Bridging the Nutritional Gap: How Multivitamins Can Prevent Deficiencies

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As modern agriculture and food processing methods reduce the vitamin and mineral content in the foods we eat, a basic multivitamin is one solution people often turn to to help fill nutritional gaps. From enhancing the immune system and improving mental clarity to supporting energy levels, multivitamins can offer a complementary approach to overall well-being. Multivitamins are not a substitute for a well-balanced diet but they can be a practical way to ensure that essential nutrients are not overlooked in the face of changing food quality or less than perfect food choices.

This article will explore the potential health benefits of multivitamins, the science behind them, and how they might fit into an individual’s broader health and wellness strategy.

What Are Multivitamins?

Multivitamins are dietary supplements that contain various vitamins, minerals, and sometimes other nutritional elements. They can provide nutrients that might not be consumed in sufficient quantities in the regular diet. These supplements may include essential vitamins like A, C, D, and E, and key minerals such as iron, potassium, and zinc. Available in forms like tablets, capsules, or liquids, the specific composition of multivitamins can vary widely. Some are designed to support general health, enhance performance, or target particular life stages like pregnancy or aging. They are not meant to replace a balanced and varied diet but can supplement it, especially when nutritional needs might not be met through food alone.

Why Do Some Headlines Say Multivitamins Don’t Work?

Surprising headlines get all the attention, don’t they? And these headlines get so much attention that even your doctor may shrug and discourage the use of multivitamins. In the latest large population trial, the US Preventative Services Task Force (USPFTS) found that the evidence doesn’t support recommending multivitamins for the prevention of cancer or heart disease, and they won’t keep you alive any longer. [PMID: 35727272]

Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use.

Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer

It is tempting to focus on the fact that the larger the study, the more statistical power it will have to show a difference, assuming that there is a difference between the treatment and the placebo. Statistically, this is absolutely true.

But it distracts from the fact that the larger the group studied, the more confounding variables will be left uncontrolled. Here’s a good example of a confounding variable: If you did a study comparing test scores to shoe size and found that elementary students with larger feet scored better on a standardized test, the confounding variable would be the children’s ages. Now think about the unbelievable number of variables like cholesterol, inflammation, diet quality, blood pressure, sleep and stress management that were not controlled for in the population study on multivitamins. It would actually be completely astounding if taking a multivitamin could overcome all those factors to the degree that would be needed in order to show a significant effect.

How to Choose A Quality Multivitamin

When searching for a quality multivitamin, it’s important to consider a few key factors that align with your specific health needs. Here are some of the things you should consider when choosing a multivitamin:

• Specific: You can look for a product tailored to your age, gender, and health requirements, as these can affect nutritional needs.
• Complete: Check that the multivitamin contains essential vitamins and minerals such as vitamin A, C, D, E, iron, potassium, and zinc without exceeding the recommended daily intake.
• Methylated B Vitamins: Choosing a product with methylated B vitamins is important, especially for individuals with certain genetic variations that may hinder the proper metabolism of standard B vitamins. Methylated forms of B vitamins are already in their active state, which allows the body to use them more efficiently, promoting better absorption and utilization, especially in those with a reduced ability to metabolize these nutrients.
• Reputable Sources: Choose products from reputable companies such as the ones carried on Fullscript. You can also look for products with United States Pharmacopeia (USP) verification. This certification assures that the product meets stringent quality and purity standards. Avoid multivitamins with unnecessary fillers, artificial colors, or allergens, and consult with a registered dietitian to select a product that best fits your individual health goals and dietary preferences.

Also, it’s important to watch out for poor-quality multivitamins that may not be absorbed effectively. This can be caused binding agents such as Titanium Dioxide, Magnesium Stearate, and certain shellacs and glazes. These agents might hinder the breakdown of the tablet in the digestive system or affect nutrient absorption in other ways. Nurses often report that some of the most well-recognized brands of supplements suggested by physicians are the very ones most easily recognized in the stool of their patients.

Who Would Need Multivitamins?

• People with Less-Than-Perfect Eating Habits: Not everyone has access to or chooses a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Consistent lack of variety and essential nutrients can lead to deficiencies and health issues. A multivitamin can provide a base level of essential vitamins and minerals, helping to prevent deficiencies and promote overall health.
• Elderly Individuals: As the body ages, it may become less efficient at absorbing certain vitamins and minerals, particularly Vitamin B12, Vitamin D, and calcium. Additionally, dietary habits may change due to altered taste preferences, difficulty in chewing, or reduced appetite. This can easily lead to deficiencies in essential nutrients. Multivitamins tailored for the elderly often include higher levels of Vitamin B12, Vitamin D, calcium, lutein, zeaxanthin, zinc, and Vitamin C to support bone health, cognitive function, eye health, and immune function, and may have reduced or no iron to minimize potential health risks associated with excess iron in older adults.
• Pregnant and Breastfeeding Women: Pregnancy and breastfeeding are periods of increased nutritional demands to support both the mother and the growing child. A multivitamin specifically formulated for pregnancy often contains higher levels of nutrients like folic acid, which is vital for the synthesis of DNA and iron for preventing anemia. By supplementing with a prenatal multivitamin, women can help ensure that they meet these increased nutritional needs and promote optimal fetal development.
• Children and Adolescents: Growing children require an array of nutrients to support their rapid physical and cognitive development. Picky eating or imbalanced diets common in this age group can lead to nutrient deficiencies. Multivitamins formulated for children typically include Vitamin D for bone health, Iron for blood development, Vitamin C for immune support and iron absorption, Folate for cellular function and growth, Vitamin A for vision and immune function, Vitamin E as an antioxidant, and B Vitamins like B6 and B12 to support energy metabolism and the needs of a growing body.
• Vegetarians and Vegans: Following a vegetarian or vegan diet may lead to a lack of nutrients typically found in animal products, such as Vitamin B12, iron, and omega-3 fatty acids. While a well-planned plant-based diet can be nutritionally adequate, some individuals may find supplementation beneficial. Multivitamins formulated for vegans often include specific nutrients to address potential deficiencies in a plant-based diet, such as Vitamin B12 for proper nerve function, Iron for red blood cell formation, Zinc for immune function and wound healing, and Iodine for thyroid function.
• Athletes and Highly Active People: Engaging in intense physical exercise increases the body’s demand for nutrients to support energy metabolism, muscle repair, and recovery. Athletes and active individuals may require higher levels of certain vitamins and minerals, such as antioxidants and B vitamins. A multivitamin formulated for athletes can provide these nutrients in the appropriate amounts, enhancing performance and recovery. Multivitamins formulated for athletes often include increased levels of B vitamins to support energy metabolism and higher levels of antioxidants, such as Vitamins C and E, to neutralize free radicals generated by intense exercise and extra iron to meet unique nutritional demands of those engaged in intense physical activity.
• Individuals with Dietary Restrictions or Allergies: Food allergies or specific dietary restrictions can make obtaining a balanced intake of nutrients challenging. Whether due to lactose intolerance, gluten sensitivity, or other specialized diets, individuals may miss out on essential vitamins and minerals. A multivitamin can act as an insurance policy to ensure they receive the nutrients otherwise lacking from their diet.
• People Under Stress: Stress causes depletion of B Vitamins and supplementing with a multivitamin improves stress and mood. Specifically, supplements that contain higher doses of B vitamins have been shown to be more effective in improving mood states. [PMID: 23362497]
• People Concerned About Maintaining Optimal Immune Function: Numerous vitamins are crucial for the normal functions of the immune response. There are over 40 different nutrients needed by each cell in the body. Immune cells are particularly affected by the lack of vitamins A, B6, B12, C, D, E, selenium, copper, iron and zinc. Anyone with a less than optimal diet, higher need due to genetic factors, passive or active smoking, or alcohol intake will need additional nutrients. [PMID: 17726308]
• People Concerned About Mental Health: Researchers have shown a reduction in overall scores on a depression anxiety and stress scale and an improvement in alertness and general daily functioning in a group taking a multivitamin compared to placebo. [PMID: 22095836]

Why One Multivitamin Is Better Than a Handful of Separate Pills

• More Is Not Better: There is always the temptation to think that “if a little is good, more has got to be better.” Not true. While some water-soluble vitamins can be taken at high doses without any problems, many nutrients provide benefits only within a certain dosage range.
• Some Nutrients Compete With Others: This is particularly true for minerals that compete for the same absorption sites. For example, if you take too much zinc, it will interfere with iron absorption.
• Some Nutrients Depend on Others: A classic example of nutrient interdependency is the relationship between calcium and vitamin D. When there is not enough vitamin D, calcium absorption is reduced. Another: iron is absorbed better when taken with vitamin C.

What’s in the Typical Multivitamin

• Vitamin A is needed for vision and wound healing.
• B Complex Vitamins are needed for cellular energy metabolism.
• Vitamin C is an antioxidant and helps build collagen.
• Vitamin D is involved in immunity and bone health.
• Vitamin E is an antioxidant.
• Vitamin K is involved in blood clotting.
• Vitamin K2 is involved in bone health.
• Iron is involved in hemoglobin function.
• Chromium is involved in blood glucose metabolism.
• Iodine is involved in thyroid function.
• Magnesium is involved in muscle contraction and glucose metabolism.
• Manganese is a cofactor for numerous enzymes.
• Molybdenum is also a cofactor in many enzymes.
• Selenium functions as an antioxidant.
• Zinc is involved in wound healing.

Safety Of Multivitamins

Multivitamins are widely recognized for their safety when taken in the recommended dosages. They contain essential vitamins and minerals that are necessary for the body and are formulated to stay within safe and tolerable levels. Reputable companies provide quality control procedures that ensure that multivitamins meet specified criteria for purity and content, contributing to their overall safety profile.

Health Conditions That Require Professional Advice On Supplements

There are health conditions that are simply too complex and individualized to safely do your own online supplement research without professional advice. A physician or pharmacist may be able to help you assure that a supplement is not harmful medically. But expecting physicians and pharmacists to provide the practical advice that is needed in complex health conditions is not practical because of their limited time and training in nutrition and food.

On the other hand, Registered Dietitians specializing in various health conditions are properly trained and experienced in answering complex questions that involve the consideration of individual food preferences, appetite, medication interactions, individual food intolerances, and considerations about nutrient absorption, metabolism, and excretion. And when people are sick and malnourished, there is no simple pill or supplement that can meet the body’s needs without the right foods in the right amounts for the situation. It is unfortunate that our disease care systems place so little emphasis on improving nutritional health. Request a referral to a Registered Dietitian specializing in your health condition.

• Multivitamins in Cancer: Professional advice regarding your supplementation plans is critical because some supplement ingredients may interfere with certain cancer therapies. Chemotherapy might affect a wide range of nutrients, requiring individualized assessment and supplementation. Do not take any nutritional supplement without discussing it specifically with your oncologist or cancer dietitian.
• Kidney disease: Kidney diet restrictions along with a poor appetite can lead to deficiencies, but it is important to get professional advice from a Registered Dietitian specializing in kidney disease when selecting any nutritional supplement. Specialized multivitamins for people with kidney disease are carefully formulated to control the levels of phosphorus, potassium, sodium, Vitamin A, and magnesium, tailoring to the unique nutritional needs and restrictions associated with impaired kidney function.
• People with Celiac or Inflammatory Bowel Disease (IBD): These digestive conditions are known for their interference with the absorption of nutrients. In addition to a multivitamin, iron, Vitamin D, and extra B Complex vitamins are typically needed until the gut is healed completely. Every situation is different. Because digestive health is so critical to overall health, anyone who is dealing with a digestive health issue should consult with a Registered Dietitian specializing in digestive health to get the needed education on their individual needs.
• Liver Conditions such as Cirrhosis or Non Alcoholic Fatty Liver Disease (NAFLD): Consult your physician about whether the severity of your liver condition would make it unsafe to take a multivitamin. NAFLD affects up to 80% of people with a BMI over 30, the cutoff usually defining the clinical term “obesity”. [PMC8424975] In impaired liver function, vitamin A intake must be reduced to avoid harming liver function, while Vitamin E might be beneficial for its antioxidant properties. Care must also be taken with iron, as an imbalance may worsen liver issues. Adjustments to certain B vitamins and zinc may also be necessary, as these can affect liver function and inflammation.

How Do Medications Affect Nutritional Needs?

• Cholesterol-Lowering Drugs: Statins interfere with the metabolic pathways that produce CoQ10, a nutrient vital for energy production and heart health. This is why statins cause muscle aches as a side effect.
• Metformin for Diabetes: This medication decreases Vitamin B12 absorption therefore people taking metformin should supplement with B12 to prevent symptoms that range from fatigue to nerve damage and cognitive decline.
• Oral Contraceptives: Women taking oral contraceptives might experience lower levels of vitamins B6, B12, and folic acid, and might consider supplementation of these vitamins. B6 deficiency can cause depression
• Proton Pump Inhibitors (PPIs) and H2 Blockers: Reduced acid secretion lead to poor absorption of protein, minerals, and B12 and those on long-term PPI therapy might need to monitor and supplement these nutrients.
• Anti-Inflammatory Medications (NSAIDs): Regular use of NSAIDs like ibuprophen, aspirin, and Cox-2 inhibitors can lead to malabsorption due to their effects on the lining of the digestive tract.
• Antibiotics: These can interfere with the absorption of various B vitamins and may also affect gut flora, impacting overall nutrient absorption.
• Diuretics: Some diuretics can lead to a depletion of potassium, magnesium, and other essential minerals. Monitoring and supplementing these nutrients can be crucial for those on these medications.
• Anti-seizure Medications: These medications can lead to deficiencies in Vitamin D and biotin, requiring monitoring and possible supplementation.

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Unique nutrient features of O.N.E. Multivitamin by Pure Encapsulations are the inclusion of:

• Methylated forms of B vitamins: Important for people with MTHFR genetic mutation.
• High level of Vitamin B12: Important for people taking acid-reducing medications or metformin.
• B6: Important for women who take oral contraceptives that may deplete B6 levels.
• Zinc: Needed for optimal immune function.
• Coenzyme Q10: Important in aging, and depleted in statin users.
• Lutein and Zeaxanthin: Important for eye health.
• Chromium: Important for anyone with insulin resistance or diabetes. 

Prenatal Vitamins – For Preconception, Nursing Mothers, or Anyone Needing Extra Iron

Prenatal vitamins are designed for pregnancy, pre-conception, and lactating women. This prenatal vitamin has 45 mg of elemental iron, and it is provided in the Bisglycinate form, which should be better tolerated.

Female Athletes and People With Anemia: A prenatal formula might be appropriate for anyone with mild iron deficiency anemia–pregnant or not, because of its high iron levels. The usual go-to supplement for anemia, Ferrous Sulfate at 325 mg typically contains 65 mg of elemental iron with a common side effect of constipation. Prenatal vitamins with the better tolerated bisglycinate form of iron at 45 mg of iron per day may be better tolerated and adequate for people needing extra iron.

Unique features of the Essential Multivitamin by EuroMedica include:

• Ginger: Reduces stomach upset.
• Chromium: Reduces insulin resistance.
• Vitamin K2: Important for bone health and to reduce cardiovascular risk.
• Methylated B Vitamins: Important for people with the MTHFR gene mutation.
• Magnesium: Supports blood pressure and 300+ enzyme functions. Most people have inadequate intake; 150 mg meets 1/3 to 1/2 of adult daily needs.
• Benfantomine: Prevents thiamine deficiency in people with high alcohol intake.

Food First!

Although this article discusses supplements in detail, don’t forget that we are absolutely committed to the “Food First” approach to nutrition. When it comes to your health, the totality of your eating habits far surpasses the impact of individual nutrients or any single supplement you consume. Even though this article doesn’t delve into the broader picture of your overall diet, it’s crucial to keep this element at the forefront of our minds. Your food needs to provide all the vitamins, minerals, fiber, and phytochemicals to nourish your body systems down to the cellular level.

Food choices, rather than supplements, are the most critical factors for a healthy gut microbiome. These trillions of tiny inhabitants in your gut affect your brain waves; they orchestrate your immune system. They possess the power to create molecules that can switch genes on or off and are even capable of synthesizing neurotransmitters. Opting for organic foods and steering clear of plastic packaging (including those labeled BPA-free) is a smart move to limit toxin exposure. The sum of all these parts leads to a powerful conclusion: the ultimate key to your health lies in the quality and balance of the food you consume. Supplements are secondary.

To Sum It Up

Multivitamin supplements offer various benefits by filling nutritional gaps in the diet. They provide essential vitamins and minerals that may be missing from everyday food intake. Taking multivitamins can support overall health, boost energy levels, and help maintain a healthy immune system. Though not a substitute for a well-balanced diet, these supplements serve as a helpful addition for those seeking to ensure they’re getting a broad range of nutrients.

This Article is Not a Substitute for Medical Advice

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician. Specifically, pregnant women and individuals being treated for cancer or liver or kidney problems must consult their physician about every nutritional supplement they plan to take. People taking medications for the treatment of HIV or with a history of organ transplant must not take supplements without consulting with their physician.