To multivitamin or not to multivitamin?

It seems like common sense that taking a multivitamin on a daily basis is a smart move if you're looking to stay healthy. A quick stroll down any pharmacy aisle will turn up a dazzling array of bottles proclaiming to help with everything from anti-aging to cancer prevention. But how many of us really know if we truly need to take a multivitamin? Should everyone be taking one, regardless of age and health status, or are these tablets only providing us with a false sense of security about our health? And how do we even go about the process of choosing the right vitamin for our needs, if we do decide to go the supplement route? We tapped Baltimore-based internal medicine physician, Vivek Cherian, MD, to gain some insight into the complicated multivitamin conundrum.

Are multivitamins actually good for you?

Nearly half of adults in the U.S. take a daily multivitamin, and that number increases to 70 percent for adults over 70 years old. But does that mean a daily multivitamin should be part of everyone's health regimen? According to Dr. Cherian, the answer isn't as clear-cut as a simple yes or no.

"Most people take vitamins because they want to be on top of their health and make sure they're getting all the vitamins they need, in case they aren't getting enough from their regular diets," he says. "It may seem like common sense to be taking multivitamins, but there actually isn't much evidence that a daily cocktail of essential vitamins and minerals actually delivers what you expect." 

In fact, most studies have found no significant benefit from taking a daily multivitamin in protecting the brain or heart, or preventing cancer. Despite the general claims that multivitamins are good for X or Y health goals, these are not necessarily backed by research yet. 

That said, Dr. Cherian adds there's no harm in taking multivitamins (they aren't "bad for you), and the potential benefits may make them worth taking for some people. "Whenever my patients ask me about taking multivitamins, I tell them to consider taking one daily because there may in fact be benefits (though they have not been proven at this time) and there are no known risks to taking a daily multivitamin," he says. "Multivitamins may help improve your memory and mood. Additionally, antioxidant vitamins and minerals may help slow the progression of certain diseases that cause blindness." The point being, while the benefits are not clearly proven yet, that doesn't mean they may not exist. 

Who should consider taking a multivitamin?

If the general consensus is that the risks are low, but the benefits are unproven (but potential), the question then remains: Are there certain individuals who would truly benefit from taking a multivitamin? According to Dr. Cherian, people who eat a healthy, balanced diet that incorporates whole grains, fruits, vegetables, and proteins, will likely obtain all the vitamins needed, and a multivitamin won't provide much benefit. 

Unfortunately, this does not cover everyone. "A large percentage of Americans, however, don't get enough vitamin D and vitamin E only from their diet, so a multivitamin can be beneficial," he adds. It can be hard to get the recommended amount of vitamin D and E through food alone, and vitamin D deficiency is especially problematic in populations in places with less sunlight during the winter. A multivitamin that includes these essential vitamins can be helpful in protecting immune health and bone strength

Additionally, certain groups of individuals are also more prone to nutritional deficiencies.

"Taking certain medications can lead to vitamin and or mineral deficiencies. To name some examples, commonly prescribed for high blood pressure (diuretics) can lead to low potassium, magnesium, and calcium levels. Certain acid reflux medications can also reduce the absorption of vitamin B12," says Dr. Cherian. Other groups of people that may require help reaching their nutritional needs, include:

  • Pregnant women: "Folate (Vitamin B9) is particularly important during the early stages of pregnancy to help assure proper development of the baby and decrease the chance of certain birth defects such as spina bifida. Prenatal vitamins contain this vitamin as well as other important nutrients for pregnancy."
  • Older adults: "Vitamin B12 absorption can decrease with age, and older adults may need more calcium and vitamin D."
  • 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."

What should you look for in a multivitamin?

If you do decide to take a multivitamin, the options can be a little overwhelming. Here are a few factors and tips to consider when choosing the right one.

1 Consult with your doctor.

"Our need for nutrients varies based on age and sex," Dr. Cherian says. Your doctor will help you determine what your nutritional requirements may be and help point you in the direction of the right vitamin.

2 Choose one with 100 percent of the daily value of most of its ingredients...

...with a few exceptions. "Some ingredients such as magnesium and potassium levels are kept low to avoid interactions, and calcium will be lower also simply to keep the pill reasonably-sized," Dr. Cherian says.

3 Check the label for United States Pharmacopeia (USP) verification.

The USP is a nonprofit independent organization that essentially determines whether supplements are pure and contain what they claim to contain.

4 Watch out for marketing gimmicks.

Be wary of general marketing statements on vitamin labels that don't carry scientific weight. These could include claims about increasing energy levels, improving specific things like hair and nails, or supporting brain health. Dietary supplements make extravagant claims to draw consumers in that often are not backed by research. 

Multivitamins and Your Optimal Health

Ultimately, taking a multivitamin is a personal choice you should make in partnership with your doctor based on your unique health and nutritional requirements. Whether you choose to do so or not, it's important to remember what a vitamin can do, and what it cannot. "No multivitamin substitutes a proper, well-balanced diet," Dr. Cherian cautions. "Multivitamins are not any kind of silver bullet to achieve optimal health. Evidence that they improve health for people is inconsistent at best." 

This isn't to say that multivitamins are bad, but that more research is required to truly understand the relationship between vitamin intake and overall health.

The risks of taking a multivitamin are low—in fact, Dr. Cherian chooses to take a multivitamin himself every day. But it is important to understand their limitations. While multivitamins pack many nutrients, your body may not actually be in need of most of the contents. He reminds us that if you have a specific nutrient deficiency, it's always best to supplement with that specific nutrient (e.g., vitamin D or B12). It's a more targeted way to meet your health goals and rebalance your body. Whatever you choose, always focus first and foremost on eating a well-balanced diet before supplementation.