Pharmax Multivitamin & Mineral 120 capsules

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Pharmax Multivitamin & Mineral 120 capsules

• Multivitamin mineral formulation
• An antioxidant for the maintenance of good health (1)
• Helps the body to metabolize carbohydrates, fats and proteins (2)
• Provides support for healthy glucose metabolism (3)
• Helps in the absorption and use of calcium and phosphorus (4)
• Helps normal growth and development (5)
• Helps in the development and maintenance of night vision, bones, cartilage, teeth and gums (6)
• Helps to maintain eyesight, healthy skin, membranes, immune function and proper muscle function (7)
• Helps to produce and repair connective tissue (8)
• Helps to form red blood cells (9)
• Helps in tissue formation and wound healing (10)
• Helps in the function of thyroid gland (11)
• Convenient vegetable capsule format
• Increases patient compliance

1 NHPD Monograph on Multivitamin and Mineral. October 2007.
2 NHPD Monograph on Multivitamin and Mineral. October 2007.

Additional product info:
Vitamin A at 65-3,000 micrograms Retinol activity equivalents per day is a factor in the maintenance of good health, helps maintain eyesight, skin membranes and immune function, helps in the development and maintenance of night vision, bones and teeth (3). Corneal haze and myopic regression are the main undesirable complications after excimer laser treatment. In the past few years, several authors indicated that keratocytes and epithelial cells are mainly involved in the healing response. In particular, it was suggested that the disappearance of anterior stromal keratocytes in response to excimer laser surgery was an initiating factor, which could lead to epithelial hyperplasia and eventually to haze formation and regression. Vitamin A exerts a moderate antioxidant activity and plays an essential part in epithelial growth and limbal stem cell differentiation, promoting corneal wound healing. As slower tissue regeneration causes an increased risk of accumulation of oxidant-inflicted damage in the tissue components, corneal re-epithelialisation time is crucial. A randomized, double masked clinical trial has been performed to evaluate the effect of a high dose vitamin A and E supplementation on corneal re-epithelialisation time, visual acuity and haze following photorefractive keratectomy (PRK). In this study, the results showed that vitamins A (25 000 IU retinol palmitate) and E (230 mg alpha-tocopheryl nicotinate) for 3 months post PRK significantly decreased re-epithelialisation time, haze formation, and myopic regression occurrence (4). Another study showed that retinol palmitate at 10,000 IU by mouth for 90 days significantly reduced rectal symptoms of radiation proctopathy, perhaps because of wound-healing effects (5).

Epidemiological studies have shown that competitors in ultrarnarathon (> 42 km) footraces report a significantly higher incidence of symptoms of upper-respiratory-tract (URT) infections in the immediate postrace period when compared with the incidence among sedentary control subjects during the same time period. A double-blind placebo-controlled study determined whether daily supplementation with 600 mg vitamin C for 21 days before the marathon, would reduce the incidence of symptoms of URT infections after participation in a competitive ultramarathon race. Symptoms of URT infections were monitored for 14 days after the race. Sixty-eight percent of the runners in the placebo group reported the development of symptoms of URT infection after the race; this was significantly more than that reported by the vitamin C-supplemented group (33%). The duration and severity of symptoms of URT infections reported in the vitamin C-supplemented nonrunning control group was also significantly less than in the nonrunning control group receiving the placebo. This study provides evidence that vitamin C supplementation may enhance resistance to the postrace URT infections that occur commonly in competitive ultramarathon runners and may reduce the severity of such infections in those who are sedentary (6).

Vitamin D has complex effects on pulmonary cell biology and immunity with impact on inflammation, host defense, wound healing, repair, and other processes. While the knowledge on direct mechanistic links between Vitamin D and lung diseases is limited, a number of epidemiological and experimental are available that highlight the relevance of this connection (7). A placebo-controlled, double-blinded study involving 164 young Finnish men provides some evidence for a preventive effect of daily supplementation with 400 IU of vitamin D for 6 months against respiratory tract infection (8).
The B vitamins folate, vitamin B6 (pyridoxine), and vitamin B12 (cobalamin) are important regulators of homocysteine metabolism in the body, and randomized controlled trials have demonstrated that supplementation with folate at doses up to 500 µg daily alone or in combination with vitamins B6 and B12 significantly reduces blood homocysteine concentrations (9). Epidemiological evidence suggests that total plasma homocysteine level is an independent cardiovascular risk factor and may have a potential role with regard to outcome after coronary interventions. Studies on the pathogenesis of homocysteine-induced vascular damage have suggested adverse interaction with vascular smooth muscle cells, endothelium function, plasma lipoproteins, and coagulation cascade. A study provides evidence that homocysteine-lowering therapy with folic acid (1 mg/day), vitamin B12 (cyanocobalamin, 400 µg/day), and vitamin B6 (pyridoxine hydrochloride, 10 mg/day) for 6 months improves outcome after percutaneous coronary intervention (10).

Adequate zinc status is critical for immune function. Zinc deficiency reduces generation of T cells, depresses humoral and cell-mediated immunity, leads to lymphopenia and thymic atrophy, and increases the frequency and number of infections. A prospective, randomized, controlled clinical trial was conducted involving 231 HIV-infected adults with low plasma zinc levels, who were randomly assigned to receive zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo for 18 months. Zinc supplementation given to HIV-infected adults resulted in a 4-fold decrease in the likelihood of immunological failure, defined as a decrease of CD4+ cell count to

Impaired glucose tolerance results from Chromium (Cr) restriction in animals, and Cr supplementation improves glucose tolerance in diabetic animals. These effects are presumably due to the role of Cr in glucose tolerance factor (GTF), a complex of Cr and nicotinic acid believed to facilitate insulin binding. Sixteen healthy elderly volunteers were divided into three groups and given either 200 micrograms Cr, 100 mg nicotinic acid, or 200 micrograms Cr + 100 mg nicotinic acid daily for 28 days and evaluated on days 0 and 28. Fasting glucose and glucose tolerance were unaffected by either chromium or nicotinic acid alone. In contrast, the combined chromium-nicotinic acid supplement caused a 15% decrease in a glucose area integrated total and a 7% decrease in fasting glucose. Thus, these data suggest that the inability to respond to chromium supplementation may result from suboptimal levels of dietary nicotinic acid (12). Another study evaluated the effect of chromium supplementation, versus placebo, on insulin levels and serum lipids in a double-blind, randomized trial in 26 young adults (mean age 36 years). Fasting levels of glucose, immunoreactive insulin (IRI), and lipids (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) were measured before and after 90 days of daily supplementation with a chromium (III)-nicotinate preparation, containing 220 micrograms elemental chromium, or placebo. Those individuals within the chromium group with initial fasting IRI levels greater than 35 pmol/l had a significant decrease in IRI level after supplementation despite no significant changes in serum lipids. These subjects may benefit from chromium supplementation by improving insulin sensitivity and cardiovascular risk over time (13). The NHPD recommendations for chromium supplementation in adults to provide support for healthy glucose metabolism are between 2.2-500 µg per day (14).

Results of a study indicate that iron deficiency without anemia impairs favorable adaptation to aerobic exercise in iron-depleted, nonanemic women. In the study, forty-two iron-depleted, nonanemic women (18–33 years old) received 100 mg of ferrous sulfate (S) (20 mg elemental iron) or placebo (P) per day for 6 weeks in a randomized, double-blind trial. Iron supplementation increased serum ferritin and decreased transferrin receptors in the S compared with the P group. The S and P groups decreased 15-km time and respiratory exchange ratio and increased work rate during the 15-km time trial after training. The decrease in 15-km time was greater in the S than in the P group (15). Non-anaemic women with unexplained fatigue may benefit from iron supplementation as shown in a clinical study when oral ferrous sulphate (80 mg/day of elemental iron) was ingested daily for four weeks (16). Iron at 1.4 to 45 mg per day helps to form red blood cells and helps in their proper function (17). Copper at 65-8,000 µg per day helps to form red blood cells and helps to produce and repair connective tissue (18).

Selenium at 3.5-400 µg per day is an antioxidant for the maintenance of good health (19). In a prospective, randomized study design, immunological changes in free-living, healthy aged humans (57-84 years of age) given a placebo, beta-carotene (45 mg/day), selenium (400 µg/day) or 45 mg beta-carotene plus 400 mcg selenium per day for 6 months, and after 2 months of discontinuation were evaluated. Selenium and selenium plus beta-carotene supplementation caused an increase in total T cells. The study found that selenium enhanced immune function (NK cell cytotoxicity) and phenotypic expression of T-cell subsets, whereas beta-carotene affected only immune function (20).

Iodine at 14-800 µg per day helps in the function of the thyroid gland (21).

3 NHPD Monograph on Multi-vitamin and Mineral. October 2007.
4 Vetrugno M, Maino A, Cardia G, Quaranta GM, Cardia L. A randomised, double masked, clinical trial of high dose vitamin A and vitamin E supplementation after photorefractive keratectomy. Br J Ophthalmol. 2001 May;85(5):537-9.
5 Ehrenpreis ED, Jani A, Levitsky J, Ahn J, Hong J. A prospective, randomized, double-blind, placebo-controlled trial of retinol palmitate (vitamin A) for symptomatic chronic radiation proctopathy. Dis Colon Rectum. 2005 Jan;48(1):1-8.
6 Peters EM, Goetzsche JM, Grobbelaar B, Noakes TD. Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners. Am J Clin Nutr. 1993 Feb;57(2):170-4.
7 Herr C, Greulich T, Koczulla RA, Meyer S, Zakharkina T, Branscheidt M, Eschmann R, Bals R. The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer. Respir Res. 2011 Mar 18;12:31.
8 Laaksi I, Ruohola JP, Mattila V, Auvinen A, Ylikomi T, Pihlajamäki H. Vitamin D supplementation for the prevention of acute respiratory tract infection: a randomized, double-blinded trial among young Finnish men. J Infect Dis. 2010 Sep 1;202(5):809-14.
9 Larsson SC, Männistö S, Virtanen MJ, Kontto J, Albanes D, Virtamo J. Folate, vitamin B6, vitamin B12, and methionine intakes and risk of stroke subtypes in male smokers. Am J Epidemiol. 2008 Apr 15;167(8):954-61.
10 Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA. 2002 Aug 28;288(8):973-9.
11 Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60.
12 Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism. 1987 Sep;36(9):896-9.
13 Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract. 1995 Jun;28(3):179-84.
14 NHPD Monograph on Multi-vitamin and Mineral. October 2007.
15 Hinton PS, Giordano C, Brownlie T, Haas JD. Iron supplementation improves endurance after training in iron-depleted, nonanemic women. J Appl Physiol. 2000 Mar;88(3):1103-11.
16 Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pécoud A, Favrat B. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ. 2003 May 24;326(7399):1124.
17 NHPD Monograph on Multi-vitamin and Mineral. October 2007.
18 NHPD Monograph on Multi-vitamin and Mineral. October 2007.
19 NHPD Monograph on Multi-vitamin Mineral. October 2007.
20 Wood SM, Beckham1 C, Yosioka2 A, Darban3 H, Watson RR. beta-Carotene and selenium supplementation enhances immune response in aged humans. Integr Med. 2000 Mar 21;2(2):85-92.
21 NHPD Monograph on Multi-vitamin and Mineral. October 2007.

Other ingredients: Hypromellose, vegetable magnesium stearate