Should I take vitamins or other supplements?

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Dr. Michael Roizen, MD
Internal Medicine
A 19-year study of 38,000 Iowa women found a 6% to 45% higher death risk among those who took vitamin supplements. This makes vitamins sound like "the menace in your medicine cabinet." However, this is the kind of study that's a first step. It's a population study, which means it unveils patterns that need further investigation, and sounds warning bells that may or may not be false alarms. Also, it relies on people remembering what they ate and took -- in this case, not over the course of days or weeks, but during 7 to 9 years.

And that 6% to 45% risk applies only to comparisons of people actually in the study. When it's translated into your risk of dying from taking supplements for 19 years (what's called absolute risk), the range shrinks dramatically: 1% (for multivitamins) to 7% (for copper, the most worrisome finding). The 1% for a multi is so small it could be an error.

Furthermore, there are many unanswered questions. For instance, did the women need to take supplements, especially iron? What formulations did they take? (There's evidence that different formulas have different effects.) Also, the women reportedly ate twice as many fruits and vegetables as the average American. Really? They eat twice as healthfully in Iowa -- home of fried butter at the state fair -- than anyplace else in America?

The study didn't monitor some proven benefits, such as reduced risk for bone fractures if you take calcium, or healthier heart, brain and eyes if you take DHA omega-3 fatty acids.

The bottom line? The right supplements are still a great insurance policy if you don't eat perfectly (who does?). That said, it's a good study -- but it's a beginning, not the end. Remember, it almost always takes at least three studies to settle anything.
Before taking a supplement, you should always consult with a registered dietitian who can assess both your diet and medical history to determine if you would benefit with supplements. These can be useful for people who cannot meet their nutrient needs through a regular, varied diet.

According to the Academy of Nutrition and Dietetics, among those who may benefit from taking a dietary supplement are:
  • Women of childbearing age who may become pregnant, as they need to consume adequate amounts of folic acid to prevent certain birth defects
  • Pregnant and lactating women who can’t meet their nutrient needs with food
  • Older individuals, who need adequate amounts of vitamin D and synthetic vitamin B12
  • Individuals who do not drink enough milk and/or do not have adequate sun exposure to meet their vitamin D needs
  • Individuals on low-calorie diets that limit the amount of vitamins and minerals they can consume through food
  • Strict vegetarians, who have limited dietary options for vitamins B12 and D and other nutrients
  • Individuals with food allergies or lactose intolerance that limit food choices
  • Individuals who abuse alcohol, have a poor appetite, have medical conditions such as intestinal disorders, or are taking medications that may increase their need of certain vitamins
  • Individuals who are food insecure and those who are eliminating food groups from their diet
  • Infants who are breast-fed should receive 400 IU of vitamin D daily until they are consuming at least 1 quart of formula daily. Children age one and older should receive 400 IU of vitamin D daily if they consume less than one quart of milk per day. Adolescents who consume less than 400 IU of vitamin D daily from their diet would also benefit from a supplement.
First, it is imperative to discuss supplementation with your medical doctor as well as your pharmacist for any contraindications that could occur with pharmaceutical drugs. Individuals have the tendency to believe if it is over the counter that it is safe, that is not true. 

I have always taught that supplementation is a tool to fill the holes where your day to day eating is not sufficient enough. A good multi-vitamin might be advised by your doctor to ensure optimal health.  

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.