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Do You Need a Multivitamin

Columnist: Rajina Ranadive, M.D.
April, 2018 Issue

Rajina Ranadive, M.D.
All articles by columnist

If you take a multivitamin every day, then you’re part of multi-billion dollar industry that has been marketing various health claims. As consumers, we spend an average of $14 billion a year on tablets that contain vitamins and minerals. Many people take a multivitamin because they believe it gives them more energy, or makes them feel better. Others take multivitamins to supplement what they believe is a poor diet. Still others believe taking a daily multivitamin is a preventive measure against the common cold or flu or to prevent chronic diseases.

Vitamins and disease

Can taking vitamins help you prevent heart disease? Medical scientists once believed vitamin C and E was an essential part of reducing your risk of heart disease, but clinical trials have disproven this, and these vitamins are no longer recommended once studies revealed that there’s no benefit to taking them. Another study looked to see if taking vitamins could reduce the risk of lung cancer, but this was also disproven. The studies proved that taking multivitamins, vitamin C and E and folate did not reduce the risk of lung cancer. In fact, one study proved that taking excessive beta carotene, which converts to vitamin A, could cause lung cancer in smokers. If you’re a smoker, former smoker or an asbestos worker, it’s best to avoid beta carotene supplements in excess quantities. Food sources of beta carotene, however, are okay.

In 2014, Harvard Health published a physician-heart study, which contained a large group of male physicians who took a multivitamin that contained 31 vitamins and minerals. A similar group took placebo pills. The results of the study proved there was no protective effect against cardiovascular disease, or declining mental function. Over the years, there have been multiple observational studies that revealed there’s no association in using multivitamins with reducing cancer, cardiovascular disease or mortality.

When do you need vitamins?

There are some situations in which vitamins are essential and medical studies prove it. If you’re eating a vegetarian or vegan diet, for example, you would benefit from taking B12 supplements since the best sources of Vitamin B12 include eggs, milk, cheese, milk products meat, shellfish and poultry. Or, if you’re over the age of 50, experts believe there’s a benefit to taking B12 because it may be harder to absorb this nutrient later in life. And if you avoid dairy products, calcium supplementation may be required.

For a woman who is planning for pregnancy, taking folic acid before becoming pregnant is important to prevent neural tube defects in the fetus. (Generally, the recommended dosage is 600 to 800 mcgs, but if you have a family history of neural-tube defects, you may need more. Check with your obstetrician.) And for those people who avoid the sun or are meticulous about wearing sunscreen, vitamin D is definitely required since there may be an association with low vitamin D and heart disease, though more definitive studies are still required to prove this. Generally, if you’re fair-skinned, spending 10 minutes a day outdoors—in shorts and a tank top with no sunscreen—will give you enough radiation to produce about 10,000 international units of the vitamin. If you’re dark-skinned, you will require six times more exposure to get the same amount of vitamin D.

If you have age-related macular degeneration (vision problems), a multivitamin that contains vitamin C, E, beta carotene, Zinc and Copper could be helpful to you. A study revealed that these vitamins not only reduce the risk of developing advanced age-related macular degeneration, but also reduce the loss of visual acuity in those who’ve been diagnosed with this condition. This is likely the only situation where a supplement containing vitamins and minerals is proven to be beneficial.

Finally, if you’re not eating more than two to three servings of oily fleshed, wild caught, coldwater fish a week, some experts recommend fish oil. Salmon, mackerel and trout are good sources. The other alternative is to take fish oil supplement that has 700 to 1000 mg of EPA and 200 to 500 mg of DHA.

The benefits of a healthy diet

For most people, eating a healthy variety of fruits, vegetables, dairy and whole grains could easily replace a daily multivitamin. If you’re not getting the vitamins you need through your diet, ask your doctor next time you have a checkup, which specific vitamins you require.

Rajina Ranadive, M.D., is a board certified internal medicine physician with the St. Joseph Health Medical Group. She is also the medical director of the Petaluma Post-Acute Rehab. She can be reached at (707) 763-0802.




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