Airborne when to take

Here’s The Only Supplement You Should Take For a Cold

Unlike vitamin C, which studies have found likely does nothing to prevent or treat the common cold, zinc may actually be worth a shot this season. The mineral seems to interfere with the replication of rhinoviruses – the bugs that cause the common cold.

In a 2011 review of studies of people who’d recently gotten sick, researchers looked at those who’d started taking zinc and compared them with those who just took a placebo. The ones on zinc had shorter colds and less severe symptoms.

Zinc is a trace element that the cells of our immune system rely on to function. Not getting enough zinc (Harvard Medical School researchers recommend 15-25 milligrams of zinc per day) can affect the functioning of our T-cells and other immune cells.

But it’s also important not to get too much: an excess of the supplement may actually interfere with the immune system’s functioning and have the opposite of the intended result.

The vitamin C hype – which started with a suggestion made by chemist Linus Pauling in the 1970s and has peaked with supplements like Airborne and Emergen-C touting its benefits along grocery store shelves – is just that: hype.

Study after study has shown that vitamin C does little to nothing to prevent the common cold.

A 2013 review of 29 trials which involved more than 11,300 people, for example, found “no consistent effect of vitamin C … on the duration or severity of colds”.

The only place the authors observed some benefits of vitamin C supplementation was in marathon runners, skiers, and soldiers on ‘subarctic exercise’ – and even in those small populations, the observed effect was small.

According to the study authors, “The failure of vitamin C supplementation to reduce the incidence of colds in the general population indicates that routine vitamin C supplementation is not justified.”

Plus, megadoses of 2,000 milligrams or more may actually raise your risk of painful kidney stones.

So instead of chugging fizzy drinks loaded with vitamin C, stick to getting the nutrient from food. Strawberries and many other fruits and veggies are a great source.

And if you aren’t getting enough zinc in your diet, try a zinc supplement. Chickpeas, kidney beans, mushrooms, crab, and chicken are all rich in zinc, and lozenges like Cold-Eeze can also help boost your intake.

This article was originally published by Business Insider.

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Airborne (multivitamin with minerals) Drug Interactions

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A total of 89 drugs are known to interact with Airborne (multivitamin with minerals).

  • 4 major drug interactions
  • 80 moderate drug interactions
  • 5 minor drug interactions

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View interaction reports for Airborne (multivitamin with minerals) and the medicines listed below.

  • acetaminophen
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  • amoxicillin
  • atorvastatin
  • Benadryl (diphenhydramine)
  • Coumadin (warfarin)
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  • Vitamin B12 (cyanocobalamin)
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Major

Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.

Moderate

Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.

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The Top Five Cold Remedies That Do Not Work

One of my daughters caught a cold last week, and now she’s given it to me. We’re giving ourselves the best treatment known to science: rest. But to judge from the products offered at our pharmacies, you’d think there were dozens of options to treat a cold. In local pharmacies and in the medicines aisle at my local grocery store, I’ve found row after row of colorful packages, claiming to relieve cold symptoms, shorten the duration of the common cold, and more.

Some of these medications actually do treat symptoms, but none of them cure a cold. But mixed among them—sometimes side by side with real medicines—I found several products that don’t work at all.

How can a drug manufacturer get away with this? Simple: the products that don’t work are either supplements or homeopathic products. The manufacturers of both these types of “medicines” have successfully lobbied Congress to pass laws that exempt them from FDA regulation. Supposedly they aren’t allowed to make direct claims to cure or treat disease, but unless you read the wording on their packages very carefully, you’d never notice. (Note to older adults: bring your reading glasses to the pharmacy section!)

The secret cure for the common cold: chicken noodle soup. Source: Wikipedia

Most important for consumers: if a treatment says it’s homeopathic, then its ingredients do not have to be shown effective. “Homeopathic” simply means that the ingredients are listed on the Homeopathic Pharmacopoeia, a list maintained by homeopaths themselves. And if it contains supplements or vitamins, they too are exempted from regulation by the FDA, under a law known as DSHEA.

So next time you go searching for something to take for your cold, or for your child’s cold, here are the top 5 cold remedies you should not buy:

1. Zicam contains zinc as its active ingredient. There has been some evidence to suggest that taking zinc right at the onset of a cold might shorten its duration a little bit, from 7 days to 6. But as Dr. Terence Davidson from UC San Diego explained, if you look at the more rigorous studies, the effect vanishes. Zinc turns out to have some worrisome side effects, too. Zicam’s nasal spray and gel versions were linked to a serious loss of the sense of smell (anosmia), which led the FDA to issue a warning letter in 2009. Zicam responded by withdrawing the product for a time, but their website now says “A clinical link between the Zicam® products and anosmia was not established.” Strictly speaking, this is correct, but there have been published reports suggesting a link, such as this one from 2009.*

Zicam’s website makes the misleading claim that “all of our Zicam® products are regulated by the FDA.” This is a common ploy of homeopathic drugmakers, claiming the FDA regulates them because the FDA could step in (as they’ve already done with Zicam) if consumers are being harmed. Unlike real drugs, though, Zicam has not been evaluated by the FDA for effectiveness or safety.

2. Airborne. You can find this in the cold remedy section many pharmacies (I did), but Airborne doesn’t cure anything. It’s a cleverly marketed vitamin supplement with no scientific support for any health benefits. How do they get away with it? Actually, Airborne paid $23 million back in 2008 to settle a class-action lawsuit over its advertising. They had been calling Airborne a “miracle cold buster.” According to the Center for Science in the Public Interest’s David Schardt:

Airborne is basically an overpriced, run-of-the-mill vitamin pill that’s been cleverly, but deceptively, marketed.

After the lawsuit, Airborne modified their packaging, which now claims only that it “helps support your immune system.” This is one of those vague claims that supplement makers love, because it doesn’t really mean anything. Airborne’s products also now include a disclaimer:

These products are not intended to diagnose, treat, cure, or prevent any disease.

So what the heck are they doing in the “cold medicines” section of the store?

3. Coldcalm is a homeopathic preparation sold by Boiron, one of the world’s largest manufacturers of homeopathic remedies (including Oscillococcinum, an almost laughably ineffective flu remedy). It claims on the package to relieve cold symptoms. What’s in it? A dog’s breakfast of homeopathic ingredients, including belladonna, about which NIH says:

Belladonna is UNSAFE when taken by mouth. It contains chemicals that can be toxic.

Another ingredient is pulsatilla, which “is highly toxic, and produces cardiogenic toxins and oxytoxins which slow the heart in humans.” Neither belladonna nor pulsatilla relieves cold symptoms.

Being homeopathic, these ingredients are highly dilute, but I think I’ll pass on Coldcalm.

4. Umcka is another homeopathic preparation that claims to “shorten the duration of common cold” and “reduce severity of cold symptoms.” Sounds pretty good—if only it were true. Umcka’s active ingredient is a plant extract called pelargonium sidoides, an African geranium. Interestingly, there have been a few experiments on this extract, some of which showed a small positive effect. However, a review of these studies reported that their quality was “very low,” that all of them were conducted by Umcka itself, and that all of them were conducted in the same region of Russia. And remember: homeopathic preparations are so dilute that they contain little, and sometimes none, of the active ingredient.

5. Antibiotics. Okay, these are real medicine, and you can’t buy them over the counter at your pharmacy. But Americans take them in huge quantities to treat the common cold. The problem is, antibiotics don’t work for colds.

When my daughter told her friends she had a cold, they wanted to know why she didn’t go to the doctor. Of course, doctors can’t do anything about a cold, and going to a doctor’s office just puts other patients at risk. My daughter knows this. But her friends were astonished to hear that we never take her to the doctor for a cold. It turns out that most of them had been to doctors many times for colds, often coming away with a prescription for antibiotics.

Antibiotics treat bacterial infections, not viruses. Taking antibiotics unnecessarily can be bad for you: besides wiping out your gut flora, it increases the risk that bacteria will develop drug resistance. Perhaps if we changed the name to “antibacterials,” doctors would stop prescribing them for viruses.

I found Zicam, Airborne, Umcka, and Coldcalm for sale at Walgreens and Walmart. CVS and RiteAid don’t carry Umcka (good for them!) but do sell the others.

When you get a cold, you develop immunity to it and you won’t catch it again.We keep getting colds because they’re caused by more than 100 different viruses, most of them nasty little buggers that continually circulate in our population. Each time you catch a cold, you’re getting a brand new one. The only consolation is that once you’re over it, you won’t get that one again.

So if you get a cold this winter, save your money. Stay home, rest and drink plenty of fluids. And I have it on good authority that there is one treatment for the common cold that’s inexpensive, widely available, and really, really works: chicken soup.

*Update, 6 Dec: in response to my inquiry, Zicam’s manufacturer, Matrixx Initiatives, sent me some additional information. They pointed out that subsequent studies have not supported a link between Zicam and anosmia (loss of the sense of smell), and also that they permanently discontinued Zicam intranasal gel products (“Cold Remedy Nasal Gel and Cold Remedy Gel Swabs) in 2009, “despite the absence of any credible scientific data pointing to a potential link.” They also argue that “the efficacy of zinc-based formulations is primarily a function of bioavailable dose” and that “Zicam products are formulated to ensure availability of the zinc.” Arguing in favor of Zicam’s benefits, they pointed to several studies that I’d already read, and I remain unconvinced and, as I pointed out above, Matrixx does not have to prove efficacy to the FDA because they are selling Zicam as a homeopathic preparation, which allows them to avoid FDA regulation.

Also on Forbes:

Does Taking Vitamin C Actually Help Prevent a Cold?

At the first signs of a cold, many of us pour a big glass of OJ on the assumption that loading up on vitamin C is a surefire way to kick just about any bug. Modern-age nose-blowers may also reach for “immunity boosters” like Airborne and Emergen-C to cure the sniffles. But does vitamin C—and the supplements that tout its benefits—really work to prevent (or cure) the common cold?

Out in the Cold—Why It Matters

Researchers have studied the role vitamin C plays in preventing and treating the common cold for more than 60 years. Most experts say there is still little proof that increasing vitamin C intake will help cut down on sick days.Vitamin C for preventing and treating the common cold. Douglas RM, Hemilä H, Chalker E. The Cochrane database of systematic reviews, 2007, Jul.;(3):1469-493X. Still, the research isn’t conclusive. One study found that taking a daily vitamin C supplement reduced the frequency of catching a cold, while another discovered that it has an antihistamine effect that could reduce cold symptoms.Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. Johnston CS, Martin LJ, Cai X. Journal of the American College of Nutrition, 1992, Jun.;11(2):0731-5724. Effect of vitamin C on common cold: randomized controlled trial. Sasazuki S, Sasaki S, Tsubono Y. European journal of clinical nutrition, 2006, Apr.;60(1):0954-3007.Another study found that vitamin C made a big difference in preventing colds in those exposed to brief periods of intense cold or extreme physical exercise (like skiers, military personnel, and marathon runners) but not the general population.Vitamin C for preventing and treating the common cold. Douglas RM, Hemilä H, Chalker E. The Cochrane database of systematic reviews, 2007, Jul.;(3):1469-493X. And a different study suggests that upping vitamin C intake could reduce the severity and duration of a cold—and hopefully erase the need for that economy-size tissue box.Vitamin C for preventing and treating the common cold. Hemilä H, Chalker E. The Cochrane database of systematic reviews, 2013, Jan.;1():1469-493X.

So it looks like some vitamin C, which is found naturally in superfoods like oranges, bell peppers, and strawberries, certainly won’t do us any harm. But what about the massive doses found in products like Airborne and Emergen-C? Created by a schoolteacher in 1997, each tablet of Airborne contains 1,000 mg of vitamin C (equivalent to 11 glasses of OJ) along with zinc, vitamins A and E, selenium, and a blend of herbs including ginger and echinacea. Emergen-C also contains 1,000 mg of vitamin C (1,667 percent of the daily recommended value) and recommends users take it up to two times daily. Each serving also includes B vitamins, zinc, and electrolytes, which is why it claims to enhance energy (without the caffeine crash). While neither of them outright say they can prevent or cure colds (anymore!), the mega doses of vitamin C are generally the reason many cold-sufferers sniffle their way to the supplement aisle.

Too Much of a Good Thing?—The Answer/Debate

While there are no product-specific studies testing Airborne and Emergen-C’s effectiveness in preventing and treating the common cold, research that looks at ingredients like vitamin C and zinc can give us some insight into how well the products work. As we’ve shown, the research on vitamin C is mixed, though many professionals maintain that it’s not an effective treatment.Vitamin C for preventing and treating the common cold. Hemilä H, Chalker E. The Cochrane database of systematic reviews, 2013, Jan.;1():1469-493X. Research on zinc also remains pretty inconclusive: Multiple studies suggest that it is not effective at treating colds, though one study did conclude that it may be at high doses.Intake of vitamin C and zinc and risk of common cold: a cohort study. Takkouche B, Regueira-Méndez C, García-Closas R. Epidemiology (Cambridge, Mass.), 2002, Mar.;13(1):1044-3983. Zinc lozenges as cure for the common cold–a review and hypothesis. Eby GA. Medical hypotheses, 2009, Nov.;74(3):1532-2777. Zinc lozenges may shorten the duration of colds: a systematic review. Hemilä H. The open respiratory medicine journal, 2011, Jun.;5():1874-3064. Obviously more research is needed before anyone goes around touting zinc as the latest miracle cure.

So it looks like taking these immunity boosters is likely neither seriously beneficial nor harmful. But there are still a few things to consider before overdoing it on the fizzy drinks. Too much vitamin C, for example, can cause diarrhea, nausea, stomach cramps, and kidney stones (the National Institutes of Health suggest that adults consume no more than 2,000 mg of the vitamin each day).Ascorbic acid supplements and kidney stone incidence among men: a prospective study. Thomas LD, Elinder CG, Tiselius HG. JAMA internal medicine, 2013, Apr.;173(5):2168-6114.

Similarly, too much vitamin A (which is often included in these immune boosters) might do more harm than good. In excess doses (defined by the NIH as more than 10,000 IU per day) can cause dizziness, nausea, headaches, coma, and (in rare cases) death. In other words, it is possible to have too much of a good thing. So when it comes to catching a bug, it’s probably best to save money on the hype and listen to the classic recommendations: get lots of sleep, keep your hands clean, and cook some chicken soup.

The Takeaway

While regularly consuming adequate amounts of vitamin C may help reduce the frequency of catching colds, there’s little evidence that it can actually help prevent or treat sickness once it’s already set in.

5 Tips: Natural Products for the Flu and Colds: What Does the Science Say?

It’s that time of year again—cold and flu season. Each year, approximately 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu-related complications result in more than 200,000 hospitalizations and between 3,000 and 49,000 deaths each year. Colds generally do not cause serious complications, but they are among the leading reasons for visiting a doctor and for missing school or work.

Some people try natural products such as herbs or vitamins and minerals to prevent or treat these illnesses. But do they really work? What does the science say?

  1. Vaccination is the best protection against getting the flu. Starting in 2010, the Federal Government’s Centers for Disease Control and Prevention has recommended annual flu vaccination for all people aged 6 months and older.
    There is currently no strong scientific evidence that any natural product is useful against the flu.
  2. Zinc taken orally (by mouth) may help to treat colds, but it can cause side effects and interact with medicines. Zinc is available in two forms—oral zinc (e.g., lozenges, tablets, syrup) and intranasal zinc (e.g., swabs and gels). A 2015 analysis of clinical trials found that oral zinc helps to reduce the length of colds when taken within 24 hours after symptoms start. Intranasal zinc has been linked to a severe side effect (irreversible loss of the sense of smell) and should not be used.
    A note about safety: Oral zinc can cause nausea and other gastrointestinal symptoms. Long-term use of zinc, especially in high doses, can cause problems such as copper deficiency. Zinc may interact with drugs, including antibiotics and penicillamine (a drug used to treat rheumatoid arthritis).
  3. Vitamin C does not prevent colds and only slightly reduces their length and severity. A 2013 review of scientific literature found that taking vitamin C regularly did not reduce the likelihood of getting a cold but was linked to small improvements in cold symptoms. In studies in which people took vitamin C only after they got a cold, vitamin C did not improve their symptoms.
    A note about safety: Vitamin C is generally considered safe; however, high doses can cause digestive disturbances such as diarrhea and nausea.
  4. Echinacea has not been proven to help prevent or treat colds. Echinacea is an herbal supplement that some people use to treat or prevent colds. Echinacea products vary widely, containing different species, parts, and preparations of the echinacea plant. Reviews of research have found limited evidence that some echinacea preparations may be useful for treating colds in adults, while other preparations did not seem to be helpful. In addition, echinacea has not been shown to reduce the number of colds that adults catch. Only a small amount of research on echinacea has been done in children, and the results of that research are inconsistent.
    A note about safety: Few side effects have been reported in clinical trials of echinacea; however, some people may have allergic reactions. In one large clinical trial in children, those who took echinacea had an increased risk of developing rashes.
  5. The evidence that probiotic supplements may help to prevent colds is weak, and little is known about their long-term safety. Probiotics are a type of “good bacteria,” similar to the microorganisms found in the body, and may be beneficial to health. Probiotics are available as dietary supplements and yogurts, as well as other products such as suppositories and creams. Although a 2015 analysis of research indicated that probiotics might help to prevent upper respiratory tract infections, such as the common cold, the evidence is weak and the results have limitations.
    A note about safety: Little is known about the effects of taking probiotics for long periods of time. Most people may be able to use probiotics without experiencing any side effects—or with only mild gastrointestinal side effects such as gas —but there have been some case reports of serious side effects. Probiotics should not be used by people with serious underlying health problems except with close monitoring by a health care provider.

When you were young, Fred Flintstone and Bugs Bunny kids vitamins got you to chew up all the nutrients your little body needed. Then you became a grown-up and had to stick to boring pills and capsules. Although someone realized that capitalizing on a women’s right to a daily chocolate fix might be a smart marketing move and launched Viactiv calcium chocolate chews in the late 90s, it took a while for that ethos to make its way to other supplements.

In the past few years that the candy-as-supplement market for grownups has exploded with an even more sweet-tooth-friendly supplement: gummy vitamins. Not only can you find a multi gummy with vitamins and minerals, but there is a gummy version of many single supplements you might to take—from D to B12 to iron. And there are now even multis disguised as mints. Rejoice! Candy that’s good for you!

Of course, it is said that you can have too much of a good thing. And, sadly, this does apply to gummy vitamins. Sigh.

First there’s the issue that candy is candy, even if it has vitamins in it.

“They contain more sugar than many other vitamins, although it’s a small dose and not likely to have much impact on your health when taken as directed,” Ginny Messina, a registered dietitian and author of Vegan for Her: The Woman’s Guide to Being Healthy and Fit on a Plant-Based Diet, tells SELF.

But—taken as directed? C’mon, these are gummy vitamins. The dose is usually two, but shouldn’t they have made it six? The typical calorie load for that two-piece serving is about 10 calories’ worth of sugar (2-3 grams), which is not much on its own. But if you are absentmindedly snacking on your “healthy” gummy bears and end up sucking down 10 pieces over the course of the day, we’re talking about 50 calories or more from added sugar, which is half the daily limit for women suggested by the American Heart Association, just from your vitamins.

But more importantly, you actually can get more of many vitamins and nutrients than is recommended if you’re overdoing it on gummies—especially multivitamins.

It’s hard to overdose on most nutrients from food (which is where we’re ideally supposed to get all of our nutrition). But the pharmacological doses you get from supplements are a whole different matter. The Institute of Medicine determines “dietary reference intakes,” or the daily minimum and maximum levels of nutrients a person should get from both food and added supplements. In general, supplements can offer from around 10 or 25 percent of the recommended level to up to 4,000 or 10,000 percent of the DRI for some nutrients. Gummy multivitamins, at least, seem to skew slightly lower, ranging as low as 33 to 50 percent of the DRI for some nutrients to 100 to 250 percent for others.

Taken as directed, these percentages are considered safe. But eat them like candy and they could cause problems. It seems implausible, but people (especially kids) have gotten hurt—even died—from excess supplementation. The American Association of Poison Control Centers reported more than 50,000 cases of adverse effects from vitamins in 2014.

So what happens if you chomp on too many?

Some fat-soluble vitamins such as A or beta-carotene, and E, and minerals like iron, can build up to toxic levels quite easily. One part of DRI is the “tolerable upper intake level,” or UL, which is the most you can take of a nutrient before you run the risk of adverse effects. The UL for vitamin A, for instance, is 10,000 IU, which is surpassed if you eat just five of some popular gummy multis. Too much vitamin A can cause dizziness, nausea, headaches, skin irritation, and joint pain (and in rare instances, coma and even death). Just four gummies that contain 10 mg of niacin per serving puts you at the upper limit, above which you could experience “flushing” (burning, red, tingling sensation on skin), nausea, or vomiting. Too much iron can give you stomach pains at best and cause convulsions or be fatal at worst. You can gauge how many gummies are really too many by checking out the percent of daily value for each vitamin and mineral on the label.

Water-soluble vitamins are perceived to be safer because they dissolve in water and so any excess tends to be flushed out in urine. But even too much of these can lead to adverse effects, like diarrhea from excess C. And keep in mind that you may be taking in more supplemented nutrients than you realize from the fortified foods you might eat—such as breakfast cereals, plant or dairy milks, drinks like Vitamin Water, as well as from protein bars or shakes. And this isn’t even counting the actual food you eat every day.

The bottom line is that yes, technically, you can OD on gummy vitamins.

So you should stick to the serving size on the label. (And, OK, doubling it probably won’t kill you—but eating an entire bottle is a terrible idea.) In the big picture, though, if you eat a healthy diet full of plenty of vegetables, you really don’t need to be taking vitamins all the time anyway. And if you really just want gummy bears, that’s OK, too.

Photo Credit: Ibusca / Getty Images

Vitamin Overdose

During pregnancy, it is important to get the proper nutrients to foster healthy fetal development. You may be tempted to take a multivitamin in addition to other supplements. However, vitamin overdose can occur when an individual takes more than the recommended daily amount of a vitamin.

This can result when taking more than one multivitamin, or when taking individual vitamins in addition to a multivitamin.

While any vitamin can be toxic, if taken in large amounts, calcium and iron pose the greatest toxic risks when taken in excess. Taking a multivitamin during pregnancy is important, although it is best to talk with your doctor before taking any additional supplements to avoid overdosing.

Terms to Know:

  • Recommended Daily Allowance (RDA): the recommended vitamin dosage for 97-98% of healthy individuals
  • Tolerable upper intake level (UL): the greatest amount of a vitamin that can be taken daily without risk of negative health effects
  • Adequate Intake (AI): when available data is inadequate to determine RDA, estimates are defined experimentally or through observation
  • Vitamin Toxicity: occurs when taking megadoses of vitamin A, B6, C, D, or niacin

Recommended Daily Intake for Vitamins

Note: Adequate intakes (AIs) are shown in bold type, while recommended dietary allowances (RDAs) are shown in regular type.

*1 niacin equivalent (NE) = 1 mg niacin or 60 mg of dietary tryptophan.

†200 IU (international unit) of vitamin D = 5 μg cholecalciferol.

ND = not determinable due to a lack of data (intake should be limited to foods); RAE = retinol activity equivalents (1 µg RAE of preformed vitamin A= 3.33 IU).

Adapted from Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Washington, DC: National Academy Press.

Symptoms of Vitamin Overdose:

Symptoms of vitamin overdose also include symptoms that are a part of normal pregnancy. If you suspect a vitamin overdose, note changes in your pregnancy symptoms that might be explained by the excessive vitamins.

Symptoms of a vitamin overdose may include but are not limited to the following:

  • Cloudy urine
  • Frequent urination
  • Constipation
  • Diarrhea
  • Appetite loss
  • Nausea
  • Stomach pain
  • Muscle weakness
  • Muscle, joint, or bone pain
  • Yellow-orange tint to the skin
  • Sensitivity to the sun
  • Itching or rash
  • Headaches
  • Fatigue
  • Mental or mood changes
  • Rapid or irregular heartbeat
  • Eye irritation or sensitivity to light
  • Cracking lips

If you think you may have overdosed on a multivitamin or supplement, it is important to contact a medical professional immediately. Do not make yourself vomit unless instructed to do so by a health care professional.

Before calling, be prepared to answer the following questions:

  • What is your individual’s age, weight, and condition?
  • What is the name of the product?
  • What time was the product taken?
  • How much was taken?

You can call the National Poison Control Center’s 24-hour helpline at 1-800-222-1222. It does not need to be an emergency to call. You are welcome to call for any question or concern related to overdosing or poisoning.

Recommendations

Vitamins and supplements are not one of those things where more is better. The American Pregnancy Association recommends you follow your healthcare provider’s prescription or the directions on your prenatal vitamin bottle. Although taking vitamins can be healthy, too much can be a bad thing.

More helpful articles:

  • Natural Sources of Vitamin B6 During Pregnancy
  • Pregnancy Nutrition
  • FH PRO for Women and Men: Antioxident Supplements for Fertility and Prenatal Wellness

Compiled from the following sources:

A.D.A.M., Inc. (2013). Multiple vitamin overdose. Retrieved from

Merck Manuals. (2014). Overview of vitamins. Retrieved from https://www.merckmanuals.com/professional/nutritional_disorders/vitamin_deficiency_dependency_and_toxicity/overview_of_vitamins.html

Pregnant Women

Cat owners and women who are exposed to cats should follow these tips to reduce exposure to Toxoplasma.

  • Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and water afterwards.
  • Ensure that the cat litter box is changed daily. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat’s feces.
  • Feed your cat commercial dry or canned food, not raw or undercooked meats.
  • Keep cats indoors.
  • Avoid stray cats, especially kittens. Do not get a new cat while you are pregnant.
  • Keep outdoor sandboxes covered.
  • Wear gloves when gardening and during contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and water after gardening or contact with soil or sand.

More on: Handwashing

You should also:

Cook food to safe temperatures. A food thermometer should be used to measure the internal temperature of cooked meat. Color is not a reliable indicator that meat has been cooked to a temperature high enough to kill harmful pathogens like Toxoplasma. Do not sample meat until it is cooked. USDA recommends the following for meat preparation:

For Whole Cuts of Meat (excluding poultry)
Cook to at least 145° F (63° C) as measured with a food thermometer placed in the thickest part of the meat, then allow the meat to rest for three minutes before carving or consuming. *According to USDA, “A ‘rest time’ is the amount of time the product remains at the final temperature, after it has been removed from a grill, oven, or other heat source. During the three minutes after meat is removed from the heat source, its temperature remains constant or continues to rise, which destroys pathogens.”

For Ground Meat (excluding poultry)
Cook to at least 160° F (71° C); ground meats do not require a rest time.

For All Poultry (whole cuts and ground)
Cook to at least 165° F (74° C). The internal temperature should be checked in the innermost part of the thigh, innermost part of the wing, and the thickest part of the breast. Poultry do not require a rest time.

More on safe food handling: Fight BAC: Safe Food Handlingexternal icon

  • Freeze meat for several days at sub-zero (below 0° F) temperatures before cooking to greatly reduce chance of infection. *Freezing does not reliably kill other parasites that may be found in meat (like certain species of Trichinella) or harmful bacteria. Cooking meat to USDA recommended internal temperatures is the safest method to destroy all parasites and other pathogens.
  • Peel or wash fruits and vegetables thoroughly before eating.
  • Wash cutting boards, dishes, counters, utensils, and hands with soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
  • Avoid drinking untreated water.
  • Do not drink unpasteurized goat’s milk.
  • Do not eat raw or undercooked oysters, mussels, or clams (these may be contaminated with Toxoplasma that has washed into seawater).

Division of Disease Surveillance

Airborne and Direct Contact Diseases

Airborne diseases are caused by pathogenic microbes small enough to be discharged from an infected person via coughing, sneezing, laughing and close personal contact or aerosolization of the microbe. The discharged microbes remain suspended in the air on dust particles, respiratory and water droplets. Illness is caused when the microbe is inhaled or contacts mucus membranes or when secretions remaining on a surface are touched.

Transmission of airborne diseases can be greatly reduced by practicing social and respiratory etiquette. Staying home when ill, keeping close contact with an ill person to a minimum, allowing a few feet distance from others while ill, and wearing a mask, covering coughs and sneezes with elbow or tissue can greatly reduce transmission. Good hand washing can decrease spread of germ-containing droplets that could be picked up on hands from surfaces or hand contact with secretions. Environmental controls and engineering alternatives help reduce transmission of water droplet aerosolized pathogens.

Contact Diseases

Contact Diseases are transmitted when an infected person has direct bodily contact with an uninfected person and the microbe is passed from one to the other. Contact diseases can also be spread by indirect contact with an infected person’s environment or personal items. The presence of wound drainage or other discharges from the body suggest an increased potential for risk of transmission and environmental contamination. Precautions that create a barrier and procedures that decrease or eliminate the microbe in the environment or on personal belongings, form the basis of interrupting transmission of direct contact diseases.

Airborne and Direct Contact Diseases Include:

  • Acute Flaccid Myelitis – A rare but serious condition that affects the spinal cord and causes muscles and reflexes to become weak.
  • Anthrax – A serious disease caused by Bacillus anthracis, a bacterium that forms spores. A bacterium is a very small organism made up of one cell. Many bacteria can cause disease. A spore is a cell that is dormant (asleep) but may come to life with the right conditions.
  • Carbapenem-resistant Enterobacteriaceae (CRE) – Enterobacteriaceae (En-tero-bac-te-ri-a-ce-ae) are a family of bacteria normally found in our gut. They can also cause serious infection in the bladder, blood, wound and lungs.
  • Coronavirus – Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS and MERS.
  • Enterovirus – Non-polio enteroviruses are very common viruses that cause about 10 to 15 million infections in the United States each year.
  • Group A Streptococcus – A bacterium often found in the throat and on the skin. People may carry group A streptococci in the throat or on the skin and have no symptoms of illness. Most GAS infections are relatively mild illnesses such as “strep throat,” or impetigo. Occasionally these bacteria can cause severe and even life-threatening diseases.
  • Invasive Group B Streptococcal (GBS) – A bacterium that causes illness in newborn babies, pregnant women, the elderly, and adults with other illnesses, such as diabetes or liver disease. GBS is the most common cause of life-threatening infections in newborns.
  • Haemophilus influenza – Invasive disease caused by Haemophilus influenzae type b can affect many organ systems. The most common types of invasive disease are pneumonia, occult febrile bacteremia, meningitis, epiglottitis, septic arthritis, cellulitis, otitis media, purulent pericarditis, and other less common infections such as endocarditis, and osteomyelitis.
  • Influenza – A disease that is caused by a virus and infects the nose, throat, and lungs. Influenza can cause severe illness and life-threatening complications in many people.
  • Legionellosis – An infection caused by the bacterium Legionella pneumophila. Maine monitors the incidence of Legionellosis through mandatory reporting by health care providers, clinical laboratories and other public health partners.
  • Measles – A respiratory disease caused by a virus that causes fever, runny nose, cough, and a rash all over the body.
  • Meningococcal Disease – The leading cause of bacterial meningitis in children and young adults in the United States. Symptoms of meningococcal disease include fever, headache and stiff neck in meningitis cases, and sepsis and rash in meningococcemia.
  • MERS-CoV – Currently, all cases are associated with either direct travel to the Arabian peninsula, or contact with a returned traveler from the Arabian peninsula.
  • Mumps – A disease caused by a virus that usually starts with a fever, headache, muscle aches, tiredness, and loss of appetite followed by swelling of glands.
  • MRSA – Methicillin-resistant Staphylococcus Aureus is a bacterial infection that is resistant to some antibiotics. When MRSA bacteria are found on the skin but do not cause illness it is called “colonization.” In most cases, MRSA does not cause any problems or causes minor infections, such as pimples or boils. In some cases, MRSA can cause more serious infections.
  • Pertussis – A respiratory illness that usually starts with cold-like symptoms including a cough that can worsen after a few weeks. Pertussis is commonly known as whooping cough.
  • Plague – Plague is a disease caused by Yersinia pestis (Y. pestis), a bacterium found in rodents and their fleas in many areas around the world.
  • RSV – RSV is a respiratory virus that infects the lungs and breathing passages. Healthy people usually experience mild, cold-like symptoms, but RSV can be serious especially for infants and older adults.
  • Strep pneumoniae – a Gram-positive encapsulated coccus that often colonizes the human nasopharynx, where it can be carried asymptomatically.
  • SARS – respiratory disease caused by a coronavirus, last reported in 2004
  • Tuberculosis – A disease caused by a bacterium that usually attacks the lungs.
  • Varicella – A disease commonly known as chickenpox that is caused by a virus. The most common symptom is a skin rash found mostly on the face, scalp, and trunk.

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