Avista

Approved & Clinically Accepted Uses:

• Oxidative Stress Protection: For the prevention and reduction of cellular damage caused by free radicals in chronic diseases such as diabetes, cardiovascular disease, cancer, and neurodegenerative disorders.
• Immune System Support: Used to strengthen the immune response in individuals with recurrent infections, chronic fatigue, or weakened immunity.
• Adjunct in Chronic Diseases: Supports recovery and slows progression in conditions like:
• Type 2 diabetes (reducing oxidative burden)
• Hypertension and atherosclerosis
• Chronic kidney disease
• Liver cirrhosis
• Rheumatoid arthritis
• Skin Health and Anti-Aging: Improves skin appearance, reduces wrinkles, and promotes wound healing.
• Male and Female Fertility Support: Used in idiopathic infertility to improve sperm quality and ovarian function.
• Eye Health: Helps reduce the risk of age-related macular degeneration and cataract formation.
• General Wellness: Promotes energy, combats fatigue, and supports mental clarity.

Adult Dose:

• 1 capsule or tablet daily, preferably with a main meal.
• Some formulations may recommend up to 2 capsules daily depending on the vitamin/mineral concentration.

Pediatric Dose:

• Use only under supervision of a physician.
• Typical: ½ to 1 tablet daily for children above 6 years, depending on formulation.

Elderly:

• Same adult dose unless renal or hepatic function requires adjustment.

Renal/Hepatic Impairment:

• Caution advised due to altered metabolism/excretion of certain minerals (e.g., selenium, zinc).
• Dose adjustments may be necessary.

Route of Administration:

• Oral, with water, not to be chewed unless chewable form is prescribed.

Duration:

• Typically used long-term for chronic support or as a 30–90 day course during illness or recovery.

Super antioxidants work by neutralizing harmful free radicals in the body through the synergistic effects of vitamins (such as C, E, and A) and trace minerals (such as selenium, zinc, and manganese). These compounds stabilize or deactivate reactive oxygen species (ROS) and prevent lipid peroxidation, DNA damage, and protein degradation. This process reduces cellular damage, supports mitochondrial function, modulates inflammation, and enhances tissue repair. Additionally, some antioxidants upregulate endogenous defense systems, such as glutathione peroxidase and superoxide dismutase.

Absorption:

• Most vitamins and minerals are absorbed in the small intestine.
• Fat-soluble vitamins (A, D, E, K) require bile acids for absorption and should be taken with meals.
• Water-soluble vitamins (C and B-complex) are absorbed via active transport or passive diffusion.

Distribution:

• Widely distributed in tissues; fat-soluble vitamins are stored in liver and adipose tissue.
• Trace minerals bind to plasma proteins or enzymes.

Metabolism:

• Vitamins undergo hepatic metabolism (e.g., vitamin A is converted to active retinoids).
• Minerals generally do not undergo significant metabolism.

Excretion:

• Water-soluble vitamins and excess minerals are excreted via urine.
• Fat-soluble vitamins are eliminated slowly and can accumulate with overdose.

Half-life:

• Varies by component (e.g., Vitamin C ~10-20 days; Vitamin E ~13 hours to several days).

Pregnancy:

• Generally considered safe when taken within recommended daily allowances (RDAs).
• High doses of Vitamin A (>10,000 IU) are teratogenic and must be avoided.
• Use prenatal antioxidant supplements specifically formulated for pregnancy.

Lactation:

• Most components are excreted into breast milk in low levels.
• Generally safe; however, high-dose supplements should be avoided unless directed by a physician.

Caution:

• Always consult a physician before use in pregnancy/lactation due to varying component concentrations.

• Class: Multivitamin & Multimineral Antioxidant Supplement
• Subclass: Cellular Antioxidants & Free Radical Scavengers

• Known hypersensitivity to any ingredient in the formulation
• Hypervitaminosis A or D
• Wilson’s disease (copper-containing products)
• Hemochromatosis or iron overload
• Severe renal impairment (risk of mineral accumulation)
• Patients on high-dose anticoagulants (Vitamin K-containing formulations)

• High-Dose Toxicity: Fat-soluble vitamins can accumulate; avoid prolonged high doses.
• Renal Disease: Monitor mineral levels, especially magnesium, potassium, and selenium.
• Drug Interference: Vitamin C and E may alter blood sugar readings.
• Iron-containing formulations: Keep out of reach of children; accidental overdose is fatal.
• Monitoring: Recommended in long-term users — serum vitamin levels, liver and kidney function.
• Allergic Reactions: Rare, but possible with natural extracts (e.g., citrus bioflavonoids).

Common (Mild):

• Gastrointestinal: Nausea, bloating, constipation, or diarrhea
• CNS: Headache, dizziness
• Urinary: Yellow discoloration of urine (Vitamin B2 – harmless)

Less Common:

• Metallic taste
• Skin rashes (hypersensitivity reactions)

Serious (Rare):

• Hypervitaminosis A or D (nausea, vision changes, bone pain, liver toxicity)
• Iron toxicity (in iron-containing products): Vomiting, abdominal pain, metabolic acidosis

Major Interactions:

• Anticoagulants (e.g., warfarin): Vitamin K may reduce anticoagulant effect.
• Tetracyclines & Quinolones: Chelation with iron, calcium, or magnesium may reduce absorption.
• Levothyroxine: Iron and calcium may reduce thyroxine absorption – separate by at least 4 hours.
• Diuretics (thiazides): May increase calcium levels if used with calcium-containing supplements.
• Alcohol: Reduces absorption and increases excretion of multiple vitamins (esp. B-complex).

Enzyme Involvement:

• Some vitamins (e.g., C, E) modulate CYP450 enzymes but usually not clinically significant.

• WHO and CDC emphasize the importance of antioxidant supplementation in populations at nutritional risk, especially post-COVID recovery and in elderly patients.
• Recent studies support the use of antioxidant combinations for improving fertility and reducing diabetic complications.
• Updated formulations now include added coenzyme Q10, lutein, and alpha-lipoic acid in many brands for enhanced mitochondrial protection.

• Store below 25°C (77°F) in a dry place
• Protect from light and moisture
• Keep in original container with lid tightly closed
• Do not refrigerate unless specified by manufacturer
• Chewable/liquid forms: Shake well before use
• Keep out of reach of children