"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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Safe Upper Levels for Vitamins and Minerals

Report of the Expert Group on Vitamins and Minerals – May 2003
www.food.gov.uk/multimedia/pdfs/vitmin2003.pdf

 

The Food Standards Agency commissioned an independent group, the Expert Group on Vitamins and Minerals, (EVM), to address the matter of supplement safety.  Their report was published in May 2003, Safe Upper Levels for Vitamins and Minerals.  This report set eight Safe Upper Levels, SULs, and, where the information was less certain, twenty two Guidance Levels, GLs, for vitamins and minerals.  It also recognised that there are some situations where particular individuals should not take any amount of certain supplements.

  • Reviewed human and animal toxicity data and looked at likely and possible intakes in the UK from food, supplements and water.
  • Set Safe Upper Levels for eight nutrients and, where the evidence was not robust enough, Guidance Levels.  These are defined as “..doses of vitamins and minerals that susceptible individuals could take daily on a life-long basis, without medical supervision”. 
    This definition is open to considerable criticism
  • Some Safe Upper Levels and Guidance Levels relate to total safe intake from food, water and supplements and some to intake from supplements only
  • Safe Upper Levels and Guidance Levels were determined for an adult weighing 60 kg
  • No reporting system was established to record adverse events
  • Despite these misgivings this is a useful report.  As a general rule the values for SULs and GLs should not be exceeded unless there is a specific indication and the patient is appropriately supervised usually by a medical practitioner or an experienced dietitian/nutritional therapist.

Since the publication of this report there have been many additional published reports of adverse effects of supplements sometimes at doses less than the SULs or GLs.  A pattern of adverse events is thus slowly emerging which is not dissimilar to that of drug medication.



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576