Multivitamins – yes or no?

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Dear Dr. Mo: How useful are multivitamin supplements and when should you take them? I tend to take them during the winter when I think I might be more likely to catch a cold from my students…

Dear reader:First of all, try to eat a healthy diet – this goes without saying. A multivitamin daily dose does provide some help against nutritional deficiencies but cannot and should not replace the natural way we take in vitamins – through a healthy and balanced diet. This diet is rich in fruits, vegetables, whole grains, healthy oils, nuts and low in red meat and unhealthy fats.  For those people who manage to eat a healthy diet like that, a multivitamin may have little or no benefit.

Healthy diet removes the need for multivitamins

I realize however that many people don’t manage to eat such balanced and healthy diets for a variety of different reasons, some economic, some behavioral, some social etc.  In such cases, as well as in cases like yours (prophylactic), a simple message is this: a daily multivitamin is a good insurance policy for your nutrition!

Taking a daily multivitamin and perhaps some extra vitamin D is an inexpensive way for you to fill in some of the nutritional gaps and make sure you are getting all the nutrients you need to stay healthy.

There are even added health benefits to such habits – Folic acid found in most multivitamins helps prevent neural tube deficits in newborns if women take it before they become pregnant and during pregnancy; this acid also lowers risk for breast and colon cancer and heart disease.

Why an extra D?

In addition to its known bone health benefits, there’s growing evidence to support claims that getting some additional vitamin D can help lower the risk of breast and colon cancer. I would suggest that you aim for getting 800 to 1,000 IU of vitamin D daily—this is why I said that you likely require an extra vitamin D pill, in addition to your multivitamin. What’s more, many people may need 2,000 IU per day (or more) for adequate blood levels of vitamin D, particularly if they have darker skin, spend winters at higher latitudes (such as the northern U.S. and in Canada), or spend little time in the sun (for geographical or other reasons). So the proper course of action would be to talk to your doctor about this and perhaps order a vitamin D blood test to see exactly where you fit in.

As for any other supplements, speak to your doctor first about what’s best for you.

Do not go into extremes!

If you think you have a diet, which is not optimal, than a multivitamin supplement is a good way to compensate for that.  Remember that too much can be harmful as some vitamins (A, D, E and K) are not water soluble and may accumulate in your body to produce toxic effects. Other vitamins in high doses can also show toxicity or display undesired biochemical patterns.
It is best to stay within the optimal recommended doses (RDAs or Recommended Daily Allowances) and if your multivitamin contains an RDA of Folic acid, steer away from other foods that are fortified with Folic acid. (cereals for example)

So In general, avoid mega-dose vitamins and mega-fortified foods – simple multivitamin supplement will do.

Scientific chatter

If you read nutrition sites, news and research you will find disagreement on multivitamins. Some scientists say that there is still insufficient evidence to support claims that multivitamins benefit health. These claims are not looking at long term benefits but rather focus on short term and immediate impact.
You will also find flawed studies that link multivitamins and death – don’t trust these studies too much. There is little good scientific evidence to support the idea that multivitamins or modest doses of individual nutrients (i.e. Vitamin D, Folic acid, Iron etc.)  increase the risk for major diseases or early death.

I would say that when we account for all the evidence, they seem to suggest that potential benefits of taking a daily multivitamin outweigh any potential risk for most people. Just don’t overdo it and speak to your doctor first – some options may be better for your individual requirements.

In conclusion to your question I would say that a daily multivitamin is an inexpensive nutrition insurance policy. Try to take it every day.
It is not a magic bullet however and it will not cure a common cold or a flu or other illnesses but it will help you keep a balanced diet and have your defenses up and ready to take on a possible health threat.

Of course, I would recommend aiming for a balanced and healthy diet first and foremost.

Yours in health,

Dr. Mo