Do multi-vitamins do more harm than good?
You may not realize it, but people have been supplementing vitamins and minerals for thousands of years.
It is a common misconception that our ancestors only ate off of the land, and most people are not aware that ancient cultures treated nutritional deficiency with whatever crude methods that were available to them at the time.
The perfect illustration is how ancient Egyptians recognized and treated vision problems associated with vitamin A deficiency. The Ebers Papyrus, the famed medical papyrus of herbal knowledge dating to 1550 BC, discusses at length the techniques used by ancient Egyptian physicians to treat night blindness by squeezing the “juices” of a grilled lamb's liver into the eyes of their patients. Then the patient would eat the liver, which is extremely rich in vitamin A. (1) It’s hard to imagine what that would look like today, but it really highlights the length people were willing to go to maintain their health, doesn’t it!
Dietary supplement defined
Although it may seem a tad unconventional to use to view lamb’s blood as a supplement, it actually fits the definition of a dietary supplement perfectly. According to the U.S. Food and Drug Administration: (2)
A dietary supplement is a product intended for ingestion that contains a “dietary ingredient” intended to add further nutritional value to (supplement) the diet. A “dietary ingredient” may be one, or any combination, of the following substances:
- Herb or other botanicals
- Amino acids
- Dietary substances for use by people to supplement the diet by increasing the total dietary intake
- Concentrates, metabolites, constituents, or extracts
Dietary supplements may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. Some dietary supplements can help ensure that you get an adequate dietary intake of essential nutrients; others may help you reduce your risk of disease.
Not just isolated to ancient Egypt, the use of herbs and animal glands to treat health disorders dates back to six-thousand-year-old clay tablets written by the Sumerians, who used licorice, mustard plants, opium poppy, thyme as medicine. In spite of this legacy, however, many health experts and researchers have questioned the effectiveness of supplementation and claim that a well-balanced diet is all that we need.
Vitamin deficiencies and overdosing
Now when public health officials talk about vitamin deficiencies and the need to supplement, they're talking about specific populations and specific vitamins.
Younger women, for instance, tend to have low iodine, which is crucial for fetal brain development. (3) Another example is Mexican-American women and young children who are more likely to be iron deficient. However, even in this population, only 11 percent of children and 13 percent of women are affected.
Widespread vitamin deficiency, therefore, is not realistic in our culture and scientists are uncovering that overdosing on vitamins is actually more of a problem. Excessive vitamin A consumption, for example, has been known to cause liver damage, coma, and even death. (4, 5, 6) Other examples include:
- Vitamin A and E have been known to increase lung cancer risk in smokers. (7, 8)
- Excess zinc is linked to reduced immune function, nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, reduced iron, and headaches. (9)
- Long-term excessive intake of manganese is linked to iron-deficiency anemia. Symptoms of manganese toxicity shockingly resemble those of Parkinson's disease (tremors and stiff muscles) and excessive intake has been linked to hypertension in patients older than 40. (10)
- Niacin in excess has been known to cause liver cell damage and a slew of side effects such as flushing, itching, nausea and vomiting (11)
Natural vs. synthetic
It is interesting to point out that niacin from natural food sources is not known to cause negative side effects. However, one study noted that people who unknowingly ate vitamin-fortified bagels that mistakenly had 60 times the normal amount of niacin experienced some pretty bad consequences.
All in all, most adverse effects have been reported with pharmacologic preparations of niacin, not typical “fortified” bread and milk. (12)
Unfortunately, for the average consumer, this whole discussion gets more complicated when manufacturers mix various vitamins and minerals in one easy to swallow tablet because different minerals compete against each other for absorption. You need to be a veritable biochemist to understand what’s good for you nowadays!
Case in point:
- If you take too much calcium, you won't be able to absorb iron sufficiently.
- If you take too much iron, you won't be able to absorb zinc.
- If you take vitamin C, your copper levels will drop.
- And the list goes on and on …
The bottom line is that unless you purchase a multivitamin that is specifically designed for you and your unique biochemical individuality, it could ruin the critical vitamin/mineral balance required for health. Unfortunately, the one-size-fits-all approach that manufacturers have taken is woefully incorrect and people that regularly consume multivitamins put themselves at risk of not only vitamin/mineral deficiency but also overdose.
So, does this mean that multivitamins are not good for us?
Well, as clear-cut as it may seem, there’s actually quite a heated debate over this matter.
The ‘multi' debate
On one side of the camp, traditionalists refer back to thousands of years of use and quote most recent studies describing how the nutritional content of our fresh fruits and vegetables today pale in comparison to what our parents and grandparents ate. (13, 14)
According to biologist Donald Davis, Ph.D. from the University of Texas Austin:
“Considered as a group, we found that six out of 13 nutrients showed apparently reliable declines between 1950 and 1999….These nutrients included protein, calcium, phosphorus, iron, riboflavin and ascorbic acid. The declines, which ranged from 6 percent for protein to 38 percent for riboflavin, raise significant questions about how modern agriculture practices are affecting food crops” (15, 16)
In essence, the argument is, “If our ancestors found the need to supplement when food was full of nutrition, then how much more should we supplement today because our food is deplete of vitamins and minerals?”
On the other end of the spectrum, skeptics like said Dr. Eliseo Guallar, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health claims that the data simply doesn’t add up. “We believe that it's clear that vitamins are not working,” Guallar says. In fact, “The probability of a meaningful effect is so small that it's not worth doing study after study and spending research dollars on these questions.” (17)
A recent article published in the Annals of Internal Medicine titled, “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” supports Guallar’s theory:
After reviewing 3 trials of multivitamin supplements and 24 trials of single or paired vitamins that randomly assigned more than 400 000 participants, the authors concluded that there was no clear evidence of a beneficial effect of supplements on all-cause mortality, cardiovascular disease, or cancer. (18)
Supplement use on the rise
Yet, despite questionable evidence of no benefit or even potential harm, multivitamin use has increased among U.S. adults by 10 percent. Today more than 40 percent of people supplement with multi’s and more than 50 percent of Americans use some sort of supplement on a daily basis. (19) All in all, we spend a whopping $30 billion a year on supplements
In the words of Steven Salzberg, a professor of medicine at Johns Hopkins:
“I think this is a great example of how our intuition leads us astray. It seems reasonable that if a little bit of something is good for you, then more should be better for you. It's not true. Supplementation with extra vitamins or micronutrients doesn't really benefit you if you don't have a deficiency….You need a balance. The vast majority of people taking multivitamins and other supplemental vitamins don't need them. I don't need them, so I stopped.” (20)
However, according to Duffy MacKay – vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, a trade group that represents supplement manufacturers:
“We all need to manage our expectations about why we're taking multivitamins. Research shows that the two main reasons people take multivitamins are for overall health and wellness and to fill in nutrient gaps. Science still demonstrates that multivitamins work for those purposes, and that alone provides reason for people to take a multivitamin.” (21)
So what’s the bottom line?
Which side of the argument should we believe?
Both sides are vehement in their perspectives and considering there’s $30 billion on the line, it is easy to understand why.
Notably, several of the aforementioned studies refer to vitamins composed of synthetic isolates, rather than those sourced from Whole Foods: herein lies the issue. There are two truths to supplementation, one in which resides within the word itself.
Additional vitamins and minerals should be supplemental to an already proactive, healthy diet and lifestyle and not used as a means of avoiding health in all other aspects of your life. Millions of American take their “once-daily tablet” and believe they are “protected” and have the nutritional aspect of life “covered.” Dietary additives, combined with Proper nutrition, should be the catalyst to Healthy Living and not the crutch that deters it.
The second truth, as I mentioned above, is the derivative of the Nutrients you are taking. Using synthetic vitamins is not only counterproductive; it can also be incredibly destructive. The human body cannot assimilate, nor recognize, synthetically isolated dietetics. Your vitamins should be raw whole foods obtained from non-GMO (genetically modified organisms) and GMP (good manufacturing processes) facilities.
Identical to the “perfect” diet of the 21st Century, look for the following words and acronyms on the labels of your prospective supplements: GMP, Non-GMO, Raw, Whole Food, USDA Organic, ISO 9001, ISO 17025, Gluten-Free, Dairy-Free, Soy-Free, No Fillers or Binders, No Artificial Colors, Zero Preservatives, Pesticide and Herbicide Free.
Furthermore, unless the manufacturer procures their products from real food (e.g., iodine sourced from kale and not a synthetic culture), do not take the product.