Do You Really Need to Take a Multivitamin?

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Should you take a multivitaminDo I really need a multivitamin?

This a common question that I get asked quite often. It is also a very common topic in the area of clinical nutrition that receives a great deal of attention and scrutiny. At this point, there seems to be two distinct camps. One camp believes that you can consume all of the necessary nutrients from a “balanced diet” while the other camp believes additional supplementation is essential.

From a clinical context, depending upon the unique set of circumstances, I tend to favor supplementing the diet with specific nutrients only, but there can be a place for multivitamin/mineral (MVM) combinations.

However, when selecting a multivitamin, choose one that meets USDA production standards. The formula should also be iron free and contain no more than 1,000-3,000 IU of vitamin A.

Recommending a supplement that contains iron for an individual who is not iron deficient can be very dangerous, resulting in damage to arteries, heart, and brain.
In addition, large doses of vitamin A can be toxic as this vitamin is fat-soluble and stored in body tissues even if large doses are ingested.

Here are a few cases in which multivitamin/mineral supplementation may be necessary:

Pregnancy

It’s not a bad idea to take a supplement that contains a full spectrum of nutrients with at least one milligram (mg) of folic acid and 500 mg of omega-3 fats before, during, and after your pregnancy.
Your increased nutritional needs during this time may not be adequately met through your diet alone. Remember, iron-free formulas only.

Children and Early Adulthood

Depending upon the unique circumstances, it may be wise to supplement with a small dosage of a MVM combination.

This is a time when a phenomenal amount of growth and development occurs, and if the diet is not that sound (and frequently it is not), it may be a good idea to do this to improve health and help avoid the higher rates of infections associated with this age group.

Seniors

This group of people has unique needs based upon their age and disease prevalence. Older folks generally have a problem absorbing nutrients from their diet, and the extra calcium and vitamin D can help preserve bone mass and decrease the incidence of some cancers.

The extra B vitamins can also help lower the levels of a dangerous chemical in the blood known as homocysteine, which has been linked to the development of heart disease, stroke, and peripheral vascular disease in older people.

Sometimes older people can become quite malnourished, so in this specialized group, I recommend liquid meal replacements that contain a full spectrum of nutrients.

Dieters

Restrictive diets like vegan, gluten-free, and certain weight loss diets can make it difficult to reach nutritional requirements. With proper planning, you could fulfill these needs through healthy whole foods; however, multivitamin supplements may provide some insurance.

Here are the types of diets that can lead to deficiencies, as well as the nutrients they often lack.

Diet Main Nutrients of Concern Likely Cause of Deficit Solution
Gluten-free Calcium
Iron
Magnesium
Zinc
Folate
Thiamin
Vitamin
B12
Vitamin D
Absence of countless wheat products that are often fortified with vitamins and minerals.

Potential over-reliance on rice-based products.

Careful planning to find nutrient-dense, gluten-free foods (meat, leafy green vegetables, nuts).

Selecting rice products that are fortified with nutrients.

Vegan Calcium
Iron
Zinc
Vitamin
B12
Absence of meat and dairy—which are rich nutrition sources. Careful planning to eat nutrient-dense vegan foods like pumpkin seeds and spinach. Vitamin B12 supplementation is highly recommended for this group.
Low-carb/No-carb
(Atkins, Keto, etc.)
Calcium
Copper
Magnesium
Potassium
Pantothenic acid
Vitamin E
The elimination of an entire macronutrient group that contains a number of nutritious foods.

Absence of wheat/carbohydrate products that are often fortified with vitamins and minerals.

Plan to eat low-carb, nutrient-dense items like leafy greens/broccoli/green beans and other vegetables.

Nuts and certain legumes can also fit.

Paleo Calcium
Iodine
Riboflavin
Thiamine
Avoidance of countless nutritious foods (grains, legumes, dairy, etc.). Plan to eat plenty of leafy greens, other vegetables, and nuts.

Other Vital Groups

For some people, multivitamin supplementation is vital. For example, drug addicts, alcoholics, smokers, or people on multiple prescription drugs (as these compounds can interfere with certain nutrients and how they are absorbed and utilized) may need to supplement with multivitamins.

These folks also have increased needs for certain nutrients because of these health issues. The diet profile in these people is also frequently suspect.

People who suffer from gastrointestinal disease, chronic disease like type 2 diabetes, chronic stress, or suffer from chronic infections will also have an increased need for nutrients that may not be acquired with diet alone.

Do Multivitamins Offer Any Benefits to the General Population?

It’s possible that multivitamins—or specific nutritional supplements—can benefit certain populations. But those groups alone don’t support the multi-billion dollar industry (more than a third of Americans take one). Instead, it is largely propped up by people believing that taking a daily vitamin will improve their health and longevity.

There doesn’t seem to be much—or any—substantial evidence to show that taking multivitamins extends the lifespan or improves the health of the general population. That said, they don’t seem to hurt, either. As long as you’re not taking amounts that far exceed the daily recommended intake (without a doctor’s recommendation), you should be okay.

But while multivitamins may not enhance longevity, studies suggest they can improve mood and other issues associated with the brain. After all, brain function is highly dependent on adequate nutrition. Some research has shown that multivitamins with substantially high levels of B vitamins can help with mood, but further study is required. So far, most research looking at the effects multivitamins on mood has turned up mixed results.

One area in which multivitamins appear to have noticeable benefits to the general population is vision. A large study on vision—the Age-Related Eye Disease Study (AREDS)—found that people taking vitamin C, vitamin E, zinc, and copper, which are all found in multivitamins, lowered the risk and progression of age-related macular degeneration (AMD) and cataracts.

It should be noted that the dosages were higher than those found in a typical multivitamin, so these results might not translate. More research needs to be completed on dosages and efficacy of multivitamins for vision.

The Downsides of a Multivitamin

If you’re following the instructions and not exceeding the recommended daily allowance (RDA) for supplemental multivitamins, they are unlikely to cause physical harm. But if you’re taking too much, you can experience adverse effects. The two main downsides of multivitamins, however, are their cost and their potential to encourage poor dietary habits.

If you take a multivitamin every day, the cost can really add up. This is especially true if you’re taking a gummy multivitamin, which supplies a very low dose (and is also high in sugar, which could actually harm your health).

Furthermore, taking a multivitamin could encourage poor dietary habits. Whole foods are the best and safest sources of adequate nutrition, and relying on a vitamin may encourage poor choices. When you look to food, you’re more likely to eat a healthier, more balanced and diverse diet.

Things to Consider When Buying a Multivitamin

In my opinion, the use of an iron-free, low-dosage multivitamin/mineral combination is safe and can be useful for some groups of people who may require additional nourishment.
For those of you who are younger, very physically active, and always on the go but may not always have the best diet out there, this idea may also be appealing to you.

Some things to consider when buying MVM supplements include:

  • RDA: Choose a multivitamin that contains close to the RDA for each nutrient.
  • “Bonus” ingredients: Multivitamins loaded with special “bonus” ingredients often feature doses too little for any effect. Try to choose those containing only vitamins and minerals.
  • Serving size: Pay attention to serving sizes. A “serving size” may feature eight pills, meaning you’ll be spending a lot of money to get an effective dose.
  • Reputability: Always research the company’s reputation before purchasing a multivitamin. The most expensive brand isn’t necessarily the best. Look for products certified by a third-party organization such as USP (United States Pharmacopeia) or NSF International.

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Article Sources (+)

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