Pain, depression, immunity boosting, or just general health – whatever your physical ailment may be these days, it seems as though there is a vitamin or supplement that can help fix it. I, too, am no stranger to hoarding quite a few jars of “natural” products intended to keep my family and me in top shape. Dietary supplements are a multi-billion dollar industry with a lot of attractive claims, and I’m not averse to recommending them or even using them occasionally depending on specific issues and health conditions. In fact, I recently recommended that my husband take magnesium and calcium supplements. He most likely will be on a lifelong medication called a proton-pump inhibitor for acid reflux. This type of therapy suppresses acid and can cause reduced levels of both magnesium and calcium. By supplementing, he can help keep those levels sufficient and support good bone density.
Yet, I wouldn’t consider myself a very strong vitamin advocate for some good reasons which are explained later in the article. The draw to natural products is higher than ever these days, much of this due to the increasing knowledge that conventional therapy can fall short in more ways than one. I just saw yet another commercial advertising legal action for a popular drug – another detrimental side effect, another class action lawsuit. Sometimes conventional medication doesn’t work as well as promised, or maybe it is too expensive and insurance doesn’t cover the copay. Whatever the issue may be with traditional pills and potions, people are turning more and more to supplements to help optimize their health – products that are easily available, often relatively inexpensive, and – most importantly – offer a chance to help resolve issues “naturally.”
Many vitamins carry some purpose, but how much is too much? Does everyone need to take a multivitamin? When are some vitamins actually warranted?
The biggest reason I am not a very strong advocate for vitamin supplementation is because of some studies that show adverse side effects – even a higher risk of death – with excess dietary supplementation. Another study found that higher levels of vitamin E raised the risk of prostate cancer in healthy men. You may be thinking similarly to me when I read these studies – “how could this be?” Vitamins are supposed to be healthy, and people who take them are supposed to be healthy.
The studies should be explained a little further. They actually support a strong “U-shaped” risk curve, or – in other words – too little or too much vitamin supplementation can be detrimental to our health. To understand this concept a little better, I think of it this way: when we are deficient in a certain type of vitamin, we need to bring that level back up to par to maintain good health. However, when we go beyond those levels, sometimes bad things can happen.
Fortunately, for most healthy people, our bodies have an innate ability to keep our vitamin levels right where they should be – the setpoint that works for us and keeps us functioning as we should. In fact, if we supplement with exogenous vitamins, we can sometimes interfere with our bodies’ process to regulate levels. Our bodies do a lot of wonder on their own, and sometimes it is best to just let it be.
Of equal importance is that I try not to let these studies – especially those that examine mortality – scare me. When studies are conducted, they are meant to draw more information – not to be used as scare tactics. Many studies have inherent drawbacks that make it hard to extrapolate the results to absolutely everyone. The information that I do take home from reading these study results is that vitamin supplementation is not necessary for everyone. And, if you are solely relying on a medicine cabinet full of supplements to maintain health, you are probably doing more harm than good.
Because of these issues, the decision to supplement with a certain type of vitamin or not can be a tricky one to make. I think a positive note is that deciding to try a vitamin or mineral for a period of time is mostly harmless for the vast majority of people. My mom has some issues with restless legs at night. Sometimes magnesium can help with this, and I didn’t see any issue with her trying it. If it doesn’t help, she can always stop. This occasional use of a supplement here and there is highly unlikely to cause any issues.
If you are experiencing a condition that is severe enough, I always recommend getting a blood test done to examine the common levels of vitamins and minerals to see exactly where you stand. I find this is a huge help to people who suffer from depression or other issues that involve cognitive health. In the mental health realm, conventional medication is notorious for falling short. Many people fail traditional medication because their problem is not with serotonin or dopamine levels; they may simply be deficient in the vitamins and minerals that are associated with good cognitive health, such as vitamin B12, folic acid, and iron. I also recommend supplementing with vitamins if you are on a medication that is known to cause a decrease in certain levels, like the example of my husband and acid-suppression therapy.
The best and easiest way for our body to maintain optimal vitamin stores is to eat a variety of good foods. I know that the typical American diet is probably not ideal due to the myriad of temptations and the ease and affordability of processed foods. However, if you are a healthy individual who eats a relatively decent diet (even with indulgences), rest assured that your body is probably doing a good job extracting what it needs.
When it comes to multivitamins, I believe that only certain populations benefit. If your diet is incredibly poor (think lots of fast food and very little fruits and vegetables), a multivitamin may be of benefit to you. I keep a bottle of gummy vitamins in my cabinet for my two toddlers, yet they don’t take them every day. I try to do a good job of presenting them with a variety of food; however, I know that their young minds lack the capability to make good decisions regarding nutrient intake and that their taste buds haven’t matured enough to truly know what they like or don’t like. For instance, I’m not particularly fond of the taste of raw tomatoes, but I try to include them in sandwiches and salads anyway for their health benefit. My children don’t have the ability to do this and will just refuse (or spit it out, usually somewhere on me or in my vicinity!). I know that their young bodies are growing and that a multivitamin from time to time will probably do more benefit than harm.
Women who are pregnant or breastfeeding should also take a vitamin. Their bodies are working overtime, and many nutrients – like folic acid – are essential to the growing fetus or nursing baby. Some people have conditions that affect vitamin absorption, so they would probably benefit from a multivitamin, as well. An example would be cystic fibrosis or chronic liver disease which affects the absorption of fat-soluble vitamins.
One particular vitamin that I do advocate for everyone is vitamin D. Vitamin D is not naturally abundant in our foods, and many people have low levels. I especially recommend taking a vitamin D supplement in the winter, when our exposure to natural sunlight (an important source of vitamin D) is low. Vitamin D has also not been shown to be associated with many adverse effects in typical dosing, unless you have undetected kidney issues.
The important thing to remember about vitamins is that too little or too much can be detrimental – this is a similar concept surrounding many issues in healthcare. If you do choose to supplement with a vitamin, try to look for a product that is verified by the United States Pharmacopeia (USP). These products abide by good manufacturing processes and ensure some degree of quality.
References:
Mursu J et al. Dietary supplements and mortality rate in older women: The Iowa Women’s Health Study. Arch Intern Med. 2011;171:1625–33.
Bjelakovic G et al. Vitamin and mineral supplement use in relation to all-cause mortality in the Iowa Women’s Health Study. Comment on “dietary supplements and mortality rate in older women.” Arch Intern Med. 2011;171:1633–4.
Klein EA et al. Vitamin E and the risk of prostate cancer: results of the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011; 306:1549–56.
