A 2013 editorial in the Annals of Internal Medicine says daily multivitamins don’t prevent chronic disease or death, and their use can’t be justified — unless a person is below science-based requirement levels.
But there’s a disconnect between what science shows and what people actually do when it comes to improving health.
“In a perfect world, we would all eat a variety of fruits and vegetables and we would all exercise regularly, but that’s not reality,” says TODAY health and nutrition editor Madelyn Fernstrom, professor of Psychiatry, Epidemiology and Surgery at the University of Pittsburgh Medical Center. “People can be strapped for time or money and don't meet their daily nutrient needs. And you also have to remember that many studies look at large population groups, rather than individuals.”
That means that some people may benefit from a little supplementation, simply to bring them up to the daily recommended requirements for certain vitamins and minerals, says Fernstrom.
To help you sort through the morass, the National Institutes of Health Office of Dietary Supplements provides fact sheets of the latest information on a wealth of individual vitamins, minerals and dietary supplements.
Many people want to take some kind of supplement, so which vitamins are OK to take regularly? Which should we avoid?
Here’s a quick run-down of a few that might help. By no means is this list conclusive, just a heads up.
Remember, when choosing a supplement, look for seals of approval from the United States Pharmacopoeia (USP), NSF International (NSF), or ConsumerLab.com (CL), to help validate purity.
Although it’s probably not going to help you live to 120, a multivitamin may help you live better — if your diet is less than stellar.
“I take a ... multivitamin every day as a little insurance policy,” says David Levitsky, a Cornell University professor of nutrition and psychology and also outspoken critic of supplement industry scams.
While many experts disagree on the value of multivitamins, it’s important to look at all the evidence. “For certain groups of healthy people, especially those whose diet has nutritional gaps, a multivitamin can help fill in those gaps,” she says.
For people with medical illnesses or taking prescription medications, check with your doctor for personalized advice, because diseases and medicines can alter vitamin and mineral utilization, where more or less of a vitamin may be required.
Beginning with the teenage years, when dairy consumption drops, calcium needs can be hard to meet for both men and women. The most concentrated source of calcium in the food supply is found in dairy products like milk, yogurt and cheese, where one serving is about 1/3 of the average daily need.
Dark green vegetables are calcium-rich sources, but not equivalent to dairy, when it comes to serving size. It takes about 3 cups of broccoli, or 7 cups of arugula to match the calcium in an 8-ounce glass of milk.
For healthy people consuming 2-3 servings of dairy daily, along with a couple of servings of dark green vegetables, calcium needs are likely met. A modest amount of calcium supplements — no more than 300-500 milligrams per dose — can help.
And supplement calcium is not only found in pills or chews, but added to products like orange juice and milk-like liquids like almond milks to boost calcium intake in a tasty form.
It's important to know your total daily calcium intake from all sources, because excess amounts can contribute to the formation of kidney stones.
And, for those with heart disease, always talk to your doctor before starting a daily calcium supplement.
Although researchers fully recognize its role in bone health, vitamin D, dubbed the sunshine vitamin, may have other health benefits.
Research is far from conclusive, but it may help in prevention and even treatment of high blood pressure, diabetes, inflammation and other issues. Vitamin D is tough to get from foods and since it is produced in the body mostly through sunlight exposure, many people are D-deficient, making supplementation necessary for some individuals, says Fernstrom.
The first step is to get a blood test to determine your vitamin D level, and then your doctor will recommend appropriate dosing, depending on your age and overall health.
Now you know a few of the supplements considered valuable or safe, based on science. Here's what you need to avoid:
All weight-loss supplements
Part of the danger from weight-loss supplements is they often contain stimulants, which can be a health risk to people with cardiovascular risks, like high blood pressure.
"Because they are unregulated, the amount and purity of all compounds in a weight-loss supplement is suspect," Fernstrom says.
While some ingredients are harmless, others have strong biological impact, not on weight loss, but on temporarily "revving up metabolism."
"The dangers are too great," says clinical dietitian Lisa Cimperman, a spokesperson for the Academy of Nutrition and Dietetics.
In fact, a few weight-loss supplements have been tainted with traces of prescription weight-loss drugs. And the “wild claims that offer crazy dreams [of weight loss] are destructive for those of us who are in the legitimate business of selling nutrition,” says Levitsky.
The kava plant is native to the South Pacific and its root has been used for anxiety, insomnia and other ills, according to reports from the National Institutes of Health.
However, it carries serious risks, including liver damage, even with short-term use and normal dosing. The supplement has been banned in Switzerland, Germany, and Canada, says Cimperman.
“There is absolutely no benefit to taking this supplement and it is really very dangerous,” she says.
Mega-doses of anything
There actually can be too much of a good thing, and anything in excess — whether vitamins, supplements or food — can cause serious problems.
In terms of vitamins, some are fat-soluble, meaning they are stored in the liver, and you don’t need them every day, while others are water-soluble, and need to be replenished.
“The big problem is many people don't really understand the difference between fat-soluble and water-soluble vitamins and they think more of anything is always better,’ says Fernstrom.
Excess amounts of water-soluble vitamins are eliminated by the body in urine, but extra fat-soluble vitamins are stored by the body, mostly in the liver.
But even too much water-soluble vitamin C can cause kidney stones, while very high doses of fat-soluble vitamin A can play havoc with your liver.
The bottom line on vitamin and mineral supplementation: Talk to a medical professional about your individual needs, and always inform them about what you’re already taking, even if you think it’s benign.