You Should be Taking a Multivitamin. Here’s How to Choose the Right One.

Taking a multivitamin and mineral supplement can make the difference between feeling anxious and depressed or calm, energetic and optimistic. Ideally, we should get all our essential nutrients through diet, but for many reasons – lack of variety and nutrient density in our foods, stress, gut issues and much more – that’s not possible for most people. The recommended daily allowances (RDAs) are designed to prevent deficiency symptoms in 95 percent of the healthy population, but there are questions as to whether meeting them is enough to provide the best quality of life or prevent chronic disease. You’d have to eat what would be considered an extremely healthy and varied diet every day to even meet all your RDAs with foods alone, and that’s not taking into account absorption issues, increased needs or genetic differences.

Food-Based vs. Synthetic 

Nearly all vitamin and mineral supplements are made with nutrients synthesized from different starting materials than the nutrients found in food. For example, vitamin C (ascorbate) is unstable when extracted from food sources like oranges, so we can’t economically produce enough food-derived vitamin C to reach supplemental levels. Rather, ascorbic acid is a bioidentical molecule made through a series of chemical reactions from corn sugars. Other nutrients such as B vitamins are made through extraction from fermentation products of yeast or bacteria. There’s no evidence that these man-made but identical molecules are harmful when taken at recommended levels, and almost all scientific studies that discovered the benefits of vitamins and minerals used synthesized nutrients.

The terms “natural” or “whole food” are marketing terms for supplements that may contain powdered whole foods added to man-made nutrients. That’s not to say that multivitamins with added whole foods are bad, since they can supply health-promoting bioflavonoids, antioxidants and other phytonutrients. However it’s simply not possible for whole foods alone to supply supplement levels of all the essential nutrients in an affordable and easy-to-take tablet, powder or capsule. 

Absorption

When it comes to vitamin and mineral supplements, it’s all about absorption. Most minerals need to be attached via a chemical reaction to “carrier” molecules, forming compounds like calcium citrate, calcium carbonate or calcium ascorbate, to pass through the intestinal lining and travel through the bloodstream. As these examples show, there can be several options for a single nutrient to attach to, with one carrier being more absorbable than another. Higher-quality supplements will use the more absorbable forms. Cheaper brands may not even bother to carry out the reaction, and simply dump the powdered carrier substance in with the nutrient and claim it is the reacted compound. 

Additives

Some vitamin and mineral supplements have added coloring, fillers or other unnecessary additives that add to your liver’s detoxification burden. Avoid ingredients like Red 40 Lake, Fd&C Blue #1, modified food starch, propylene glycol etc. that are often found in cheaper supplements.

Quality Control

The cheapest vitamin and mineral supplements are often made in places like China, where they have lower environmental and quality standards and less regulatory oversight. In the  U.S., supplement production is regulated by the FDA based on current Good Manufacturing Processes (cGMP) requiring sanitation, labeling and testing. However, FDA go-ahead isn’t required before supplements hit the market, and there are far more products than FDA inspectors can handle. Look for products with third-party certifications of manufacturers’ production and testing processes such as USP or the Emerson Quality Program, but be aware that these certifications don’t necessarily mean the products don’t contain unnecessary additives or are tested for presence of reacted compounds. 

Multiple Forms

Vitamins A, E and K are actually groups of multiple different molecules. Supplemental forms of vitamin A include retinol esters, beta-carotene and other carotenoids. Vitamin E is d-alpha tocopheryl and mixed tocopherols. Vitamin K is K1 and K2, with two different K2 subclassifications, MK-4 and MK-7 having very different dosages and effectiveness in the body. In supplements, you want a variety of types of vitamins A and E, as they have different effects. For vitamin K, MK-7 is far more potent that K1 or MK-4, and may be preferred if you are deficient or have trouble absorbing fat-soluble vitamins.

Diet-supporting vs. Therapeutic Doses

The intention of taking a daily multi is to support your diet and get your nutrient levels up to a little above your RDAs. Ultra-high doses can cause toxicity symptoms, especially iron and the fat-soluble vitamins A, D, E and K because they accumulate in tissues. Taking a high dose of one vitamin or mineral could affect others, as they often have interrelated actions in the body. If you suspect you are deficient in a specific nutrient, see a nutritionist for testing, short-term supplement dosing and monitoring to get you back to adequate levels safely. 

Provitamins and “Activated” Forms

Most vitamins found in food or supplements are actually provitamins, meaning the body must convert them to active forms before they can function properly. Some manufacturers have developed supplements already in these active forms in hopes of adding value to their products. In limited circumstances, for example those with the genetic polymorphism that reduces folate methylation, taking methylated folate (5-MTHF), this can be useful. However, for most vitamins like B2 and B6, the body will convert them to their inactive forms to transport them throughout the body, so they aren’t worth the extra cost. 

So What Should I Buy?

There are many different multivitamins with various nutrient combinations and amounts. If you have depression or anxiety, make sure you get one with B vitamins (thiamine, riboflavin, niacin, pantothenic acid, pyridoxine (B6), biotin, folate and B12), iron, magnesium, selenium and zinc. If you eat red meat, don’t menstruate and aren’t an athlete, you may not need iron, and you can get enough selenium by eating one Brazil nut per day. If you aren’t getting much sun on your skin, add vitamins D and K. 

Supermarket: Olly Men’s or Women’s Gummies. These don’t have a lot of additives, and have B vitamins, D, zinc and selenium. Add Natural Vitality Calm gummies for magnesium. If you need iron, add low-dose (about 28 mg) iron glycinate or chelate.

Amazon: MegaFood One Daily. Formulated to make up for common inadequacies in the Western diet, this is my multi of choice. It has diet-supporting amounts of all the B vitamins and iron, zinc and selenium glycinate. The men’s version is iron-free. Add a magnesium gummy or tablet to help you relax. 

Top-of-the-Line: Metagenics Multigenics. High-dose B vitamins, methylated folate, multiple forms of A and E, zinc, selenium, magnesium and iron glycinate plus antioxidants and betaine HCl for digestion. There is also an iron-free version.