Should you take a daily multivitamin. Who may benefit from multivitamin supplementation. What are the potential risks and benefits of taking multivitamins. How do multivitamins impact overall health and wellness. Are there specific groups that require multivitamin supplementation.

Understanding Multivitamins: Purpose and Prevalence

Multivitamins are dietary supplements containing a combination of vitamins and minerals, typically providing around 100% of the Recommended Daily Allowance (RDA) for various micronutrients. These supplements have gained significant popularity, with nearly half of American adults and 70% of those over 71 years old incorporating them into their daily routines.

The primary purpose of multivitamins is to prevent nutrient deficiencies and support overall health. However, the necessity of these supplements for individuals with balanced diets remains a subject of debate among health professionals.

Historical Context of Vitamin Deficiencies

In the past, severe vitamin deficiencies led to various diseases:

• Scurvy (Vitamin C deficiency)
• Beriberi (Vitamin B1 deficiency)
• Pellagra (Vitamin B3 deficiency)
• Rickets (Vitamin D deficiency)

While these conditions are now rare in developed countries due to improved access to diverse foods and fortification practices, individual vitamin supplementation may still be crucial in specific cases, such as long-term malnutrition or malabsorption issues.

Identifying Nutrient Deficiency Risks: Who Needs Multivitamins?

For individuals maintaining a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, the benefits of a multivitamin may be minimal. However, certain groups face higher risks of nutrient deficiencies and may benefit from supplementation:

Older Adults

Elderly individuals are particularly susceptible to nutrient deficiencies due to various factors:

• Difficulty chewing and swallowing food
• Altered taste perception caused by medications
• Isolation and loneliness affecting appetite
• Reduced ability to absorb vitamin B12 from food sources

The National Academy of Medicine recommends that adults over 50 consume vitamin B12-fortified foods or supplements to ensure adequate intake.

Pregnant Women

Folate, a B vitamin, is crucial for pregnant women, particularly in the early stages of conception. Adequate folate intake can reduce the risk of neural tube defects such as spina bifida and anencephaly in newborns. The Centers for Disease Control and Prevention recommend that all women of childbearing age (15-45 years) consume 600 micrograms of folic acid daily.

Prenatal multivitamins typically contain essential nutrients for pregnancy, including:

• Folic acid
• Iron
• Calcium
• Vitamin D
• DHA (an omega-3 fatty acid)

Individuals with Malabsorption Conditions

Various health conditions can interfere with nutrient absorption, increasing the risk of deficiencies:

• Celiac disease
• Ulcerative colitis
• Cystic fibrosis
• Surgeries affecting digestive organs (e.g., gastric bypass, Whipple procedure)
• Illnesses causing excessive vomiting or diarrhea
• Alcoholism

Medication Users

Certain medications can impact nutrient absorption or deplete the body’s nutrient stores:

• Diuretics: May deplete magnesium, potassium, and calcium
• Proton pump inhibitors: Can affect vitamin B12, calcium, and magnesium absorption
• Parkinson’s disease medications: May reduce absorption of B vitamins

The Vitamin D Dilemma: Supplementation Considerations

Vitamin D presents a unique challenge in nutrition, as it is difficult to obtain adequate amounts solely through diet. While some foods are fortified with vitamin D, few contain it naturally. For most individuals, vitamin D supplementation is recommended to ensure sufficient intake.

Forms of Vitamin D Supplements

Vitamin D supplements are available in two forms:

1. Vitamin D2 (ergocalciferol or pre-vitamin D): Produced in plants and fungi
2. Vitamin D3 (cholecalciferol): Produced in animals, including humans

Both forms are naturally occurring and produced in the presence of ultraviolet-B (UVB) rays from sunlight. However, many people have insufficient vitamin D levels due to limited sun exposure, particularly in regions with less sunlight.

Multivitamins and Overall Health: Weighing the Evidence

Do multivitamins provide significant health benefits for those with adequate diets. Research on the effects of multivitamin supplementation has produced mixed results.

Potential Benefits

Some studies suggest that multivitamin use may:

• Reduce the risk of certain cancers
• Improve cognitive function in older adults
• Support heart health
• Enhance immune function

Limitations and Concerns

However, other research indicates that multivitamin supplementation may have limited benefits or even potential risks:

• No significant impact on cardiovascular disease prevention
• Possible increased risk of certain cancers with high-dose supplementation
• Potential interactions with medications
• Risk of excessive intake of certain nutrients

Optimizing Nutrient Intake: Diet vs. Supplements

Is it better to obtain nutrients from whole foods or supplements. While multivitamins can help fill nutritional gaps, experts generally agree that obtaining nutrients from whole foods is preferable for several reasons:

• Whole foods contain a complex mix of nutrients that work synergistically
• Foods provide fiber and other beneficial compounds not found in supplements
• Nutrients from whole foods are often more easily absorbed and utilized by the body
• Eating a varied diet promotes overall health and may reduce the risk of chronic diseases

Strategies for Improving Nutrient Intake Through Diet

To optimize nutrient intake through diet, consider the following approaches:

1. Incorporate a variety of colorful fruits and vegetables
2. Choose whole grains over refined grains
3. Include lean proteins, such as fish, poultry, and legumes
4. Consume healthy fats from sources like nuts, seeds, and avocados
5. Limit processed foods and added sugars
6. Stay hydrated with water and unsweetened beverages

Personalized Approach to Multivitamin Use

Given the varying needs and potential risks associated with multivitamin supplementation, a personalized approach is often recommended. Factors to consider when deciding whether to take a multivitamin include:

• Age and gender
• Dietary habits and restrictions
• Health conditions and medications
• Lifestyle factors (e.g., physical activity, stress levels)
• Pregnancy status or plans
• Geographic location (affecting sun exposure for vitamin D synthesis)

Consulting Healthcare Professionals

Before starting any supplementation regimen, it is advisable to consult with a healthcare professional, such as a doctor or registered dietitian. They can assess individual needs, recommend appropriate supplements if necessary, and help monitor for potential interactions or side effects.

The Future of Multivitamins: Trends and Innovations

As research in nutrition and supplementation continues to evolve, the landscape of multivitamins is likely to change. Some emerging trends and innovations in the field include:

• Personalized vitamin formulations based on genetic testing
• Advanced delivery systems for improved nutrient absorption
• Sustainable and plant-based supplement options
• Integration of probiotics and other beneficial compounds in multivitamin formulas
• Increased focus on bioavailability and synergistic nutrient combinations

Ongoing Research and Development

Researchers continue to investigate the long-term effects of multivitamin use, optimal dosages for various populations, and potential interactions between nutrients and medications. Future studies may provide more definitive answers about the role of multivitamins in preventive health care and disease management.

As our understanding of nutrition and individual metabolic needs deepens, the approach to multivitamin supplementation may become increasingly tailored and precise. This personalized nutrition approach could lead to more effective and targeted use of supplements, potentially maximizing benefits while minimizing risks.

Making Informed Decisions About Multivitamin Use

When considering whether to incorporate a multivitamin into your daily routine, it’s essential to weigh the potential benefits against possible risks and consider your individual circumstances. Here are some key points to keep in mind:

Assessing Your Nutritional Status

How can you determine if you need a multivitamin. Consider the following steps:

1. Evaluate your diet: Keep a food diary to assess your nutrient intake
2. Consult a healthcare professional: Discuss your diet and health concerns
3. Consider blood tests: Nutritional deficiencies can be identified through laboratory testing
4. Review your medical history: Certain conditions may increase your need for specific nutrients

Choosing the Right Multivitamin

If you decide to take a multivitamin, how do you select an appropriate product. Consider these factors:

• Look for third-party certifications (e.g., USP, NSF) for quality assurance
• Choose age- and gender-specific formulations when applicable
• Avoid megadoses of nutrients unless recommended by a healthcare provider
• Consider your dietary restrictions (e.g., vegetarian, vegan) when selecting supplements
• Check for potential interactions with medications you’re taking

By carefully considering your individual needs and consulting with healthcare professionals, you can make an informed decision about whether multivitamin supplementation is right for you. Remember that while supplements can be beneficial in certain situations, they are not a substitute for a balanced, nutrient-rich diet and healthy lifestyle habits.

Should I Take a Daily Multivitamin? | The Nutrition Source

Nearly half of adults in the U.S. and 70% of older adults ages 71+ take a vitamin; about one-third of them use a comprehensive multivitamin pill. [1] But is this truly a necessity?

There are certainly diseases caused by a lack of specific nutrients in the diet. Classic examples include scurvy (from a lack of vitamin C), beri-beri (vitamin B1), pellagra (vitamin B3), and rickets (vitamin D). But these conditions are rare in the U.S. and other developed countries where there is generally more access to a wide range of foods, some of which are fortified with vitamins. Individual vitamin supplementation may also be essential in certain cases, such as a deficiency caused by long-term poor nutrition or malabsorption caused by the body’s digestive system not functioning properly.

This page specifically discusses the use of multivitamins, which typically contain about 26 different vitamins and minerals, and often provide 100% of the Recommended Daily Allowance of these micronutrients. We will explore situations that a multivitamin may be health-promoting, as well as if there is a benefit or harm in taking extra nutrients from a pill if the diet is already adequate.

Who May be at Risk for a Nutrient Deficiency?

For those who eat a healthful diet, a multivitamin may have little or no benefit. A diet that includes plenty of fruits, vegetables, whole grains, good protein sources, and healthful fats should provide most of the nutrients needed for good health. But not everyone manages to eat a healthful diet. When it comes to specific vitamins and minerals, some Americans get less than adequate amounts, according to criteria set by the National Academy of Medicine. For example, more than 90% of Americans get less than the Estimated Average Requirement for vitamin D and vitamin E from food sources alone. [2]

Certain groups are at higher risk for a nutrient deficiency:

• Older age. The elderly are at risk for poor food intake for various reasons: difficulty chewing and swallowing food, experiencing unpleasant taste changes caused by multiple medications, or isolation and loneliness that can depress appetite. They also have trouble absorbing vitamin B12 from food. The National Academy of Medicine, in fact, recommends that people over the age of 50 eat foods fortified with vitamin B12 or take vitamin B12 pills that are better absorbed than from food sources. [3]
• Pregnancy. Getting enough folate, a B vitamin, is especially important for women who may become pregnant, since adequate folate can help lower the risk of having a baby with spina bifida or anencephaly. For the folate to be effective, it must be taken in the first few weeks of conception, often before a woman knows she is pregnant. Yet in the U.S., half of all pregnancies are unplanned. That’s why the Centers for Disease Control and Prevention recommend that all women of childbearing age (ages 15 to 45) consume 600 micrograms a day of folic acid. [3] This amount and other important nutrients for pregnancy—iron, calcium, vitamin D, and DHA—are available in a prenatal multivitamin.
• Malabsorption conditions. Any condition that interferes with normal digestion can increase the risk of poor absorption of one or several nutrients. Examples:
  • Diseases like celiac, ulcerative colitis, or cystic fibrosis.
  • Surgeries that remove parts of digestive organs such as having a gastric bypass for weight loss or a Whipple procedure that involves many digestive organs.
  • Illnesses that cause excess vomiting or diarrhea can prevent nutrients from being absorbed.
  • Alcoholism can prevent nutrients, including several B vitamins and vitamin C, from being absorbed.
• Certain medications. Some diuretics commonly prescribed to lower blood pressure can deplete the body’s stores of magnesium, potassium, and calcium. Proton pump inhibitors prescribed for acid reflux and heartburn can prevent the absorption of vitamin B12 and possibly calcium and magnesium. Levodopa and carbidopa prescribed for Parkinson’s disease can reduce the absorption of B vitamins including folate, B6, and B12.

A note on vitamin D

For most people, the best way to get enough vitamin D is taking a supplement because it is hard to get enough through food. Although some foods are fortified with vitamin D, few foods contain it naturally. Vitamin D supplements are available in two forms: vitamin D2 (“ergocalciferol” or pre-vitamin D) and vitamin D3 (“cholecalciferol”). Both are also naturally occurring forms that are produced in the presence of the sun’s ultraviolet-B (UVB) rays, but D2 is produced in plants and fungi and D3 in animals, including humans. Vitamin D production in the skin is the primary natural source of vitamin D, but many people have insufficient levels because they live in places where sunlight is limited in winter, or because they have limited sun exposure. Also, people with darker skin tend to have lower blood levels of vitamin D because the pigment (melanin) acts like a shade, reducing production of vitamin D.

Learn more about this vitamin and supplementation

Which Multivitamin Should I Choose?  

Multivitamins come in various forms (tablets, capsules, liquids, powders) and are packaged as a specific combination of nutrients (B-complex, calcium with vitamin D) or as a comprehensive multivitamin.  

Supplements are a multibillion-dollar industry, with endless designer labels of brands from which to choose. However, an expensive brand name is not necessary as even standard generic brands will deliver results. Look for one that contains the Recommended Daily Allowance amounts and that bears the United States Pharmacopeia (USP) seal of approval on the label. This seal ensures that the ingredients and amounts of that ingredient listed on the label are contained in the pill. The USP also runs several tests that confirm the pill to be free of contaminants like heavy metals and pesticides and has been manufactured under sanitary and regulated conditions. 

That said, you may wish to consider the following factors before starting a multivitamin or any supplemental vitamin. 

Reasons to use a multivitamin:

• I am eating a limited diet or my appetite is poor so that I am eating less than usual.
• I am following a restricted diet for longer than one week. This could be prescribed such as a liquid diet after a surgical procedure, or a self-imposed diet such as on with the goal of weight loss.
• I have a condition that reduces my body’s ability to absorb nutrients (celiac disease, ulcerative colitis) or have undergone surgery that interferes with the normal absorption of nutrients (gastric bypass surgery, Whipple procedure).
• I temporarily have increased nutrient needs, such as being pregnant.
• I’m very busy and just can’t eat a balanced diet every day.

Reasons that may not need a multivitamin:

• I eat well but am feeling tired all the time (discuss first with your doctor so they can investigate other possible causes).
• I eat a pretty good diet but want to improve my health as much as possible, so it couldn’t hurt to get some extra nutrition from a vitamin.
• I have osteoporosis and need more calcium, or I have iron-deficiency anemia and need more iron (in both scenarios, you may only need to take those individual nutrients rather than a comprehensive multivitamin).

If you are unsure about taking a multivitamin, you may wish to consult with a registered dietitian who can evaluate your current diet to determine any missing nutrients. At that time, suggestions to improve your food intake of those nutrients will be provided, or one or more supplemental vitamins may be prescribed if that is not possible. Always inform your doctor of all supplements you are taking in case of potential interactions with medications.   

Mega-doses (many times the Recommended Daily Allowance) of vitamins are not recommended. This can potentially interfere with the absorption of other nutrients or medications, or can even become toxic if too much is taken for a long period.  

Finally, be wary of supplemental vitamin labels that bait you with promises of “supporting brain health or energy production or healthy skin and hair.” These are general statements about a vitamin that are included for marketing purposes only, but are not specific to the supplement itself.  Also be wary of vitamins that contain extras, like herbs and botanicals, which are typically lacking in research about long-term effects and potential adverse effects. 

Multivitamins and Health 

Knowledge about the optimal intakes of vitamins and minerals to prevent chronic diseases is not set in stone. More long-term studies looking at this relationship are needed.   

There is no arguing that multivitamins are important when nutritional requirements are not met through diet alone. [4] The debate is whether vitamins are needed when the diet is adequate to prevent deficiency in nutrients, as some research has shown no benefit or even harmful effects when taking supplemental vitamins and minerals.  

• After a review of 26 clinical and cohort studies, the U.S. Preventive Services Task Force concluded there was insufficient evidence to support any benefits of multivitamins or individual vitamins for the primary prevention of cardiovascular disease or cancer among healthy, nutrient-sufficient adults. [5]  

For many diseases, but especially for cancer, only long-term trials are informative. The following studies looked at the effect of multivitamins on specific diseases and included healthy people as well as those with chronic diseases at the start of the study: 

Cancer

A randomized double-blind placebo-controlled trial provided a multivitamin or placebo to more than 14,000 male physicians, some with a history of cancer. After 11 years, the men taking a MVI had a significant 8% reduction in total cancers, compared with men taking a placebo. The results did not differ among men who had a history of cancer at the start of the study and men who were healthy at baseline. [6]

Cardiovascular disease

The Physicians’ Health Study II, a randomized double-blind placebo-controlled trial, provided a multivitamin or placebo to more than 14,000 male physicians, some with a history of cardiovascular disease. After 11 years, compared with the placebo, there was no significant effect of a daily MVI on cardiovascular events. [7]

Mortality

Some research has suggested that the rates of death appear higher in people using multivitamins. However, one major flaw in these studies was that many of the participants had already developed some type of serious illness. They may have started using vitamins after their health deteriorated, hoping for a benefit. But in those cases, taking a multivitamin might have been too late.

• The Iowa Women’s Health Study looked at the use of 15 vitamins and minerals, including multivitamins, at three different intervals and identified the numbers of women who died over a 19-year period. It showed that women over the age of 55 who took multivitamins were at higher risk for dying than those who did not. [8] A similar risk was found for other vitamins and minerals, including folate, vitamin B6, iron, magnesium, and zinc.
  • The Iowa study, however, didn’t exclude women who were sick or take into account how long they were using the vitamins. As a result, it is unknown whether the women were already taking vitamins when they became ill, or if they became ill and then started taking vitamins. In women who were already sick, taking vitamins was unlikely to lower their risk of dying.

The Bottom Line

It is important to remember that a multivitamin cannot in any way replace a healthful well-balanced diet. The main purpose of a multivitamin is to fill in nutritional gaps, and provides only a hint of the vast array of healthful nutrients and chemicals naturally found in food. It cannot offer fiber or the flavor and enjoyment of foods so key to an optimal diet. However, multivitamins can play an important role when nutritional requirements are not met through diet alone. When this is the case, an expensive brand name is not necessary, as even standard store brands will deliver results. Look for one that contains the Recommended Daily Allowance amounts and that bears the United States Pharmacopeia (USP) seal of approval on the label.

Related

• Vitamins and Minerals
• Workout Supplements

References

1. Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS, Thomas PR, Betz JM, Sempos CT, Picciano MF. Dietary supplement use in the United States, 2003–2006. The Journal of nutrition. 2011 Feb 1;141(2):261-6.
2. Fulgoni III VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: where do Americans get their nutrients?. The Journal of nutrition. 2011 Oct 1;141(10):1847-54.
3. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.
4. Rautiainen S, Manson JE, Lichtenstein AH, Sesso HD. Dietary supplements and disease prevention—a global overview. Nature Reviews Endocrinology. 2016 Jul;12(7):407-20.
5. Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the US Preventive Services Task Force. Annals of internal medicine. 2013 Dec 17;159(12):824-34.
6. Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012 Nov 14;308(18):1871-80.
7. Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE, Gaziano JM. Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012 Nov 7;308(17):1751-60.
8. Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR. Dietary supplements and mortality rate in older women: the Iowa Women’s Health Study. Archives of internal medicine. 2011 Oct 10;171(18):1625-33.

Last reviewed July 2021

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Multivitamins contain many nutrients that you may not need. If you have a nutrient deficiency, doctors recommend taking a supplement for that specific nutrient.

Multivitamins and multiminerals are the most commonly used supplements in the world.

Their popularity has increased rapidly in the past few decades (1, 2).

Some people believe that multivitamins can improve health, compensate for poor eating habits, and even reduce your risk of developing chronic diseases.

This article examines the scientific evidence behind multivitamins.

Multivitamins are supplements that contain many different vitamins and minerals, sometimes alongside other ingredients (3).

Given that there’s no standard for what constitutes a multivitamin, their nutrient composition varies by brand and product (3).

Multivitamins are also referred to as multis, multiples, or simply vitamins.

They’re available in many forms, including tablets, capsules, chewable gummies, powders, and liquids.

Most multivitamins should be taken once or twice per day. Make sure to read the label and follow the recommended dosage instructions.

Multivitamins are available in pharmacies, large discount stores, and supermarkets, as well as online.

SUMMARY

Multivitamins are supplements that contain different vitamins and minerals. They’re available in various forms.

Thirteen vitamins and about 15 minerals are essential to your health (4).

Many produce enzymes and hormones, boost your immunity, and keep your nerves and organs functioning properly (4).

Your body also needs these nutrients for reproduction, maintenance, growth, and the regulation of bodily processes.

Multivitamins may offer many of these vitamins and minerals — but in varying amounts. They may also contain other ingredients like herbs, amino acids, and fatty acids.

Because the Food and Drug Administration (FDA) doesn’t regulate dietary supplements as strictly as it regulates prescription drugs, some may contain higher or lower levels of some nutrients than stated on the label.

Additionally, some supplements may contain ingredients that can interact with medications, so speak with your healthcare provider before starting a new supplement (5, 6).

Furthermore, the nutrients in multivitamins may be derived from real foods or made synthetically, making it essential to purchase your vitamins from a reputable manufacturer.

SUMMARY

In addition to vitamins and minerals, multivitamins may contain herbs, amino acids, and fatty acids — though the amount and number of nutrients can vary.

Heart disease is one of the leading causes of death worldwide (7).

While some believe that taking multivitamins can help prevent heart disease, research doesn’t seem to support it conclusively.

Some studies suggest that multivitamins are correlated to a reduced risk of heart attacks and death, while others show no effects (8, 9, 10, 11).

The Physicians’ Health Study II investigated the effects of daily multivitamin use in over 14,000 middle-aged male doctors for over a decade and found no reductions in heart attacks, strokes, or mortality (12).

However, a more recent study revealed that among women — but not men — taking a multivitamin for more than 3 years was linked to a lower risk of dying from heart disease (13).

SUMMARY

While some studies indicate that people who take multivitamins have a lower risk of heart disease, others have found no connection. Overall, the evidence is mixed.

The evidence regarding multivitamin use and cancer risk is also mixed.

Some studies suggest no effect on cancer risk, while others link multivitamin use to increased cancer risk (9, 11, 14, 15).

One review examined five randomized controlled trials including 47,289 people. It found a 31% lower risk of cancer in men who took multivitamins, but no effect in women (16).

Two observational studies, one including only women and the other including both men and women, tied long-term multivitamin use to a reduced risk of colon cancer (17, 18).

Finally, the Physicians’ Health Study II noted that long-term, daily multivitamin use reduced cancer risk in men with a history of cancer, as well as those with no history of the disease (19).

SUMMARY

Some studies link multivitamin use to a reduced risk of cancer, while others find no benefit.

Multivitamins have been studied for several other purposes, including promoting brain function and eye health.

Brain function

Several small studies examining specific populations have found that multivitamins can improve memory in older adults (20, 21, 22).

Multivitamins may also affect your mood. Research has not only revealed links between poor mood and nutrient deficiencies but also between nutritional supplements and reduced symptoms of anxiety and depression (23, 24, 25, 26, 27, 28).

However, other studies reveal little to no changes in mood (29, 30).

Eye health

Age-related macular degeneration is one of the leading causes of blindness worldwide (31).

One study found that taking antioxidant vitamins and minerals may slow its progression and help prevent it (32, 33, 34).

Furthermore, some evidence indicates that multivitamins may reduce your risk of developing cataracts, another widespread eye disease (35, 36, 37).

SUMMARY

Multivitamins may help improve your memory and mood. What’s more, antioxidant vitamins and minerals may help slow the progression of certain diseases that cause blindness.

Dosage is an essential factor to consider when taking multivitamins.

Although high doses of some vitamins and minerals are acceptable for some people, high amounts can be harmful.

The appropriate dosage can depend on a vitamin’s solubility, which is categorized into the following two groups:

• Water-soluble. Your body flushes out excess amounts of these vitamins through your urine.
• Fat-soluble. Since your body has no easy way to get rid of these, excess amounts may accumulate in your liver.

Pregnant people need to be especially careful with their vitamin A intake, as excessive intakes have been linked to congenital disabilities (38).

Vitamin D toxicity is rare and unlikely to develop from multivitamin use. However, vitamin A toxicity is more common (39, 40, 41, 42).

If you take multivitamins and eat many nutrient-dense foods, you could exceed the recommended daily intake of many nutrients.

Smokers should avoid multivitamins with large amounts of beta carotene or vitamin A, as these nutrients may increase your risk of lung cancer (43, 44).

High doses of certain minerals, such as iron, can lead to stomach upset, constipation, vomiting, and fainting. Iron can also limit the body’s ability to absorb zinc (45).

Particularly, men should be mindful of their iron consumption, as they tend to store more of it than women do, as well as individuals who have hemochromatosis.

This condition can lead to a buildup of toxic levels of the mineral and may cause liver cirrhosis, liver cancer, and heart disease. Those with this condition should also avoid vitamin C supplements (45).

Another risk is faulty manufacturing processes, which may cause multivitamins to harbor much larger amounts of nutrients than intended (46).

SUMMARY

Supplementing with large doses of certain nutrients can have harmful effects. This is more likely to occur if you take a high-potency multivitamin on top of a nutrient-dense diet.

Multivitamins aren’t right for everyone and may even harm some individuals.

That said, specific populations may benefit from multivitamins, including:

• Older adults. Vitamin B12 absorption can decrease with age. Also, older adults may need more calcium and vitamin D (47, 48).
• Vegans and vegetarians. As vitamin B12 is found primarily in animal foods, those who follow plant-based diets are at a higher risk of deficiency of this vitamin. They may also lack calcium, zinc, iron, vitamin D, and omega-3 fatty acids (49, 50).

Other people who may benefit from multivitamins include those who’ve undergone weight loss surgery, are on low calorie diets, or don’t get enough nutrients from food alone (51, 52).

SUMMARY

Some individuals, including older adults, vegetarians, and vegans, may need higher amounts of certain vitamins or minerals.

Multivitamins are not a ticket to optimal health.

In fact, evidence that they improve health for most people is inconsistent. In some cases, they may even cause harm.

If you have a nutrient deficiency, it’s best to supplement with that specific nutrient. Multivitamins pack many nutrients, most of which you may not need. It may be best to speak with your healthcare provider to decide your best course of action.

Additionally, it’s best if you don’t take a multivitamin to compensate for a poor diet. Eating a balanced diet of fresh, whole foods is much more likely to ensure good health over the long term.

Spring and well-being: why do we need multivitamins?

Brittle nails, burrs, faded skin, hair loss and depressed mood, we are accustomed to attribute to a lack of vitamins. “This is beriberi,” we say and sigh heavily, throwing handfuls of multi-colored vitamin capsules into ourselves. In fact, beriberi is not to blame for anything, few people are familiar with it at all.

Roskachestvo, together with Doctor of Medical Sciences, nutritionist, reflexologist Mariyat Mukhina, is seriously dealing with the issue of spring ailments.

Mariyat Mukhina

doctor of medical sciences, nutritionist, reflexologist

Spring blues

In the spring, diseases are exacerbated. Tired of flu epidemics and cloudy days, the body asks for rest. In early spring, you especially want to sleep, people become lethargic, depression and apathy even come to someone. Meteorologically dependent suffer from pressure surges and headaches, aching joints and mood swings. Flashes in the sun provoke emotional outbursts, and weather changes – frequent colds.

It turns out that it’s not just about vitamins. Although their lack affects many processes inside the body.

Let’s get acquainted: vitamins

Vitaminoses can be divided into several types. Here are the main ones:

• Avitaminosis is a serious pathology in which one or more vitamins are not supplied to the body. It is very rare, in Russia among the peoples of the Far North, where the food is of the same type, and the diet is not balanced.

• Hypervitaminosis – an excess of vitamins, in which they are more than normal by 9-10 times. Moreover, we are talking about fat-soluble vitamins A, D, E, F and K. For example, in order to earn an excess of vitamin A, you need to eat 1.5 kg of carrots every day, and for quite a long time, or chew vitamin complexes instead of breakfast, lunch and dinner.

• Hypovitaminosis – lack of vitamins in the body. It occurs in 85% of the population, especially in people who eat processed foods, canned foods, fast food lovers living in ecologically disadvantaged areas.

The risk group also includes workers in hazardous industries, smokers, fans of “therapeutic” starvation and uncontrolled medication. Corrected by changing the diet. But to know for sure whether you have enough vitamins, you can only by a blood test.

If our poor health can be attributed to a lack of vitamins, then it is worth calling it hypovitaminosis. Here we’ll talk about it.

Vitamins are not enough only in spring?

If you forbid yourself to eat vegetables and fruits in the summer, then the sun, fresh air and a minimum of viruses will still help the body feel good. And, in comparison with summer well-being, spring seems terrible to us. By the way, things are no better in autumn and winter. You need to monitor your diet almost all year round.

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It is naive to believe that vegetables and fruits have all the necessary vitamins. In fact, they contain a sufficient amount of only folic acid, carotene and vitamin C. To get B vitamins, you need to eat wholemeal bread, bran, eggs, nuts, cereals, meat and dairy products

Is it worth it to overeat with “vitamins” from the garden in summer?

Fresh vegetables and fruits are needed all year round. Hoping that in the summer you can gain nutrients for the future, unfortunately, is useless.

It will be possible to stock up only with vitamins A, D and E, which are deposited in the fatty cells of the liver.

Vitamin B1 is stored in the body for 4 to 10 days.

B2 and B6, as well as vitamins C and K – about 1.5 months.

It turns out that until winter, and even more so until spring, summer stocks will not be preserved in any way. And the body itself can only produce vitamins D, PP and K, and even then a little.

Therefore, in the spring it is important to take a multivitamin for good health.

Is it possible to do without multivitamins?

It seems that with the current abundance of products in stores, this is not so difficult. You build a balanced diet, where there are products of different composition – and be healthy!

Each vitamin has its own daily requirement. We used to think that it is enough to eat an orange and a carrot a day to get the right amount of vitamin C and vitamin A. A piece of meat to replenish the reserves of vitamins B1 and B2 …

But we forget that, for example, 2-3 cups of coffee a day lead to the fact that thiamine (vitamin B1) is completely decomposed in the body. That during the heat treatment of the product, more than half of the vitamins are lost. After all, it is unlikely that most of you are able to eat three raw carrots every day.

It turns out that you can live without vitamin complexes in tablets, but who can withstand such a diet? Otherwise, we again come to hypovitaminosis.

So you need a multivitamin. They can be drunk for a long time, but, like any medication, multivitamins should be prescribed by a doctor, taking into account the region of residence, individual health characteristics, the amount of physical activity and the current composition of the blood.

Regular intake of properly selected multivitamins is reflected not only in the general well-being and freshness of the skin. About a third improves short-term memory, facilitates the course of many chronic diseases, even if taken 50% of the recommended dose.

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Remember, taking vitamin complexes will not make junk food healthy. Do you still eat chips and drink beer? Get a disturbed metabolism, obesity and other troubles.

You still need to keep an eye on your diet. If you really want to eat something forbidden and useless, you can afford it, of course. But only occasionally, otherwise no vitamins will help.

Why do we need multivitamins, if our ancestors got along just fine without them?

Many people have a natural question. For some reason, before people did not take any vitamin complexes and felt great, but now, even if you adhere to a healthy diet, you cannot do without multivitamins.

Indeed, vitamin intake rates have changed dramatically in the past 50 years for several reasons.

1. Environmental background. Now, going out on any street in a large city, we get more free radicals in 15 minutes than our grandparents in a lifetime. And to neutralize them, antioxidants are needed, which are vitamins.
2. Breeding of horticultural fruits and vegetables . It goes to the needs of the tastes of buyers towards an increase in sugars, sizes and a decrease in acid, which means a decrease in vitamins. When they say that before “the grass was greener, and the apples were tastier” – so it was! There are much fewer vitamins in greenhouse vegetables than in those grown in the summer in the garden.
3. Alcohol, smoking. Many people lead an unhealthy lifestyle – they smoke, drink … Nicotine and alcohol lead to the fact that the body loses useful substances at a catastrophic rate.

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By the way, our ancestors constantly used sauerkraut, pickled berries as a source of vitamins. These are fermented foods, in which, as a result of the activity of lactobacilli, the amount of vitamins increases several times.

However, along with taking a multivitamin, proper nutrition is very important.

Top 10 products that will allow you to cope with hypovitaminosis in the spring:

1. Sauerkraut
2. Carrot
3. Frozen blackcurrant
4. Frozen sea buckthorn
5. Fresh herbs
6. Honey
7. Nuts
8. Fish
9. Lean meat
10. Dairy products

Add them to your diet and be healthy!

Are multivitamins for everyone?

The opinion of Internet “experts” regarding the need to take vitamin complexes is obvious: hypovitaminosis haunts us all. These “experts” even provide “evidence” of the vital need for this kind of dietary supplements, based, however, on their personal logic about the origin of people from a world filled with fruits and vegetables. Anthropologists, by the way, do not agree with this: people have never eaten as fully and varied as they do today. Real experts — dietitians, gastroenterologists, endocrinologists — write for the media relatively rarely (which is a pity), apparently believing that a person with a problem will come to them anyway, and if someone wants to take part of their salary to a pharmacy, then the effect Nobody canceled the placebo, and it will not get worse.

So does the average citizen need additional vitamins in capsules and tablets? Let’s take it scientifically.

Educational program on vitamins and their effect on the body can be found on almost any site dedicated to beauty and health; however, almost everywhere the authors make some kind of bias towards either working capacity, or the condition of the skin and hair. In fact, vitamins are coenzymes, that is, they help special intracellular enzyme proteins to perform functions inside the cell. The quality of work performance affects the characteristics of metabolism in specific tissues and cannot be reduced only to “preventing brittle nails” or “improving heart function” – everything is much more complicated and complex, and therefore the manifestations of vitamin deficiency can be multifaceted and coincide with various biologically active substances. But we always want to receive generalized information in brief, so that it is clear.

In principle, all vitamins perform two functions: they are involved either in the creation (healing, development) of tissues, or in the fight against oxidative stress (external and internal toxins).
Vitamins A, D, E, K are fat-soluble, they are easy to overdose, which is dangerous, because. they accumulate in adipose tissue. The rest are water-soluble, and an overdose of them is difficult to achieve, since the excess will be excreted by the kidneys.

A – retinol – necessary for vision and bone growth, healthy skin and hair, normal functioning of the immune system.
Contained: in fish oil, meat, oil, egg, liver; in peppers, pumpkins, carrots, which must be eaten with sour cream or butter.
B1 – thiamine – plays an important role in the metabolism of carbohydrates, fats and proteins, is necessary for normal growth and development and helps maintain proper functioning of the heart, nervous and digestive systems.
Contained: in wheat bread from wholemeal flour, legumes, in the liver, kidneys, meat. Destroyed by the use of fresh fish and seafood, tea and coffee, alcohol.

B2 – riboflavin – an antioxidant, necessary for the formation of red blood cells, antibodies, for the regulation of growth, reproductive functions and in general for the health of the whole organism, including thyroid function.
Contained: in the kidneys, liver, milk, meat, mushrooms, cabbage.

B3, aka PP – niacin (and its “brother” – nicotinamide) – fights dermatitis, diarrhea and dementia.
Contained: in any protein food, rye bread.
B5 – pantothenic acid – is required for the metabolism of fats, carbohydrates, amino acids, the synthesis of fatty acids, cholesterol, histamine, acetylcholine, hemoglobin.
Synthesized by intestinal microflora, contained: almost everywhere.

B6 – pyridoxine – regulates protein digestion, takes part in the production of hemoglobin, participates in the uniform supply of cells with glucose and in the functioning of the nervous system.
Contained: almost everywhere.

B9 – folic acid – essential for the growth and development of the circulatory and immune systems.
Synthesized by the intestinal microflora, found in: green vegetables, wholemeal bread, yeast, liver.

B12 – cyanocobalamin – responsible for hematopoiesis and nerve transmission.
Contained: in the liver, kidneys and other animal products. Completely absent in plant foods (note to vegetarians!)

C – ascorbic acid – protects blood vessels from fragility, antioxidant.
Found in: fruits and vegetables.

D – cholecalciferol (D3) and ergocalciferol (D2) – ensures the absorption of calcium and phosphorus.
D3 is produced in the skin under the influence of ultraviolet radiation, D2 comes only with food, is found in oily fish.

E – tocopherols – antioxidant and antihypoxant (allows you to save oxygen consumption by cells), necessary for reproductive function, immune activity and nervous system activity. Destroys bones in overdose.
Contains: in oils

K – phylloquinone – increases blood clotting, metabolism in bones, connective tissue and kidneys
Synthesized by the intestinal microflora, found in: green vegetables

P — rutin — reduces blood clotting, improves blood circulation
Found in: fruits, berries, red vegetables.

As you can see, all vitamins are contained in ordinary food, and with a variety of foods consumed, there will be no deficiency. If, due to circumstances, you have malnutrition, then hypovitaminosis is quite difficult to miss, because its manifestations are obvious. If you’re reading this article, you probably have an internet connection, and most likely a fridge full of food, so if you ever see pellagra, scurvy, or beri beri, it’s only in pictures. Hidden vitamin deficiencies, which Runet persistently warns about, will do less harm than chronic stress at work or at home and sleep disturbance. Therefore, if your hair splits or circles appear under your eyes, do not rush to the pharmacy – maybe you just need to get enough sleep and put filters on the apartment’s water supply? If the nervous system, digestion and immunity are not in order, it is better to go to the doctor so that he finds the true cause of the ailments.

In the English-language medical literature, if they write about hypovitaminosis, they only mention vitamin D in osteoporosis, and this has long been questioned. The remaining vitamin deficiencies are considered only in the vein of casuistry and isolated clinical cases. Vitamin A deficiency is generally described mainly in cows, because humanity practically overcame it more than 20 years ago, and “night blindness”, at least in developed countries, does not occur. The lack of iodine is filled by salt iodization. In Russia, apparently, they still remember the “hungry 90-e”, and out of habit they seek to make up for the imaginary “deficit”.

Another thing is if you are a pirate, a pregnant woman, a nursing mother, are on artificial nutrition after surgery, or take heavy drugs such as methotrexate or prednisolone. During periods of active biological stress, the need for vitamins really increases, and food can be supplemented with dietary supplements. For each of the vulnerable groups of people, special complexes have been created, where the ratio of vitamins takes into account the peculiarities of their interaction during absorption and assimilation. Synthetic preparations, contrary to myths, are no worse than natural ones, at least due to the decrease in the absorption of vitamins that are not associated with proteins, taken into account when selecting concentrations. It is worth noting that vitamins and minerals (iron, cobalt and other magnesium) mutually interfere with each other’s assimilation, so it is better to take them separately, the first in the morning and the second in the evening, although this is not so important.

So who needs to take vitamins and which ones.

Pregnant and lactating – Alphabet Mom’s Health, Vitrum Prenatal, Elevit Pronatal – from the second trimester until the end of feeding. Folic acid is mandatory for everyone from the moment of pregnancy (or even from the moment of its planning).

Women in the postmenopausal period, with osteoporosis and young children – vitamin D (Vigantol or Aquadetrim) or in combination (for example, Calcium-D3 Nycomed) – the dose is individual.
Against the background of taking methotrexate, prednisolone, with B12-deficiency anemia – folic acid tablets (Metafolin, Folacin) and vitamin B12 1000 mg intramuscularly 1 time per month or in tablets (for example, Solgar).

In polyneuropathy, radicular syndrome (sciatica) – complexes B1, B6, B12 – Milgamma only intramuscularly (tablets do not contain B12) or Combilipen in the muscle or in tablets – adequate doses, Neurobion – low doses of B12. Courses for 2 weeks under the “cover” of the stomach (you need acid reduction, for example, Nolpaza).

Athletes with intense loads – multivitamins (Alfavit Effect, Complivit Active). In fact, there are a great many drugs – look at the ratio of the concentration of substances to the daily requirements for them (this should be indicated on the package). Daily consumption norms practically do not differ in different producing countries.

Vegetarians – B12, D3, A, omega-3 (and almost all other vitamins), iron, zinc, calcium, iodine. Yes, they are also found in plant foods, but eating so many kilograms of food a day to fill the need is unrealistic. The complex is selected depending on the specific type of vegetarianism by a nutritionist, but everyone needs to take at least B12, D3 and iron.