Nutrition and the deleterious side effects of nutritional supplements

The 2010 document outlines the potential adverse effects of oral vitamin (A, D, E, niacin) and mineral (zinc, copper, iron) supplements in dermatology, cautioning against excessive intake beyond the RDA due to severe side effects. It notes hematologic and neurologic issues from zinc, liver damage from copper, and gastrointestinal issues and increased risk of hypertension and diabetes from iron. Vitamin A can cause hypervitaminosis A, niacin can lead to flushing and liver toxicity, vitamin D excess can result in hypercalcemia, and vitamin E, while beneficial for skin health, can cause allergic reactions and has been linked to increased mortality at high doses. A study with 96 patients showed oral vitamin E improved atopic dermatitis symptoms, but a meta-analysis of 19 trials with over 135,000 participants associated high-dose vitamin E with increased all-cause mortality. Dermatologists should prescribe supplements with caution, considering drug interactions, therapeutic and toxic levels, and potential side effects.