Do multivitamins work

Do Multivitamins Work? What the Research Really Shows

August 26, 2019 Published by

You’re at the store, perusing the health supplement aisle. You slowly make your way over to the vitamin section, and it hits you like a bolt of lighting – there are seemingly endless choices! But do multivitamins work?

Multivitamins comprise the single most prolific niche of dietary supplements. It’s estimated that upwards of 50% of the U.S. adult population takes multivitamin supplements

Yet, the benefits of taking a multivitamin remain controversial in research.

We are led to believe that the health benefits of taking a multivitamin are numerous and that these supplements can make up for poor dietary choices, but is that truly the case? If so, how can you possibly find the multivitamins that work in such a vast sea of supplements? 

So, how do multivitamins work? Are multivitamins good for you? 

Well, as with many predicaments in life, educating yourself is necessary. This article will examine the research behind multivitamin use and help you understand how vitamins work. 

What Are Multivitamins?

At their most basic, multivitamins are dietary supplements that contain a blend of vitamins and minerals. Hence, multivitamins are also referred to as multiminerals, multi-V’s, multis, or plainly vitamins.

variety of pills in a cup

Aside from vitamins and minerals, some multivitamins feature other ingredients like omega-3 fatty acids and vegetable/fruit blends. However, just because a multivitamin has a large number of ingredients doesn’t necessarily make it more beneficial. (We’ll explain why that is later.)

What Goes into Multivitamins?

Many people take a multivitamin supplement every day without knowing half of what the pills contain. This blind approach doesn’t lend itself to much success, no matter what supplement(s) you’re taking. 

It doesn’t take a rocket scientist to realize that vitamins and minerals are essential to our health and wellness. However, understanding what multivitamins actually do and how vitamins work is a bit more complicated.

The vitamins and minerals you find in multivitamins are two classes of micronutrients. The prefix “micro-” means we require relatively small amounts of these nutrients for optimal health and function. In this context, we’re talking about just a few milligrams, if not micrograms, per day.

Contrast that with macronutrients (e.g., protein, fat, carbs); as you likely deduced, the prefix “macro-” means “large,” which is why we need many grams worth of these nutrients daily for proper health. 

Due to this difference between macronutrients and micronutrients, vitamins and minerals are often overlooked. Yet, vitamins and minerals are highly important components of the human diet.

How Do Multivitamins Work?

natural supplemenets out of a bottle

Unlike macronutrients, vitamins and minerals do not contain energy/calories. As an abbreviated overview, vitamins and minerals support biological processes by acting as cofactors, coenzymes, electrolytes, and antioxidants. In layman’s terms, vitamins and minerals are basically “assisting molecules.” 

Even the most basic human functions, like respiration and muscle contraction, require vitamins and minerals. Without these micronutrients, we would live in quite a debilitated state, before perishing altogether. 

Naturally, there may be health benefits of taking a multivitamin since it can help you meet your daily vitamin and mineral needs.

But there’s a catch…

Multivitamins are not substitutes for poor food choices. No supplement will ever make up for destructive eating habits. Any supplement company or “health expert” that tells you otherwise is blatantly lying. 

Therefore, you should not use a multivitamin as a replacement for a diet rich in plant foods (especially vegetables and fruits). Instead, the best way to take a multivitamin is in conjunction with a healthy, balanced nutrition plan.

What Are the Health Benefits of Taking a Multivitamin?

Multivitamins help you meet your daily micronutrient needs. Naturally, consumers are quick to hop on the multivitamin bandwagon.

But the evidence is equivocal and goes both ways. 

For example, some research suggests that multivitamins can reduce the risk of heart disease, which is the leading cause of death across the globe. While other research shows no difference in cardiovascular risk factors.

Other studies suggest that multivitamins are good for eye health, the brain, and immune function. But again, a generous amount of research shows no benefit of taking a multivitamin for cognitive function, resistance to infections and slowing the progression of macular degeneration

The controversial findings of multivitamin research are even disconcerting in some instances. 

A recent meta-analysis concluded that there were no significant differences in the health, longevity, and quality of life between people who use multivitamins regularly and those who don’t. In fact, several longitudinal studies included in this meta-analysis found that the all-cause mortality and cancer rates of people who regularly used a multivitamin were actually higher than those in the control groups. 

Moreover, two meta-analyses of randomized clinical trials have raised concerns about the safety of taking large doses of specific vitamins and minerals. These meta-analyses found an association between large doses of vitamin E supplements and a small but statistically significant increase in all-cause mortality.

One analysis described an increased risk of mortality at vitamin E doses of 400 IU per day, but the risk began to increase at 150 IU. In the other analysis of studies, the highest quality trials linked vitamin E use (average dose of 569 IU per day), taken singly or in conjunction with other vitamins/minerals, to a greater risk of all-cause mortality.

Vitamins: Beneficial or lethal?

Participants in the analyses mentioned above were mostly middle-aged or older and had chronic diseases or risk factors for life-threatening health conditions. Also, these participants typically consumed other dietary supplements along with vitamin E.

We also can’t overlook the fact that most of these studies took place in developing countries in which a majority of the populations are malnourished and have vitamin deficiencies.

Ironically, the studies within these analyses that were done on healthy individuals found no compelling evidence that vitamin E or other vitamin supplements increase the risk of death.

This seems so counterintuitive and bizarre, though. Do vitamins only work for those who are already in good health?

Well, in this case, it depends on how you define “work.” 

Many dietary supplements “work,” but that doesn’t mean they’re necessary for optimal health. his also doesn’t mean they will make you live longer if you’re in poor health.

Remember, you shouldn’t take a multivitamin as a “replacement” for your diet. Wholesome foods should always be your primary source of vitamins and minerals. 

There are potential health benefits of taking a multivitamin as part of a well-balanced diet. The key is to find a multivitamin with high-quality ingredients and bioavailable forms, like Vita-XT

Do Vitamins Really Work?

There are several explanations for the inconsistent findings of studies about multivitamin benefits.

For one, a good chunk of multivitamin research is observational. Such studies don’t control for lifestyle factors like diet, alcohol consumption, tobacco usage, and activity level. Obviously, eating a poor diet, smoking cigarettes daily, and drinking habitually is probably not going to extend your lifespan. It’s nonsensical to think a multivitamin would make up for subpar lifestyle choices.

Another factor is the difference between multivitamin supplements that consumers take in studies. Admittedly, not all multivitamins are created equal. A person taking a low-quality multivitamin is less likely to benefit than someone who takes a high-quality multivitamin.

Regardless, the findings of such studies shouldn’t be overlooked because they included hundreds of thousands of average people from a diverse range of ethnicities and ages. The sheer volume of participants gives some weight to the data. 

Going forward, we need more well-controlled, long-term studies before we can draw any conclusive statements about multivitamin benefits. 

All we can really say at this point is that multivitamins may serve as a preventative safeguard for health and well-being, not a cure or remedy for all that ails you.

Natural vs. Synthetic Vitamins and Minerals

Multivitamin supplements come jam-packed with an array of vitamins and minerals. To the unwitting consumer, the sheer multitude of ingredients has a captivating quality. 

Sadly, many of the vitamins and minerals present in cheap multivitamins are not very bioavailable. In non-nerd lingo, this means that your body doesn’t readily absorb them, meaning they are virtually useless. 

The tricky thing with multivitamins is that synthetic ingredients aren’t inherently ineffective and naturally occurring vitamins and minerals aren’t necessarily the most effective. Though, in most cases, naturally occurring vitamins and minerals are well-absorbed. 

For example, folic acid (synthetic vitamin B9) can be converted to biologically active vitamin B9 (L-methyltetrahydrofolate, aka L-MTHF) through a series of enzymatic reactions in the body. 

However, there’s a somewhat prevalent genetic predisposition among humans to have a mutation in the MTHFR gene. Consequently, this mutation interferes with the conversion of folic acid to its active form, L-MTHF. 

The vitamin B9 found in leafy greens and cruciferous vegetables is in the form of folate, which can be directly methylated to create L-MTHF even if someone has an MTHFR gene mutation. 

Fun fact: The term folate is actually derived from the Latin word for foliage, folium. Hence, much of our dietary folate comes from plant foods that contain leaves, like spinach and romaine lettuce. 

When man-made micronutrients are better

There are instances where synthetic vitamins and minerals may actually be more beneficial than their naturally occurring counterparts.

In fact, a recent research review published in Current Nutrition & Food Science found that healthy men absorb an average of only 30-40% of dietary (naturally occurring) magnesium. Men with gastrointestinal dysfunction may absorb as little as 10% or less of dietary magnesium.

In such instances, it’s pointless to tell someone they should just eat more magnesium-rich foods if their body won’t absorb it.

So, what should they do? 

Ironically, research suggests that supplementing with man-made forms of magnesium, such as magnesium taurate and magnesium glycinate, might be the answer. These forms are more absorbable than naturally occurring magnesium.

Minerals in their native forms are technically inorganic molecules since they don’t contain carbon. (Scientifically, the term organic simply means any substances that contain carbon, of which there are millions.)  

Magnesium glycinate – which is the magnesium salt of amino acid L-glycine – is indeed an organic molecule despite being man-made.

At the end of the day, you and I are humans. Let’s have some admiration for the advancements we – the modern Homo sapiens – have made in science and our understanding of the natural universe. 

The efficacy of micronutrients isn’t dictated solely by their origin, whether they are naturally occurring or synthetically produced. The sources of vitamins and minerals are important insofar as they tell you where they come from (e.g., plant-based, man-made, etc.) and what potential allergens they may contain. 

You might assume that a multivitamin works better simply because the product label is emblazoned with flashy and catchy words like “Organic,” “100% Natural”, “Earth-Grown” and “From the Greek Goddess of the Sea”…

Be wary that supplement and food companies use lingo like that to create buzz, not to prove efficacy. The doses and bioavailability of vitamins and minerals should be your primary focus when shopping for multivitamins.

Vitamin Doses: Is More Always Better?

Pretty much everyone and their mother has tried the old-school home remedy of megadosing vitamin C when they feel a cold coming on. After all, vitamin C is renowned for its “immune-boosting” properties, and since grade school, we are taught it helps fight off illness. 

So, does this mean you should take as much vitamin C as possible when you feel like you’re getting sick? 

The short answer: No. 

Multivitamin pills

Overloading your body with any substance, whether it’s “healthy” or not, doesn’t translate to even greater benefits. In the case of water-soluble vitamins like vitamin C, taking an excessive amount will simply lead to the majority of it being flushed down the toilet. The body can only make so much use of the substances you consume. 

A review of clinical trials on vitamin C supplementation found that people who regularly took vitamin C were no less likely to experience colds than those who took a placebo. 

However, the authors of the review noted that active people and athletes may benefit from a vitamin C supplement since the stress from intense exercise can weaken the immune system. Regular use of vitamin C may also reduce the duration of colds by a small margin.

So, yes – some vitamins do work for the better.

But it’s not always about finding multivitamin supplements that contain the most vitamins and minerals. The quality and balance of vitamins and minerals in a multivitamin generally supersedes the quantity. 

Why do multivitamins contain more than the recommended dose?

Many multivitamin supplements provide more than the recommended dose of the micronutrients they contain.

In certain circumstances, consuming more than the recommended dose of specific vitamins and minerals is beneficial, particularly for those who are highly active, those over 55 years of age, and those who are ill

Vitamin B12 (cobalamin) – arguably the most popular of all vitamins – has a reference daily intake (RDI) of a mere 2.4 micrograms (mcg) per day for adults. But we all know that supplement enthusiasts and gym-goers want more than the “measly” RDI.  

After all, higher doses equal more gains, bro…

Jokes aside, what are the benefits of taking a multivitamin supplement with 2.4 mcg of vitamin B12 when you can just slam an energy drink or pre-workout supplement with 500 times that amount? 

In the case of supplemental vitamin B12 pills and powders, very little of it is actually absorbed by the body. In fact, it’s estimated that the body only absorbs about 2% of an oral vitamin B12 supplement. Vitamin B12 has highly complex metabolism and requires a specific glycoprotein called intrinsic factor for it to be adequately absorbed. Any aberration or dysfunction in vitamin B12 metabolism can lead to deficiency over time, often without any immediate symptoms to suggest there’s an underlying problem. 

Using complex calculus equations and computational algorithms, we determine that about 10 mcg of a 500 mcg oral dose of vitamin B12 makes reaches the systemic circulation. 

Hence, in some instances, you should take larger doses of vitamins since only a fraction of what you consume is “put to good use,” so to speak.

Can you have too much of a “good” thing?

If you suspect you have a deficiency of any vitamins or minerals, the prudent thing to do is consult with a physician. People with low B12 levels are usually given injectable vitamin B12 since it bypasses the alimentary canal.

In other words, avoid the urge to nosh on Flinstones chewables like they are candy just because you think you lack vitamins and minerals. You may require a specific form of vitamin/mineral or route of administration to correct a deficiency.

Furthermore, micronutrients do not contain calories as macronutrients do. So yes, you can consume copious amounts of them and not have to worry about turning into a giant ball of fat.

But not so fast…

You can undoubtedly overdose on vitamins and minerals. Micronutrient excess and deficiency are equally as concerning from a health standpoint. 

While vitamins and minerals are generally seen as a “good” thing, you can have too many of them. 

As the adage goes, the difference between medicine and poison is in the dose. There’s a healthy dose of vitamin C and a lethal dose. Heck, it’s even possible to die by drinking too much water.  

More is not always better, and less is not always worse when it comes to vitamin and mineral doses. Do you know what’s best? The right amount, which for the vast majority of the population is, in fact, the RDI. 

Which Vitamin and Mineral Forms Are Optimal?

It would be extremely time-consuming to discuss the “best” and “worst” forms of all vitamins and minerals. However, there are a select few that stand out when looking at a men’s multivitamin.

Notably, if you’re taking a men’s multivitamin that contains magnesium oxide, you can safely presume that it is not the best quality.

How poor is the bioavailability of magnesium oxide, you ask? A pitiful 3% or less…

A recent clinical study found that healthy adults who supplemented with 300-mg of magnesium oxide daily for two months had no difference in serum magnesium concentrations than those who took a placebo. This is to say that magnesium oxide was no more effective than a “sugar pill” (i.e., it was useless). 

The same study also showed that those who supplemented with a matched amount of magnesium citrate had three-fold higher serum magnesium levels than the magnesium oxide and placebo groups. 

In general, salts and chelated forms of minerals, like those in HYDRASURGE, are well-absorbed.

Hyrdasurge

The complex nature of Vitamins

When it comes to vitamins, it’s a bit more complicated since they often go through several conversions before they become biologically active. Many people just assume that taking the most bioactive form is best, but that’s not necessarily true.

For example, vitamin D3 (cholecalciferol) needs to go through several enzymatic conversions in the liver and kidneys to reach its most bioactive form – calcitriol. These conversions are tightly regulated and necessary for avoiding an excess of calcitriol in the system (which can significantly increase the risk of hypercalcemia since calcitriol enhances calcium absorption).  

Therefore, it’s much safer to supplement with cholecalciferol as opposed to calcitriol. The former is essentially a storage form of vitamin D that is converted to biologically active vitamin D as needed. 

But recall from earlier that there are circumstances in which taking the bioactive form of vitamins is necessar. 

Ultimately, crowning a unanimous optimal form of each vitamin and mineral remains a topic of contention among the scientific and medical communities. The reality is that many supplemental forms of each vitamin and mineral exist, and a good chunk of them are highly bioavailable. 

Whenever you’re in doubt about a particular form of vitamin or mineral, read open-source studies to get unbiased, evidence-based insights into what works and what doesn’t.

Do Multivitamins Work?

The research backing multivitamin benefits is tenuous and ambiguous. The fact that some studies found multivitamin use to be harmful is what’s most alarming, but we can’t discount the promising findings either.

In any case, certain people may benefit by taking a multivitamin more than others, including:

  • Men and women over 50
  • Bodybuilders and athletes
  • Vegetarians and vegans
  • Women who are pregnant/nursing
  • People who are malnourished, ill, or on a calorie-restricted diet

To reiterate for the 957th time, you should not take a multivitamin with the outlook that it will make up for poor eating habits. Your diet is, and will always be, the primary source of sustenance. Be sure to read our Guide to Dieting Without Tracking Macros if you want to start eating healthier. 

As general advice, aim for at least five servings of vegetables per day, particularly leafy greens, cruciferous veggies, mushrooms, and carrots. These foods will help you meet your daily micronutrient needs. Fruits are also good choices in limited amounts due to their antioxidant and polyphenol content. Just don’t go too crazy with fruit since it can pack a lot of fructose into your diet. 

If you’re a picky eater and don’t like the taste of veggies, Green Surge makes it simple to get more plant-based foods in your diet. Some people may also benefit by taking an electrolyte supplement as well, particularly athletes, gym-goers, and bodybuilders who train regularly. 

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About the author

Elliot Reimers, CNC, M.S. Candidate

I'm a NASM Certified Nutrition Coach (CNC) and M.S. candidate in the Molecular Pharmacology program at Michigan State University. My undergraduate studies in the biological sciences led me to take a keen interest in research pertaining to nutritional science, exercise physiology, and dietary supplements. As such, I've been writing about these topics for the better half of the last decade. My main ambition is to educate readers and help them make sense of these evolving, yet increasingly hard to navigate, fields of study.

  • David R

    Dear Elliott,

    I just today discovered your articles and I am highly impressed with the content you’re producing! It’s super clear by your writing that you have the education and credentials to be speaking about these topics. It is a breath of fresh air to find an author as yourself among the sea of writers of half-truths that are so common online. Thank you for doing what you do.

    DR

    • Elliot Reimers

      Hey David,

      My apologies I didn’t see your comment sooner. I highly appreciate the feedback you gave and the time you took to read it. Always makes my day when I hear these kinds of comments.

      Regards,
      Elliot

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