Margaret Gordon-Fogelson is a third-year medical student at the Larner College of Medicine at UVM. She is pursuing a specialty in primary care and family medicine.

Margaret Gordon-Fogelson is a third-year medical student at the Larner College of Medicine at UVM. She is pursuing a specialty in primary care and family medicine.

There are some misconceptions about multivitamin use, specifically that they are “medications” meant for treating or preventing disease.

Let’s be clear: Multivitamins are not FDA approved as medications. They are not meant to cure disease.

According to the federal government’s 2010 Dietary Guidelines for Americans, “[s]ufficient evidence is not available to support a recommendation for or against the use of multivitamin/mineral supplements in the primary prevention of chronic disease for the healthy American population.” Currently, many experts support a “no benefit, no harm” role of multivitamins.

A number of large-scale randomized trials suggest that, for the majority of the American population, taking multivitamin supplements does not provide an overall benefit to health and mortality. In fact, multivitamin misuse is associated with deleterious effects on health.

So, when should you take a multivitamin? Here are some questions (and answers) to help you find clarity.

What if I’m not getting enough of certain nutrients?

Multivitamins are meant to supplement diets that are deficient in various nutrients. They help people get the suggested amounts of vitamins when they cannot meet their needs from food alone. A multivitamin-mineral is a dietary supplement containing three or more vitamins or minerals. Although there are some vitamins that our bodies can make, we get other vitamins from different foods in our diet.

When dietary intake is poor, multivitamins play a beneficial role in preventing vitamin deficiencies that lead to serious illnesses. For example, a lack of Vitamin D may cause rickets, which can result in permanent deformities in children (Learn more about Vitamin D for children in this video featuring the UVM Medical Center pediatrician Lewis First, MD). Vitamin deficiencies are usually due to dietary inadequacy, impaired absorption, increased requirement, or rapid excretion.

Do I need to eat fruits and vegetables if I take a multivitamin?

A multivitamin should NOT replace eating fruits and vegetables nor should it supplement an already healthy and balanced diet. Healthy people with adequate diets rich in vitamins probably do not require additional amounts. In fact, too much of certain vitamins can have harmful effects. That being said, many busy Americans find it difficult to make time for eating well-balanced meals.

Is there too much of a good thing when it comes to multivitamins?

Some vitamin pills contain levels that are much higher than you could ever get from eating food alone. Without appropriate regulation, some pills may contain doses that are substantially higher than the recommended daily amounts. They may also have other unspecified nutritional and herbal ingredients.

  • Vitamin A: In natural doses, can provide protective antioxidant effects. However, in large amounts, the effects become “pro-oxidant” and can damage cells, blood vessels, and organs like the liver.
  • Vitamin E: In normal levels, serves as an antioxidant and protects blood vessels from harmful cholesterol. In some studies, vitamin E toxicity (over 1,000 mg/day) has been associated with an increased risk of bleeding and possible long-term risk of prostate cancer.

What is the best way to choose a multivitamin?

Read the labels. Specifically, consider:

  1. What vitamins and minerals are included?
  2. Do you need all the vitamins? Which vitamins do you already consume enough of from diet alone? Which vitamins are you lacking?
  3. How much of each vitamin is in the pill? The USDA and CDC publish recommendations regarding the “safe” amounts of daily vitamin intake. Consuming more than the recommended amount can have harmful side effects. According to the experts, “trust your body.” It will use what it needs and get rid of the rest. Do not buy multivitamins containing more than 100% of the recommended daily amount. Your body will just eliminate the excess.
  4. Cost does not = quality. Just because it’s expensive does not mean it is better. Learn more about vitamins in the UVM Medical Center’s Health Library, stop by the Frymoyer Community Health Resource Center to speak to a health librarian, or tweet us your questions at twitter.com/UVMMedCenter.

Margaret Gordon-Fogelson is a third-year medical student at the Larner College of Medicine at UVM. She is pursuing a specialty in primary care and family medicine. Most recently, she was a clerkship resident with the Colchester Family Practice, part of the UVM Medical Center’s network of family medicine providers. 

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