Dr. Mary (Clifton) Wendt,
This whole question of what kind of vitamin or mineral supplement you need is highly individualist. It can depend on your age, how far north you live, the color of your skin, how much you exercise, and the vagaries of your body.
Taking vitamins every day was always assumed to be a pretty wise thing to do. After all, it’s an easy way to ensure you were getting your vitamins, from A to Zinc, as one vitamin manufacturer likes to put it.
More than half of American adults, in fact, take a multi-vitamin or supplement, spending a whopping $20 billion a year.
But an editorial, "Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements," published in the Annals of Internal Medicine, pretty much says it all.
We’re not getting a whole lot of health bang for our buck.
The editorial was based on three studies published in the same issue. They found that multivitamins had no benefit in helping to prevent heart attacks, cancer or improving cognitive function in men older than 65, according to the December 2013 editorial.
Conclusions from University of Minnesota researchers went even further. They followed 38,000 women in the Iowa Women's Health Study, beginning in 1986 when the women were around 62. Data on their supplement use was collected in 1986, 1997 and 2004.
The study results showed that women who regularly took supplements had a slightly increased risk of dying over the course of the 19-year study compared compared to women who took none, according to the study published in the Journal Archives of Internal Medicine (October 2011).
One possible reason: a lot of processed food is already enriched with vitamins. A multi-vitamin is probably redundant, and unable to deliver all the benefits of a whole food.
The study authors advised that individuals reconsider whether they really
need supplements. The better answer is to emphasize a healthy diet.
However, I don’t think the issue is as simple as throwing out supplements altogether.
To get your arms around this, first know there are water-soluble vitamins and fat-soluble vitamins, such as vitamins A, D, E and K. Your body only needs miniscule amounts of fat-soluble vitamins and not every day. If you take them in excess amounts, they get stored up in your liver and fatty tissue.
Water-soluble vitamin, such as vitamin C, on the other hand, are washed out of your body—“expensive urine,” as some doctors like to say. Unlike fat-soluble vitamins, water-soluble vitamins need to be replaced every day.
Problems can develop when you take more fat-soluble vitamins than you need. Most of these supplements contain far more micro-nutrients than your body can utilize. Because your body stores them, they can potentially build up. Furthermore, we don’t know how excess fat manages fat soluble vitamins. Triathletes are 14% fat by weight. At that weight, we know that fat will store and release substances easily. As body weight and fat percentages increases, the behavior of the excess fat is less reliable in terms of vitamin storage and release. In this way, a person may have high levels of fat soluble vitamins, but still be vitamin deficient in their system.
This whole question of what kind of vitamin or mineral supplement you need is highly individualist. It can depend on your age, how far north you live, the color of your skin, how much you exercise, and the vagaries of your body. Female endurance runners, for example, tend to be on the anemic side. Blood work is the only sure way to know if you have any deficiencies and need a supplement. However, blood work for vitamin levels can be unreliable.
Do you need to take a supplement?
Only blood work can tell you the real answer, but here is my impression on some leading supplements.
Are you a female athlete? Keep a very close eye on your iron levels. Strenuous training increases the demand for iron because it triggers a higher production of red blood cells and blood vessels. The “foot strikes” of an endurance runner on hard surfaces can lead to iron loss, along with heavy sweating.
If you are anemic, you can get a ton of iron from whole plant foods,
especially whole grains. The absorption of iron from grains and beans is
regulated tightly by your body, so you will get just enough.; Heme iron
from meats bypass the regulatory systems of the small intestine, increasing
iron levels in your body whether you need it or not.
In addition, you must have Vitamin C in your system to absorb the iron. Plants are loaded with Vitamin C, while meats don’t have any. http://www.ncbi.nlm.nih.gov/pubmed/2507689
People with higher blood iron levels are at higher risk for heart disease
and some cancers
Dr. Mary’s Advice: avoid iron supplementation. Eat more whole grains to increase your iron in the most natural and healthy way.
Everyone must absolutely take vitamin B-12.; This water-soluble vitamin isn’t made by plants, but is found in microbes in dirt and grows in the guts of animals we eat. Nobody wants to eat dirtier food, like we would if we were still hunter-gatherers. The consequences for a B-12 deficiency can be very grave and include suicidal depression, psychotic delusions or even death.
The best way to get vitamin D, technically a pre-hormone, is from sunshine—just 10 to 15 minutes a day on bare skin (no sunscreen) is all you need. Excessive sun exposure won’t cause vitamin D toxicity, but take it easy—there’s always the risk of sunburn and skin cancer.
But getting vitamin D from the sun isn’t so easy in the darker months of winter. Even when the sun is shining, it doesn’t deliver enough ultraviolet light. So I recommend to all my patients that they take a vitamin D supplement in the wintertime since it’s really hard to get enough of the vitamin from food sources—fortified milk and oily fish, like herring, salmon, sardines, along with cod liver oil.
And some need to take the supplement all year-round: those who are black, Hispanic, elderly, stay inside all the time, or never leave the house without sunscreen (breast-fed infants need it, too). However, if you are normal weight, you could increase your sun exposure in winter months and rely on your body fat to release the Vitamin D appropriately over the winter months.
Timing is important with this one. To ensure your body actually absorbs it, you have to take vitamin D with a big meal, according to a Cleveland study.
You might wonder if you can get vitamin D from sunshine streaming through a window. Negative on that one.
Vitamin D deficiency is often described as a major problem in this country. One study estimates that 42 percent of Americans are vitamin D deficient. Deficiencies were often found in folks suffering from poor health and who never drank milk.
These deficiency rates are concerning because vitamin D is key in helping your body absorb calcium to form bones. It also boosts immunity and controls cell growth. There’s growing evidence that vitamin D efficiency might even be linked to several chronic diseases, including heart disease and cancer.
When it comes to taking a vitamin D supplement, don’t overdo.; Excessive amounts of this fat-soluble vitamin can prove toxic. The Endocrine Society recommends 600 to 1,000 IU for older children and teens; 1,500 to 2,000 IU for adults.; Doctors were advised that vitamin-deficient adults might need 10,000 IUs daily for two months.
With the very low rates of regular exercise in our country, Vitamin D may simply be an expensive marker for a lack of routine outdoor activity. The best Vitamin D is the Vitamin D you make from the cholesterol in the skin when you play and work outdoors. Your brilliant body will store that Vitamin D in your healthy fat stores for future use.
I recommend taking a vitamin D/magnesium combo supplement, only if you are getting outside most days and testing reveals that you are still deficient. Most Vitamin D deficiency is simply outdoor time deficiency.
Just like vitamin D, our bodies can’t make omega-3 so be diligent seeking out food that contains omega-3, like seeds and nuts. Fish, such as salmon, anchovies and trout, are higher in healthy fats, but the people with the highest levels of omega 3 fats concentrate their diets on vegetarian sources of healthy fats, like beans, nuts and seeds - http://www.ncbi.nlm.nih.gov/pubmed/10556987 - f Omega 3 can boost your memory and mood; enhance joint and vision health; strengthen skin, hair and nails; and reduce inflammation that may lead to all kinds of bad stuff—heart disease, high blood pressure, and fatal heart arrhythmias. Supplements are not nearly as effective as choosing a diet that is high in these omega-3 rich foods.
Pregnant women (or women trying to get pregnant) should supplement with a multi-vitamin that includes folate—an essential vitamin that prevents birth defects like spina bifida.
Boston University Medical Center. "Weekly And Biweekly Vitamin D2 Prevents Vitamin D Deficiency." ScienceDaily.Com: (October 28, 2009).
Volkov, I. Rudoy, M. Machagna, I. Glezer, U. Ganel, A. Orenshtein, & Y. Press. “Modern society and prospects of low vitamin B12 intake.” Ann Nutr Metab, 51(5):468-470, 2007.
Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54.
Mulligan GB, Licata A. Taking vitamin D with the largest meal improves absorption and results in higher serum levels of 25-hydroxyvitamin.” D. J Bone Miner Research: (April 2010).;
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