Confused about whether you really need a multivitamin to be healthy?
It’s understandable, given all the conflicting information from various studies, experts, and nutritional gurus.
On the one hand, the idea of taking a multivitamin makes sense.
After all, no one eats perfectly all the time, so why not take a multi to fill in potential nutritional gaps? Plus, research has shown nutrient levels in many foods are less than they used to be.REF#3493
On the other hand, nearly everyone agrees that whole, natural foods are the best source of nutrients.
Additionally, highly publicized research studies suggest taking a multivitamin has little to no benefit and may even be counterproductive.
So, do you really need a multivitamin, or would your money be better spent elsewhere?
In this article, we’ll shed some light on the multivitamin controversy, including:
- The challenges and pitfalls of multivitamin research
- The potential harms of taking a multivitamin
- Are whole foods multis better than synthetic?
- The story on herbal multivitamins
- Nutrient-dense herbs to supplement your diet
The Challenges and Pitfalls of Multivitamin Research
We’ve all heard the news reports about various studies showing no benefit to taking a multivitamin.
Yet, at least one-third of American adults are not convinced.
According to research published by the National Institutes of Health,REF#3494 multivitamin and mineral supplements accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019, totaling approximately 8 billion dollars.
Many conventional and integrative doctors also recommend multivitamins and multiminerals as part of a healthy lifestyle.
So, why the great divide in opinions?
It’s complicated. This is why many people are skeptical of the need or lack of need for multivitamin products.
For starters, it is not easy to study the effects of a multivitamin supplement for various reasons, including:
- The many forms of vitamins and minerals used in multivitamins: From citrates and chelates to glycinates and ascorbates, there are endless forms of natural and synthetic vitamins and minerals, some of which may be better absorbed than others and at different amounts.REF#3495
- Genetic variations in populations studied: There are many nuances to this. For example, certain genetic variations or “mutations” can affect a person’s ability to absorb B12, iron, and folate. Ancestry can also play a role in this.REF#3496
- A person’s diet, lifestyle, and current nutrient status: Studies have shown endurance athletes, for example, may have higher nutrient requirements than others.REF#3497 Likewise, someone who eats a lot of fat, sugar, and highly processed foods likely has different nutrient gaps than someone who eats a healthier, whole-food diet.
- How nutrient status is measured: Some nutrients are easy to track with blood tests, and others aren’t.
For example, you can measure a person’s iron levels by doing a complete blood count, but that does not account for their levels of stored iron (known as ferritin), which must be measured by testing ferritin levels specifically.REF#3498
Magnesium levels are also challenging to track as the majority is stored in the bones and soft tissues.REF#3499
The need for more reliable, standardized, universal nutrition screening tests used within studies makes it almost impossible to track multivitamin supplementation's obvious and subtle possible benefits.
- A lack of a consistent scientific or regulatory definition of what constitutes a multivitamin/multimineral: A quick look at a few different labels will show you the vast differences in ingredients and nutrient concentrations in various multivitamin brands.
For example, Some are formulated to contain approximately 100% of the DV for as many as 30 vitamins and essential minerals, while others are formulated with less of some vitamins and more of others to target a specific health concern, such as energy or women’s health.REF#3500
- Controversy about optimal nutrient levels: Many of the recommended daily amounts (RDAs) of vitamins and minerals were established to prevent malnutrition, not to optimize health. This is partly why experts are split on what levels of specific vitamins, minerals, and other nutrients should be contained within a multivitamin/multimineral supplement.
- Medications: Many common medications, such as birth control pills REF#3501 or proton pump inhibitors/antacids REF#3502, can affect a person’s nutrient status and how they assimilate specific vitamins.
- Gut and digestive health: Research has shown our digestive health and microbiome diversity play a significant role in how we assimilate and absorb nutrients. For example, a lack of hydrochloric acid and gut health issues like SIBO can affect B12 status.REF#3503 Gut microbiome health is not typically considered a factor in multivitamin/multimineral efficacy studies.
These are just a few examples of what researchers are up against in their quest to determine if multivitamins/multiminerals are worth taking.
Imagine trying to design these studies!
Firstly, you’d have to have the funds and resources (research studies are costly) to study many different multivitamin formulas, of which there are thousands.
Next, you’d have to implement reliable, universal screenings for your test groups to determine the endless variables of nutrient status, gut health, genetic variations, and other factors that would weigh into the results.
You’d also have to track your group's nutrition and lifestyle habits, as these will influence nutrient status and other health outcomes.
All of this would be nearly impossible given the sheer amount of multivitamin products available and all the factors and variables involved in tracking their absorption and effects.
Other complications are involved, such as the lack of funding for non-patentable vitamins and nutrients and other factors.
All that said, plenty of studies have been conducted on the outcomes of taking various multivitamins/multiminerals, and the results are mixed.
What the Studies Say About Taking a Multivitamin
Several large-scale studies show no significant benefit to taking a multivitamin.
There are also studies showing various benefits of taking them for things like cognitive health, REF#3504 memory, REF#3505 healthy pregnancy outcomes (prenatal vitamins), REF#3506 and prevention or treatment of nutrient deficiencies. REF#3507
Some studies show a possible benefit for cancer prevention, some show no benefit, and some even show a potential harm.REF#3508
One of the largest, most-referenced randomized clinical studies, “The Physicians' Health Study II,” followed the effects of taking a common multivitamin on 1,464 male doctors over age 50 for over a decade and showed mixed results.
The study participants demonstrated modest reductions in cancer and cataracts and no benefits to preventing cardiovascular disease or declining cognitive function.REF#3509
It’s also worth noting that a meta-analysis of randomized, controlled trials by MacPherson et al. indicated that taking a multivitamin/multimineral supplement did not affect overall mortality. However, primary prevention studies showed a modest trend toward a reduction in the risk of all-cause mortality.REF#3510
So it’s a mixed bag, with most large-scale studies showing no significant benefit based on the particular multivitamin or multivitamins they were researching within the specific context.
Yet, some studies on multis and single nutrients and ample anecdotal evidence suggest a benefit.
With all the variables and new research surrounding our growing understanding of how specific nutrients impact health, genetic factors involved, and which forms may be most absorbable, the case for multivitamins/multimineral supplements appears far from settled.
Can Multivitamins Be Harmful?
There are varying opinions on this question as well.
Some doctors and nutritionists believe there is no harm in taking a multivitamin, while others recommend a more cautious approach.
Research shows there is very little danger in taking a multivitamin with nutrient levels consistent with established RDAs.REF#3511
However, you can overdo the consumption of certain vitamins and minerals, such as fat-soluble vitamins A, D, E, and K, and iron if you take them in very high amounts and/or combine a multivitamin with a high intake of fortified or very nutrient-dense foods.
The most common side effects of multivitamins include:REF#3512
- Constipation
- Diarrhea
- Upset stomach
- Nausea
Exactly what amounts are considered excess is highly and hotly debated based on the same factors of study limitations discussed above.
The best course of action is to talk to your healthcare practitioner or nutritionist about the optimal nutrient amounts for you. In the meantime, sticking to the recommended daily allowance (RDA) is a safe course of action.
It is also essential to purchase multivitamins from a reputable company that employs end-product testing to ensure consistent nutrient levels (listed on labels) are present in every batch.
Are Whole Foods or Organic Multivitamins Better than Synthetics?
As awareness about the benefits of whole foods nutrition grows, many consumers seek organic whole foods-based multivitamins versus synthetic ones.
What’s the difference?
Although the processing of different vitamins, minerals, and nutrients varies from company to company, whole foods vitamins are concentrated forms of whole foods and herbs made into powders.
For example, Camu Camu Berry is often used as a source of Vitamin C, and sea vegetables may be used as a source of iodine in whole foods supplements.
Synthetic vitamins are artificially created in labs from various sources. Examples include ascorbic acid, biotin, dl-alpha tocopherol acetate, and most forms of Vitamin D.
Label reading requires some skill as some brands are 100% whole-foods-based, others are 100% synthetic, while other brands combine synthetic and whole-food vitamins for optimal absorption.
Is one better than the other?
Like the research and opinions on the benefits of multivitamins, this is a mixed bag.
Some research has shown that food-based vitamins are better absorbed than synthetic ones. The theory is that a whole foods vitamin exists within the full spectrum of the food or herb and all its other nutrients (enzymes, antioxidants, fibers, etc.).REF#3513
Other research suggests that the body treats synthetic or whole foods vitamins equallyREF#3514—a hot topic debated by health and nutrition experts.
Ultimately, more unbiased research is needed to determine which forms of vitamins are superior.
What About Herbal Multivitamins?
Herbs are used in many multivitamin formulas—synthetic blends, whole foods blends, and 100% whole foods multis—because many contain specific nutrients.
The following are some examples of traditional herbs used in multivitamins:
- Acerola cherry, Amla, or Camu Camu may be used as a source of Vitamin C and other antioxidant compounds REF#3515
- Alfalfa contains calcium, magnesium, B vitamins, Vitamin K, and other micronutrients REF#3516
- Barley Grass contains magnesium, calcium, Vitamin A, and various other vitamins and minerals REF#3517
- Dandelion contains calcium, iron, potassium, zinc, and Vitamins A, C, and E REF#3518
- Goji Berries contain several vitamins and minerals, such as Calcium, Vitamins A and C, along with antioxidant compounds REF#3519
- Moringa contains various nutrients, including iron, potassium, calcium, beta-carotene, and Vitamin C REF#3520
- Mushrooms and Algaes may be used for their Vitamin D content REF#3521 REF#3522
- Nettles: May be used as a source of iron, potassium, magnesium, calcium, B vitamins, beta carotene, vitamins A and K REF#3523
- Oats/Milky Oats: Milky oats are rich in magnesium, calcium, iron, B vitamins, and Vitamins A and C REF#3524
- Parsley contains zinc, lutein, Vitamins C and K, calcium, and other nutrients REF#3525
- Rosemary contains calcium and other minerals REF#3526
- Sea vegetables, such as brown seaweed, kelp, and dulse, are a natural source of omega-3 fatty acids, iodine, and other trace minerals REF#3527
- Spirulina: While technically a type of algae, spirulina contains several vitamins and minerals, including iron, copper, and B vitamins REF#3528
Other herbs, such as Green Tea, Red Raspberry Leaf, Elderberry, Red Clover, Saw Palmetto, Turmeric, and Holy Basil (Tulsi), may be added to various multivitamins for their antioxidants and traditional uses in supporting multiple aspects of health.
Are Herbal Multivitamins Safe?
Generally, yes, given their long history of traditional use and the amounts generally used in multivitamins.
Talk to your healthcare practitioner if you have concerns or are taking certain medications.
So, Do You Really Need A Multivitamin?
Whether to take a multivitamin depends on many factors, including your current state of health, your diet, nutrient levels, genetics, and your health goals.
As we’ve covered, the research on whether a multivitamin can make a difference is mixed.
However, nearly all the experts agree that real, whole foods are your best source of nutrients.
Therefore, focusing on eating plenty of high-quality, nutrient-rich whole foods should be primary in any nutrition strategy.
Incorporating specific herbs, like the ones discussed here, may also be beneficial for supporting optimal nutrient levels.
If you’re concerned you’re not getting enough nutrients or absorbing enough nutrients from your diet, talk to a doctor or healthcare practitioner well-versed in nutrition for individual recommendations.
As stated above, taking a multivitamin is generally very safe as long as the nutrient profile aligns with the standard RDAs.
Additionally, a prenatal multivitamin is always recommended for all pregnant women and people and those breastfeeding.
Whatever you decide, be sure you are sourcing your multivitamins from a company that operates under cGMP manufacturing standards, including end-product testing for contaminants and nutrient levels.
Finally, consider buying brands that do not use synthetic preservatives, dyes, fillers, artificial colors, flavors, or sweeteners.