars to drop too low.
Source: NIH, Office of Dietary Supplements
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