The near consensus from doctors, pharmacists, and others who have studied it is that if you have a halfway decent diet, vitamins are unlikely to do you any good. And you should be careful not to overdose on any of the minerals or fat-soluble vitamins, most (all) of which are dangerous it taken in excess. But the amounts in the typical iron-free “daily multivitamin” are safe for almost all adults. That’s not what I mean when I say “it’s a hard no”. An ordinary multivitamin is dirt cheap and safe. I don’t know any doctors who recommend it routinely, but i don’t know any doctors who advise patients to stop taking one, either. They’ll probably mention that it’s unlikely to help, but not say, “don’t do that!” And i know a lot of doctors.
The first study i saw of vitamin D and covid found randomly gave vitamin D to 2/3 of the patients in the study (of patients being treated for covid) and observed a higher survival rate among those who got vitamin D. The amount they gave wasn’t a lot, it was what you’d give someone deficient in vitamin D, it wasn’t a mega dose or anything. The discussion mentioned that they hadn’t tested anyone for vitamin D deficiency, but it was common there.
The meta studies have been less conclusive. But that seemed like decent evidence at the time.
Obesity (which can correlate with low vitamin D levels) is a known risk factor for disease, including greater severity of Covid-19. So that’s another potential confounder.
The idea that vitamin D deficiency is a public health issue so people should take a bunch of it “just in case”, has marked drawbacks.
However, after a few rounds of blood tests on my doctor’s recommendation, I have learned that the way I stay within normal Vitamin D ranges is to take a multivitamin plus an additional 5,000 IU a day of Vitamin D. No idea why, but apparently that’s how my body works. Of course I am a relatively olive-skinned person with an indoor job in a northern climate. But I do have to wonder if Vitamin D/calcium absorption issues have anything to do with the osteoporosis that runs on my mom’s side of the family, and which I would like to avoid.
VItamin D is the only vitamin an average American is going to potentially be deficient in. Other than in cases of a bizarre diet or some kind of underlying disease process that impairs the absorption of nutrients, the only other vitamin or mineral that may be a problem is iron, and that’s from excess loss in people with heavy menses rather than deficiency in diet. Vitamin D is hard to come by from foods unless you’re eating seafood on a regular basis or fortified foods (at which point one gets into a semantic debate of what really constitutes a supplement).
Anecdotally, vitamin D deficiency is the only vitamin / mineral deficiency that I typically find in my patients (again barring diseases that cause problems with absorption or bizarre diets). This is among a population of frail elderly who live in nursing homes.
At work we do get people who are on chemotherapy coming in with a list of supplements to take from their oncologists as, apparently, this aids in their treatment. I will also note that the dosages suggested even there tend toward the low to middle range of commercially available supplements. Which is telling. They also will typically specify which brands, so presumably the docs consider those more reliable than some others.
I think there are other medications that may deplete specific things and, again, we have people arriving at the pharmacy counter for assistance in locating them in the appropriate dosages. But, once again, these are people undergoing some form of medical treatment under a doctor’s supervision with (presumably) appropriate monitoring. Again, often with specific brands.
Which is a lot different than the do-it-yourself crowd pushing large dosages of questionable provenance.
The good news is that the average person isn’t likely to adopt a harmful regimen if for no other reason than finances and swallowing pills isn’t fun. And a lot of them you’d have to work at getting harmful doses. But harm is still a possibility, and personally, as a big advocate of a healthy diet approach, I’d rather many of these people, especially the ones with shaky finances, spend their money on unprocessed, fresh foods rather than pills and powders.
Yes, I even stopped taking it for a while. (mostly because I was messing around with finding the right dose of an unrelated drug, and my pill box was cluttered.) But I’m taking it again because it’s winter and I have a record of not having enough and when I mentioned it to my doctor at my last annual physical he encouraged me to take it again.
I actually think that vitamin D deficiency is so common among indoor workers in northern climes that it’s not a bad idea for those of us who do that to just take some unless you have a blood test that says you shouldn’t. But by “some” I mean ~1000 units a day, which costs pennies.
For the people recommending saving your money for fruits and vegetables, I just priced Kirkland Signature multivitamins at $0.04 per day. I’ve allocated today’s savings to the purchase of most of a grape. What should I spend tomorrow’s savings on to maximize my nutrient density?
The single grape is giving you more health value than the MVI is, is the point.
With the debatable exception of the RDA of vitamin D in it.
FWIW …
I have seen vitamin D toxicity … a preschooler, given at a chiropractor’s guidance, vitamin D drops daily, that exceeded some absurd amount (I fail to recall the exact dose but something like 30,000 IU/d). She had some renal calcium scars but otherwise was and is okay. (Still my patient.)
Professionally I can neither recommend for or against vitamin D outside of the first year of life in breastfed babies. I share my skepticism but I also share that likely many walking around are low and as long as it’s just RDA the argument can be made for “why not?” Better to just take than to test everyone. No idea what the NNT (number needed to treat) is to be preventing any adverse outcome associated with severe deficiency would be, but as long as doses are modest little risk of harms.
People taking handfuls of supplements from A to zinc though are at risk of falling into the megadosing harms. The risk of routine supplementation has to include the unavoidable number that can’t help thinking that a little is good so more is better
You are comparing apples to oranges. You have to eat…something…so why not spend the money on fruits and vegetables instead of the multivitamins? Unless you are living only on the vitamins. Its not like you are buying multivitamins instead of food, are you?
No discussion of vitamin D toxicity is complete without mention of alt med guru Gary Null, who revealed that his own brand of “Power Meal” supplement nearly killed him due to unexpectedly high levels of vitamin D.
Again, one of the risks you run with poorly regulated supplements is their not containing what’s claimed on the label, though it’s more likely that they don’t contain as much of the active ingredient as claimed (or don’t have it in a readily metabolizable form) compared to containing too much.
The champion of massive supplement guzzling may have been Nicholas Gonzalez, whose protocols (including a notorious one for pancreatic cancer patients*) involved scarfing down huge amounts of supplement pills. Quoting from a Gonzalez Foundation website:
“Gonzalez Protocol cancer patients consume 150-200 capsules a day (nutritional supplements and pancreas product). Some supplements are taken with meals. Others are taken away from meals. Some are taken in the middle of the night. Non-cancer patients consume 80-100 capsules a day, depending on their health status and medical problems.”
*this was actually tested in a government-funded study alongside mainstream therapy for pancreatic cancer. The Gonzalez protocol patients survived for a much shorter period, with poorer quality of life.
**Gonzalez was one of the alleged victims of the Holistic Doctor Murder Conspiracy.
Because the marginal value of that 4 cents per day is not enough to matter. Yes, you should eat a healthy diet that contains a variety of vegetables and fruits and seeds and whatnot. But whether or not you choose to take a multivitamin is totally irrelevant to your food budget, and ought to be irrelevant to your food choices, as well.
So it’s kind of pointless to talk about how much money you are wasting, because the vast majority of people in the US who take vitamins aren’t wasting enough money to matter for pretty much anything.
If you take one, get it from a reputable brand. (Something like Kirkland, for instance, which doesn’t want the reputational risk of having Consumer Reports announcing their vitamins are full of lead would be good, and they can afford to check their suppliers.) And don’t get one with iron unless you are a menstruating woman or have a medically documented reason to need more iron. And don’t get any mega doses. Aim for something like the US RDA or less for each ingredient. It probably won’t help you, but it’s unlikely to do any harm.
Sometimes the right formulation helps. I tried B complex from the store, got indigestion. Finally found one that doesn’t, more organic. Does it help me? Yeah. I’m a little less nervous and anxious, although that is not a formally measured data point. It’s entirely subjective.
The other thing I take regularly is calcium-magnesium citrate, mostly mag. (The calcium is to keep the mag from causing loose bowels.) I definitely notice my muscles and body is more supple, less brittle. I take yoga and it makes the yoga practice better.
