What Multi-vitamin Should You be Taking?


Everyone should take a multiple vitamin-mineral (MVM) supplement. One double-blind study of healthy volunteers published in Psychopharmacology (2000) found that an MVM supplement significantly reduced anxiety and perceived stress levels, and possibly improved energy and the ability to concentrate.

Preliminary and double-blind trials have shown that women who use an MVM containing folic acid, beginning three months before becoming pregnant and continuing through the first three months of pregnancy, have a significantly lower risk of having babies with neural tube defects (e.g., spina bifida) and other congenital defects.

In another double-blind trial, schoolchildren received a daily low-potency vitamin-mineral tablet containing only 50 percent of the U.S. Recommended Daily Allowances for most essential vitamins and the minerals for three months. Dramatic gains in certain measures of IQ were observed in about 20 percent of the supplemented children. These gains may have been due to the correction of specific nutrient deficiencies (for example, iron) found in these children.

The primary purpose of an MVM supplement is to provide a convenient way to get a good variety of nutrients from a single product. They are not meant to replace a healthy diet. They only serve to enhance the nutritional quality of your diet.

Micronutrients that should be included in a complete MVM are vitamin A (or beta-carotene), vitamin B-complex (thiamine, riboflavin, niacin and/or niacinamide, vitamin B6, folic acid (folate), vitamin B12, pantothenic acid, biotin, vitamin C, vitamin D3, and vitamin E (as d-alpha tocopherol or mixed tocopherols), and the minerals calcium, magnesium, zinc, iodine, selenium, copper, manganese, chromium and molybdenum.

Phosphorus is another essential dietary mineral, but is so abundant in the diet that it does not need to be included in an MVM formula. The only exception is for elderly people, whose diets tend to be lower in phosphorus or have impaired digestion. Calcium interferes with the absorption of phosphorus, so older people who are taking a calcium supplement might benefit from taking additional phosphorus.

Both potassium and iron are efficiently recycled by the body. If potassium is included in an MVM, it usually has only trivial amounts. Most people get enough potassium from their diets if they include at least two servings per day of broccoli, bananas, sweet potatoes or avocados. MVMs may contain iron, but these should be taken only by people who have been diagnosed as having, or being at high risk of iron deficiency, or who have a history of frequent iron deficiency.

Some nutrients may be beneficial at levels above what is possible to obtain from diet and an MVM alone. Nutrients that may be useful to most people in larger amounts include vitamin C, folic acid and B-12 (never take folic acid without B-12), magnesium, vitamin D, vitamin E and calcium.

Many MVMs contain other usually insignificant amounts of flavonoids, choline, inositol, quercetin, herbs and various amino acids. These are usually negligible amounts but are otherwise harmless.

What about "one-per-day" multiples? One-per-day MVMs usually do not provide sufficient amounts of many nutrients such as vitamin E, calcium, magnesium and vitamin C. One-per-day MVMs should therefore not be viewed as a way to "cover all bases" in the way that high-potency MVMs, requiring three or more pills per day, are viewed.

Because one-per-day formulas typically do not contain even the minimum recommended amounts of some of the nutrients listed here, multiples requiring several capsules or tablets per day are preferable. With two- to six-per-day multiples, intake should be spread out over two or three meals each day, instead of taking them all at one sitting. The amount of vitamins and minerals can be easily increased or decreased by taking more or fewer of the multiple.

Which is better: capsule or tablet? Multiples are available as a powder or liquid inside a capsule or that you can mix with water or juice to drink, or as a tablet. Occasionally the B vitamins react with the rest of the ingredients in the capsule or tablet. This reaction, which is sped up in the presence of moisture or heat, can cause the B vitamins to "bleed" through the tablet or capsule, discoloring it and also making the multiple smell. While the multiple is still safe and effective, the smell can be a deterrent and usually not very well tolerated. Liquid multiples in a capsule – or tablets or capsules that are kept dry and cool – do not have this problem. Capsules are usually not as large as tablets, and thus some people find capsules easier to swallow.

With liquids and powders that you drink, you need to be concerned about the "other ingredients" in the product. See below for more details.

One concern people have with tablets is whether they will break down sufficiently to allow the nutrients to be absorbed. Properly made tablets will dissolve readily in the stomach. To test your supplement, simply put the supplement into a glass of clear vinegar. This creates an acidic environment much like that of your stomach. Stir the solution occasionally. If the supplement disintegrates within 30 minutes, it should dissolve in your stomach, too. If the supplement does not completely dissolve, choose another brand.

How to quickly tell if you’re taking a quality MVM: Look at the source of Vitamin D and Vitamin E. The Vitamin D should be D3 or cholecalciferol. It should not be the synthetic form D2 or ergocalciferol. The Vitamin E should be d-alpha tocopherol or mixed tocopherol. Mixed tocopherols are the best. It should not be the synthetic form dl-alpha tocopherol.

Look at the "other ingredients" at the bottom of the label. Are there artificial sweeteners such as aspartame, saccharin or sucralose? Are there artificial colors or dyes such as FD&C blue #1 or yellow #6? How about artificial preservatives? If it contains any of these ingredients, put it back on the shelf.

Acceptable sweeteners are sucrose, fructose, stevia or xylitol. Monitor yourself for a few days when you start to take a new MVM. If you have stomach upset, it could be the sweetener being used.

When is the best time to take a multiple? The best time to take vitamins or minerals is with meals. Multiples taken between meals sometimes cause stomach upset and may not be absorbed as well.

Do I need more than just a multiple vitamin? Even if you ate a perfect diet, USDA data has shown that our food supply is simply not as nutritious as it was 30 years ago. Supplementing your diet can help to correct these shortcomings. The only way to know if the supplements you’re taking are working or to know exactly what vitamins/minerals and dosages YOU need to take is to get tested. Starting with a consultation, the doctor will determine the testing that should be done. Using bloodwork and other diagnostic tools, we do an in-depth analysis of your system. The testing will tell us where the problem areas are occurring or just developing. During your report of findings we will carefully note major and minor conditions that may lead to serious illness. This detailed report will explain your test findings, as well as the nutrient and dietary recommendations based upon your test results.

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Dr. Shannon O'Keefe
Dr. Shannon O'Keefe is a graduate of Northwestern College of Chiropractic. She is certified by the Institute for Functional Medicine and is a practicing member of the American Chiropractic Association. She has 18 years experience in the Chiropractic and Functional Medicine field and has completed her Diplomat degree in Clinical Nutrition. An article she authored will be published in the April 2008 issue of Nutritional Perspectives: Journal on the Council of Nutrition of American Chiropractic Association for her research on bacterial and parasitic infections as it relates to disease. She co-owns and operates O'Keefe/Matz Chiropractic Clinic in St. Paul, specializing in treating patients with complex and challenging health issues including Depression, Diabetes, Rheumatoid arthritis, cholesterol and heart disease, M.S., Autism, Allergies, Heavy Metal Toxicity and Skin disorders. Visit www.okeefechiropractic.com or call 651.292.8072. Copyright


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