may help provide missing nutrients
Millions of Americans take a daily multivitamin. Health experts agree that certain groups of people can clearly benefit
from a multivitamin, especially women who are pregnant or may become pregnant. Others
may not need a multivitamin because the majority of Americans get plenty
of nutrients from their daily diet. However, most experts say there is no harm
in taking a daily multivitamin and it might help with nutrient balance if, for
example, you can't stand eating your veggies, or eat a restricted diet for whatever
However, if you have any health concerns, pre-existing
conditions, or take other supplements or medications, always check with your
healthcare provider before adding a multivitamin into your regimen. Also check
with your child's pediatrician before giving your child a multivitamin. We do
not cover multivitamins for children because most experts say you should not
give your child supplements without a specific recommendation from a healthcare
The FDA made an important change to its folate/folic acid
The FDA announced in July of 2016 that it was making changes
to the way it measures folate, which is naturally occurring in foods, and folic
acid, the synthetic form of folate. Since synthetic folate is metabolized
differently than naturally-derived folate from food, synthetic folates are
considered to be a higher concentration than they used to be. The new labeling
takes into account both micrograms (mcg) and "dietary folate
equivalents" (DFE). So, for example, if the folate levels in a supplement
are exclusively from synthetic folate and currently are listed at 800 mcg, it
will, in the future, be listed as 1,360 mcg DFE (the ratio is 1:1.7 for folic
acid, 1:1 for naturally occurring folate). This means that, currently, almost
all prenatal multivitamins with folic acid as its folate source actually provide
more, sometimes much more, than the recommended RDA for folate, in spite of
what the label says. However, since these rules have not yet taken effect, the
current supplements are considered to be truthful in their labeling and still
pass in testing for that. These labeling changes will take effect from July of
2018 to July 2019.
While there are legitimate concerns about ingesting too much
folate because it can mask other issues, that is very rare and generally
happens at much higher levels of supplementation. In the meantime, the take
home message is this: if you're pregnant, folate supplementation is highly
recommended. Work with your doctor to find the right type and amount of folate
Types of Multivitamins
Multivitamins for Adults over 50
The reason that there are so many vitamins targeting adults over age 50 is because they have different nutritional needs than their younger selves. Older adults typically need more B vitamins, especially B-12, more calcium, less iron (especially women), less folate, and may benefit from a thermogenic ingredient, which can help burn calories. Some companies even make multivitamins specifically for older men or women, with tweaks to their formulas targeting that demographic. One thing you do need to watch out for: if you take a blood thinner, vitamin K can interfere with it, so be sure to check with your doctor.
Multivitamins for Women
Experts agree: all women of childbearing age should take a multivitamin containing folate or folic acid. Even though you may not be intending to conceive, if you do, the risk of neural tube defects is greatly increased without this supplement. The recommended daily allowance of folate for women ages 14 and up is 400 mcg DFE (which represents the FDA's newest measurements for folate as micrograms dietary folate equivalents). Multivitamins targeted at women under age 50 reflect these needs, and, in addition, often provide other nutrients, like iron, that menstruating women may lack.
As noted above, all women of childbearing age should take a daily multivitamin with at least 400 mcg DFE of folate. Pregnant and breastfeeding women need even more folic acid – 600 and 500 mcg DFE, respectively. Again, these reflect the FDA's latest guidelines in measuring folate supplements, making it even more important that you discuss your supplement needs with your doctor.
Multivitamins for Men
Vitamins targeted at men often have formulations that specifically claim to benefit prostrate or heart health. While these statements have not been evaluated by the FDA, the fact is that men can benefit from a multivitamin made for them. For one thing, men generally don't need more than 8 mg (milligrams) of iron a day, which is easy to get from diet alone, so men's formulas tend to be very low in iron.
Are multivitamins safe?
Enacted in 1994, the Dietary Supplement Health and Education
Act (DSHEA) restricts the ability of the U.S. Food and Drug Administration
(FDA) to regulate supplements or ensure the safety of their ingredients. Under
this act, the FDA is limited to collecting information on adverse side effects
and to monitoring labeling claims. That means the most the FDA can do is pull a
product off store shelves after a problem becomes apparent. It's
up to the manufacturer to ensure that its multivitamins and supplements are
safe. Under DSHEA, multivitamins don't require
FDA approval, and manufacturers aren't required to register their supplements
with the FDA before putting them on the market.
In an ideal world, manufacturers would be diligent about the
safety of their multivitamins and truth in labeling. However, as professional testing
shows, consumers need to be concerned about multivitamin quality. Among 35 products
evaluated by ConsumerLab.com, 46 percent fail at least one test. Many don't meet the nutrient claims on the label, others improperly list ingredients.
It's not unusual for a multivitamin to exceed the upper limit (UL) for
niacin and yet stay off of the "not approved" lists of most
professional testing organizations. That's because niacin has thermogenic
properties and is often targeted to other purposes, such as increased energy, aiding
weight loss or lowering cholesterol. However, it's important to note that
niacin can cause flushing and tingling at high doses -- and more serious side
effects in a small minority of the population. Again, check with your
healthcare provider if you have any concerns.
Regardless of existing regulations, consumers should be
skeptical about health claims listed on multivitamin labels. While the original
provisions of DSHEA require that manufacturers make no claims about their
products preventing or curing diseases, some do so anyway. Keep in mind, there
are no studies to show that any supplement can prevent or cure any condition
(with the notable exceptions of iodine and folic acid). The only reason for the
average person to take a multivitamin is to ensure you have a full range of
daily nutrients, especially if you don't eat a balanced diet.
Finding The Best Multivitamins
"Product Review: Multivitamin and Multimineral Supplements"
"Top 10 Multivitamins"
Choosing a multivitamin can be as difficult as swallowing a
horse pill, especially with the multitude of options available. The most
important factor in finding the best multivitamin is choosing one that is
verified to contain the amount of ingredients that the label claims and that
has been tested to be free of contaminants.
Fortunately, several sources provide good coverage of multivitamins
to help narrow your choices. ConsumerLab.com is the best reviewer of
multivitamins; it tests dozens of products to ensure that they dissolve
properly, contain the ingredients listed on the label, and aren't contaminated with lead and other toxins. Some
manufacturers pay to have their multivitamins included in the testing through
ConsumerLab.com's voluntary Quality Certification Program, but those products
are clearly listed in the results table and that payment does not influence the
results. ConsumerLab.com's reports are available to subscribers only.
Labdoor is another good source for laboratory testing of
multivitamins. They test a number of multivitamins for label accuracy, product
purity, nutritional value, ingredient safety and projected efficacy. The multis
tested are also ranked and rated against one another. Full results are
available after free registration. Consumer Reports evaluated multivitamins in
September 2010 to ensure they meet nutrient claims and dissolve properly; that report,
though older, is free to the public.
User reviews are helpful for information on side effects
like stomach upset, any odor or taste issues, and how easy a multivitamin is to
swallow. Overall, though, when making our choices we focused our attention on
accuracy in labeling to be sure that, when you do make a decision, you get what
you're paying for.