Vitamins

What’s in Your Multivitamin? The Good, The Bad, and the Fillers

multivitamin

Essential Vitamins and Minerals

Even the healthiest diet might not provide optimal amounts of essential vitamins and minerals.

“Ninety-two percent of Americans are deficient in one or more essential vitamins and minerals, 80 percent are deficient in vitamin D, and over 99 percent are deficient in the essential omega-3 fatty acids,” says Mark Hyman, MD, in The UltraMind Solution.

Over time, deficiencies in even one micronutrient can contribute to numerous conditions including osteoporosis, cognitive performance, and cancer.

How Can an Optimal Diet Be Deficient in Nutrients?

There are lots of reasons. Here are five.

  1. Soil depletion means fruits and vegetables that grow today lack the amounts of vitamins and minerals they had decades ago.
  2. Chronic stress, which manifests in nearly every area of our lives, can deplete nutrients. “[H]igh stress can make you absorb nutrients poorly, especially B vitamins,” says Sara Gottfried, MD, in Younger.
  3. More people eat processed, fast, and otherwise-convenient foods rather than cook their own healthy meals.
  4. The Environmental Protection Agency (EPA) estimates that over 85,000 chemicals fall under the Toxic Substances Control Act. Environmental toxins permeate nearly everything, including the air we breathe, the food we eat, and many household and beauty products, which impact nutrient levels.
  5. We don’t always choose organic foods, which tend to be higher in nutrients and low in pesticides.

A multivitamin-mineral (abbreviated here as a multivitamin, although many contain minerals too) can help fill those “relatively small but critical nutritional gaps” and help maintain or improve overall health.

Health Benefits of Taking a Multivitamin

Almost everyone who takes a multivitamin says they get sick less often. Research supports those claims: Specific nutrients in multivitamins (including zinc and vitamin C) can support your immune system.

The right supplement can also benefit many other conditions. If you want to lose weight, you might consider taking a multivitamin. Two studies found taking a multivitamin seemed to suppress appetite among females and help men lose more weight compared with those who didn’t take one.

A multivitamin can protect your body and brain. One large population-based observational study found that healthy older adults who used one containing antioxidants were 50 percent less likely to experience cognitive decline five years later than those who didn’t.

The benefits go on, and research becomes more clear: The right multivitamin can benefit you in so many ways.

“Used smartly, [multivitamins] can provide therapeutic doses of important nutrients that are difficult to get from food, at least in the optimal doses,” write Jonny Bowden, Ph.D. and Steven Masley, MD, in Smart Fat. “They can also provide good insurance that your body has all the micronutrients it needs every day.”

Are Store-Bought Nutrients Bad?

Over one-third of Americans take supplements. Multivitamins account for almost one-sixth of all supplement purchases and 40 percent of all vitamin and mineral supplements sales. Of the estimated $36.7 billion Americans spent on supplements in 2014, about $5.7 billion was for multivitamins.

Everyone loves a bargain. Walking through your favorite supermarket or warehouse store, you’ll find lots of things to stock-up on. But one thing you should never, ever skimp on is a multivitamin, the most commonly used dietary supplement in America.

That’s because taking the wrong multivitamin can potentially create more harm than good. In 2015, researchers tested herbal supplements from four national retailers and found out of five products did not contain any of the herbs listed.

“The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies,” says Anahad O’Connor in the New York Times.

While these researchers investigated herbal supplements, their conclusions left some critics wondering whether other supplements (such as multivitamins) could also contain inferior ingredients, different amounts of specific nutrients than the label says, or potentially harmful ingredients.

Take selenium, usually found in micrograms — very, very tiny amounts — in supplements. In the correct amounts, this mineral can provide brain, thyroid, heart, and other health benefits.

But too much selenium — which can easily occur if manufacturers miscalculate amounts in supplements — can create hair and nail loss, lesions of the skin and nervous system, nausea, nervous system abnormalities, and other problems.

That’s not to say that commercial multivitamins are mislabeled or otherwise misleading, but as the herb-supplement investigation revealed, you could easily purchase mislabeled store-bought supplements.

While the U.S. Food & Drug Administration (FDA) regulates dietary supplements, they use a different set of regulations than with conventional foods and drug products. For the most part, the FDA can only take action after the product is on the market.

That mostly makes manufacturers responsible for putting out quality, efficacious products. Many reputable brands will submit products for third-party testing, where a laboratory can verify purity and product label accuracy. You’ll typically find that seal of approval on the product label.

Recommended Dietary Allowances (RDAs) and Daily Values (DVs) – Are They Enough?

Look at many one-a-day multivitamins and you’ll find the Recommended Dietary Allowances (RDAs) — listed as Daily Values (DVs)– which are the average daily level of intake sufficient to meet the nutrient requirements for most healthy people, for specific vitamins and minerals.

While most commercial one-a-day multivitamins generally contain at least 100 percent of the RDA for specific vitamins and minerals, some critics argue that isn’t enough.

“RDAs were developed during World War II as part of the dietary recommendations for soldiers and others who were living on rations,” say Bowden and Masley. “They aren’t—and never were—a good measure of what nutrients we need for optimal health, and there is a vast difference between the minimum amount we need to avoid a specific vitamin-deficiency-triggered disease and the optimal amount we should have for overall excellent health.”

Put another way, you don’t want to simply bypass illness or disease, you want optimal amounts of nutrients to help you thrive and cultivate vibrant health.

Consider vitamin D, in which Hyman noted 80 percent of Americans are deficient. In one study, researchers argued that the (RDA)  “underestimates the need by a factor of ten,” arguing insufficiencies have a broad impact on health and disease.

Likewise, consider the many roles B vitamins play, including energy metabolism. Numerous factors — including age, pregnancy, dietary choices, medical conditions, genetics, medication, and alcohol use — can increase your body’s B vitamin requirements.

Supplementing with optimal amounts of these B vitamins–which often exceed the RDAs–can help you better manage mood disorders, including stress, anxiety, and depression.

Similarly, vitamin C is your brain’s most prevalent antioxidant that can also help specific immune cells optimally perform. Research shows that a high-dose B vitamin complex (plus vitamin C and minerals) could improve stress levels, cognitive performance, and vigor.

(Worth noting: Higher amounts of certain B vitamins can turn your urine bright yellow. That’s simply your body’s way of getting rid of excess water-soluble nutrients. Don’t panic!)

That’s not to say you should take megadoses of specific vitamins and minerals (although therapeutic doses of specific nutrients under a healthcare practitioner’s guidance can benefit certain conditions). As the aforementioned selenium example showed, too much of a good thing can become a bad thing.

Instead, you want to get optimal amounts of vitamins and minerals in your multivitamin, but you also want to take those nutrients in the correct formulation.

Look at the Ingredients

 

Most one-a-day multivitamins contain just enough of those nutrients to get by, but even that amount becomes meaningless if you aren’t absorbing those nutrients, you’re taking inferior forms of specific nutrients, or you’re getting nasty ingredients in that multivitamin.

Here’s the ingredients list for one popular one-a-day multivitamin:

Calcium Carbonate, Microcrystalline Cellulose, Dicalcium Phosphate, Ascorbic Acid, Ferrous Fumarate, Maltodextrin; Less than 2% of: Beta-Carotene, Biotin, Cholecalciferol, Chromium Chloride, Croscarmellose Sodium, Cupric Oxide, Cyanocobalamin, D-Calcium Pantothenate, dl-Alpha-Tocopheryl Acetate, FD&C Blue #2 Aluminum Lake, FD&C Yellow #5 (tartrazine) Aluminum Lake, FD&C Yellow #6 Aluminum Lake, Folic Acid, Gelatin, Hydroxypropyl Methylcellulose, Magnesium Oxide, Manganese Sulfate, Niacinamide, Phytonadione, Polyethylene Glycol, Potassium Iodide, Pyridoxine Hydrochloride, Riboflavin, Silicon Dioxide, Sodium Selenite, Stearic Acid, Thiamine Mononitrate, Titanium Dioxide (color), Vitamin A Acetate, Zinc Oxide.

The Bad Ingredients

Let’s break down a few problems with this multivitamin:

  • It contains the oxide form of minerals like zinc. Many commercial brands use this cheap, poorly absorbable form of minerals. One study showed zinc oxide absorbed most poorly among several other forms of this mineral, and that three of the 15 healthy young adults absorbed little or no zinc from zinc oxide.
  • It contains synthetic versions of some nutrients. This multivitamin contains the synthetic form of alpha-tocopherol, an isomer of vitamin E. Research shows that synthetic alpha-tocopherol (labeled “dl-alpha-tocopherol”) is only half as active as the same amount in the natural form (labeled “d-alpha-tocopherol”).
  • It contains folic acid rather than folate. In better multivitamins, you will find vitamin B9 as folate, the form this vitamin occurs naturally in food. Your body eventually converts both forms — folic acid and folate — into 5-methyltetrahydrofolate (5-MTHF). However, for folic acid, that process is slow and inefficient. Researchers find un-metabolized levels of folic acid in some people’s bloodstream, potentially increasing the risk of cancer and (for elderly people especially) disguising vitamin B12 deficiencies.
  • It contains iron. While some women’s multivitamins, such as this one, contain iron (as ferrous fumarate), research shows that taking this mineral along with vitamin C can exacerbate oxidative stress in the gut, potentially creating ulcers and even cancer in some individuals. “The body tends to hold onto extra iron — and if you take too much, that can be dangerous,” says Stacy Wiegman, PharmD. “Over the long run, an excess may lead to liver damage and even diabetes.”
  • It contains junk fillers. Here, they include artificial colors (like FD&C Blue No. 1). “[A]rtificial colors in your vitamins serve no function other than making food look more ‘fun’, or even worse, cover up the fact that the active ingredients in the vitamin has been degraded by exposure to light, air, moisture, heat, or poor storage conditions,” says Erika Yigzaw from the American College of Healthcare Sciences. Likewise, titanium dioxide — which provides more color to many multivitamins — has been linked to problems including lung inflammation, immune system dysfunction, kidney damage (in mice), and small intestine inflammation. “Yet again, our health is risked so our vitamins can be a pretty color,” says Yigzaw.
  • It contains potential food sensitivities. Maltodextrin, a highly processed white powder usually derived from corn or other starch, is a filler that also helps preserves the shelf life of packaged foods (or in this case, supplements). If you have corn sensitivities, this multivitamin could trigger or exacerbate symptoms.

Other multivitamins can contain inflammatory hydrogenated oils, poorly absorbable binders, and inferior sources of specific nutrients including vitamin D2. (Vitamin D3 raises your levels of this crucial vitamin better than vitamin D2.)

When you’re not optimally absorbing the nutrients in multivitamins, you’re wasting money. And when you’re getting potentially harmful ingredients, you’re compromising your health.

The Good Ingredients

At the same time, choosing the right multivitamin can feel bewildering and confusing. Here are some items to look for:

  • The ideal form of vitamins such as vitamin D3 and natural vitamin E (as alpha-tocopherol).
  • Optimally absorbed forms of minerals like selenium as SeleniumSeLECT®.
  • Mixed tocopherols and tocotrienols (these are different isomers of vitamin E that mimic what you get in food).
  • Other B vitamins including inositol and choline.
  • Additional antioxidants such as lycopene.
  • No iron. (Talk with your healthcare practitioner about using iron supplements based on your specific needs.)
  • Targeted nutrients for your condition, such as breast health or stress management (for women) and prostate health (for men).
  • Ingredients are certified to be non-genetically modified (non-GMO), free of preservatives as well as artificial colors and flavors, sugar- and salt-free, gluten-free, and free of food sensitivities including nuts.

Remember: What’s not in your multivitamin becomes just as important as what is!

If you really want to simplify things, only purchase professional-quality supplements from a healthcare practitioner. That eliminates the guesswork since these professionals stand by the quality of their supplements. After all, their reputation is on the line!

Inferior multivitamins are a real misfortune because everyone benefits from getting optimal nutrients, and the wrong supplement can potentially create more harm than good.

“The answer to the quality problem is not to stop taking supplements—it’s to take better quality supplements,” said Bowden and Masley. “Unfortunately, you’re rarely going to find them at your regular grocery store, ‘big box’ stores, or local pharmacy.”