Classification of Vitamins: Water-soluble & Fat-soluble

Instructor: Rebecca Gillaspy

Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.

Vitamins are classified based on their solubility. The fat-soluble vitamins are A, D, E and K. They can be stored in the body. The water-soluble vitamins are the B-complex vitamins and vitamin C. They are easily flushed out of the body.

 

Vitamins

When we hear about vitamins, we tend to associate them with good health. This is why so many food manufacturers love to brag about the vitamin content of their foods. Breakfast cereal boxes have bold lettering letting you know that they are packed with vitamins, and even sports drinks have added vitamins to boost their appeal. Vitamins are organic compounds that are essential for the proper functioning of your body. You get vitamins from the foods you eat, but you can also get them from vitamin supplements.

In total, you need 13 vitamins for good health, and they were initially named in the alphabetical order that they were discovered. Since their initial discovery, this order has gone through some revisions, and the vitamins got somewhat shuffled around and classified into two main groups. So, the purpose of this lesson is to sort through the alphabet soup of vitamins and provide some tricks to help you remember how they are classified.

Fat-Soluble Vitamins

Vitamins are classified by their solubility, or, in other words, the vitamin's ability to dissolve into another substance. For instance, fat-soluble vitamins are vitamins that dissolve in fat. Because fat is easily stored on your body, fat-soluble vitamins can be stored within your fat. This means they can accumulate and be saved for later use. The fat-soluble vitamins are A, D, E and K.

Now these four letters represent four different vitamins, but if you try to pronounce them like they spell a word, then you might pronounce them as 'attic.' So, a great little memory jogger for recalling the fat-soluble vitamins is 'The fat cat is in the ADEK (attic).' These vitamins are important to the normal functioning of your body.

For example, did your mom ever tell you to eat your carrots so you could see better at night? This is because carrots contain vitamin A, which helps with vision. Or, maybe your mom was one to tell you to go outside and play in the sunshine. This was also good advice because exposure to the sun helps your body make vitamin D, which is a vitamin that helps calcium absorption for healthy bones.

Vitamin E helps with your 'immunit-E' because it works as an antioxidant protecting your cells from free radicals. And vitamin K is needed for blood clotting, or would it help you recall this fact if you spelled clotting with a 'K' and thought of vitamin K as the blood 'K-lotting' vitamin?

Water-Soluble Vitamins

If a vitamin is not fat-soluble, then it is classified as one of the water-soluble vitamins, which are vitamins that dissolve in water. Because your body is a watery environment, these vitamins can move through your body pretty easily, and they can also be flushed out in your urine with ease. So, your body does not store water-soluble vitamins, and you need to replenish them daily.

Water-soluble vitamins include the B-complex vitamins and vitamin C. The B vitamins were initially thought to be just one vitamin, but later it was discovered that they were a group of vitamins with different characteristics; this is why B vitamins have numbers and different names. There are eight B vitamins, including vitamin B1, B2, B3, B5, B6, B7, B9 and B12.

Getting Too Much of Vitamins And Minerals

The health consequences of going overboard.

Nowadays, everything from bottled water to orange juice seems to have souped-up levels of vitamins and minerals in it. That may sound like a way to help cover your nutritional bases, especially if your diet is less than stellar. But routinely getting an overload of vitamins and minerals can hurt you.
Too much vitamin C or zinc could cause nausea, diarrhea, and stomachcramps. Too much selenium could lead to hair loss, gastrointestinal upset, fatigue, and mild nerve damage.
While most people aren't getting megadoses, if you eat a fortified cereal at breakfast, grab an energy bar between meals, have enriched pasta for dinner, and take a daily supplement, you could easily be over the recommended daily intake of a host of nutrients.
Here's what you need to know to avoid overdoing it.

Slideshow: The Truth About Vitamin D

“There's no real advantage to taking more than the recommended amounts of vitamins and minerals.” --
Johanna Dwyer, RD.

Supplements: Check the Dose

Chances are, the unfortified foods you eat aren't a problem. "It's pretty hard to overdo it from food alone," says Johanna Dwyer, RD, a senior research scientist with the National Institutes of Health's Office of Dietary Supplements.

So you'll want to think about the supplements you take and fortified foods or drinks.
"Most people don't realize there's no real advantage to taking more than the recommended amounts of vitamins and minerals, and they don't recognize there may be disadvantages," Dwyer says.
"If you're taking a supplement, stick to one that's no more than the daily value," Dwyer says. (Daily value is the amount of a vitamin or nutrient that a person should get for optimum health.)
Talk with your doctor about any supplements you're taking, including vitamins and minerals, and the dose you're taking, too. That way, your doctor can help you keep doses in a safe range.
"If you're taking a basic multivitamin, there's no need to fear taking too much," says Andrew Shao, PhD, senior vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, a trade group for the supplements industry.
"Most multivitamins have such a wide margin of safety that even when you're combining them with fortified foods, it's still not going to cause you to keel over," Shao says.

Subtle Signs You're Getting Too Much

"I have not seen someone off the street who was taking a toxic level of vitamin A or D -- those are very unusual," says David Katz, MD, director of the Yale University Prevention Research Center in New Haven, CT, whose medical practice specializes in nutrition. "What I'm more likely to see is a person with a dosing level of supplements that's higher than optimal."
Scientists don't yet know if routinely getting a little bit too much of a vitamin or mineral (as opposed to a megadose) is a problem, Katz says.
"There might be hints of concern, but they would be very subtle signs," he says.
These fairly mild symptoms may include difficulty sleeping or concentrating, nerve problems such as numbness or tingling, or feeling more irritable -- depending on the nutrient that's going overboard.
The bigger concern, Katz says, is that we're "garnishing the food supply with over fortification."
He says manufacturers have shifted their focus from what they've taken out of food -- such as its fat, sugar, or salt -- to what they're putting in, whether it's vitamin D, probiotics, or omega-3 fats -- whatever nutrient is in vogue.
"When more and more foods are enhanced, it becomes impossible for consumers to know what dose they're getting over the course of a day," Katz says. "Clinicians have to realize we might be introducing new dietary imbalances because of this practice."

Three Nutrients to Watch

Dwyer says vitamin D, calcium, and folic acid are three nutrients you may get too much of, especially through supplements.
Adults who regularly far exceed the 4,000 international units (IUs) daily safe upper limit for vitamin D might may end up with serious heart problems.
Folic acid is added to enriched grain products -- white flours, pasta, rice, breads, and cereals -- to help prevent birth defects in babies due to folic acid deficiency in pregnant women. While folic acid fortification has cut the number of birth defects by 25% to 50%, it might have created other health concerns in people getting too much.
It's not hard to get more than 1,000 micrograms of folic acid a day (the safe upper limit for adults) from fortified foods and supplements on a regular basis. Doing so might hide the signs of a vitamin B12 deficiency in older adults. Vitamin B12 deficiency can sometimes lead to permanent nerve damage if left untreated.

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An Interview with Terry Gatewood, Treatment Specialist at Sexual Recovery Institute

People struggling with sex addiction often feel alone and ashamed, as though no one could possibly understand all that they’ve been through. Then they meet Terry Gatewood, a treatment specialist at the Sexual Recovery Institute (SRI). Kind and insightful with a sharp sense of humor, Terry has a unique ability to relate to his clients.

Terry knows what it’s like to feel like damaged goods, to lose family and friends, and to feel that there is no hope for the future. Originally from Oklahoma City, Terry discovered he was HIV positive at the age of 23. Doctors gave him one to two years to live. When he was diagnosed with cancer a few years later, he found himself in a very dark place. Sex and drugs became his escape from dealing with his medical issues and past trauma, including experiencing the Oklahoma City bombing in 1995.

Thanks to treatment, Terry’s life took a positive turn. He got sober in March 2005, and one year later, he and his husband loaded a Ryder truck, their pick-up and two dogs and drove to California, where Terry earned his master’s degree and began his career as a forensic social worker working with offenders who had been mandated for treatment.

Since 2009, Terry has worked in SRI’s intensive outpatient program (IOP). He stumbled upon SRI through his work with crystal meth addicts, a number of whom raved about the treatment they received for sex addiction at SRI. He met with Rob Weiss and Sharon O’Hara, who recognized his passion for this work and offered him a job. Drawn to the program because of its national reputation and collaborative treatment team approach, Terry accepted the position and never looked back.

Rebuilding Relationships

In addition to group lectures and individual therapy, Terry does Couples work at SRI. At the IOP level, couples are often in crisis. Discovery of the sexual acting out has often just occurred and emotions are intense and wide-ranging. Many years ago, Terry found the challenge of Couples work unnerving. Today, it’s one of his favorite parts of his job.

In one exercise, called “I See You,” Terry calls on each partner to hold the other and look deep into their eyes in a way that says, “I see you, hear you, acknowledge and honor you.” Seeing the connection made in this very intimate moment can be incredibly powerful, he says.

He also draws on Maslow’s Hierarchy of Needs to help clients understand their spouse or partner’s need for emotional safety after experiencing the betrayal of sex addiction. In addition to feeling angry and outraged, partners grieve the loss of the relationship they thought they had, Terry explains. Rebuilding trust takes time and a great deal of effort, but once the process is set in motion, the couple can build up to intimacy and belonging, and later, a spiritual connection and self-actualization.

“Clients sometimes struggle to understand their spouse or partner’s feeling that they are no longer safe. They reason, ‘I’ve never hurt them or put them in danger,'” Terry says. “But emotional heartbreak is just as devastating as physical pain or a broken bone. If it was as easy as putting a cast on, our jobs would be so much easier.”

Terry also uses the Four Agreements and the 12 Steps to help sex addicts and their spouses/partners develop a common language and a common understanding. It can be liberating for spouses/partners to recognize that the problem is not about them personally, but rather the sex addict’s underlying issues. Partners also develop a process for dealing with any issues of their own. At the same time, sex addicts learn how to make themselves vulnerable despite their fears and to love themselves for who they are, imperfections and all.

Addressing Trauma and Co-Addiction

From personal and professional experience, Terry knows that most sex addicts have a co-addiction of some kind, whether to drugs, alcohol, gambling or another substance or behavior. Since sex is one of the primary reasons people relapse into drug or alcohol abuse, the team at SRI works in a collaborative effort with substance abuse treatment centers to identify and assess clients for sex addiction. Coordinating this care increases the client’s chances for successful recovery. While recovery from addiction is the primary goal of treatment, Terry aims higher, to “help clients live their best lives and truly be happy, whatever that means for them.”

With more than 20 years of experience working with gay, lesbian, bisexual and transgender issues, Terry has a particular passion for helping gay men figure out what sobriety is and how it can work in their lives.

“So many gay men have endured intense shame and trauma simply because of their orientation,” he says. “To see them soften their own self-hatred and make a transformation is truly inspiring.”

Terry is not one to hide his feelings. He is visibly moved by his clients’ heartbreaking stories of trauma, as well as their courage in working toward recovery. Given the strong association between sex addiction and trauma as well as his own trauma history, Terry is beginning training in Somatic Experiencing to help clients fully address these issues.

A Man with Many Hats: Therapist, Advocate and Teacher

A former political consultant, Terry is a strong and passionate advocate who lends his voice for those who have been silenced. He’s also a natural-born teacher.

“In this field, we’re as much teachers as we are therapists,” Terry says. “At first it can be difficult for clients to identify with one another instead of focusing on their differences. That’s where we step in to help them realize how a wide variety of addictive and compulsive behaviors can have the same roots.”

Once they recognize themselves through the stories of their peers, the shame associated with sex addiction lessens and the process of change begins.

“Almost immediately after treatment starts, we see a marked reduction in shame. Clients see people with similar problems talking openly, and not only are they not judged or rejected but they are celebrated for their courage,” Terry says. “Like a mood ring changing color, clients at SRI start out a dull grey and within days we see the brightness come back in. They are no longer in treatment because of an ultimatum from a spouse or partner, but because they feel worthy of a better life.”

Payday Loans

Payday loans are short term loans that are often used to get through a rough spot. Unfortunately, there are very few situations in which these loans actually end up being helpful. Before you use one, make sure you understand the costs and risks. This page gives you a quick overview of how payday loans work, and ideas on how to avoid them.

What are Payday Loans?

Payday loans are small loans you can use when you are temporarily out of money. Most often, payday loans are short term loans (two weeks or so) for a modest amount of money (a few hundred bucks). To get a payday loan, you typically write a check for the amount you are borrowing – plus a fee. You might leave the check with the lender, and they cash it once you are ready to repay.

What Is APR?

If you can’t repay your payday loan when it comes due, you can “roll it over” so that the loan is extended. You don’t have to repay it, but fees keep accumulating.

Payday loans are sometimes marketed as "no credit check" loans.

Costs of Payday Loans

In general, payday loans are extremely expensive. You end up paying an annual percentage rate (APR) that may be several hundred percent. For example, you might pay a $20 fee to borrow $100.00 for two weeks. The Consumer Federation of America has some nicecalculations comparing payday loans to the alternatives. These show that you would pay about 426% APR on a payday loan, but paying an APR above 1000% is not unheard of.

Payday Loan Pitfalls

The main pitfall with payday loans is their cost. Due to extremely high fees, they don’t help you solve the real problem. If you’re having financial difficulties, payday loans can only make things worse. You’re paying a really high rate of interest which means that your expenses are just going up. As a short term strategy – maybe once or twice in your life, if that – payday loans can get you through a rough patch.

For example, you might need an emergency repair for your car so that you can get to work and keep earning income. As a long-term strategy, payday loans will pull you under.

You can get yourself in trouble if things get out of hand. Bouncing checks that you write to the payday loan establishment can end up on your ChexSystems file and result in overdraft charges from your bank. Banks and retailers may then be unwilling to work with you. The lender may also sue you or send your account to collections, which will ding up your credit.

• Credit Score Basics

If you keep stretching out payday loans, you'll pay far more in interest and fees than you ever borrowed in the first place.

What About Bank Payday Loans?

Banks have moved into the payday loan industry, most likely in order to earn more revenue. While traditional bank loans (loans that you have to qualify for based on your credit, income, and assets) can be a better alternative, bank payday loans are no better than any other payday loan. They may go by a variety of names, but they’re still expensive and risky.

In fact, payday loans from banks can be even worse than the loans you get at a payday loan store. Why? The bank has access to your checking account, and you agree to let them pull funds from your account to repay the loan. If they want their money (but you still need to make mortgage or car payments) they’ll take it as soon as it's available – before you have the chance to spend it on other important things. When you borrow elsewhere, you might have more control over how and when your money leaves.

This doesn’t mean you should never use a payday loan at the bank; using one of these loans is risky no matter where you get it, and it’s possible that your bank can offer better terms.

Alternatives to Payday Loans

Instead of using a payday loan, consider some alternatives:

• Build up an emergency cash fund in your savings account (sometimes easier said than done)
• Build credit so you can borrow from mainstream lenders (in moderation)
• Keep an open credit card for emergency expenses
• Get a signature loan (or unsecured loan) from your bank or credit union
• Pick up a part time job for extra cash
• Negotiate a payment plan with your lenders (ask about loan modification)
• Investigate overdraft protection plans for your checking account
• Try peer to peer lending services for a better deal

Defending Payday Loans

The payday loan industry is not shy about defending itself. They argue that payday loans can be less expensive than bounced check fees and overdraft protection programs. In addition, they argue that payday loans are the best quick and easy way for some people to get money.

What Are the Differences Between Cialis, Levitra, Staxyn, Stendra, and Viagra?

Cialis, Levitra, Staxyn, Stendra, and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the drug works and how quickly it works. Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, the effects last approximately 4 hours.

Cialis works a bit faster (within about 15 minutes), and the effects last much longer -- up to 36 hours in some cases. Stendra can start working in as little as 15 minutes and last up to 6 hours. Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets. It has the potential for a more rapid onset of action.

If One of These Drugs Isn't Effective for Erectile Dysfunction, Can I Try Another?

Yes, but because these drugs work the same way, it's unlikely that you'll have success with one if you've failed to achieve an adequate erection with another.

What Precautions Should I Take Before Taking One of These Drugs?

There are certain situations in which these drugs may not be safe to take. Before taking them, tell your doctor:

• If you are allergic to any drugs, including Viagra or other ED medications.
• About any prescription or nonprescription medications you are currently taking, including herbal and dietary supplements.
• If you are scheduled for surgery, including dental surgery.
• If you take nitroglycerin or a long-acting nitrate to treat chest pain. The combination of Cialis, Levitra, Staxyn, Stendra, or Viagra with these drugs can cause dangerously low blood pressure.
• If you take alpha-blockers for blood pressure or prostate problems. The combination of Cialis, Levitra, Staxyn, Stendra, or Viagra with these drugs can also cause dangerously low blood pressure. Patients should not be started on Staxyn unless they have previously taken Levitra as directed by their doctor.

In addition, always follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part that you do not understand. Take these drugs exactly as directed. Do not take more or less or take it more often than prescribed by your doctor. Do not take these drugs more than once a day.

Am I getting too much vitamin D?

Although most people take vitamin D supplements without any problems, it’s possible to take too much. This is called vitamin D toxicity. Vitamin D toxicity, where vitamin D can be harmful, usually happens if you take 40,000 IU per day for a couple of months or longer, or take a very large one-time dose.

Vitamin D is fat-soluble, which means your body has a hard time getting rid of it if you take too much. When you take large amounts of vitamin D, your liver produces too much of a chemical called 25(OH)D.

When your 25(OH)D levels are too high, this can cause high levels of calcium to develop in your blood. High blood calcium is a condition called hypercalcemia.

The symptoms of hypercalcemia include:

• feeling sick or being sick
• poor appetite or loss of appetite
• feeling very thirsty
• passing urine often
• constipation or diarrhea
• abdominal pain
• muscle weakness or pain
• feeling confused
• feeling tired

In some rare diseases, you may be at risk of hypercalcemia even if you have low vitamin D levels and haven’t taken much vitamin D. These diseases include primary hyperparathyroidism, sarcoidosis and a few other rare diseases. See our Hypersensitivity page page for more information.

How do I know if I have taken too much?

A blood test to measure your 25(OH)D levels can tell you whether you have too high of vitamin D levels. If your 25(OH)D levels are above 150 ng/ml this is considered potentially toxic and potentially harmful to your health. You know if your 25(OH)D levels are toxic by a blood test to measure calcium. If calcium is high and 25(OH)D is high, then you are getting too much vitamin D.

Very high levels of 25(OH)D can develop if you:

• take more than 10,000 IU/day (but not equal to) everyday for 3 months or more. However, vitamin D toxicity is more likely to develop if you take 40,000 IU/day everyday for 3 months or more.
• take more than 300,000 IU in a 24 hour period.

If you have taken this much vitamin D, seek medical attention. Your health providers will get your calcium and 25(OH)D levels tested.

The current recommended daily allowances for vitamin D set by the Food and Nutrition Board are conservative, so you don’t need to feel worried about toxicity if you take more than their recommended daily allowance. You can find out more about daily vitamin D supplementation on our page, How do I get the vitamin D my body needs?

What should I do if I think I have taken too much vitamin D?

Have you taken more than 300,000 IU in the past 24 hours OR have you been taking more than10,000 IU/day for the past three months or longer?

• If yes, check to see if you have symptoms of toxicity (listed above); symptoms like feeling sick, feeling thirsty, constipation or diarrhea, poor appetite and feeling confused. If so, you may have hypercalcemia and need medical attention.
  • If you do not have any symptoms, you likely do not have hypercalcemia. However, you should get a blood test for 25(OH)D and make sure that you do not have a level above 150 ng/ml. Consider lowering your vitamin D dose. See our page How do I get the vitamin D my body needs? for more information.
• If no, you likely do not have hypercalcemia and are not toxic. If you are still concerned, you may choose to get a blood test to measure 25(OH)D to see what your levels are. See ourTesting page for more information.
  • If you have symptoms of toxicity but have not taken more than 300,000 IU in 24 hours or more than 10,000 IU/day for the past three months, you may have a very rare condition that is sensitive to vitamin D. Please see our Hypersensitivity page for more information.

What about children?

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The more you weigh, the more vitamin D your body can handle; the less you weigh, the less vitamin D your body can handle. The above cutoffs of 300,000 IU in 24 hours or more than 10,000 IU/day for three or more months apply to average adult weight (125-200 lbs).

So, how do you know if your child has gotten too much vitamin D?

• For children that weigh 25 lbs or less, more than 50,000 IU in 24 hours or 2,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 25 and 50 lbs, more than 100,000 IU in 24 hours or 4,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 50 and 75 lbs, more than 150,000 IU in 24 hours or 6,000 IU/day for over three months is too much and potentially toxic.
• For children that weigh between 75 lbs and 100 lbs, more than 200,000 IU in 24 hours or 8,000 IU/day for over three months is too much and potentially toxic.

If your child has taken too much vitamin D, seek medical attention.

I already tested my 25(OH)D. Is my level too high?

If your level is greater than 150 ng/ml, this is considered too high and potentially toxic. Seek medical attention if you have symptoms of hypercalcemia (listed above). If you do not have symptoms, consider lowering your level. Please see our pages on 25(OH)D reference ranges and our page on how to get the right amount of vitamin D:

• Testing for vitamin D
• How do I get the vitamin D my body needs?

If your level is not greater than 150 ng/ml, then you are not potentially toxic in vitamin D. Please read our pages on vitamin D levels and how to interpret your results:

• I tested my vitamin D level. What do my results mean?
• How do I get the vitamin D my body needs?

References

1. Cusano NE, Thys-Jacobs S and Bilezikian JP. “Hypercalcemia Due to Vitamin D Toxicity.” In Vitamin D, Third Edition, by Feldman D, Pike JW and Adams JS. Elsevier Academic Press, 2011.
2. Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. American Journal of Nutrition, 1999.