The essential vitamins and minerals share a delicate
dance in the body. For many body processes to function optimally, you must have
the right balance of the nutrients. Many nutrients work synergistically, so a
deficiency in one might appear as or exacerbate a deficiency in another and
vice versa.
Other nutrients are antagonists, so care must be
taken when supplementing with one so it does not negatively impact the
absorption, uptake, or metabolism of the other. For some nutrient pairs, the
balance is delicate, with the pairs in certain situations enhancing the work of
the other, and in other situations, they antagonize one another.
The following is a brief overview of the
relationships and interactions between the essential nutrients. As you will
see, some vitamins and minerals have a relationship with several other
essential nutrients, while some have few if any known synergistic or
antagonistic interactions.
VITAMINS
Vitamin A
Synergistic Nutrients:
Vitamin E
- Vitamin E enhances vitamin A intestinal
absorption at medium to high concentrations, up to 40 percent.
- Vitamin A and E together lead to increased
antioxidant capabilities, protect against some forms of cancer, and
support a healthier gut.
- They work synergistically to prevent or support obesity,
metabolic syndrome, inflammation, immune response, brain health, hearing
loss.
Iodine
- Retinoic acid is involved in iodine uptake.
- Severe vitamin
A deficiency decreases the uptake of iodine and impacts thyroid
metabolism.
- Iodine deficiency and vitamin A deficiency
leads to a more severe case of primary hypothyroidism compared to iodine
deficiency alone.
Iron
- Iron is required for converting beta-carotene
into retinol.
- Vitamin
A increases iron
absorption, especially non-heme iron.
- Iron increases the bioavailability of pro-vitamin
A carotenoids, including alpha-carotene, beta-carotene, and
beta-cryptoxanthin.
- Supplementing with vitamin A might help
reverse iron deficiency anemia in children, and vitamin A
deficiency might contribute to anemia.
Zinc
- Zinc is
required for vitamin A transport.
- Supplementing with vitamin A and zinc in
children led to a reduced risk of infection and increased linear
growth.
- Zinc along with vitamin A helps maintain eye health.
Antagonistic Nutrients:
Vitamin E
- High levels of beta carotene might decrease
serum levels of vitamin E.
Vitamin K
- Vitamin A toxicity inhibits the synthesis of
vitamin K2 by intestinal bacteria and interferes with hepatic actions of
vitamin K.
- Vitamin A interferes with absorption of vitamin K.
Vitamin B1 (Thiamin)
Synergistic Nutrients
Magnesium
- Magnesium is required to convert thiamin to
its biologically active form and is also required for certain
thiamin-dependent enzymes.
- Overcoming thiamin deficiency might not occur if magnesium
deficiency is not co-treated.
Antagonistic Nutrients
Vitamin B6
- Vitamin
B6 can inhibit the biosynthesis of thiamin.
Vitamin B2 (Riboflavin)
Antagonistic Nutrients:
Calcium
- Calcium might form a chelate with riboflavin,
decreasing riboflavin absorption.
Vitamin B3 (Niacin)
Synergistic Nutrients:
Zinc
- Supplementing with nicotinic acid might provide
a dose-dependent improvement in hepatic zinc levels
and better antioxidant markers, including less lipid peroxidation, reduced
glutathione levels.
Vitamin B5 (Pantothenic Acid)
Antagonistic Nutrients:
Copper
- Copper deficiency increases vitamin B5
requirements.
Vitamin B6 (Pyridoxine)
Synergistic Nutrients:
Magnesium
- Magnesium enhances the uptake of vitamin B6 and vice
versa.
- Co-supplementing with vitamin B6 and magnesium helps
PMS symptoms and possibly autism.
Antagonistic Nutrients:
Vitamin B1
- Vitamin B6 can inhibit the biosynthesis
of thiamin.
Vitamin B9
- Vitamin B6 increases folate requirements
and possibly vice versa.
- Along with vitamin B12, co-supplementation with
vitamins B9 and B6 improves homocysteine levels,
of which high levels have been linked to cardiovascular disease, thrombin generation,
and neurodegeneration.
Zinc
- High levels of vitamin B6 might increase the
need for zinc.
- Chronic and acute vitamin
B6 deficiency increases intestinal uptake of zinc but
serum zinc levels decrease, demonstrating an impairment in zinc
utilization.
Vitamin B9 (Folate)
Antagonistic Nutrients
Vitamin B6
- Vitamin B6 increases folate requirements
and possibly vice versa.
Vitamin B12
- Supplementing with B9 increases the need
for B12 and vice versa because both play key roles in
the methylation cycle.
- Deficiency or insufficiency can increase
homocysteine levels, which are connected to a higher risk of
dementia, Alzheimer’s disease, and cardiovascular disease.
- Deficiency can also cause megaloblastic anemia.
Zinc
- Supplementation with folic
acid, especially in a state of zinc
deficiency, might reduce absorption of zinc through forming a chelate,
but there are mixed results.
Vitamin B12 (Cobalamin)
Antagonistic Nutrients
Vitamin C
- In aqueous solution, vitamin C might degrade B12 especially when B1
and copper are also present.
Vitamin B9
- Supplementing with B9 increases the need
for B12 and vice versa because both play key roles in
the methylation cycle.
- Deficiency or insufficiency can increase
homocysteine levels, which are connected to a higher risk of
dementia, Alzheimer’s disease, and cardiovascular disease.
- Deficiency can also cause megaloblastic anemia.
Vitamin C (Ascorbic Acid)
Synergistic Nutrients
Vitamin E
- Vitamins C and E work synergistically for
antioxidant defense, with vitamin
C regenerating vitamin E.
- Works in synergy, so large supplementation of
one needs large supplement of other.
Copper
- Post-absorptive, vitamin C can stimulate uptake
and metabolism of copper.
- Vitamin C deficiency could lead to symptoms of
copper deficiency.
Iron
- Increases absorption of
non-heme iron, even in the presence of inhibitory
substances; vitamin C also regulates uptake and metabolism of
iron.
Selenium
- A diet high in vitamin C led to increased
percent of absorption of sodium selenite and retention of the
absorbed selenium.
Antagonistic Nutrients
Vitamin B12
- In aqueous solution, vitamin C might
degrade B12, especially with B1 and copper also present.
Copper
- High levels of vitamin
C inhibits absorption of copper,
possibly through increasing iron absorption, which is a copper antagonist.
Iron
- Excess vitamin C could increase iron overload risk.
Selenium
- Converts sodium selenite to elemental selenium which inhibits absorption but only when
supplements are taken on an empty stomach.
Vitamin D
Synergistic Nutrients
Vitamin K
- Optimal levels of vitamin K prevents some of
the problems of excess vitamin D and leads to better outcomes.
- Sufficient levels of vitamins D and K lead to
reduced risk of hip fractures and an increase in BMD and other markers of
bone health.
- Sufficient vitamin K and D also improves insulin levels and
blood pressure while reducing the risk of arthrosclerosis.
Calcium
- Vitamin D increases calcium absorption.
- Along with vitamin K, supplementing with calcium and vitamin D
leads to improved bone, heart, and metabolic health.
- Calcium and vitamin
D also work synergistically for skeletal muscle function.
- Co-supplementation of vitamin
D and calcium led to an improved response to children with
rickets.
Magnesium
- Supplementing with vitamin
D improves serum levels of magnesium especially
in obese individuals.
- Magnesium is
a cofactor for the biosynthesis, transport, and activation of vitamin D.
- Supplementing with magnesium improves vitamin
D levels.
- Deficiency in both vitamin
D and magnesium increase risk for cardiovascular disease, diabetes,
metabolic disease, and skeletal disorders.
Selenium
- Supplementing with vitamin
D improves serum levels of selenium.
Antagonistic Nutrients
Vitamin A
- High levels of vitamin
A decrease vitamin D uptake by 30 percent.
Vitamin E
- Medium and high levels of vitamin
E significantly reduce vitamin D uptake by 15 percent and 17
percent respectively.
Vitamin E
Synergistic Nutrients
Vitamin A
- Vitamin E enhances vitamin
A intestinal absorption at medium to high concentrations, up to
40 percent.
- Vitamin A and E together lead to increased
antioxidant capabilities, protect against some forms of cancer, and
support a healthier gut.
- They work synergistically to prevent or support obesity,
metabolic syndrome, inflammation, immune response, brain health, hearing
loss.
Vitamin C
- Vitamins C and E work synergistically as
antioxidant defense, with vitamin
C regenerating vitamin E.
- Because they work synergistically,
large supplementation of one needs large supplementation of other.
Selenium
- Selenium deficiency aggravates effects of
deficiency of vitamin E and vitamin E can prevent selenium
toxicity.
- Together they induce apoptosis.
- Combined selenium and vitamin
E deficiency has a great impact that the deficiency of one of the
nutrients.
- Synergy of vitamin
E and selenium might help with cancer prevention through
stimulating apoptosis in abnormal cells; selenium and vitamin
E work synergistically to help mitigate iron excess.
Zinc
- Some effects of zinc deficiency were helped by vitamin E
supplementation.
Antagonistic Nutrients
Vitamin A
- Vitamin
A reduces vitamin E intestinal uptake in a dose-dependent manner.
- High levels of beta carotene might decrease serum levels of
vitamin E.
Vitamin D
- Vitamin
D reduces vitamin E intestinal uptake in a dose-dependent manner.
Vitamin K
- Metabolites can inhibit vitamin
K activity, so care is needed when supplementing with high doses.
- Also, large doses of vitamin
K inhibit intestinal absorption of vitamin E.
Iron
- Iron interferes with absorption of vitamin E.
- Vitamin
E deficiency exacerbates iron excess but supplemental vitamin E
prevented it.
- It is best to take the supplements at separate
times.
Vitamin K
Synergistic Nutrients:
Vitamin D
- Optimal levels of vitamin K prevents some of the problems of excess
vitamin D and leads to better outcomes.
- Sufficient levels of vitamins D and K lead to
reduced risk of hip fractures and an increase in BMD and other markers of
bone health.
- It also improves insulin levels, blood pressure,
and reduces the risk of arthrosclerosis.
Calcium
- Along with vitamin D, vitamin K and calcium help to improve
bone and heart health.
Antagonistic Nutrients
Vitamin A
- Vitamin A toxicity inhibits synthesis of vitamin
K2 by intestinal bacteria and interferes with hepatic actions of vitamin
K.
- Vitamin A inhibits intestinal absorption of
vitamin K.
Vitamin D
- Inhibits intestinal absorption of vitamin
K.
Vitamin E
- Metabolites can inhibit vitamin K activity, so
care is needed when taking large doses.
- Vitamin
E can also inhibit the intestinal absorption of vitamin K.
MACROMINERALS
Calcium
Synergistic Nutrients
Vitamin D
- Vitamin
D increases calcium absorption.
- Along with vitamin K, supplementing with calcium and vitamin D
leads to improved bone, heart, and metabolic health.
- Calcium and vitamin
D also work synergistically for skeletal muscle function.
- Co-supplementation of vitamin
D and calcium led to an improved response to children with
rickets.
Potassium
- Potassium enhances calcium reabsorption.
- Potassium excretion is positively related to
bone mineral density.
Antagonistic Nutrients
Iron
- High levels of calcium decrease
absorption of non-heme iron in
the short term but might not have a long-term impact on iron levels; this
can be mitigated by vitamin
C.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Magnesium
- High levels of calcium decreased tissue levels
of magnesium and exacerbates deficiency and
decreases magnesium absorption.
- Magnesium supplementation can decrease calcium
absorption, especially in those with renal
stone disease.
Manganese
Phosphorus
- High levels of calcium supplements
decrease phosphorus absorption.
- The ideal ratio of phosphorus to
calcium is 1:1. Higher levels of phosphorus to calcium ratio was shown to
hurt bone health in pigs and humans.
Sodium
Zinc
- High levels of calcium supplements
decrease zinc absorption and zinc balance.
- High levels of zinc might impact calcium absorption.
- Zinc deficiency reduces serum calcium levels
and calcium entry into cells, and it increases PTH levels.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Magnesium
Synergistic Nutrients
Vitamin B1
- Magnesium is required to convert thiamin to its biologically active form and is
also required for certain thiamin-dependent
enzymes.
- Overcoming thiamin deficiency might not occur
if magnesium deficiency is not co-treated.
Vitamin B6
- Magnesium enhances
the uptake of vitamin B6 and vice
versa.
- Co-supplementing with vitamin B6 and magnesium helps
PMS symptoms and possibly autism.
Vitamin D
- Supplementing with vitamin
D improves serum levels of magnesium especially
in obese individuals.
- Magnesium is
a cofactor for the biosynthesis, transport, and activation of vitamin D.
- Supplementing with magnesium improves vitamin
D levels.
- Deficiency in both vitamin
D and magnesium increase risk for cardiovascular disease,
diabetes, metabolic disease, and skeletal disorders.
Potassium
- Magnesium is required for potassium uptake in cells.
- Combination of magnesium, calcium, and
potassium reduces the risk of stroke.
Antagonistic Nutrients
Calcium
- High levels of calcium decreased tissue levels of magnesium and
exacerbates deficiency and decreases magnesium absorption.
- Magnesium supplementation can decrease calcium
absorption, especially in those with renal
stone disease.
Zinc
- Supplements of high levels (142 mg/day) of zinc
might reduce magnesium absorption.
Phosphorus
- Along with calcium, phosphorus can reduce the
absorption of magnesium in the intestines.
Phosphorus
Antagonistic Nutrients
Calcium
- High levels of calcium supplements decrease phosphorus
absorption.
- The ideal ratio of phosphorus to
calcium is 1:1; higher levels of the phosphorus to calcium ratio was shown
to hurt bone health in pigs and humans.
Magnesium
- Along with calcium, phosphorus can reduce the
absorption of magnesium in the intestines.
Potassium
Synergistic Nutrients
Calcium
- Potassium enhances calcium reabsorption.
- Potassium excretion is positively related to bone
mineral density.
Magnesium
- Magnesium is required for potassium uptake in
cells.
- Combination of magnesium, calcium, and
potassium reduces the risk of stroke.
Sodium
- Potassium/Sodium balance required for optimal
health, especially for reduced blood pressure and heart health.
- The right potassium to sodium balance increases
bone health through decreasing excess excretion of calcium due to high
levels of sodium.
- It also decreases obesity load and improves net
dietary acid load.
Sodium
Synergistic Nutrients
Potassium
- Potassium/Sodium balance required for optimal
health, especially for reduced blood pressure and heart health.
- The right potassium to sodium balance increases
bone health through decreasing excess excretion of calcium due to high
levels of sodium.
- It also decreases obesity load and improves net
dietary acid load.
Antagonistic Nutrients
Calcium
- Excess sodium enhances
calcium excretion.
- High sodium increases bone turnover
and reduces bone mineral density.
TRACE MINERALS
Copper
Synergistic Nutrients
Vitamin C
- Post-absorptive, vitamin
C can stimulate uptake and metabolism of copper.
- Vitamin C deficiency could lead to symptoms of
copper deficiency.
Antagonistic Nutrients
Vitamin C
- High levels of vitamin
C inhibits absorption of copper, possibly through increasing iron
absorption, which is a copper antagonist.
Iron
- Copper and iron compete for absorption, so high levels of
one might lead to deficiency of the other.
Molybdenum
- Molybdenum interacts
with protein-bound copper in and outside the cells and can even remove
copper from the tissues, so excess molybdenum contributes to copper
deficiency.
- Molybdenum can also be used to treat problems
associated with excess levels of copper, such as Wilson’s disease.
- The antagonistic relationship between copper
and molybdenum might contribute to diabetic complications.
Selenium
- When consuming low to normal levels of
selenium, high intakes of copper reduces
absorption, although this might not occur when consuming high levels of
selenium.
- An imbalance of selenium and copper ratio could
contribute to oxidative stress.
Zinc
- Zinc inhibits copper absorption and can lead to a
deficiency.
- A high copper to zinc ratio increases oxidative
stress, all-cause mortality, inflammation, immune dysfunction, sleep
disturbances, AD, heart failure, physical disability, diabetes, and
autism.
Iodine
Synergistic Nutrients
Vitamin A
- Retinoic acid is involved in iodine uptake.
- Severe vitamin
A deficiency decreases the uptake of iodine and impacts thyroid
metabolism.
- Iodine deficiency and vitamin
A deficiency leads to a more severe case of primary
hypothyroidism compared to iodine deficiency alone.
Selenium
- Adequate levels of both iodine and
selenium are necessary for the metabolism of thyroid hormone. Selenium is
required for the enzyme that deiodinizes T3 to convert it to the active
form, T4.
- Concurrent iodine and selenium deficiencies
might create a balancing effect to maintain and normalize T4 levels while
T4 levels were lowered when there was a deficiency of iodine or selenium.
Iron
Synergistic Nutrients
Vitamin A
- Iron is required for converting beta carotene
into retinol.
- Vitamin
A increases iron absorption, especially non-heme iron.
- Iron increases the bioavailability of pro-vitamin
A carotenoids, including alpha-carotene, beta-carotene, and
beta-cryptoxanthin.
- Supplementing with vitamin A might help reverse iron deficiency anemia
in children but vitamin A deficiency might contribute to anemia.
Vitamin C
- Vitamin C increases absorption of
non-heme iron, even in the presence of inhibitory
substances; vitamin C also regulates uptake and metabolism of
iron.
Antagonistic Nutrients
Vitamin E
- Iron interferes with absorption of vitamin E.
- Vitamin
E deficiency exacerbates iron excess but supplemental vitamin E
prevented it.
- It is best to take the supplements at separate
times.
Calcium
- High levels of calcium decrease
absorption of non-heme iron in
the short term but might not have a long-term impact on iron levels; this
can be mitigated by vitamin
C.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Copper
- Copper and iron compete
for absorption, so high levels of one might lead to deficiency of the
other.
Manganese
- High levels of manganese inhibits iron absorption
and uptake in a dose-dependent manner and vice versa due to shared
pathways of absorption and similar physiochemical properties.
Zinc
- Non-heme iron and zinc compete for absorption.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Manganese
Antagonistic Nutrients
Iron
- High levels of manganese inhibits iron absorption
and uptake in a dose-dependent manner and vice versa due to shared
pathways of absorption and similar physiochemical properties.
Calcium
Molybdenum
Antagonistic Nutrients
Copper
- Molybdenum interacts
with protein-bound copper in and outside the cells and can even remove
copper from the tissues, so excess molybdenum contributes to copper
deficiency.
- Molybdenum can also be used to treat problems
associated with excess levels of copper, such as Wilson’s disease.
- The antagonistic relationship between copper
and molybdenum might contribute to diabetic complications.
Selenium
Synergistic Nutrients
Vitamin C
- A diet high in vitamin C led to increased percent of absorption
of sodium selenite and retention of the absorbed selenium.
Vitamin D
- Supplementing with vitamin
D improves serum levels of selenium.
Vitamin E
- Selenium
deficiency aggravates effects of deficiency of vitamin E and vitamin E can prevent selenium
toxicity.
- Together they induce apoptosis.
- Combined selenium and
vitamin E deficiency has a great impact that the deficiency of one of the
nutrients.
- Synergy of vitamin
E and selenium might help with cancer prevention through
stimulating apoptosis in abnormal cells; selenium and vitamin
E work synergistically to help mitigate iron excess.
Iodine
- Adequate levels of both iodine and
selenium are necessary for the metabolism of thyroid hormone. Selenium is
required for the enzyme that deiodinizes T3 to convert it to the active
form, T4.
- Concurrent iodine and selenium deficiencies
might create a balancing effect to maintain and normalize T4 levels while
T4 levels were lowered when there was a deficiency of iodine or selenium.
Antagonistic Nutrients
Vitamin C
- Vitamin C converts sodium selenite to elemental
selenium which inhibits absorption but only when supplements are taken on
an empty stomach.
Copper
- When consuming low to normal levels of
selenium, high intakes of copper reduces
absorption, although this might not occur when consuming high levels of
selenium.
- An imbalance of selenium and copper ratio could
contribute to oxidative stress.
Zinc
Synergistic Nutrients
Vitamin A
- Zinc is required for vitamin
A transport.
- In one study, supplementing with vitamin
A and zinc in children led to a reduced risk of infection and
increased linear growth.
- Zinc along with vitamin A helps maintain eye health.
Vitamin B3
- Supplementing with nicotinic
acid might provide a dose-dependent improvement in hepatic zinc
levels and better antioxidant markers, including less lipid peroxidation,
reduced glutathione levels.
Antagonistic Nutrients
Vitamin B6
- High levels of B6 might increase the need for zinc.
- Chronic and acute B6
deficiency increases intestinal uptake of zinc but
serum zinc levels decrease, demonstrating an impairment in zinc
utilization.
Vitamin B9
- Supplementation with folic
acid, especially in a state of zinc
deficiency, might reduce absorption of zinc through forming a chelate,
but there are mixed results.
Calcium
- High levels of calcium supplements decrease
zinc absorption and zinc balance.
- High levels of zinc might impact calcium absorption.
- Zinc deficiency reduces serum calcium levels
and calcium entry into cells, and it increases parathyroid hormone levels.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Copper
- Copper inhibits zinc absorption and can lead to a
deficiency.
- A high copper to zinc ratio increases risk of
oxidative stress, all-cause mortality, inflammation, immune dysfunction,
sleep disturbances, AD, heart failure, physical disability, diabetes, and
autism.
Iron
- Non-heme iron and zinc compete
for absorption.
- Supplementing with calcium and iron greatly
reduced serum levels of zinc.
Magnesium
- Supplements of high levels (i.e. 142 mg/day) of
zinc might reduce magnesium
absorption.
As you can see, many of the minerals compete with
one another for absorption, making it important to ensure proper balance so
that one does not overpower the others, contributing to a deficiency.
SPECIAL GROUP INTERACTIONS
Antioxidant Network
Zinc,
selenium, vitamin A, vitamin C, vitamin E
- Balanced and sufficient quantities keep
antioxidant enzymes and other antioxidant defenses high
to mitigate oxidative stress, which is connected to numerous
diseases, including Alzheimer’s disease, cardiovascular disease, obesity,
cancer, and metabolic syndrome.
- Along with magnesium, antioxidant vitamins
can also help to protect against hearing loss and reduce inflammation.
B-vitamins
The B-vitamins often work together,
especially vitamins B2, B6, B9, B12.
- In addition to the above one-on-one
interactions, the B
vitamins work together and play key role as cofactors and enzymes
in one-carbon metabolism, which is involved in amino acid metabolism,
nucleotide metabolism, and DNA methylation, as well as production of SAM,
which is a methyl donor used in various reactions including
neurotransmitter production. These cofactors and enzymes are also involved
in energy metabolism.
- A balance of B
vitamins supports brain health, including neural development and
prevention of neurodegenerative diseases, as well as cardiovascular
health.
As always, check with your healthcare practitioner
to see which vitamins and minerals you may need and how best to take them.
You may also want to learn more about foods and
supplements in my upcoming Rainbow Foods and
Supplements Course starting January 29, 2018. Email us at info@foodandspirit.com if you
have questions.
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