Multivitamin Review

Do you really need a multivitamin?

Consumers are bombarded by advertising for vitamins that purportedly help you lose weight, make your skin glow, lower cholesterol or give you energy. However, none of that advertising answers the essential question: Do you really need a multivitamin? Health experts agree that certain groups of people can clearly benefit from a multivitamin, especially pregnant or breastfeeding women. Multivitamins are also recommended for people with nutrient-depleting diseases of the gastrointestinal system, such as diabetes and cancer. Strict vegans and vegetarians and people on restricted diets should also consider a multivitamin to replace nutrients that they may not be getting through diet alone.

However, for most people, getting vitamins and minerals from food is best. Many Americans don't eat enough healthy foods to get all of the recommended vitamins and minerals, which is where a multivitamin can help fill the gaps. Just don't expect miracles from your multi. In a recent study published in the Archives of Internal Medicine, researchers tracked more than 160,000 postmenopausal women and found that multivitamin use had "little or no influence" on rates of cancer and heart disease. In 2002, the Journal of the American Medical Association recommended that all adults supplement their diets with a multivitamin, but a review by a federal panel in May 2006 concluded that there's no evidence to recommend multivitamins for people who don't fall into one of the risk groups mentioned above. This leaves the decision squarely in consumers' laps. Like all over-the-counter supplements, it's best to get your doctor's recommendation.

Choosing a multivitamin can be as difficult as swallowing a horse pill, especially with the multitude of options available. Fortunately, several sources provide good coverage of multivitamins to help you narrow down the options. ConsumerLab.com is the best reviewer of multivitamins; they test dozens of multis to ensure that they dissolve properly, contain the ingredients listed on the label and are not contaminated with lead or other toxins. Based on their testing, each of the multivitamins receives an "approved" or "not approved" rating. Few sources can compare to ConsumerLab.com; ConsumerReports.org and the Center for Science in the Public Interest review vitamins, but their reports are several years old. Because multivitamin formulas change all the time, recent reviews are more helpful.

Are multivitamins safe?

Because multivitamins are not regulated by the Food and Drug Administration (FDA), consumers rely on manufacturers to ensure that supplements are safe and contain the nutrients listed on the label. ConsumerLab.com's excellent testing shows that consumers should be concerned about multivitamin quality -- among 45 multivitamins, seven fail at least one test. One is contaminated with lead, and many others have levels of nutrients that exceed upper tolerable intake levels. Even more worrisome, three out of four of the children have higher levels of vitamin A as retinol than the label states.

Lead contamination is a real concern, and FDA tests of multivitamins in 2008 indicate that most multivitamins probably contain small traces of lead. Of 324 multivitamins, 320 contain small amounts of lead. None of the multivitamins exceeds the upper intake for lead, but some multis contain more lead than others. Among multivitamins for children, two vitamin powders contain the highest amount of lead -- Nature's Plus Animal Parade Shake (*Est. $18 for 1.3 pounds) with 2.88 micrograms (mcg) of lead per daily dose and Superior Multi Age (*Est. $24) with 2.24 mcg of lead in a daily dose. Even though these multivitamins have the highest lead content among children's multivitamins, they are still below the provisional total tolerable intake levels (PTTI) of 6 mcg of lead per day for children less than 6. Several prenatal vitamins also contain higher lead levels compared to others on the list, although all were under the PTTI of 25 mcg a day for pregnant women. Even though these multivitamins don't exceed the safe/tolerable levels for lead, ConsumerLab.com recommends avoiding any unnecessary lead exposure, and multis with lower levels of lead in the FDA test may be a better choice. See the Our Sources section for a link to the full list of multivitamins tested by the FDA.

Some multivitamins contain too little rather than too much. ConsumerReports.org warns about buying ultra-cheap off-brand vitamins from closeout and dollar stores. In testing several years ago, half the tested vitamins do not contain the claimed amount of at least one nutrient, and several don't dissolve enough for the nutrients to be absorbed. However, store brands from well-known retailers such as Wal-Mart, Walgreens, CVS and Eckerd can be a good choice. In fact, many generic and store-brand vitamins from major retailers perform as well as well-known brands like Centrum and One-A-Day in analysis by the Nutrition Action Healthletter.

Consumers should also be skeptical about the health claims listed on multivitamin labels. Some multivitamin manufacturers are facing scrutiny over claims they make about their products.. In June 2009, the Center for Science in the Public Interest (CSPI) announced that it intended to sue Bayer Healthcare over claims the company made about One-A-Day Men's 50+ Advantage (*Est. $26 for 150 tablets) and One-A-Day Men's Health Formula (*Est. $22 for 250 tablets) multivitamins. In advertisements, Bayer touted the positive effects of the selenium in these men's multivitamins. CSPI says that multiple studies have shown that selenium does not prevent prostate problems, and David Schardt at CSPI says that Bayer is "exploiting men's fears of prostate cancer just to sell more pills." Bayer says it plans to change its ads. Bayer has faced issues like this before: In 2007, it was fined $3.2 million in connection with weight-loss claims regarding One-A-Day WeightSmart. The makers of Airborne were fined in 2008 in connection with their claims about their vitamin tablets and the common cold.