An estimated one in two Americans take a vitamin supplement. However, when you’re facing a wall of products, it’s not always easy to know which one to buy.
Should you select a multivitamin and mineral, opt for a bespoke blend, or buy each nutrient individually? This is an excellent question, to which the answer is: it depends on why you want to take them!
Of course, none of the following information is intended to be medical advice, but, we hope that it gives you something to discuss with your doctor on your next visit.
If your diet isn’t as good as it could be, then a multivitamin and mineral that supplies around the daily recommended intake of as many micronutrients as possible can act as a nutritional safety net.
If you are seeking a particular therapeutic result, however, then a selected blend, or a single vitamin or mineral, may prove a better option.
Whichever supplements you choose, make sure they are produced to pharmaceutical standards (known as GMP in the UK and CGMP in the US, which stands for Current Good Manufacturing Practice).
This means the supplements and their ingredients are checked at all stages of production for purity and consistency of dose.
Although diet should always come first, national dietary surveys consistently show that significant numbers of people do not meet the recommended intakes for particular vitamins and minerals. While average intakes seem OK, an average is only an average – half are getting more, and half are getting less.
There are many reasons why your diet may lack particular micronutrients. These range from poor appetite and difficulty chewing to following a restricted diet for ethical, religious, or health reasons.
Perhaps you have particular food intolerances, or are cutting back to lose weight. In these cases, a multivitamin is probably exactly what you need.
Not all multivitamins are the same, though. As a result, make sure you know what to look for.
As a family doctor working in a deprived inner-city area, I dealt with countless patients who felt tired all the time and lacking in energy. They had little money for fresh fruit and vegetables, so I ended up prescribing a vitamin and mineral supplement. When they perked up and felt better, they were more open to improving their diet.
Some supplements contain a carefully selected blend of vitamins and minerals aimed at maintaining a particular body part or function.
Antioxidant blends (e.g., vitamins A, C, E, and the mineral selenium) are also popular to protect cells from the damaging particles (free radicals) that are associated with premature ageing.
Supplements to support eye health tend to contain research-based blends of antioxidants, B vitamins, carotenoids (lutein and zeaxanthin), and zinc. And those designed for older women tend to major on calcium, magnesium, vitamin D, vitamin K, and possibly boron for healthy bones.
Calcium is usually combined with vitamin D to aid its absorption. Ideally, look for a supplement that also includes vitamin K2 to reduce the chance of excess calcium being deposited in artery walls.
You get the idea – if you have a particular health problem, look for a blend designed to address it. This isn’t always clear from the product label, unfortunately, due to legislation that prevents food supplements from making unapproved health claims.
Single nutrients are usually recommended or prescribed medically, to treat or prevent an identified deficiency.
Iron deficiency is the most common mineral deficiency world-wide. Supplements may be prescribed to treat iron-deficiency anemia when your level of the red blood pigment, hemoglobin, is demonstrably low.
A low iron reserve is also associated with restless legs, thinning hair, and recurrent Candida infection even when iron status is not low enough to cause overt anemia. As iron is toxic at levels only just above the required intake, take care not to exceed recommended doses.
While scurvy, due to severe deficiency of vitamin C is rare, it remains the most popular single vitamin supplement, often taken in high doses to boost immunity against viral infections.
As a water-soluble vitamin, it is relatively safe, but an upper tolerable level of 1000mg per day is suggested for long-term use from supplements to avoid indigestion. It can be taken in higher doses short-term and non-acidic forms (e.g., ester-C) are available.
Folate is the most widespread vitamin deficiency in developed countries. Single supplements are recommended before and during early pregnancy to reduce the risk of developmental abnormalities.
Outside of pregnancy, lack of folate is associated with a particular form of anemia. This is often accompanied by lack of vitamin B12, and these two B vitamins are prescribed together long-term (partly to avoid masking the blood changes used to help identify a B12 deficiency).
If you have a raised level of homocysteine (an amino acid that damages blood vessels), vitamin B6 is added to the mix to help convert homocysteine into safer forms.
High doses of vitamin B12 are prescribed to treat pernicious anemia. This develops when the immune system attacks the stomach cells that make intrinsic factor, which is needed for vitamin B12 absorption.
However, if you lack this factor, you are unlikely to absorb enough even from high oral doses, so it is usually given by injection, or via sublingual sprays/lozenges for absorption under the tongue.
Popular among women with premenstrual tension, Vitamin B6 is sometimes recommended to treat carpal tunnel syndrome although evidence for its effectiveness is inconsistent.
Another vitamin often taken on its own, especially during winter months, is Vitamin D. This is when people living at northern latitudes do not meet enough UV light to synthesize their own supplies.
People over the age of 60 are especially vulnerable as you are only able to make a half to a quarter of what you could synthesize in your 20s – even when the sun is shining. What constitutes the right dose is controversial.
The popularity of single-supplement vitamin E waxes and wanes. It is usually taken together with other antioxidants – especially vitamin C which is needed to regenerate vitamin E once it has acted as an antioxidant.
Magnesium is one of the few supplements that I take individually – partly because of compelling research that it might help me to live longer! It also has a useful laxative action and promotes a good night’s sleep. Several different magnesium salts are available, all with different absorptions.
Diet should always come first. If you are healthy but know your diet is not as good as it could be, a multivitamin and mineral is the best option if you decide to take a supplement.
During winter months, additional extra vitamin D may be advisable, depending on where you live. If you have a particular health issue, such as raised blood pressure or a family history of osteoporosis, then a bespoke blend may be the way to go.
Take care, however. If you mix and match supplements, it’s easy to obtain too much of certain micronutrients (e.g., vitamin A, iron, or magnesium) which can lead to toxicity in excess. Check upper safe levels here.
If you are taking any prescribed medication, or if you are in doubt about what you need, always check with your doctor or with a pharmacist.
Do you take any vitamin or mineral supplements? If so, which ones did you select, and why? I’m always curious to know what people take and how they reach their decisions. What healthy aging tips would you like to share? Please share in the comments section below.