Hesperian Health Guides
Vitamin and Mineral Supplements
Mixed (or multi) vitamins
Nutritious food is the best source of vitamins. But when adequate food is not available or during pregnancy when women have a greater need for nutrition, a mixed vitamin supplement should be used.
Vitamin and mineral supplements come in many forms, but tablets are least expensive. Injections of mixed vitamins are unnecessary, a waste of money, and can cause unnecessary pain and infections. Tonics and elixirs often do not include the most necessary vitamins and are usually too expensive for the little good they do.
Many mixed vitamin tablets use 1 tablet daily, but read the label for instructions.
Vitamin A, retinol
Vitamin A prevents night blindness and xerophthalmia.
To get enough vitamin A, people need to eat enough yellow fruits and vegetables, dark green leafy vegetables, and foods such as eggs, fish, and liver. In areas where night blindness and xerophthalmia are common and eating enough of these foods is not always possible, give children vitamin A every 6 months.
Do not use more than the suggested amount. Too much vitamin A from capsules, tablets, or oil can be dangerous. Do not give the regular adult dose of 200,000 U to girls or women who could become pregnant, or women in the first 3 months of pregnancy because this can harm a developing baby. For pregnant women, vitamin A is given in smaller doses more often instead of a single large dose.
Swallow pills or capsules. But for young children, crush tablets and mix them with a little breast milk. Or cut open capsules and squeeze the liquid into the child’s mouth.
To prevent vitamin a deficiency in children
As part of a prevention program:
Over 1 year: give 200,000 U by mouth one time. Repeat every 6 months.
To treat night blindness
If someone already has difficulty seeing or has other signs of night blindness, 3 doses are given. The first dose is given right away, the second is given one day later and the third dose at least 2 weeks later.
For each of the 3 doses:
6 months to 1 year: give 100,000 U by mouth in each dose.
For children with measles
Vitamin A can help prevent pneumonia and blindness – two common complications of measles.
Over 1 year: give 200,000 U by mouth 1 time a day for 2 days.
If the child has already received a dose of vitamin A in the last 6 months, give this treatment for one day only. If someone with measles is severely malnourished or already starting to lose her vision, give a third dose of vitamin A after 2 weeks.
Vitamin B6, pyridoxine
Persons with tuberculosis being treated with isoniazid (INH) sometimes develop a lack of vitamin B6. Signs of vitamin B6 deficiency include: pain or tingling in the hands or feet, muscle twitching, nervousness, and sleep problems.
Give vitamin B6 every day the person is taking isoniazid.To prevent B6 deficiency
Larger children and adults: give 25 mg each day.
To treat B6 deficiency
Children older than 2 months: give 10 to 20 mg, 3 times a day for as long as there are any signs of deficiency.
Adults: give 50 mg, 3 times a day for as long as there are any signs of deficiency.
Iodized salt and seafood are the best ways to get enough iodine. Where it is impossible to get these, and where there is goiter or hypothyroidism (cretinism), you can give iodine supplements.
6 years to adult: give 400 mg once a year.
For pregnant women, to protect them from goiter and their babies from disabilities: give 400 mg one time during pregnancy. As early in pregnancy as possible is best, but any time is OK.
With iodized oil:
6 years to adult: give 0.5 to 1 ml (480 mg) once a year.
Pregnant women: give 1 ml (480 mg) one time as early in pregnancy as possible. Repeat 1 year after giving birth.
Iron, ferrous sulfate, ferrous gluconate
Ferrous sulfate is useful in the treatment or prevention of most cases of anemia. Treatment with ferrous sulfate by mouth usually takes at least 3 months.
Iron works better when taken with vitamin C (either by eating fruits and vegetables, or taking a vitamin C tablet).
Iron sometimes upsets the stomach and is best taken with meals. Also, it can cause constipation especially in older people, and it may make the stools (feces) look black. See advice for constipation.
Drinking liquid iron supplements blackens the teeth. Drink it through a straw or brush the teeth afterwards.
Be sure the dose is right. Too much ferrous sulfate is poisonous. Do not give iron to severely malnourished persons. Wait until they have recovered their health.
Different forms of iron contain different concentrations of this mineral. For example, a 300 mg tablet of ferrous sulfate contains about 60 mg of iron. But a 325 mg tablet of ferrous glucanate contains 36 mg of iron. So read the label of your tablets, syrup, or other iron supplement to learn the iron content.To PREVENT anemia in pregnant and breastfeeding women
To TREAT someone who is already anemic:
|DOSE BY AGE FOR FERROUS SULFATE|
300 MG TABLETS
|Under 2 years||125 mg
|Use iron syrup, or crush
about ¼ of a 300 mg
ferrous sulfate tablet in
|Give enough to provide
25 mg iron
|2 to 12 years old||300 mg
|1 tablet of 300 mg
|Give enough to provide
60 mg iron
|12 years to adult||600 mg
|2 tablets of 300 mg
|Give enough to provide
120 mg iron
Zinc helps a person with diarrhea to get better faster. It should be given along with rehydration drink.
Over 6 months: give 20 mg, once a day for 10 to 14 days.