The time has finally come! I’m extremely excited to dive into the 2nd of this 6 part series on supplements. And what better topic to start us off than one of the most popular nutritional supplements available on the market: MULTIVITAMINS. With about ⅓ of all Americans popping a multivitamin pill daily, it’s about time to clear some of the confusion away about this controversial topic. In this post, I will address the following: who should take a multivitamin, what form is best, special considerations, current research and safety considerations.
You didn’t know multivitamins were causing such a buzz lately, did you? Or maybe you have seen the flurry of news stories like this one from Health Line that reads, “Stop Taking Multivitamins to Help Your Heart. Researchers Say They Don’t Work.” Indeed, a recent study (http://circoutcomes.ahajournals.org/content/11/7/e004224) showed that people taking multivitamins were no less likely to die of heart conditions than those not taking multivitamins. The study also looked at cancer outcomes, which again showed no difference in those taking multivitamins. But there have been so many other studies evaluating the effects of multivitamins over the years (some good, some bad), so why is this one causing such big waves? Well not all studies are created equal. This particular one gathered many other studies together, and compiled the data for a much more powerful statistic. As you can imagine, this creates a very convincing set of data.
So, what does this mean exactly? Should you stop taking your multivitamin immediately? Well, not necessarily. But the recent study does show us that we cannot expect one pill to prevent major disease like heart disease and cancer. A multivitamin alone will not likely have such an effect, it is just one piece of a much bigger puzzle.
What is a Multivitamin anyway?
You may still be wondering: what exactly IS a multivitamin? The definition of a multivitamin is a dietary supplement that contains multiple vitamins, minerals and sometimes other nutritional components such as herbs. Most often, essential vitamins such as the ones listed below are in the formula, along with important minerals:
B6 (Pyridoxal phosphate)
The above vitamins are classified as essential vitamins because our bodies do not make these naturally, nut rather it is essential that we obtain these vitamins from other sources (like food, sunshine, and supplementation).
Can I Just Get These Nutrients Through Food?
Absolutely! Vegetables, fruits, grains, and certain animal products like meat, eggs and cheese contain much, if not all, of your daily needs for these vitamins. You can absolutely get these nutrients (and many more) through your diet, you just have to be sure to have enough of them. Much of what I do as a Naturopathic Doctor is encourage people to eat a healthy, balanced, and nutrient loaded diet in order to have the building blocks you need to sustain a healthy body. And if you indeed get the recommended amount of fruits and vegetables daily (3 or more cups of vegetables, and 2 or more cups of fruit) then you may consider yourself at a lower need for a multivitamin.
The fact is though, that most Americans do not get enough of these foods on a daily basis to meet the recommended intake of essential vitamins and minerals. The typical American diet is referred to in the medical community as “SAD” (Standard American Diet). Appropriately labeled due to its generally low nutrient content. When I recommend that someone take a multivitamin, I present it as a stepping stone on the journey to optimal health. As individuals work to incorporate more nutrient dense foods into their diet, a multivitamin may be a good way to supplement in the meantime. But it’s certainly no replacement to a healthy diet.
To Supplement or Not to Supplement
There are many people in the world who do not have access to nutritious food, or even enough food in general. In reality, it is these people that would benefit most from access to a daily multivitamin. Ironically though, it is the people that have ready access to these resources that are much more likely to take supplements of any kind.
In addition, there are those that need to supplement with a certain vitamin because of a deficiency (think iron deficiency in menstruating women, or B12 deficiency in the elderly). These are very specific situations that require evaluation by a medical professional and targeted supplementation.
And then there’s those that have access to food, without any known specific nutritional deficiencies, but that just want to make sure they’re doing all they can to maintain a healthy mind and body for as long as possible. If you fall into this category and are wondering whether or not you should be taking a multivitamin, I will tell you this, it depends. The data shows that a multivitamin is very unlikely to cause you any harm. But do you really need to be spending $20-$30 a month on one? Could you use that extra money to supplement your diet with healthier foods? Do you have a medical condition that may increase your need for certain vitamins and minerals? These are all questions that you must ask yourself and your doctor. As a Naturopathic doctor, I am uniquely positioned to be able to help you decipher this path and make the best decision for you.
Picking the Best Multivitamin for You?
As the consumer, you should be able to trust the brands you buy. However when it comes to supplements, you will want to be extra scrutinous because of the relative lack of regulation. Part of my training as a Naturopathic Doctor was to evaluate supplements and supplement companies for quality and integrity. Because of this, there are certain brands that I trust and prefer over others. While I will not be providing specific brand names in this context, I will provide you with the bullet points I look for in a good multivitamin supplement.
As I said before, almost every multivitamin bottle you pick up may have a different formula, there is no standard formula that all multivitamins must adhere to. This can make things quite confusing for the consumer. Here are a few key things you can look for when picking a multivitamin:
It contains what it says it contains. Third party testing is when a company hires a completely separate company to evaluate their products on a regular basis. This eliminates any bias and proves that the product is the real deal. You should be able to find this information on their website or email a representative and ask. Many companies use in house testing, but this is an unacceptable practice in my opinion.
Does not exceed tolerable upper intake level (UL). For the general public, multivitamins should not exceed a certain amount of each nutrient. Here is a link to the listed upper intake levels of all the vitamins so that you can compare your favorite multivitamin. https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytables.t7/?report=objectonly
Contains the best forms of each nutrient. Genetic testing is very popular right now, and with all the new information coming out, we now know that many people have a certain gene that causes the underfunctioning of a particular enzyme in our bodies called MTHFR (no, I didn’t just curse at you, that’s really it’s name). I won’t go into detail, but there is a certain form of folic acid that is more bioavailable for individuals with this genetic variant. In my opinion, ALL multivitamins should have this more available form of folic acid. The form I’m talking about is called “methylfolate”, or “MTHF”. Your multivitamin should contain this, not folic acid.
No added sugar. The biggest place I see this being a problem is in the gummies. But gummies are also known to have varying amounts of nutrients because of the way thye're processed. And they hardly ever contain high enough amounts to be beneficial. So I would steer clear of this form in general. Stick with capsules or powder.
Appropriate dosing for YOU. If you are a woman, your multivitamin may look different from a man’s because of the extra iron content. If you are a pregnant female, your multivitamin may look different because of the extra folic acid content needed for the healthy development of your growing baby. Do not make the mistake of thinking all multivitamins are the same. Be sure you are taking the right one for you.
Well there you have it. With more research coming out all the time, this is definitely not a black and white issue. The choice to take a multivitamin is an individual one based on your lifestyle and health status. And as I’ve said before, just because something is “natural” doesn’t mean there aren’t considerations that should be made about safety. Multivitamins, just like any supplement you take should be discussed with your doctor first.
I hope this was helpful. Please comment with any questions or you can email me directly at firstname.lastname@example.org. I encourage you to make an appointment with me if you want to discuss your individual need for certain dietary supplements, whether that be a multivitamin or anything else. We can work together to evaluate your unique situation.
Be on the lookout in the next few weeks for the third installment of this 6 part series where we will tackle fish oil supplementation next. Pun intended 🙂
Emily Hudson, ND