Health in a Pill? Vitamin Benefits and Cautions - A Commonsense Approach

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Vitamin Benefits? Are there any?

“Do I need supplements? Should I take a multivitamin?” They are questions many ask because there is so much confusion surrounding supplements in the media and among people generally.

… the answer to whether you should take a multivitamin? Probably yes.

Sorry for the wishy-washy answer but neither question leads to a yes-no answer. I’ll explain and hopefully clear up the confusion, so you can decide whether to buy and what to buy.

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Vitamins’ Benefits – Do you need them?

You likely don’t need supplements if - and it’s a big “if” … you are healthy; live in an ideal world with nutritionally and environmentally pristine food, water and air; and follow all the best nutritional practices to the letter.

Remember all those vegetables Mom talked about eating? Do you?

Since nobody I know, including myself, can manage nutritional sainthood on a consistent 365 day basis, despite the best of intentions and a pretty savvy take on what’s good nutrition-wise, a quality multivitamin and multi-mineral is a good idea. They can correct some of our occasional, if inevitable, nutritional lapses. Extra Vitamin C and Omega 3 fatty acids are wise too, if you’re living the hectic pace many of us do.

If you suffer specific a health condition or are member of a group at high risk for certain health problems or nutritional deficits, consider a multivitamin/mineral designed for your specific needs.

Keep in mind, however, that a quality diet containing a wide variety of whole foods, including whole grains, legumes and fruits and vegetables, is your most reliable path to nutritional health. Don’t rely solely on supplements to resurrect a chronically nutrient deficient diet.

Vitamin benefits are like white out – they are good to correct minor nutritional deficits, not rewrite a wholly deficient diet.

Why reliable information about Vitamin Benefits and Risks is Necessary and Why Consumers Should learn about Vitamin Benefits and Risks

More than one third of Americans take a multivitamin mineral (also known as multis, multiples, multi-vitamin, multiple vitamin/mineral, MVMs, multivitamin-mineral complex and other names). Of the $26.9 billion spent in 2009 in the US on dietary supplements; $11.3 billion was for vitamin and mineral-containing supplements; and $4.8 billion for multivitamin/multi-minerals specifically.

In the US, dietary supplements are considered a food by the Food and Drug Administration (FDA) and, therefore, are largely unregulated, except when it comes to labeling and purity. The FDA will do spot checks for quality and contents i.e., are the nutrients stated really there? It, however, doesn’t proscribe the types or amounts of nutrients in a multi-vitamin/multi-mineral product. That is left to manufacturers who can include and change ingredients and amounts at will.

It follows the consumer (you) must know what he or she needs and, for that matter, doesn’t.

With you and your family’s health and pocket book at stake, it’s worth your while to learn about the risks and benefits of vitamins and mineral supplements.

Vitamin Benefits in a Nutshell (if not a gel cell, capsule or tablet)

A multivitamin/multi-mineral can be a cost-effective insurance that you’re covering the nutritional basics, in the off chance or, for many, on chance, you aren’t.

                    They can also help prevent or resolve certain health conditions when taken in therapeutic doses in correct combination. For this it is best to work with a qualified health care provider who knows about nutrition.

Overfed but undernourished – Supplements Can Ensure you get the Nutrients you need – A major Benefit of Vitamin and Mineral Supplements

While the USDA and other government watchdogs assure us that we can get all our nutrients through diet, the fact is …. we don’t.

Americans, as populations go, are overfed (look at the escalating rates of obesity for starters) but under-nourished, a situation vitamins may benefit. The USDA gives a blunt assessment in its 2010 document Dietary Guidelines for Americans (DGAC).

• 75% to 95% of Americans don’t eat enough vegetables. More than 95% fail to get enough whole grains. Together these lead to deficiencies in Vitamins C, A, K, magnesium, potassium, dietary fiber as well as poor iron absorption.


• 75% of girls 9-18 and 50% of adult pre menopausal women don’t get enough iron. The result is wide-spread iron deficient anemia in this age group.


• Up to 30% of people age fifty and over are unable to absorb Vitamin B12 adequately from food. They should be eating fortified food or taking B12 supplements to avoid the risks of B12 deficient anemia.


• Across all age groups, intake of Vitamin D, calcium, potassium and fiber are insufficient and pose a significant public health risk for certain diseases and health conditions.

While a multi-vitamin and mineral supplement cannot replace the many health benefits a healthy balanced diet provides through the complex interplay of nutrients naturally found in food, vitamins can help.

Six Reasons to supplement your Diet with a Multi-vitamin Multi-mineral Formula – the How of Vitamins Benefits

Here are six reasons that might prevent us getting all the nutrients we need from food and why a multi vitamin might help.

1. Hectic lives mean many of us routinely don’t eat as nutritiously as we should. Instead, our busy school, work and commuting schedules may result in skipped meals or unhealthy reliance on nutrient-depleted foods, including refined and junk food. Vitamins can benefit.


2. The food we buy varies in nutrient content and may not contain the levels of vitamins we think due to storage, transport or cooking methods – An average sized orange can contain upwards of 70mg of vitamin C or 0 mg, depending on when it was picked; how it was stored and transported; and how long it’s been sitting in your fridge. Cooking methods can destroy nutrients in food. While you can endeavor to buy local or grow and cook your own, this is impractical for many. Vitamins may benefit.


3. Agricultural practices including rearing livestock with nutrient-depleted or nutrient-limited feed as well as growing foods in mineral-depleted soils can result in nutritionally inferior food. Like us, animals are what they eat; they are no healthier than the food they are fed; plants too are a product of their growing environment, including soil mineralization. For example, the UK generally has low selenium levels in soil; the low selenium content of UK produce reflects this. Vitamins may benefit.


4. Widespread environmental assaults may increase our need for antioxidants and detoxifying nutrients found in many vitamins and minerals. Our exposure to exhaust; radiation; cigarette smoke; the sun; pesticides; nitrates in meat; xynoestrogens in food, water and plastics; and the proliferation of untested chemicals are factors that increase our need for anti-oxidant and detoxifying nutrients. A mineral and multivitamin may benefit.


5. Common life stressors, including emotional and physical and positive and negative kinds, can increase our need for nutrients in a crunch. Emotional and physical stress whether from trauma, illness, athletic endeavor, religious fasting, chronic and occasional dieting, pregnancy or breast feeding as well as aging and illness, can increase our need for nutrients in the long and short term. Vitamins may benefit.


6. Those who have medically or voluntarily restricted diets may benefit from Vitamin and Mineral Supplements. Food allergy sufferers may have difficulty getting all their nutrients because of their food restrictions. Vegans or those who eat no animal products need a source of Vitamin B12. While some plant based algae can supply Vitamin B 12, it is got most readily from animal products and, failing that, B 12 supplements. These are yet more vitamin benefits.

The Argument against Vitamin Supplements and Vitamin Benefits – Some say Vitamin Benefits Don’t Outweigh the risks

Those opposed to vitamin and mineral supplements argue that a healthy well balanced diet should be able to supply adequate nutrition. They caution that, through supplementing, you might get too much of a good thing, with many minerals and vitamins, particularly, fat soluble ones like Vitamins D, E and A, being susceptible to overdose. Instead of Vitamin Benefits; there are serious Vitamin side-effects they argue.

Overdosing is unlikely if you are taking a standard multi vitamin combination. Mega dosing or supplementing specific vitamins or minerals in large amounts is another matter and you should proceed with caution on this front, following recommended intakes for specific conditions with your health care provider in order to ensure vitamin benefits. Talking to your health care provider before starting a supplement program is wise, both to maximize vitamin benefits and minimize any risks.

Read labels and follow the guidelines below to make sure that you’re not getting too much of any one or combination of nutrients.

Remember when it comes to supplements and vitamin benefits ….

… too much of a good thing may not always be good.

Balance is key to so much with diet including vitamin and mineral supplements.

Maximizing Mineral and Vitamin Benefits – What and How Much Should You Take?

Look for a multivitamin and mineral supplement with, at least, the following ingredients in the following amounts. Recall that if you fall into a specific age, gender or risk group, you may benefit from additional or lesser amounts of specific vitamins or minerals. A multivitamin mineral supplement with nutrients designed especially for your requirements may be beneficial. The key to achieving vitamin benefits and avoiding risks is to become an educated consumer.

Achieving Multi-vitamin Benefits - Nutrient Types and Amounts in a multivitamin mineral supplement to achieve Maximum Vitamin Benefits*. 5,000 IU of Vitamin A (Beta- carotene and Retinol) 600 IU of Vitamin D, 150 IU of Vitamin E (D-Alpha Tocopherol is the natural form – prefer this to the synthetic version Dl-Alpha Tocopherol) 250 mg of Vitamin C (Ascorbic Acid), 25 mg of Vitamin B 1 (Thiamin), 25 mg of Vitamin B 2 (Riboflavin), 25 mg of Vitamin B 3 (Niacin), 25 mg of Vitamin B 5 (Pantothenic Acid), 25 mg of Vitamin B 6 (Pyridoxine), 10 mcg of Vitamin B 12 (Cyanocobalamin), 50 mcg of folic acid, 50 mcg of biotin. Calcium, magnesium, zinc and selenium are minerals important for a balanced healthy diet and should be included in your multivitamin/multi-mineral combination to maximize multivitamin mineral benefits. *Source Patrick Holford’s The New Optimum Nutrition Bible except for Vitamin D amounts, which reflect new 2010 intake amounts for most people, except for infants and those over age 70

The above amounts are in some cases higher than US government minimums. See the Dietary Reference Intakes generated by the Food and Nutrition Board.

In a multivitamin/multi-mineral formula with reasonable nutrient levels overdosing should not be a problem. Often the problem, especially with cheap formulas, is the opposite; Manufacturers skimp on nutrients, use forms that are not easily digested or as effective as more expensive forms, and supply too little to make a difference.

The result - no vitamin benefits; only a waste of money.

Specific Health Conditions and Vitamin Benefits – Some Health Conditions that may benefit from Vitamin and Mineral Supplements

Researching the effects of single nutrients on human health, whether in food or supplements, can be a challenge. This is because isolating the effects of one nutrient from those of others or determining additional factors that might promote or hinder disease, are elusive. It may be that some nutrients don’t work as well singly as they do in network with other nutrients or cofactors. Studies testing the effects of multiple nutrients are difficult to design and complex to interpret.

Indeed, the body’ ability to metabolize nutrients often requires several cofactors. For example, iron is better absorbed in the presence of Vitamin C; calcium absorption requires both Vitamin D and magnesium; the antioxidant effects of Vitamins C, E and A are greater when taken together than alone.

While you should speak to your health care provider about your specific health conditions and the possible dietary supplements that may help, below is a smattering of potential therapeutic benefits of vitamins and minerals.

• Diabetes - Chromium as well as zinc have been used therapeutically to regulate blood sugar in diabetics.
• Ostopenia and Osteoporosis - Calcium supplementation for postmenopausal women to improve bone health and specifically prevent ostopenia and osteoporosis and reduce risk of bone fracture.
• Anemia - Iron for those at risk for or suffering from anemia like pregnant and menstruating women; with some anemia being caused by lack of Vitamin B 12, for which supplementing that vitamin will benefit.
• Macular Degeneration - Vitamin C in amounts of 500 mg and Vitamin E in doses of at least 400 IU, along with beta carotene, zinc and copper have been found to prevent age related macular degeneration.

There are many health conditions which supplementing minerals and vitamins benefit.

… with others the jury remains out.

Cautions when Taking a Multi-vitamin and multi-minerals to Ensure Vitamin Benefits and Reduce Vitamin Risks

To maximize vitamin benefits and minimize risks, keep the below in mind.

1. Multi vitamins cannot replace a healthy balanced diet, so don’t try. A healthy balanced diet provides nutrients including trace minerals, phytochemicals and fiber essential for long term health in combinations and forms that cannot be replicated exactly in a supplement. In fact, researchers are still identifying nutrients and health promoting elements of foods. For example, infant formula manufacturers haven’t been able to reproduce all the benefits of breast milk, despite decades trying – Adult supplements are no different.


2. Don’t take more than 10,000 IU /day of Vitamin A in the form of retinol (as opposed to beta-carotene) especially if pregnant. Excess retinol, whether from vitamins or prescription meds for acne and other conditions, is linked to birth defects.


3. Don’t supplement iron, before discussing with your health care provider. Generally, women of child bearing age are at most risk for iron deficiency and may need supplemental iron. If a healthy male or a post-menopausal woman, you likely won’t need supplemental iron. While essential for energy production, excess iron can function as an oxidant increasing risk for heart disease and other conditions.


4. Keep supplements, especially those containing iron, out of the reach of infants and children. Amounts of iron and other nutrients safe for an adult can kill a child.


5. If undergoing surgery or taking over-the-counter or prescription meds, discuss any supplements with your health care provider. Vitamins E, K, C as well as Omega 3 fish oil supplements can thin blood and prevent blood clotting. This can accentuate the blood thinning effects of Warfarin, Coumadin, aspirin and other medications.


6. If you smoke, don’t supplement Vitamin A, either as beta-carotene or retinol – get it from food. Several studies have shown a significant increase in lung cancer risk among smokers who supplemented beta carotene alone (18% higher risk than placebo) or in combination with high doses of retinol (28% increase in lung cancer risk compared to placebo). While some commentators speculate this was because the beta carotene and retinol (anti-oxidants when taken in combination with other nutrients) may have oxidized without complimentary nutrients. For more on lung cancer and diet press here.
   


7. If suffering or at high risk for colon cancer, don’t consume excess folic acid. Studies have suggested that since widespread fortification of folic acid in flour and breakfast cereal to reduce neural tube defects, there has been a statistically observable increase in colon cancer. Press here for more on Cancer and Nutrition, Cancer Prevention and Cancer Fighting Diets.
   


8. Folic acid supplements can interfere with some anticonvulsants. By contrast, some anticonvulsants deplete folic acid; so discuss with your health care provider, if you take epilepsy medication and want to supplement folic acid.


9. Some mineral supplements can diminish the effectiveness of thyroid replacement hormone when taken at the same time. Take vitamin and mineral supplements, including multivitamin and multi minerals as well as calcium, more than 4 hours before and 2 hours after consuming thyroid replacement hormone (Levothyroxine, Synthroid etc.). Again, discuss any supplements with your health care provider.

Common but Harmless Side-effects of Some Vitamins

• Vitamin B2 (Riboflavin) makes urine a vivid yellow, which is psychedelic looking but normal.


• Vitamin B3 (Niacin) in doses of 100 mg or more may make you flush. The effect is temporary. Use no-flush niacin if irritating.


• Vitamin C in high doses (usually over 5 grams) may have a laxative effect. The effect varies among individuals. Reduce dose to tolerance level.

Wanting to Ensure you get the Benefits from Your Vitamins? - Tips for Maximizing Vitamin Benefits

• Take your multivitamin/multi-mineral with food, unless the manufacturer states differently. This avoids nausea from taking on an empty stomach and promotes absorption.


• Avoid mineral imbalance by supplementing too much of one at the expense of another. Minerals are antagonistic to other minerals. An excess of one dietary mineral can deplete another. For example, zinc is antagonistic to copper. Too much can zap your copper stores and vice versa. A similar interplay happens between calcium and magnesium. It is why calcium, essential for bone health, should be supplemented along with magnesium, important for bone, as well as muscle and nerve function. Click here for more information about the interplay of magnesium and calcium in the benefits of calcium and the benefits of magnesium.

Maintaining Vitamin Benefits– Avoiding Overdosing.

Check your proposed Multi-vitamin multi mineral to make sure, when combined with your dietary intake including fortified foods, you don’t exceed healthy levels. While sufficient amounts of vitamins are important, overdoing it can erase any vitamin benefits and, possibly, cause harm.

As a rule, water soluble vitamins including Vitamins C and B are excreted in urine when consumed in excess. This is why it is hard to get too much and why they need to be replenished on a regular basis.

By contrast, fat soluble vitamins including Vitamins D, E and A can potentially build up in the body, along with excess minerals, and intake should be monitored to avoid excess.

The advantage of taking a quality well-balanced multi-vitamin mineral formula is to avoid vitamin or mineral excess or imbalance.

The Government’s View on Mineral and Vitamin Benefits -Despite words to the contrary, the government agrees supplementation works.

While the US government shies from endorsing vitamin and mineral supplements, it promotes and even requires fortification of food and has done so for years. Both government-mandated and voluntary fortification is widespread throughout the world. For more information on fortification in South Africa and worldwide click here. Fortification of the food supply is nothing less than supplementation.

• Folic acid has been added to flour and uncooked cereal grains since 1996 followed by a significant drop in neural tube defects in children.


• Calcium is added commonly to orange juice and soya milk.


• Vitamin D is required to be added to fluid milk in the US. It is added routinely to yoghurts and other dairy products, as a matter of course. Despite fortification, studies show we aren’t getting enough Vitamin D from diet.


• Iodine routinely is added to table salt to prevent goiter.


• Vitamin B3 (Niacin), removed during the milling process of refined flour, is required to be replaced, although not all nutrients are.

Maximizing Vitamin Benefits and Minimizing Risks– It is often not the Amount of a Nutrient but the Form of the Nutrient That is the Issue – Cheap but less effective Versions are Used

Generally with multivitamins, if taken as directed, overdosing is not an issue; by contrast, the better question is is your supplement giving you enough nutrients and the right kind? Many multis, especially the cheaper kinds, provide too little of a nutrient and in forms that are not as bio-available or effective as other types.

For example, some multivitamins provide the synthetic and less effective version of Vitamin E (Dl-alpha tocopherol), as opposed to the natural form of E (D-alpha tocopherol). Even if using the natural form of Vitamin E, few multi vitamins provide the full complement of Vitamin E forms including tocotrienols, which have been found to have specific health giving benefits, aside from the tocopherol form.

Calcium citrate or calcium chelate is absorbed twice as effectively as calcium carbonate but often the latter is used in supplements. See Benefits of Calcium for more information.

In order to maximize vitamin benefits, it’s worth considering the specific form of a vitamin or mineral used in the supplement.

Note on Dietary Values (DVs), Recommended Dietary Allowance (RDA) and Adequate Intakes (AIs) – They may not be the same as optimal intakes – What levels of minerals and vitamins benefit and what levels harm? Not always an easy answer

Daily Values (DV) or Recommended Daily allowance (RDA) are nutrient levels established by US public health officials to prevent nutritional deficiency diseases. In the case of nutrients, where there is not enough data to establish a DV, the government may provide an Adequate Intake (AI).

Neither DVs, RDAs or AIs are designed to promote optimal health; instead they are aimed to avoid vitamin and mineral deficiency.

In some cases, as we discover more about the effect of certain nutrients on health, we learn that the government DV’s and AIs are insufficient to achieve maximum health. Mineral and Vitamin Benefits will only be achieved if greater amounts are consumed than the government guidelines.

For example, the government recommended daily intake of Vitamin D is 600 IU (increased in 2010 from 400 IU). Nevertheless, as new research about the connection of Vitamin D and many diseases including cancer, heart and cardiovascular disease, as well as autoimmune conditions like MS, many physicians recommend their patients take up to 10,000 IU of Vitamin D, well beyond the DVs recommended by the government.

Click here for additional information on the recommended levels of Vitamin D and the government and other's position.

For the latest research on the upper safe levels of Vitamin D, press here.

In fact often, therapeutic doses of vitamins or minerals aimed to prevent or treat certain health conditions may be higher than DVs, RDAs or AIs. Check with your health care provider for his or her recommendation.

Vitamin Benefits for Specific Populations - Groups Who Could Benefit from tailored Vitamin and Mineral Supplements

The following populations have specific nutritional needs that might benefit from specially formulated multivitamin-multi mineral formula.

• Women pregnant and wishing to get pregnant – should get 400 mcg per day of folic acid through fortified food or supplements to reduce risk of birth defects. Due to the risk of birth defects, pregnant women should avoid supplementing Vitamin A from retinol. Instead, they should supplement beta-carotene to satisfy Vitamin A needs.


• Pregnant women – should take an iron supplement, as recommended by their health care provider.


• Breast fed and partially breastfed infants should receive a vitamin D supplement of 400 IU per day. Consult with your health care provider for the best form and frequency.


• Postmenopausal women should consider calcium and vitamin D supplements to prevent osteoporosis and bone fracture.


• Children have specific nutritional needs to ensure proper growth and brain development including sufficient Omega 3 fats.


• People fifty and over often don’t absorb dietary sources of Vitamin B-12 adequately and need supplements or fortified food containing adequate amounts of B 12.

Guidelines for Supplementing Key Vitamins and Minerals – Optimizing Mineral and Vitamin Benefits & Reducing Risks

The below list is from Patrick Holford’s The New Optimum Nutrition Bible, an invaluable reference for nutrition and supplements, including vitamin benefits and risks. He gives the following guidelines for the following Vitamins and Minerals, except for the RDA for Vitamin D which since 2010 is 600 IU per day for all persons, except infants and those 70 and over.

For the purposes of this chart, RDAs are Recommended Daily Allowance. These are generally similar to the Daily Value (DV’s) and Adequate Intakes (AI’s). ODA’s are Optimum Dietary Allowance as proposed by Holford. SR is the Supplement Range including healthy upper limits. Note that these SR figures may differ from the tolerable upper limit (UL) figures. To see a UL list click here for the Food and Nutrition Board Site.

All figures are given for healthy adults. Other populations groups may need less or more of certain nutrients. Finally, all figures represent nutrient amounts from all sources including food, both fortified and unfortified, as well as supplements.

GUIDELINES FOR SUPPLEMENTING KEY VITAMINS AND MINERAL – Helping you achieve Mineral & Vitamin Benefits and Avoid Risks. Vitamin A (Retinol and Beta-Carotene) - RDA 5,000 IU - ODA 8,250 IU – SR 3,300 to 10,000 IU B1 (Thiamine) – RDA 1.5 mg - ODA 35 mg – SR 15 to 45 mg B2 (Riboflavin) – RDA 1.7 mg - ODA 35 mg – SR 15 to 45 mg B3 (Niacin) – RDA 20 mg - ODA 85 mg – SR – 25 to 50 mg B5 (Pantothenic Acid) - RDA 10 mg - ODA 100 mg – SR 30 to 130 mg B6 (Pyridoxine) – RDA 2mg – ODA 75 mg – SR 45 to 95 mg B12 (Cyanocobalamin) – RDA 6 mcg – ODA 25 mcg – SR 10 to 40 mcg Folic Acid RDA 400 mcg – ODA 800 mcg – SR 200 to 600 mcg Biotin RDA 300 mcg– ODA 225 mcg – SR 30 to 180 mcg Vitamin C (Ascorbic Acid) RDA 60 mcg – ODA 2,000 – SR 800 to 2,800 mcg Vitamin D (Ergolciferol, Cholecalciferol) RDA 600 IU– ODA 4000 IU– SR –120 to 200 IU Vitamin E (D-Alpha Tocopherol is the natural form – prefer this to the synthetic version Dl-Alpha Tocopherol ) RDA 30 IU – ODA 450 – SR – 225 to 600 IU MINERALS Calcium RDA 1,000 mg– ODA 1,000 mg– SR 1 to 400 mg Magnesium RDA 400 mg – ODA 500 mg – SR 50 to 250 mg Zinc RDA 15 mg– ODA – 20 mg - SR 5 to 20 mg Selenium RDA None Established– ODA 100 mcg – SR 25 to 150 mcg

A Final Comment on Vitamin Benefits and Risks

The above vitamins and minerals are listed because they are often deficient in the average diet. The key when supplementing minerals and vitamins and achieving dietary health benefits in general, as well as vitamin benefits in particular, is balance.

Hopefully, this page will give you some food for thought – as well as some common sense resources to help achieve nutritional health and the many benefits of vitamin and minerals for you and your family.

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For more reading about Vitamin Benefits and specific supplements for specific issues....

Click here for more information on Vitamin Benefits and Risks from the National Institute of Health (NIH) Office of Dietary Supplements. This is an informative fact sheet containing useful information about the risks and benefits of vitamins.

Click here to read more about a Healthy Balanced Diet.

Click on Benefits of Magnesium to learn more about magnesium supplementation.

Click on Benefits of Vitamin D to learn more about the powers of Vitamin D.

Click on the Benefits of Zinc to learn more about the importance of zinc.

Click on the Benefits of Vitamin C to learn more about the usefulness of C.

Click on the Benefits of Chromium to learn more about the importance of chromium for blood sugar.

Click here to read more about a Omega 3 Benefits.

Click here to read more about anti-oxidants and orac values.

Click here to read about anti-inflammatory diets.

Click here to read about the top anti-inflammatory supplements.

Click here to read about low glycemic diets.

Click here to read about healthy diet tips.

Click here to read about the benefits of organic food.

Healthy Diet News Blog for current news and updates on health including recent discoveries about specific vitamin benefits and risks.

Click here to return to Healthy-Diet-Healthy-You home page.