Deficiency might be overrated


This post is about Multivitamins/ Vitamins. I am apprehensive about commenting on this topic because of how much controversy there is on this topic. The conclusion to the question of “Which multivitamins/ vitamins should I be taking? ” is quite simple and short however the journey to this conclusion has been long. This post is not meant to be a literature review but to provide concise, relevant information to my millennial and/ or non medical friends. My disclosure is that in my practice I follow evidence based guidelines however I am open minded about and don’t discredit anecdotal evidence.

So the short  answer to the question above is that there is INSUFFICIENT evidence to to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer.

The slightly winded answer, however sticking to the KISS (Keep It Simple Stupid) Rule is that we need to meet our daily quota of vitamins and minerals and it is possible to acheive this by following a balanced diet (not reviewed here).The problem is that most of us do not commit to a healthy balanced diet. One school of thought is that if we have an unbalanced diet and we have nutritional gaps we can supplement those gaps with a multivitamin. My thoughts re this issue are-

1.If you swear that you feel better when you take a multivitamin – then take it – even if the benefit experienced is a placebo effect- that’s worth it

2.If you feel that you have room for improvement with your diet and realistically can focus on making healthier choices by incorporating more veges, fruits ,omega fatty acids and less processed foods then that would be the more difficult but better choice.

Wait a minute there are a few exceptions to this “wishy washy do what you please with these vitamins” rule and they are  FOLIC ACID, VITAMIN D, Vitamin A (Beta Carotene) and VITAMIN E.

FOLIC ACID- all women who are planning pregnancy should supplement their diets with 400 micrograms of folic acid to prevent neural tube defects of the baby.

VITAMIN D-  supplementation is effective in preventing falls in adults aged 65 years or older who are at increased risk for falls (from US Preventive Service Task Force recommendation) 80o I.U. would be reasonable unless you are terribly deficient then you can discuss with your primary care the right dose for you.

VITAMIN A (Beta Carotene)  and VITAMIN E – There is sufficient evidence to demonstrate that supplementation with VITAMIN A  can increase the risk of lung cancers in people to are already at risk for lung cancers. But wait a second,  it is an antioxidant, that’s supposed to be magic. Well in reality antioxidants are not thoroughly understood and there is some evidence to suggest that in certain environments/ circumstances they can act as a pro- oxidants (i.e. BAD NEWS). So we recommend AGAINST supplementation with vitamin A. There is also sufficient evidence to show that supplementation with Vitamin E has few to no harms but it is NOT recommended to improve your cardiovascular health or deter cancer.

Any other herb or supplement should be reviewed with your primary care provider especially if you are taking medications for any reason. I hope this saves you time and money, Make you feel less guilty for not “popping your gummies” or at least encourage you to direct the monies spent on multivitamins to better quality FOOD.

For details can click the link here for up to date guidelines multivitamins USPSTF

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