My doctor has been telling me for a while that I should take a multivitamin for various reasons. I’ve always responded that I have no objection, but there are many different kinds for sale; which vitamins do I need, and in what doses? He never really knew what to answer, so I got nothing, until a few days ago, when he finally suggested “Centrum Silver, or whatever the One-A-Day equivalent is.”
So today I went to the vitamin section and started comparing labels. I am totally baffled by what they put in these things. Many of the ingredients are dosed at 100% of the Food and Drug Administration’s recommended amount, which is exactly what I’d expect these things to contain. And many of them are in smaller doses; my guess is that those vitamins are common in regular food so less is needed in the pill and/or they’re too expensive to include at the 100% level.
But what really drives me crazy are the ingredients which are at levels above - or FAR above - the 100% mark. There are several of these, but I’ll just give one as an illustration. “One-A-Day Men’s” contains 18 mcg of Vitamin B12, which it says is 300% of the Daily Value. Why do they think a typical customer would need or want three times as much as the government suggests? “Centrum Silver - Men’s” is even worse, with 100 mcg of it - 1667%, or almost seventeen times the recommended amount!!!
That scares me. Why are they giving us so much? I looked it up in Wikipedia, and they say that overdosing is unlikely, even at high doses. But even so, why do they want me to have so much?
As an aside, can anyone suggest an easily-obtainable multivitamin that simply has 100% of the daily amount of lots of vitamins and minerals?
As it was your doctor who suggested this, presumably because of his analysis of your health, why not ask for a recommendation from your doctor? This is hardly the place for medical advice. On re-reading your post, as your doctor has no idea of what to recommend, I’d recommend a different doctor.
I believe vitamin B12 doesn’t have a particularly high absorption rate from non-chewable tablets. The value on the label represents the amount contained - X mg - and the recommended dose might be Y mg, but the actual absorption from that tablet formulation is perhaps expected to be Z mg <= Y mg.
This is, of course, an assumption. The FDAdoesn’t evaluate the development and biochemistry of vitamins and other supplements, though presumably the manufacturer has.
This. The advice I’ve always seen is that you shouldn’t need supplemental vitamins unless you’ve been diagnosed with a specific deficiency. If your doctor is unable to determine what you’re lacking, why is he telling you to take extra vitamins?
I think most of these megadoses you see on labels are marketing bullshit, not in the sense that they are lying to you about what is in the pill (though they may be sometimes), but in the sense that they think many people will assume that a pill that contains 200% of RDA must be twice as good as one with a mere 100%, and buy their brand instead of someone else’s.
Note that massive overdoses of some vitamins can cause quite severe ill effects, up to and including death or permanent brain damage, although it is extremely unlikely that you would be in any danger from taking a manufacturer’s recommended dose of multivitamin per day. On the other hand, unless you have a specific deficiency problem, it is not very likely to do you very much good either. It probably does not matter much which brand you take (or whether you take any at all).
Short answer: The RDA is a minimum, not a maximum. Special circumstances might require more.
Longer answer: The RDA is built up from multiple studies. There is can never be a study that looks at the health of every single person in the country and comes up with a magic number for each and every one of the couple of dozen nutrients that are present in food. It is especially hard to isolate any individual nutrient from the effects of others. Studies like that tend to come from people in such extreme cases that their needs are hardly representative of the rest of the population.
The RDA was built up over decades as information developed. It changes as new studies warrant, though only after a long period of review and arguing by a raft of medical associations and other bodies. In the meantime, a specialized association might jump the gun and recommend higher or lower amounts than the current RDA standards. That’s especially true for segments of the population. RDAs are different for men and women, and for people of different ages, and for pregnant women.
So what they really come down to is minimums. I.e., if you take said amount you won’t be likely to get any of the diseases that are known to occur with an insufficiency of that nutrient. That’s it. It’s not what you are supposed to take, or the most healthy number to take, or the best number for you individually. It’s a safeguard to ensure you don’t fall below the minimum.
And that’s the rationale behind a multivitamin. It is a supplement to what you are getting from your food. If you’re eating a healthy, balanced diet you may already be getting at least 100% of the RDA of all your nutrients before you put the pill in your mouth. You can take the pill anyway. It won’t hurt you. The leeway on all vitamins and minerals is far more than 100%. What the multivitamin does is ensure that you hit at least 100% on anything - just in case your diet is insufficient in any one or more of the ingredients.
The reason that different multivitamins have differing amounts is twofold. For one thing, no multivitamin I’m familiar with is aimed at every population. They are for men or women, or seniors or kids, or whatever. The same amount could be 80% for one population or 120% for another. Secondly, the manufacturers read the latest reports and compete based on whatever seems to be the latest recommendations even if those haven’t been officially adopted yet. If some major studies show that senior men need twice as men vitamin G as recommended, they’ll double the vitamin G.
Short answer again: Buy whatever bottle is aimed at your group and don’t overthink it. It’s a supplement, not a medicine.
Some people cannot absorb vitamin B-12 through their digestive system, or absorb it poorly, due to a lack of or an insufficent amount of the “intrinsic factor,” an enzyme produced in the stomach. This is especially true for older folks, and since you mentioned Centrum Silver, I assume you are over 50. I am 74 and take the regular Centrum from Costco. Years ago (many years ago), I compared the nutrients in many different multivitamins. Centrum is one of the better ones.
I know the medical establishment is saying that you don’t need supplements, but I’ve always considered supplements as insurance. My diet is probably more healthy (or healthful if you are a linguistic puritan) than most. But they are so cheap, and any slight overage is not dangerous. You have to watch the fat-soluble vitamins, A and D, but it would take much megadosage over a long time to be dangerous.
Moreover, the recommended dosage of some nutrients, such as calcium (esp. for those over 50), have been increased recently. And if you take calcium, you have to add Vitamin D, without which, you won’t be able to absorb calcium.
So, since your doctor recommended one, I would stick with Centrum Silver or Centrum. Regular Centrum has 100% (6 mcg) of the DV for calcium.
Thank you all. As expected, the Teeming Millions have been very informative.
Excellent question, and the excellent answer is: Because I am planning on gastric bypass surgery shortly, and for all the benefits of that, one of the side effects is assorted vitamin deficiencies because of the rejiggered digestive system. So a standard part of the procedure (across the board, not just from my doctor) is to build up a good supply of all the vitamins in advance.
Debates on whether or not you agree with that can be in another thread, but it was a good question, and (as I wrote) it deserved at least a quick answer.
Your doctor might have suggested the “Silver” variety due to its relatively low dose of iron, which can be very upsetting to the stomach. Presumably the blood tests, etc. you’ve had in consultation showed your hematocrit/hemoglobin/iron status as normal.
And a very good reason to simply take normal amounts of vitamins. Your body does not store most (water soluble) vitamins in any significant level. The vitamins your body can store (fat soluble) are precisely the ones with the highest potential for toxicity.
Any daily dose vitamin taken in the recommended dosage is unlikely to cause toxicity, and unlikely to cause a deficiency, either. If you search the internet diligently, of course, you can find absolute proof that this is all lies promulgated by Big Pharma in order to increase the market for drugs to treat the diseases caused by inadequate ingestion of dietary supplements.
Or, if you want, absolute proof that eating anything other than raw organic food produced by starving peasants will kill you.
Tris
P.S. Oh, and good thoughts for your upcoming surgery.
First, recommendations for how much of a given Vitamin you need vary across countries and sometimes across different organizations.
Second, as has already been said, the absorption rate (bio-availability) of isolated (artificially produced) vitamins is very low compared to just eating an apple … to get your Vitamin C and a carrot for Vitamin A, because the apple contains about 1 000 active ingredients interacting with your system and each other in adsorption, unlike the tablet.
Third, I just read an article about a study confirming once again that eating vitamin tablets causes far more harm than good (it’s not even neutral to doing no good, it’s actively harmful) and doctors recommending once again that the average person shouldn’t eat vitamins just because they eat junk food instead of healthy. Although I disagree with the conclusions drawn, the data itself is rather big.
Fourth, in your special case, Could you try to up your vitamin levels with more fruit and veggies?
I’ve always had a problem with taking vitamins. Why do I need 100% of anything, if I eat, you know, food? If there was a specific deficiency and a doctor recommended a specific vitamin supplement (such as calcium), then I might take that, but shotgunning things with megadoses (or even 100%) across the board makes no sense to me. I’m sure it’s a billion dollar industry, but it’s largely based on bad “science”, fads, and scare tactics.
I agree. A recent study reported on here by the BBC seemed to find a link between taking multivitamin tablets and shortened lifespan. It’s only one study and it’s not conclusive, but it highlights the fact that it’s best to try not to take daily pills of anything unless it really is necessary. If your doctor was recommending you supplement with a specific vitamin then obviously you should take his advice; if he’s not then that’s strange, and I’d recommend asking him again which specific vitamins he thinks you should be taking.
Megadoses are largely scams, although some studies do show major health effects for proper large doses of certain vitamins.
RDAs are absolutely not scams and absolutely not bad science. They are agreed to by every major medical association in the world. The simple fact is that the majority of people in the U.S. and in pretty much all societies, for that matter, demonstrably eat suboptimal diets and do not get 100% of every nutrient. There is no doubt of this at all.
If you’re equating megadoses with RDAs you haven’t done the research and shouldn’t be making such claims in GQ. The science is readily available. The National Research Council summarized it and made it available in paperback, Recommended Dietary Allowances. I have it and I’ve read it throughout. The specific numeric recommendations have changed since this edition was published but the science behind it is timeless, because it’s a summary of how science, good science, is done.
As an anecdotal story - I used to get a splitting headache every month or two since I was a kid. (Many years later I wondered if it was migraine. What’s a migraine? How do I tell?) When I started taking a multivitamin (Used to be Centrum, now the Costco brand) I have probably had about 1 minor headache per year in the last 20 years.
As long as you don’t overdose enough to do damage, your body will ignore the extra vitamins and minerals. (As Sheldon says on Big Bang Theory, “you’re just making expensive pee…”) Like organic food, the health nuts will tell you the artifical stuff is not the same. Who cares, if it works better than a crappy diet and no vitamins you are ahead. One multi once a day will not do damage.
Nope, not what I was saying at all, but thanks for asking first. Never said that RDAs are a scam, nor equated them with mega-doses. I don’t think that taking a vitamin that provides 100% of 20 or 30 different vitamins/minerals every day is necessary. If I’m not getting 100% of something (like vitamin D in winter), then I’ll take a target vitamin that provides that, but multivitamins are a waste of money for most people who eat at least somewhat reasonably.
I’m 64. I didn’t take vitamins as a child, and seldom as an adult. I’ve had spates in my life where I didn’t eat properly and drank excessively and didn’t have much money. But I’ve never had a serious illness and can’t remember the last time I even had a head cold, let alone a vitamin-related illness. Vitamin manufacturers would certainly like you to believe that you’ll get sick if you don’t take their products daily, but then they’re in it for the shareholders. The more research that is done reveals that many claims as to benefits are not verifiable. The latest debunking, I believe, is about Vitamin E and selenium (in pill form) as antioxidants.
There’s a much simpler reason for the large doses of B12…it peps you up. That’s why they put the stuff in energy drinks and bars, sell it in sub-lingual form, etc.
So by putting in a whomping dose of B12, the manufacturers are hoping that you’ll feel more energetic from the vitamins, which means you’ll keep buying them.
I checked fairly carefully a few years back when I realized that one of the trail bars I favored for MTB supplies had 1667% of the RDA for B12 - I was eating 2 or 3 on a ride. You can’t really overdose on the stuff. Expensive pee, as someone already said.
[ul][li]Apples are not a very good source of vitamin C.[]Generally, vitamins do not work by adsorption. []Please provide the cite that lists the 1000 “active ingredients” that apples contain that makes artificially produced vitamins be metabolized at a different rate than naturally occurring vitamins. [*]“Isolated” and “artificially produced” do not mean the same thing. The vitamins in multi-vitamin tablets are not isolated, by definition.[/ul][/li]