The content was written for two audiences. Health professionals will find standardized monographs, levels of evidence, biomarkers with cutoffs, interaction tables and protocols by indication. Patients and interested readers will find, throughout the text, "For the Patient" boxes with explanations in plain language.
The doses presented correspond to the ranges described in clinical studies, guidelines and integrative practice for adults. The choice of vitamin, form, dose and duration of use depends on individual assessment, lab tests and current medications, and must be made by a licensed professional, within the rules of their professional board.
ATTENTION: The "functional" ranges cited in this guide are clinical targets used in integrative practice and in part of the literature. They do not replace the laboratory's reference values and must be interpreted together with the clinical picture, inflammation, kidney and liver function and current medications.
FOR THE PATIENT: Vitamins are not always harmless. Those that dissolve in fat (A, D, E and K) are stored in the body and can accumulate. That is why high doses should only be used with lab tests and guidance, for a defined period.
REGULATORY STATUS: The salts and forms cited (for example, calcium L-methylfolate, methylcobalamin, pyridoxal-5-phosphate, riboflavin-5-phosphate sodium, MK-7 and cholecalciferol) are available in compounding pharmacies and in supplements. Check the health regulations in force, the compatibility between the active ingredients and the stability of each formulation with the pharmacist in charge (see the stability Table in Module 1). Fat-soluble vitamins should be delivered in oil or oil-based capsules; high-dose vitamin C and minerals may require separate capsules.
ATTENTION: Before prescribing any formula, add up the doses of all the products the patient already uses, especially B6, vitamin A, vitamin D, niacin and biotin, and respect the upper limits in Module 25.
ATTENTION: The therapeutic and pharmacological doses in this guide are used for a defined period, with a documented indication and monitoring. Above the upper limit, the vitamin is being used as a medicine and requires professional follow-up.
Sources and method
- The scientific basis is the book The Vitamins: Fundamental Aspects in Nutrition and Health, by Combs and McClung (5th edition, Academic Press/Elsevier, 2017). On this basis, the e-book adds the functional reading of clinical practice, the active forms available in supplements and compounding pharmacies, the protocols by indication and the most relevant clinical trials.
- The biomarker cutoffs were compiled from the source book and from the NIH Office of Dietary Supplements. The functional targets are used in integrative practice and must be individualized.
- The clinical cases in Module 23 are illustrative and were developed based on the presentation patterns described in the source book and in integrative practice.
- Module 28 brings together 33 scientific references, grouped into 9 topics, all with a link except the source book.
- The key to the evidence labels is Table 2 of the e-book (page 11):
- [MA] Meta-analysis or systematic review of clinical trials
- [ECR] Published randomized controlled trial
- [EC] Smaller, open-label or observational clinical study
- [PC] Preclinical evidence (cell or animal studies)
- [CS] Consensus or guideline of a scientific society or regulatory agency