Archive for August, 2011

To Vitamin Supplement Or Not…That Is The Question

August 27, 2011

When I turned 50, I started taking a multivitamin and mineral supplement, not previously having taken a vitamin since I took Zestabs or Chewable Chocks as a kid.  I figured I was on the back nine of life and needed all the help I could get.  Being the value-oriented consumer that I am, I headed over to Costco and picked up One-A-Day Men’s Health Formula that claimed to support prostate health, heart health and healthy blood pressure…sounded really good to me!  Each tablet contained Vitamins A, C, D, E, K, B1, B2, B3, B6, folic Acid, B12, biotin, calcium, pantothenic acid, iron, magnesium, zinc, selenium, copper, manganese, chromium, potassium and lycopene.  It seemed like a lot of bang for the buck.

I continued taking the vitamins for a year or so, but did not notice any tangible kind of benefit—I did not feel better, was not more energized, stronger, more potent in any way imaginable, did not get less colds, and my annual blood chemistries were unchanged.  I came to the realization that I derived a lot more benefit from my morning caffeine infusion than from the daily vitamin!  Frankly, I had felt pretty good before starting the vitamin and mineral supplement and since I felt absolutely no different after using them, I stopped taking them and have never looked back.  That stated, I eat a very healthy diet with an abundance of vegetables, fruits, legumes, whole grains, and lean sources of protein and have little doubt that my diet leaves me in good shape in terms of sufficient vitamin and mineral intake.

Approximately one in three Americans use multivitamins and mineral supplements on a regular basis.  There is no question that we need these micronutrients in sufficient quantity to sustain our health.  A nutritious and well-rounded diet should most certainly provide these essential micronutrients.  The exceptions to this are the following: If your diet is poor; if you are pregnant; if you are a child; or if you are ill or immuno-compromised due to certain medical conditions.  Under such circumstances, supplementation is important.  According to Tufts University Professor of Nutrition Susan Roberts, “multivitamins can fill in the gaps if you get too little of some vitamins and minerals from your food.”  Specifically, there are five micronutrients that many Americans do not get enough of: vitamin D, folic Acid, B12, iron and calcium.

Vitamins and minerals that exist within vegetables, fruits or other nutrients are advantageous because these foods contain important enzymes, peptides, and phyto-nutrients that are necessary to the utilization of the vitamins and minerals.  Many scientific studies have concluded that vitamins and minerals derived from dietary sources are superior to synthetic or formulated vitamin pills.  Bioavailability, as defined in Mosby’s Medical dictionary, is the degree of activity or amount of an administered drug or other substance that becomes available for activity in the target organ/tissue.  In short, the bioavailability of the vitamins and minerals within a multivitamin is often very much less than that of the vitamins and minerals in their natural form.

The other issues aside from bioavailability are that multivitamins vary greatly in quality, some have only trivial amounts of some micronutrients, and many have claims that are not clinically proven.  Nobody even knows if the recommended quantities (the RDA or Recommended Dietary Allowances) are accurate or relevant.  Another point is that the fat-soluble vitamins D, E, A, and K are stored in the body, and excessive quantities can be problematic.  On the other hand, excessive intake of the water-soluble vitamins B and C end up being urinated out into the toilet bowl.

The Bottom Line:  In my humble opinion: If you eat a healthy, well-balanced diet that includes fruits, vegetables, lean protein, and whole grains, don’t waste your dollars on a multivitamin or mineral supplement.  You are better off spending your money at Starbucks!  However, this does not refer to children, pregnant women, those suffering certain illnesses and those with a poor diet.  If you are deficient in D, B12, folic acid, iron or calcium, it is of paramount importance to supplement your diet appropriately.

Andrew Siegel, M.D.