Should I take a multivitamin?

That is a question I frequently hear in my integrative medicine clinic in San Jose, CA. It seems that the supplement industry has done a great job in instilling in our minds that everyone should be on a multivitamin but in reality, if you eat a well-balanced healthy diet, it is unlikely that you need a daily multivitamin. You might need a multivitamin as a gap filler a few days of the week but probably not daily.

The population of people who need a multivitamin either on a daily basis or multiple days out of the week are those with specific needs such as, but are not limited to, those with a surgical history where absorption might be poor (i.e., those who had gastric bypass history) or the elderly where absorption is naturally lower as we age or those with absorption issues secondary to a disease like Crohn’s disease or ulcerative colitis or small intestinal bacterial overgrowth.

For these people, a daily multivitamin or a multivitamin multiple days out of the week should indeed be considered. The safest thing is to check vitamin levels on labs and if the labs look deficient, then supplementation should be started. If you are not deficient, taking too much vitamins or minerals can be detrimental to your health, so getting lab levels checked is important. Whenever possible, you should ask your doctor for intracellular vitamin levels instead of just ones in the fluid part of your blood. For example, you can ask for RBC magnesium or RBC folate levels to be done to see how much is actually in cells.

If you are wondering where this concept is coming from, let’s go over what the science behind multivitamins show.

Studies have indicated that if we take too many vitamins thus leading to vitamin levels that are excessive, it can do harm to our body. For example, B6 toxicity can lead to nerve damage issues. Other studies have shown that if a multivitamin is taken at high dosages, there are potentially increased risk of various diseases like cancers. This is why I suggested getting labs done first to see if you truly need repletion of vitamin levels. If lab levels look fine, you are likely fine just continuing to eat well and getting your nutrients from your foods only. It’s important to remember that overdosing on vitamins is definitely not a good thing.

Interestingly, there was a study done where people who used multivitamins as a gap filler and ate healthy balanced meals had lower risks of diseases including some forms of cancers. So basically what that tells us is that you should use real whole food as your “multivitamin” and then use a multivitamin only here and there as a gap filler to make sure you’re getting everything you need and you should get labs done to double check that the levels are within ideal range.

Nowadays, we are lucky enough to have the lab capabilities of checking our levels in our body, we might as well utilize that to our advantage. So, in summary, eat a wide variety of healthy balanced food groups, keeping in mind that high levels of diversity tends to bode well for our nutrient levels, and get your labs done to see if there are any nutrient levels you need some help with and then at that point, use vitamins or a multivitamin to help fill those gaps. Finally, after a few weeks of being on vitamins, you should have your levels checked again to make sure your levels are in the healthy range.