Vitamin and Mineral Synergy

By Staci Gulbin, MS, MEd, RD

Staci Gulbin is a registered dietitian with BumpVitamins.com. Staci is also a freelance writer, health editor, the founder of LighttrackNutrition.com, and the author of The High-Protein Bariatric Cookbook. 

Staci has graduate degrees in Biology, Human Nutrition, and Nutrition Education from New York University and Columbia University, respectively. She has treated thousands of patients across many wellness arenas such as weight management, fitness, long-term care, rehab, and bariatric nutrition. 

HAVE YOU EVER wondered if you are getting the most out of your vitamins? Are they actually doing their job or are you literally pissing them away? Do you spend a ton of money on individual Vitamin D or Vitamin C supplements, but aren’t sure if you’re getting your money’s worth?

You may not be getting the full benefit of certain supplements, like vitamin D or vitamin C, if you are buying them as stand-alone supplements. Certain vitamins and minerals depend on each other for to absorb best in the body. In other cases, certain nutrients not only directly benefit specific health concerns, but they can also be synergistic, helping other nutrients do their job better as well. In fact, in order to be effective, some nutrients require the presence of other vitamins or minerals to even be absorbed by the body.

One could not contain the number of “power pairs” of nutrients in just one article. However, read below to learn about some of the more common pairs and groups of vitamins and minerals you should take together to optimize your health benefits.

Vitamin D, K, and Calcium

When you think about bone health, it’s likely that calcium comes to mind. About 99-percent of the calcium in the body is stored in the bones and teeth (2). Meanwhile, the other 1-percent is vital for certain metabolic functions like nerve transmission, as well as the contracting and dilating of blood vessels. But without certain minerals like vitamin D and K to help the body absorb calcium, it couldn’t perform at its best. Vitamin D is required by the body to help it absorb calcium. Without it, your bones and teeth would be very weak and brittle.

Vitamins D and K are both fat-soluble vitamins that play a crucial role in bone and heart health (3,4). Vitamin D plays a role in reducing inflammation and assisting in cell growth and immune function (4). Meanwhile, vitamin K plays a vital role in blood clotting (3).

Research shows that the two of them together may be more effective for bone and heart health than when they are on their own (5). Also, a 2019 study shows that vitamin D and calcium together can help reduce fractures more than vitamin D taken alone (6).

Vitamin C and Iron

Iron is an important mineral that delivers oxygen from the lungs to the cells of tissues in the body (7). Those who are pregnant, or breastfeeding will need more iron than those who are not, and iron deficiency can lead to conditions like anemia which cause fatigue, weakness, and impaired cognitive function.

Vitamin C is a water-soluble vitamin that is known for its immune health function. For iron to be most effective, it needs vitamin C to help it absorb better in the body (8). This is especially true of the nonheme iron found in plant-based foods like beans, legumes, and leafy green vegetables (8).  Through this action, research shows that vitamin C can help prevent iron deficiency anemia (9).

Vitamin B12, folate, and other B vitamins

Vitamin B12 is a water-soluble vitamin that is well-known for its ability to form red blood cells and neurological function, among other things (10). Folate is also a B vitamin and it works in DNA synthesis and in adequate amounts can prevent neural tube defects in infants (11).

Research shows that B group vitamin supplementation, such as that with vitamin B12 and folate, may help improve mood in those healthy individuals and those at-risk for mental health conditions (12). Not only that, but together these B vitamins, along with others in this group, can help to support nerve health (13). Also, a 2019 study shows that higher intakes of vitamin B6 and folate may lower risk of coronary heart disease in the general population (14).

Zinc and copper

Zinc is an essential mineral that plays a vital role in body processes including immune function, wound healing as well as growth and development (15). People with digestive disorders, those who limit meat or cut meat out in the diet, as well as pregnant women, alcoholics, and people with sickle cell disease are at risk of becoming deficient in zinc.

Copper is also an essential mineral and works in the body to assist with processes including energy production and immune system function (16). Copper deficiency is rare in humans but those at risk for deficiency include those with celiac disease, Menkes disease, or those taking high doses of zinc supplements.

Research shows that these two minerals taken together can strengthen immune function and may also, along with selenium, play a role in maintaining healthy skin (17,18).

Zinc and vitamins A and C

Not only can zinc benefit from a relationship with copper, but it also provides benefit to health when paired with the fat-soluble vitamin A. Vitamin A is a fat-soluble vitamin vital for optimal immune and vision health (19). Vitamin A deficiency is rare in most people except for perhaps those with conditions like cystic fibrosis or malabsorption issues.

Vitamin A is an antioxidant which means it can help reduce oxidative stress and related inflammation that can damage cells and increase your risk of chronic disease (19). Research shows that together with zinc, vitamin A may help reduce risk of anemia in children (20). Vitamin A and Zync help each other synergistically, making it easier for the body to transport and absorb the nutrients, than if they were present individually.

Vitamin C and zinc together can support nervous system health (21). Both vitamin C and zinc may also strengthen immune function and can lessen symptoms of respiratory tract infections, as well as improve wound healing or conditions like pressure ulcers (22,23).

The Bottom line

Whether you have a vitamin or mineral deficiency or just want to prevent one from happening, then it may take more than one supplement to do the trick.  The combinations listed above are just a small list of the many interactions that vitamins and minerals have with one another.

To find out if you have a deficiency in any of the above vitamins or minerals, it’s vital to have an annual exam and labs checked at your primary care physician. Common tests already included in the standard lab set are the major electrolytes sodium and potassium as well as calcium and iron. However, if you’re curious about your vitamin B12 or vitamin D levels, you may have to ask for these labs directly.

In the meantime, if you think you’re not consuming enough nutrients from the foods you eat, a multivitamin is a good place to start. Then as you gather more information about your health status, you can home in on the vitamin and minerals that your body would benefit from most.

References:

• Harvard Health Publishing Harvard Medical School (published July 2009) “Nutrition’s dynamic duos.” https://www.health.harvard.edu/newsletter_article/Nutritions-dynamic-duos
• National Institutes of Health Office of Dietary Supplements (updated March 26, 2020) “Calcium.” https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
• National Institutes of Health Office of Dietary Supplements (updated June 3, 2020) “Vitamin K.” https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
• National Institutes of Health Office of Dietary Supplements (updated October 9, 2020) “Vitamin D.” https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
• van Ballegooijen, A. J., Pilz, S., Tomaschitz, A., Grübler, M. R., & Verheyen, N. (2017). “The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review.” International journal of endocrinology, 2017, 7454376. https://doi.org/10.1155/2017/7454376
• Yao, P., et al. (2019) “Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis.” JAMA Netw Open., 2(12):e1917789.
• National Institutes of Health Office of Dietary Supplements (updated February 28, 2020) “Iron.” https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
• National Institutes of Health Office of Dietary Supplements (updated February 27, 2020) “Vitamin C.” https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
• He H., Qiao Y., Zhang Z., Wu Z., Liu D., Liao Z., Yin D., and He M. (October 2018) “Dual action of vitamin C in iron supplement therapeutics for iron deficiency anemia: prevention of liver damage induced by iron overload.” Food Funct.,9(10):5390-5401.
• National Institutes of Health Office of Dietary Supplements (updated March 30, 2020) “Vitamin B12.” https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
• National Institutes of Health Office of Dietary Supplements (updated June 3, 2020) “Folate.” https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
• Young, L. M., Pipingas, A., White, D. J., Gauci, S., & Scholey, A. (2019). “A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals.” Nutrients, 11(9), 2232. https://doi.org/10.3390/nu11092232
• Calderón-Ospina, C. A., & Nava-Mesa, M. O. (2020). “B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin.” CNS neuroscience & therapeutics, 26(1), 5–13. https://doi.org/10.1111/cns.13207
• Jayedi, A. and Zargar, M.S. (2019) “Intake of vitamin B6, folate, and vitamin B12 and risk of coronary heart disease: a systematic review and dose-response meta-analysis of prospective cohort studies.” Crit Rev Food Sci Nutr. 59(16):2697-2707.
• National Institutes of Health Office of Dietary Supplements (updated July 15, 2020) “Zinc.” https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
• National Institutes of Health Office of Dietary Supplements (updated June 3, 2020) “Copper.” https://ods.od.nih.gov/factsheets/Copper-HealthProfessional/
• Gombart, A. F., Pierre, A., & Maggini, S. (2020). “A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection.” Nutrients, 12(1), 236. https://doi.org/10.3390/nu12010236
• Raj U.L., Sharma G., Dang S., Gupta S., Gabrani R. (2017) “Impact of Dietary Supplements on Skin Aging. In: Farage M., Miller K., Maibach H. (eds) Textbook of Aging Skin.” Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47398-6_174
• National Institutes of Health Office of Dietary Supplements (updated February 14, 2020) “Vitamin ” https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/
• Chen, L., et al. (2012) “Effects of vitamin A, vitamin A plus zinc, and multiple micronutrients on anemia in preschool children in Chongqing, China.” Asia Pac J Clin Nutr., 21(1):3-11.
• Gromova, O.A., Torshin, I.Yu., Pronin, A.V., and Kilchevsky, M.A. (March 2019) “Synergistic Application of Zinc and Vitamin Cto Support Memory and Attention and to Decrease the Risk of Developing Nervous System Diseases.” Neuroscience and Behavioral Physiology, 49: 357-364.
• Wintergerst, E.S., Maggini, S., and Hornig, D.H. (2006) “Immune-enhancing role of vitamin C and zinc and effect on clinical conditions.” Ann Nutr Metab., 50(2):85-94.
• Ellinger, S. and Stehle, P. (2009) “Efficacy of vitamin supplementation in situations with wound healing disorders: results from clinical intervention studies.” Curr Opin Clin Nutr Metab Care,12(6):588-95.