Chances are you’ve been told from a young age to take your vitamins. But just how important are they in our daily routines? Is a multivitamin “one size fits all,” or can vitamin supplementation be targeted to your specific dietary needs? Do vitamins really ward off ailments like the common cold, or could they be doing more harm than good? We’re answering some common questions about vitamins and nutritional supplements, and clearing up some misconceptions surrounding their ability to protect against cancer and other chronic diseases.
Vitamins: Exactly How Important Are They?
“In a perfect world, we would get all of the nutrients we need from our dinner plates,” says Melissa Bennett, certified natural health practitioner at Natural Health Atlanta. “Unfortunately, with today’s processed food and our natural affinity toward refined flour and sugar, we really fall short of the nutritional mark.”
Bennett says the best way to determine what vitamins you need to be taking is to have a nutritional evaluation and micronutrient test. This will determine if you are absorbing nutrients, or if you need to increase the amount through supplementation or food sources. “As a general baseline, I always recommend a good whole food multivitamin, a probiotic and opti DHA/EPA as foundation products,” she says.
That is not to say that taking vitamins gives you a free pass from eating healthily. “Food cannot be replaced with vitamin supplements,” says Amanda Bakalar, lead nutritionist at Dramatic Weight Loss. “The body absorbs vitamins much better in their natural state from fresh foods rather than taking a supplement.”
Also keep in mind that over-supplementing could be too much of a good thing. “Some vitamins have toxicity levels, and getting too much of them could actually cause harm,” Bakalar says. “A lot of foods are already fortified with vitamins. So if you are already a healthy eater, then it is probably best to focus only on supplementing certain vitamins where your diet may fall short.”
Could You Be Vitamin Deficient?
It is possible to be vitamin deficient and not know it because it usually develops slowly, and in the early stages, there are no classic symptoms. According to Mayo Clinic, some common characteristics of low vitamin status include fatigue and lethargy, insomnia, irritability, loss of appetite and poor concentration.
It is also important to note that “clinical” vitamin deficiencies result in specific diseases. For example, a lack of vitamin C eventually produces scurvy and is characterized by swollen joints, bleeding gums and aching bones. Scurvy is treatable by increasing vitamin C intake with supplements or citrus fruits.
Other cases of vitamin deficiency could be the result of a medical procedure. “Some people who have had bariatric surgery, for example, need supplements because they are unable to absorb vitamins normally,” explains Dr. Sylvia Morris, a board-certified physician in internal and holistic medicine at Emory University. Certain health conditions, especially those that affect how our bodies absorb nutrients, can cause vitamin deficiencies as well. “People suffering from celiac disease are extremely sensitive to gluten, which is a type of protein found in wheat, barley and rye,” says Dr. Kelly Degraffenreid, chief of primary care at Kaiser Permanente of Georgia. “Doctors often prescribe vitamin and mineral supplements to ensure those patients get the nutrients their bodies need.”
But more often than not, a vitamin deficiency is easy to diagnose and requires just a simple fix. “People who avoid sun exposure may be low in vitamin D and need supplementation,” Dr. Morris says. “Bone fracture in elderly or post-menopausal women may be an indicator of vitamin D or calcium deficiency. Change in memory may indicate vitamin B12 deficiency. Cheliosis (splitting of corners of mouth) is associated with vitamin B deficiency.”
Organic vs. Synthetic Vitamins
With so many multivitamin supplements on the market, it can be difficult to decipher what’s what. “Always look for a ‘whole food supplement,’” Bennett says. “These supplements are easily assimilated and processed by the body. If a supplement has too many additives, dyes and other fillers, your liver has to process these as well as the supplement. I always say ‘if you can’t pronounce it, don’t ingest it.’”
So just what makes a vitamin “natural” or “organic”? “Natural vitamins often have a plant-based source, rather than a chemically manufactured source,” explains Dr. Tasneem Bhatia, Medical Director at Atlanta Center for Holistic and Integrative Medicine. “Organic labeling means the products comply with certain requirements as regulated by the USDA and have minimal pesticides, phthalates or parabens. A product cannot claim it is organic unless it meets the certification guidelines.”
It’s also important to understand that there are two types of vitamins—water-soluble and fat-soluble. “B vitamins, such as folic acid and biotin, are water-soluble,” Dr. Degraffenreid says. “If you take too much of those vitamins, your body can flush out the excess through your kidneys. Vitamins A, D, E and K are fat-soluble. The body can store these vitamins, which may lead to health problems. Although you will find ‘mega’ doses of vitamins on the market, the most efficient and cost-effective is a regular multivitamin.”
And when considering a new vitamin, always read the labels. “All ingredients should be listed, in the appropriate amounts,” Dr. Bhatia says. “Some supplement companies seek certifications that verify authenticity of the product. Common seals are the NSF, GMP and USP.”
Vitamins and Drug Interactions
It is always important to tell your doctor or healthcare provider what vitamins or supplements you are taking due to the risk of certain drug interactions. “Proton pump inhibitors (PPIs) can inhibit magnesium, calcium and iron absorption,” Dr. Morris says. “Iron supplements and thyroid medications should be taken separately (morning and night or at least two to three hours apart), as iron causes reduced concentration of levothyroxine. Iron also reduces the concentration of levodopa (Parkinson’s medication).”
Certain medications can also make your body deficient of certain nutrients. “For example, antibiotics may cause nutrient loss in zinc and iron,” says Saira Gillani, naturopathic doctor at Natural Health Atlanta. “And antidepressants may cause nutrient loss in vitamin B12 and CoQ10.”
Do Vitamins Help Prevent Disease?
Unfortunately, the jury is still out on supplements and disease prevention. “Vitamins’ role in cancer and disease prevention is not clearly understood,” Dr. Morris says. “Vitamin E and beta carotenes were reported to prevent cancer, however, the study results have not been consistent and therefore recommendations cannot be made.”
Dr. Degraffenreid concurs. “With the exception of vitamin D and calcium supplementation being beneficial for bone health and possibly colon cancer, additional vitamins are not needed, according to evidence-based medicine,” she says. “Researchers initially thought many vitamins would help prevent heart disease, cancer, dementia and respiratory illnesses, but that has not been proven by controlled studies.”
Still, many experts do see a connection between vitamin deficiencies and certain diseases. “Many diseases can be traced back to pathways that begin as a result of dietary or genetic nutritional deficiencies,” Dr. Bhatia says. “Breast cancer and heart disease, for example, can be diseases of B vitamin and magnesium deficiency, or poor utilization. If caught early enough, these micronutrients can prevent disease.”
Did You Know? Vitamins and the FDA
Unlike medications and prescription drugs, the Food and Drug Administration (FDA) does not have to approve or even inspect vitamins sold in the United States. Federal law classifies vitamins as a “dietary supplement,” which places them under the category of food and not drugs.
As a dietary supplement, the FDA does not need to “authorize” a vitamin for sale, so it is the job of the manufacturer to ensure that the vitamins it sells are safe before entering the market. However, the FDA can limit the sale of vitamins if it finds a product is unsafe.
Manufacturers have to be sure that the product is safe, and if the manufacturer receives any reports of harmful health effects from people using its product, it has to report those to the FDA. The FDA can then investigate these claims and issue a recall if it concludes a product is unsafe.
Amanda Bakalar - Dramatic Weight Loss
Melissa Bennett ND, Saira Gillani ND - Natural Health Atlanta
Tasneem Bhatia MD - Atlanta Center for Holistic and Integrative Medicine
Kelly Degraffenreid MD - Kaiser Permanente of Georgia
Sylvia Morris MD - Emory Healthcare