All multivitamins are not created equal

A good multivitamin can ensure your patients are getting the nutrients they need.

While suggesting that patients consume a diet full of nutritious, wholesome foods is the best way to ensure they get a good dose of vitamins and minerals, sometimes a multivitamin is necessary to “fill in the gaps” says Arizona State University’s Wellness program.

This is often the case when they don’t get the sleep necessary to rejuvenate their body and mind, when they’re under higher levels of stress, or if their diet isn’t quite as balanced as it should be—all factors that affect a large amount of the population today.

But all multivitamins aren’t created equal, and, to make matters even more complex, what is a good multivitamin choice for one person may not be as beneficial for the next.

Therefore, in order to help you help your patients pick the best multivitamin possible for them, we’ve reached out to a couple experts in this field and asked for their input on this often confusing topic.

About DVs and RDAs

The National Institutes of Health explains that supplements are regulated by the U.S. Food and Drug Administration and require that certain information be listed on the label. This includes “serving size, list of dietary ingredients, amount per serving size (by weight), [and] percent of Daily Value (%DV), if established.”

However, if you look at the labels on different products and brands, you’ll quickly realize that they all have different amounts and percentages of each nutrient. Which one is best?

According to Arielle Levitan, MD, co-founder of Vous Vitamin and co-author of The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health, “Many vitamins should not exceed the U.S. RDA [recommended daily allowance] in supplement form. For example, calcium and vitamin A can be harmful if taken via supplement and many people do not need them (calcium is associated with kidney stones and calcium deposits in breast and arteries while vitamin A taken via supplement is associated with cancer and osteoporosis).”

Consider patient demographics and lifestyle

Levitan also suggests that you consider patient demographics before making any type of multivitamin recommendation.

For instance, Harvard University stresses that calcium is of more importance for females as it “may help lower their risk of osteoporosis,” a condition that afflicts more women than men. Iron is also a must-have for women over men, especially those in child-bearing years “because they lose iron with each menstrual period.”

However, “most people need some amounts of supplemental vitamin D, B vitamins, magnesium, vitamin C, and iodine,” says Levitan. Therefore, a multivitamin that contains all of these nutrients is a great choice.

The undesirable multivitamin 

Jennie Ann Freiman, MD, founder of the wellness company Oobroo, advises that it’s just as important to pay attention to the inactive ingredients in multivitamins as some have been linked to health issues. “That common white multivitamin color comes from titanium dioxide,” says Freiman, adding that “titanium dioxide nanoparticles have been linked to DNA damage and cancer.”

For this reason, Dr. Freiman suggests that people bypass supplements in pill or tablet form “because their shape is held together by these types of inactive ingredients.”

Instead, she recommends taking “a whole food multivitamin supplement in capsule form, with no active ingredients,” citing this as the best next choice.

Ask about other medications

Another consideration before recommending a good multivitamin for patients is whether or not they’re taking other medications.

In some cases, vitamins can help, such as for those taking cholesterol-lowering medications (called statins), says Levitan, “because vitamin D and magnesium can be useful in helping to avoid muscle aches and pains.”

In other cases, the taking of prescription medications can interact with a multivitamin and make it less effective. For instance, synthroid, a medication used to treat hypothyroidism, “cannot be taken within several hours of a multivitamin containing iron or calcium,” advises Levitan, “because they compete for absorption.”

Thus, it’s important that your patient realize this so he or she can enjoy the benefits of a multivitamin without compromising a current medical condition.

More multivitamin advice

When advising patients about the best multivitamin to take, there is other advice you can give to help make this part of their health program more effective.

For instance, Levitan says that most multivitamins are “best taken with a large glass of water and a meal for optimal absorption.” He goes on to say that, “multivitamins can be taken any time of day, though some feel taking them in the morning is more helpful and gives them more energy,” adding that “this is purely anecdotal.”