The vitamins and nutrients obtained from foods represent the quintessential components for sustaining health and, ultimately, helping to contribute to healthy skin. There are many instances where elements of faulty digestion and environmental factors impact both the quality and quantity of nutrients obtained from foods. Vitamin supplements are a means of aiding in the support of imbalanced nutrients; however, they should never be substituted for critical nutrients supplied to the body by nutritious foods. The goal of consuming vitamin supplements is to augment nutritional status or support nutrient deficiencies in the ratios of vitamins, minerals and nutrients generally per the RDA and RDI daily allowances recommended by the Food and Drug Administration. Multivitamin mineral supplements were first introduced in the United States in the early 1940s and today represent an important and primary concept in nutritional wellness.

STUDIES AND REGULATIONS

There is no shortage of studies both for and against the use of vitamin supplements and nutraceuticals. One great area of concern is the safety of vitamin supplementation, as most countries place dietary supplements under the general umbrella of foods and not drugs. This passes the accountability of safety and efficacy of the vitamin supplements with the manufacturer. The Food and Drug Administration has defined many aspects of dietary supplements, including the categories of supplements, definitions, and a very clear statement advising consultation with a healthcare professional regarding consuming dietary supplements, as supplements may be harmful when taken improperly, with certain medications, surgery, diseases, and health conditions.^3,4 The Dietary Supplement Health and Education Act of 1994 is a federal law that regulates the supplement industry regarding standards, scope of claims, and nomenclature for marketing the sale of supplements. The act is jointly shared by the FDA and the FTC. All guidelines regarding supplements fall into this jurisdiction, including the structure-function claim, which allows supplement manufacturers to promote their products as aids in supporting the health of particular physiological functions provided there is some scientific evidence to back the claim, of which requires evaluation by a trained healthcare practitioner in biochemistry, nutrition, diseases, nutritional supplementation sciences, and related health studies. The Center for Nutrition Advocacy supports nutritional and health practitioners who may recommend nutritional supplements by providing information on the Unites States regulatory guidelines concerning the practice of nutrition.

According to JAMA Internal Medicine (The Journal of the American Medical Association), there are over 90,000 different supplements and, unfortunately, reactions are possible as with any medicine or product consumed and ingested. An estimated 23,000 emergency room visits occur each year that are directly related to nutritional supplements, in combination with medications, overdosing of supplements, side effects, and allergic reactions. Between 2007 and 2016, the FDA identified 746 brands of supplements adulterated with pharmaceutical agents. The adulterants included prescription medications, unapproved pharmaceuticals, and designer steroids. Most supplements adulterated with drugs were marketed as weight loss, sports supplements, and other performance supplements.⁵ Vitamin supplements are compounds that are laboratory synthesized, whether they are derived from natural sources or synthetics.

Natural source vitamins deliver nutrients derived from food sources and are heavily processed before they can be made stable enough before distribution.

Nature-identical/synthetic vitamins are entirely synthetic, formulated in a lab using molecular structures that are identical to their natural counterparts. The majority of vitamins fall into this category.

Synthetic supplements are lab created and are not identical to their natural counterparts. They have the same chemical components but vary in their molecular shape.

Food cultured are derived from cultured foods, such as sauerkraut and yogurt. They are usually grown in algae or yeast and yield high bioavailability.

Food based supplements are compounded in a laboratory in a way that delivers natural nutrients without growing whole foods and extracting the nutrients from the food.

Bacterial fermentation are produced via the genetic manipulation of bacteria to produce nutritional byproducts.⁶

CLASSES OF SUPPLEMENTS

Multivitamins and Minerals: Multivitamins help to increase nutrient intake and assist with obtaining the recommended levels of vitamins and minerals when they cannot be met with foods alone for specific reasons. Although multivitamins can improve the intake adequacy of various nutrients, they can also increase the possibility of intake of other nutrients at levels that are higher and potentiate disproportionate imbalances. This factor is of concern when any supplements are consumed, whether they are multivitamins or single factor supplements (A or C). Base levels of nutrients should be determined by testing by a health professional to ensure that supplement consumption is not creating imbalances or the potential for imbalances or reactions.

Nutraceuticals: The term nutraceuticals is generally used to describe a hybrid of the word nutrition and pharmaceutical. They are products that are used to assist in the maintenance of normal physiological function and health. Although the use of nutraceuticals has a fairly long history, only recently scientifically supported nutritional and medical evidence has allowed nutraceuticals to emerge as being potentially effective.¹

Fiber: One of the most important nutrients for the human body. Whole plant foods are rich in different types of fiber, such as pectin, gum, mucilage, cellulose, hemicellulose, lignin, and soluble fiber. The soluble components of dietary fiber have been shown to lower low-density lipoprotein cholesterol, improve glucose tolerance, and help to promote bulking and viscosity producing capabilities. Dietary fiber increases fecal bulking due to increased water retention and increases the growth of bifoidobacteria in the gut including fructooigosaccharides.¹

Prebiotics: Prebiotics are dietary ingredients that are linked to the development of helpful bacteria for the digestive system. They accomplish this by beneficially altering the composition and metabolism of the gut microbiota by promoting lactobacillus and bifodobacteria. Prebiotics are short chain polysaccharides such as chicory roots, Jerusalem artichokes, garlic, onions, leeks, asparagus, bananas, oats, apples, cocoa, flax seeds, wheat bran, and seaweed. Prebiotics are most effective in their natural state when obtained from foods.

Probiotics: Probiotics number in the thousands of species of bacteria and yeasts found in fermented foods and specific species supplements. The effects of probiotics are to balance the ratio of the gut microbiota that includes bacteria, fungi, protozoa, and viruses that reside in the gastrointestinal tract.

Probiotics can colonize the human gut with a beneficial ratio of bacteria depending on the baseline microbiota, probiotic strain, and gastrointestinal tract region. Probiotics are identified and should be consumed by their specific strain, which includes the genus, the species, the subspecies, and strain designation. The seven core genera of microbial organisms most often used in probiotic products are lactobacillus, bifidobacterium, saccharomyces, streptococcus, enterococcus, escherichia, and bacillus. With regard to the skin, there has been an increase in the amount of research outlining the connection to the microflora of the skin and the gastrointestinal tract. Leaky gut syndrome, SIBO, and general digestive disorders have been connected to eczema, psoriasis, acne, dermatitis, rosacea, and even hives. Furthermore, skin infections and faulty microbial defense systems may lead to pathogenic and secondary infections.²

Fatty Acids: Essential fatty acids are functional components with regard to both the dermis and epidermis and are a form of polyunsaturated fats that cannot be synthesized by the human body and must be obtained from various and specific foods. An essential fatty acid deficiency can produce severe cutaneous abnormalities by affecting both function and appearance, including hyperproliferation of the epidermis, transepidermal water loss, and dermatitis. Transepidermal water loss is directly related to structural cell lipids and essential fatty acids – biochemical evidence of essential fatty acid deficiency can be determined from just a few days to weeks. Symptoms include dryness, scaling, flaking, itching, increased sensitivity, keratosis pilaris, and potential rashes.²

Enzymes: Enzymes are composed of amino acids and are released by the body to help catalyze many vital functions, including digestion, assimilation, and absorption of food. More than 3,000 different enzymes have been identified, each having a specific task to build and rebuild the body, including energy production, absorption of oxygen, and cellular nutrient transport. Digestive enzymes utilized in supplements have specific biochemical reactions with foods and gastric secretions to help assimilate digestion and the assimilation of nutrients.

Antioxidants: Antioxidant compounds occur naturally in many nutritious foods and are highly desirable in vitamin supplements because of their ability to fight free radicals and perform hundreds of functions in the human body. Although there are hundreds of antioxidants, five of them are cited as network antioxidants: vitamin C, E, glutathione, lipoic acid, and CoQ10. Antioxidants function and support each other as co-factors, recyclers, or reactors through a cohesive relationship called antioxidant synergism. Antioxidant synergism supports the scientific premise that the sum together provides better activities than by themselves.

Amino Acids: All metabolic processes are dependent on activity from various proteins formed from amino acids. Proteins fuel enzymes that assist in generating power for the body and rely on metabolic sequencing. Metabolic sequencing in cellular chemistry requires that cells possess an active yet specific enzyme to be in correct positioning, in order to coordinate sequencing of metabolic reactions from nutrients. There are more than 50 amino acids supplied by proteins, and typically 100 to 10,000 amino acids are linked together as chains to form structural units and fibrous proteins for the development of skin, tendons, bone, and muscle. One third of the protein content in the body is made up of collagen, which is the major fibrous protein found in the extracellular matrix and in connective tissue. Amino acid supplements are utilized to support critical deficiencies of amino acids evidenced in the body, such as catabolism, that may occur from the lack of protein intake in the diet. Amino acid supplements should not be consumed without professional guidance, as an excess intake may cause gout, unhealthy drop in blood pressure, and abdominal pain, and place undue stress on the kidneys.

Functional Foods: These are food products designed to be taken as part of the regular diet that have reportedly enhanced beneficial effects beyond that of normally consumed foods. They may have specific vitamins added, be fortified with additional nutrients, or may just have naturally occurring high nutrient levels. These specialized food products (as all supplements) need to comply with Federal Drug and Food Administration regulations for claims regulatory labeling and safety.

VITAMINS AND THE SKIN

Much of the role of nutrition in skin health focuses on the effects of deficiency, since the structural components of the skin have established requirements that instinctively are applied through nutritional intake. Assessing the physiology of the skin, we know that the epidermal layers do not contain blood vessels and that blood vessels are found in the dermis. The dermis receives nutrients through the bloodstream from the small intestine. Many nutrients also have factors that are not commonly known, such as molecular weight, and may have the ability to oxidize before they reach protein synthesis and the differentiation of keratinocytes. Unfortunately, while the skin is the largest organ of the body, it is the least of importance in terms of nutrient uptake, as the vital organs receive nutrients first (heart, liver, and brain). An impaired nutritional status alters the structural integrity and biological function of the skin, resulting in an abnormal skin barrier. The best options for the prospects of maintaining nutritional health of the skin is to continually maintain a steady intake and balance of all nutrients from foods. The key micronutrients for skin health are vitamins A, C, D, and E, zinc, copper, and selenium. While these may be available as single nutrient supplements, they are best utilized in a supplement complex with the proper ratios of combined nutrient co-factors, minerals, and vitamins in the product. In selecting supplements, there are always variables that impact whether they are effective for an individual and this includes hair, skin, and nail vitamins, protein and collagen powders, and other popular nutrient concepts. It is also important to remember that vitamin supplements should not be selected because they are trending but are selected because the body is indicating symptomology that additional nutrients are necessary. Herein lies both the safety and efficacy of supplementation by establishing a baseline nutrient level reading with a nutritionist or functional medicine practitioner. Consuming too much of a good thing can be instrumental in undesirable side effects, even though supplements are generally recognized as safe.

Here are very important supplement considerations:

• The key process selected in the manufacturing of the supplement itself
• Safety standards, laboratory certifications, and manufacturing ethics
• Safety record and violations log of the manufacturer
• Price point versus actual ingredient deck and formula
• The isolation of the intended ingredients (quality, naturally derived, or synthetic, and so on)
• The quantity of the efficacious nutrient in a single serving
• The compound form (liquid, tablet, or capsule), as this impact’s absorption into the body
• The addition of any extraneous materials and fillers to add bulk or weight to the product
• The bioavailability of the supplement itself based on the absorption potential of the individual person
• The baseline nutrient status of the person consuming the supplements
• Consideration of all other supplements the individual is taking and ratios
• Medications and health status – in particular the gastrointestinal tract

The most effective way to help maintain healthy skin is to consume plenty of well-balanced nutrients from foods. Be sure to include nutrient dense fruits and vegetables, sea vegetables, quality sources of proteins containing all of the amino acids, high-quality sources of fats and essential fatty acids, lots of fiber to help skin clarity, and, of course, plenty of water. Augmenting with vitamin supplements as necessary and rotating a professionally recommended supplement program will assist in creating skin health.

References

1 Das, Lipi, Eshani Bhaumik, Utpal Raychaudhuri, and Runu Chakraborty. “Role of nutraceuticals in human health.” Journal of Food Science and Technology 49, no. 2 (2012):173-183. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550857/.

2 Madigan-Fleck, Erin. “Identifying Core Components in Skin Health.” DERMASCOPE. https://www.dermascope.com/ingredients/identifying-core-components-in-skin-health.

3 “FDA 101: Dietary Supplements.” FDA. https://www.fda.gov/consumers/consumer-updates/fda-101-dietary-supplements.

4 Incze, Michael. “Vitamins and Nutritional Supplements What Do I Need to Know?” JAMA Internal Medicine 179, no. 3 (2019): 460. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2720139.

5 Cohen, Pieter A., Anita Wen, and Roy Gerona. “Prohibited Stimulants in Dietary Supplements After Enforcement Action by the US Food and Drug Administration.” JAMA Internal Medicine 178, no. 12 (2018): 1721-1723. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2707947?widget=personalizedcontent&previousarticle=2720139.

6 “How are Vitamins Made From Scratch?” SMP. https://smpnutra.com/how-are-vitamins-made-from-scratch.

Dr. Erin Madigan-Fleck, NMD, CDT, LMC, L.E.I., brings over 30 years of experience to the aesthetic and natural health industry. She is a licensed master cosmetologist and aesthetic instructor in Georgia and holds certification as a dermatology technician. She received her naturopathic medical doctoral degree from the University of Science, Arts, and Technology College of Medicine. She is the southeast director of the Association of Holistic Skin Care Practitioners and is the owner of DermaEducationTV post-graduate training for aestheticians, and private naturopathic and aesthetic practice in Atlanta, Georgia, Naturophoria.