Multivitamins: What to Look For and What to Avoid

“Should I be taking a multivitamin?” It’s a question I get asked all the time. My answer? YES with one critical caveat … you must choose a high-quality multivitamin to get benefits (more on that below). Even if you eat perfectly, and let’s be honest, most people don’t, it’s nearly impossible to get what you need from food alone. Read on as I share common indicators of nutrient deficiencies that I see every day among nutrition counseling clients.

Note: for those that prefer video content, catch Choosing A Multi-Vitamin Ask A Nutritionist video at the bottom of this post.

However, first I want to address some recent unfortunate and misleading information in the media stating that multivitamins don’t actually provide any benefit. We completely disagree with that. I personally have taken a daily multivitamin for many years, and I often recommend them to my clients. I like to think of it as extra insurance to fill the nutritional gaps that even the most diligent of us still have. Vitamins and minerals play a role in every function in our bodies, including: strengthening immune function, converting food into energy, making neurotransmitters, detoxifying, making hormones, and maintaining and repairing tissues and cell regeneration.

How (Most) Bodies Become Nutrient Deficient

Back to those nutritional gaps, here are some common reasons our bodies are nutrient deficient:

• Not eating enough vegetables (Are you getting 5 cups or more per day? That’s the recommended minimum, and we’re the first to admit that can be difficult).
• Not eating enough healthy fat (butter, olive oil, nuts, olives, etc.) and real protein (pasture raised, grass fed, free range).
• Eating only conventionally raised meat and eggs, which don’t contain as many nutrients as their grass fed, free range, pasture raised counterparts.
• Stress (Living through a pandemic doesn’t help to say the least) and toxin exposure from the environment (which you can’t avoid nowadays) increases nutrient needs.
• Soils have been depleted of nutrients from industrial farming.
• Eating too many processed foods; sugar and flour can deplete nutrients from your body. Processed food actually requires more nutrients to break them down.  

Recommended nutrient intakes (often called percent daily value (%DV) or recommended daily allowance (RDAs)) have been established as minimum guidelines for healthy individuals. These guidelines can help prevent severe nutrient deficiency but aren’t a reflection of optimal daily intake for prevention of disease. The World Health Organization (WHO) defines health as “complete physical, mental, and social well-being - and not merely the absence of disease or infirmity.” Based on that definition not many individuals are “healthy.” 

With that in mind, one study found that those who took a multivitamin had an 8% lower risk of developing cancer. Another study of a group of healthy men found that those who took a multivitamin had less anxiety and perceived stress.

How to Choose a Quality Multivitamin

The key to getting benefit from your multivitamin is ensuring you’re buying a good quality one. Frankly, you get what you pay for in the world of supplements, especially with multivitamins. Let’s break this down into the components you need to look for in a multivitamin.

Third Party Testing: Look for the cGMP (good manufacturing practices) facility stamp, which means it’s been third party tested. This ensures what the bottle says the supplement contains is actually what it contains. Yes, there are supplements out there that don’t even contain what the bottle claims. Scary!

Form of Nutrients: The form of nutrients is a huge indicator of quality. Often supplement companies use the cheapest form of nutrients, which are not bioavailable to your body (basically your body won’t be able to utilize them). A waste of money.

• Two nutrients you should see on a multi to indicate quality are magnesium and calcium. However, if it contains calcium carbonate and/or magnesium oxide— it’s not a good quality multivitamin. Calcium carbonate can actually cause calcium deposits in your body because you’re not able to absorb it, so it has nowhere to go. Magnesium oxide won’t provide you the benefits of magnesium supplementation that we often talk about (relaxation, better sleep, less muscle pain), but it will likely give you diarrhea. I’ve heard people refer to multivitamins as giving you expensive urine. Well, that is true if you’re buying poor quality.
• Look for a multivitamin that contains minerals from Albion® labs, which is the world leader in manufacturing highly bioavailable mineral chelates, a specialized form of minerals bound to amino acids. This patented process creates natural mineral compounds that enhance mineral absorption. Comparison studies show significantly superior absorption over other forms of minerals.

Dosage Requirements: Getting the optimal vitamins and minerals requires at least two capsules or tablets per day. If a multivitamin only recommends one capsule/tablet per day that’s another sign of poor quality.

Other Ingredients to Avoid and Which Are Safe: Often there are fillers and other additives in multivitamins, which can also make them difficult to absorb. Just like you would read the ingredient list on your food, it’s also important to do that for your supplements.

• NOT SAFE INGREDIENTS
• Maltodextrin
• Corn starch
• Food coloring/dyes
• BHT
• SAFE INGREDIENTS
• Magnesium stearate
• Natural Vegetable Capsules
• Stearic Acid

Our Recommended Options

• Alpha Base without Iron is a comprehensive multivitamin for anybody. It contains a 2:1 ratio of magnesium to calcium, which is ideal. It also contains activated (methylated) forms of B12 and folic acid. This product is higher in minerals, which makes it a great comprehensive multi option.
• Twice Per Day multivitamin is a wonderful general multivitamin for anyone who’s looking to fill nutritional gaps. The serving is only 2 capsules per day, which is helpful for those who may have difficulty taking multiple capsules per day. It also contains activated (methylated) forms of B12 and folic acid.
• Mitocore is a multivitamin that is specifically designed to help individuals that are struggling with a lot of fatigue. In addition to vitamins and minerals it also contains acetyl L-carnitine, which helps with cellular energy, N-acetyl cysteine and alpha lipoic acid which are both powerful antioxidants. Along with anyone struggling with a lot of fatigue, this is a great multi for individuals that have fibromyalgia, Long COVID and cancer survivors.
• Liquid Multi is a great option for those individuals who have difficulty swallowing capsules or tablets. It’s lightly flavored with natural pineapple and coconut, which provides a delicious taste. Extra perk of this multi— it’s suitable for the whole family.  

What to Look for In Children’s Multivitamins

It’s important for children to take multivitamins for the same reasons listed above. However, you need to be even more aware of the ingredients in children’s multivitamins. Since these mulitvitamins are typically in a liquid or powder form, ingredients are added to make them palatable, which often includes some form of sweetener – some of which are okay, while others are not.

NOT SAFE SWEETENERS

• High fructose corn syrup or corn syrup
• Artificial sweeteners (sucralose, aspartame, acesulfame potassium (acesulfame K))

SAFE SWEETENERS

• Stevia or Rebaudioside A (a form of stevia)
• Monk fruit extract
• Sugar alcohols (erythritol, sorbitol, typically they end in -itol- in some individuals these cause digestive symptoms such as diarrhea, gas, or stomach aches)
• Fruit sources

Our Recommended Options

• SuperNutes is a comprehensive chewable children’s vitamin in a natural lemon flavor that kids enjoy. It provides a variety of micronutrients to help support a child’s development.
• Suppy’s is a chewable children’s multivitamin that not only contains vitamins and minerals but also includes 6 organic vegetables. This tastes like a sweet and sour treat in tropical punch flavor.
• Liquid Multi is a great option if your child won’t take a chewable multi. It’s lightly flavored with natural pineapple and coconut, which provides a delicious taste. This could easily be added to a smoothie or a little water to make it more appealing for your child. Because it’s a liquid form, you can start with a lower dose for kids under 3 years of age. For children ages 1-2 take 1 tsp and 3-year-olds take 2 tsp.

Other Considerations

There are many different nutrient needs throughout our lifespans. Depending on your age and other health conditions there may be other vitamins and/or minerals and supplements that could benefit you. If you’re interested in finding out what your specific nutrient needs may be, I’d highly recommend making a one on one appointment with me or one of the other dietitians or nutritionists on staff. We take the guesswork out of the process, helping to make sure you’re making the most of your health and money.

Resources

Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE (2012) Multivitamins in the Prevention of Cancer in Men: the Physicians' Health Study II Randomized Controlled Trial JAMA. 2012;():1-10. doi:10.1001/jama.2012.14641.

Carroll D, Ring C, Suter M, Willemsen G. (2000) The Effects of an Oral Multivitamin Combination with Calcium, Magnesium, and Zinc on Psychological Wellbeing in Healthy Male Volunteers: a Double Blind Placebo-Controlled Trial. Psychopharmacology. 2000; 150(2):220-5. doi: 10.1007/s002130000406

Graff et al. Magnesium: wide spread benefits. Albion Research Notes 1992; 1(2):1.