Most people don’t need multivitamin supplements. All the evidence has shown that taking them if you have a healthy diet and are otherwise healthy, they really don’t do anything for you, Multivitamins are generally considered safe, but if you take individual vitamins along with a multi, you might accidentally get more than the recommended daily amount, that can sometimes be harmful. For example, too much of certain forms of calcium can cause kidney stones. Overdoing it on magnesium may cause diarrhea, while excess iron can result in constipation. Moreover, multivitamins—which are sometimes larger than other pills—may also be difficult to swallow, especially for some older adults. With dietary supplements, there’s no restriction on how big the pill is, so there could be a risk of choking.
To ensure that you get all the nutrients you need, I recommend eating a plant-based diet with lots of different fruits and vegetables. Overall, it’s always better to get your vitamins and minerals from food in your diet because you don’t have the extra risk that can be associated with supplements. There are, however, a few exceptions. People who don’t get enough nutrients through their diets, such as those who have undergone weight loss surgery, might benefit from a multivitamin. The same may be true for people with conditions that affect overall nutrient absorption, such as those with inflammatory bowel disease. People who simply do not eat a nutritious variety of foods may benefit from a multi as well, according to the National Institutes of Health. One recent study found that older adults who took a multivitamin had improved short-term memory, but the effect was small, and the research was partially funded by supplement companies. As a result, such findings should not be accepted until further studies are done.
Research has long shown that, unless you receive a vitamin deficiency diagnosis, there are few benefits to vitamin supplementation in general. Some people have medical conditions, diets, or drug regimens that can cause such deficiencies. For example, chemotherapy drugs and medications used to treat rheumatoid arthritis can both cause a B₁₂ deficiency. It’s also common for older adults to be deficient in vitamin D, especially those who receive little or no sun exposure. Those adhering to a vegan or vegetarian diet might need extra iron, B₁₂, or zinc. But in these cases, providers can advise on individual supplements rather than a multivitamin.
If you are considering a multivitamin, think of it as you would a medication. Discuss it with your doctor first, and if you do take one, choose one with a high-quality third-party certification, from the U.S. Pharmacopeia (USP), for example. That organization requires that vitamins in a given pill are available for absorption within a set amount of time, and that products contain the vitamin amounts listed on the label.
At the beginning of each appointment, you should also share with your caregiver a list of the medications and supplements you take—including multivitamins, which will help direct the conversation about what you should and shouldn’t be taking.
Morton Tavel, MD.
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