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Mom has dementia and I have been giving her B vitamins, B-12, Iron, Magnesium, D-3, and Centrum Silver chewables.

I do not know how much good any of these vitamins do, but she has been complaining that there are just too many pills to take so I started leaving off everything except the D-3. When I stopped the Centrum, she seemed to calm down a lot during the day but I do not know if that was a fluke or what.

I would appreciate everyone's thoughts on vitamins in general and what is best to take or avoid. I know iron can cause constipation, but Mom has loose stools every single day so I thought the iron might actually help.

The doctor said her vitamins were "okay" but never said if they were needed or beneficial.

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Formulations of vitamins vary greatly when it comes to absorption. Some of the hard pills are made for shelf life and aren't broken down enough in the body to do any good. Capsules are generally more effective for absorption, liquids often even better. Some high tech liquids have smaller molecules and are absorbed easily.

Since elderly people often don't have top functioning digestive systems, even those who eat well may not be getting the nutrition we think they are.

Some vitamins can't be taken with some medications which further complicates issues.

Much depends on the individual. The Mayo Clinic has a book on integrative medicine which is excellent. It will likely take years, but the integrating of Western medicine, Eastern medicine and nutritional supplementation that is determined for each person's needs will likely - eventually - become the norm.

Meanwhile we live in the here and now. B12, B6 and folic acid have been used in an Alzheimer's study showing great results (prevention and even some reversal), however many more studies will need to be done to confirm this.

My personal opinion is that the latest information that vitamins are just "expensive pee" will eventually be shown to be flawed because, by necessity, the study was too broad to cover individual needs and every form of supplementation. I do agree that common sense needs to be used. Immense amounts of supplements should be avoided unless used under the supervision of a qualified physician.

Meanwhile, fish oil, D3 and calcium (which generally should be balanced with magnesium) are frequently prescribed.

Again, as with most things, common sense is our best friend with most supplements, though a doctor you trust should be in on everything you take.
Carol
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There are quite a few peer-reviewed articles now on specific supplements in PubMed - just google the supplement by name and pubmed as a search term. There is evidence of benefit with some specific things - e.g. B1 and B2 for migraine in doses that are quite a bit more than you get in the average daily vitamin pill. Most people with mitochondrial disorders now get a combo of B vites, carnitine and CoQ and they do a LOT better than they used to before this was common.

Most things in this category are not toxic to most people; there are exceptions. Do not take too much B6, and if you are anticoagulated with Coumadin (warfarin) avoid Vitamin K. In general it is good to check for interactions. Getting stuff from foods is ideal because we don't really know what all the compounds are that are good for us. It wasn't too long ago that they came up with "Vitamin PQQ" that is abundant in whiskey, parsley, and a few other foods. (Google it if you don't believe me!) Antioixdants are generally good, but I did run into someone who found they have an overactive MTHFR variant and too much might be especiallly harmful for them. Calcium intake should be moderate maybe 1,200 mg a day, and 1-3,000 units of Vitamin D a day is plenty unless you are deficient (but then a lot of people are). We sometimes give 50,000 a week to correct deficiency. More severe osteoporosis rarely reverses with just that, and medications may be the best bet especially if you have had a fracture and/or can't do lots of weightbearing activity.

Just my $0.02!
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My father's doctor said Centrum Silver, Calcium supplement (so I bought Caltrate with Vit.D3) and iron pills. Because father suffered from a stroke, his other doctor recommended Z-BEC - it's a B-complex supplement with zinc, Vitamin E and C (folic acid and biotin.) This is to help with circulation.
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My mom was taking Centrum Silver for Women for awhile, but am not sure if it helped and she stopped taking it. But you have to be careful because some of your Mom's other pills could actually be vitamin supplements. My mom had two prescription medications that really were vitamin supplements and her doctor had to remove her from them. They checked her for B-12 because she was having memory issues and it turned out that she actually had too much B-12. Definitely check with your Moim's pills to make sure you're not adding to what she's already getting.

The thing about it is that you have to have an idea what you're trying to address with the vitamins, too. Not everyone has an iron deficiency, for example, and I think that is something that Centrum Silver for Women might be heavy on. It really depends on the individual person's needs as what they might be deficient in.
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The latest research confirms vitamins are basically "expensive pee", however, the Centrum has calcium in it which will make your mom constipated, and I would continue Magnesium Citrate 250 mg. 3X a day because almost 80% of Americans are deficient in this nerve activating mineral. To coordinate its effectiveness, add Vitamin D3, and B-12 shots are the best method of delivering a B-12 deficiency which can cause "dementia-type" symptoms. Your doctor is going to be uncommitted regarding vitamins because he/she don't have the nutritional background in their education to know the difference. For that you can go to a registered dietician. I focused my nursing education with a naturopathic slant because I know Chinese medicine really works and Western medicine is just now recognizing it works, but not all are convinced. Gee, it seems to have been working in China for over 5,000 years and I definitely recommend acupuncture. The tiny needles are barely felt, but they help so many ailments. So save some money and concentrate on real fruit and veggies. Best of health!
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Oh, I might add, the Vitamin D3 can be made in the body with just 15 minutes of exposure to sunlight. Depending on where you live, this can be an alternative. If the patient does not have a skin cancer risk (fair skin, red hair) just 15 mins. will work, and it will boost the mood.
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Meanwhile, fish oil is best gotten through fish. Pills usually cause stomach upset, and the latest on calcium is to get it through dairy, vegetables such as broccoli and NOT through a pill. They can cause kidney stones. I do agree however there are vast differences in the manufacturers and one cannot know for sure what one is buying and from what country and at what strength.
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I gave my mother Centrum Silver and the doctor added Vitamin E but later stopped the Vitamin E and said it was dangerous. All my family had Osteoporosis and took Fosamax. I worked in Getiatric Research. There was a Vitamin D study which showed the more Vitamin D you took. The less likely an older person would have a fracture. The bone gurus where taking up to 3000mg a day. I know Vitamin D is water soluble. So my mother and I started taking Vitamin D 1000mg twice a day. For me it was prevention of Osteoporosis. I was hoping for my mother's Osteoporosis don't to get worse. She had many falls and never broke a bone. 4 months before she died. She fell and had a wound right down to the bone. We had to take her to the hospital even though she was a DNH. But this didn't apply. They asked her if she hit her head. I couldn't say yes or no. They did a full body C scan. I was wondering if the Vitamin D helped her. The results where almost of her Osteoporosis was gone except for a small part of her spine. It also answered a question. I always felt my mother had Vascular Dementia and not AD even though they say 85 % is a mixed Dementia. They told me from the scan they could see more Vascular Dementia. But, I have just recently heard Vitamin E is the best for preserving memory. I know Vitamin E is fat soluble. You have to be very careful about the dose.
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Unless blood tests show that she's lacking in any particular vitamin, I'd just give her a really tasty meal full of fresh, healthy food. Tonight I made my mum a dish of onion, capsicum, tomato, bacon and chicken - all fresh and chopped up - threw in some garlic infused olive oil and rice, and cooked it in vegetable stock until the rice was soft. She loves it, and it may not provide *every* nutritional need, but it's better than a pill.

PS. My mum has diabetes, heart failure, and receives dialysis three times a week for kidney failure and takes a FISTful of pills three times a day. Her bloods usually only show that she could do with more protein, and since she's not a lover of red meat, I try to sneak eggs and chicken into her meals as often as I can. I think if a diet is well-balanced, it can remove the need for vitamins, and if it's tasty, it encourages the patient to eat it!
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I asked about the vitamins for a couple of reasons...
1. She complains about taking SO MANY PILLS, even if there are only three
2. She has stopped eating. I do not know how a person can survive on about 3 tablespoons of food for breakfast, a small cup of ice cream at 1pm and maybe 3 tablespoons of food for dinner. And about 8oz of water a day...she has never drank a lot of fluid

It is driving me crazy, I do not know what to do anymore, and I am at my wits end. Tonight I came home from grocery shopping and cooked dinner, Mom was fine until I said dinner was ready, then she is sick to her stomach and needs to use the restroom. When she returned, she is breathing hard and sits on her recliner very close to an anxiety attack (if not having one). She does this all the time so my daughter and I went ahead and ate. My sister was eating yogurt and offered one to Mom who refused, but i nodded, Yes bring the Activia on over. I gave it to Mom and told her to just take her time and eat it slow. When she finished she got up and went and got the tin of cookies. We said, "wait Mom you need food, not cookies." She got upset. So I offered to make her a small cup of cereal with raisins and my sister gave her Pepcid for her stomach. She ate the small cup of cereal but I did not see if she finished it, as I was now feeding the dog.

She had gall bladder surgery in Sept 2013 and has been fine, she was on Remeron which let her eat a good meal, now she has been changed to Ativan .25 mg twice a day. I really think she is going through anxiety and that has stopped the eating, but I am afraid that she could actually still have a problem after the gall bladder surgery so I do not want to put her on Megace and basically force her to eat until we can figure out what is happening. At times she will even say it is her heart but I have checked her pulse and she is fine, it is normal.

I told her Gerontologist and he just said, I don't know what is happening there! What kind of answer is that? I thought they knew about the elderly and he is suppose to deal with dementia and Alzheimer's patients exclusively! My Uncle just told me that Alzheimer's has messed up my Aunts eating so they feed her yogurt, and fresh fruit. No protein?

I am blindly muddling my way through this maze while trying to keep myself in check. I do appreciate all of your responses.
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