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, that’s not realistic all the time, 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 to your health. 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 missing nutrients:

• Not eating enough vegetables (Are you getting 5 cups or more per day? That's the recommended minimum for a healthy diet, and we're the first to admit that can be difficult).
• Not eating adequate amounts of healthy fat (butter, olive oil, nuts, olives, etc.) and real protein (meat, fish, dairy, eggs, and seafood).
• Stress and toxin exposure from the environment (which you can't avoid nowadays) increases nutrient needs.
• Soils have been depleted of nutrients from industrial farming. One study found that 43 garden crops lost 5-40% of nutrients between 1950 and 1999.
• 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 deficiencies but aren't a reflection of optimal daily intake for prevention of disease and for feeling your best. 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 taking a daily multivitamin showed benefit in episodic memory and cognition. A literature review looked at 142 studies and found that multivitamin supplementation in healthy populations predominantly showed mild to significant improvements in perceived stress, physical stamina, concentration, and general mental health, and significant reductions in anxiety and improvements in self-reported vigor.

What you May Notice From Taking a High-Quality Multivitamin

• Improved energy levels – especially the B vitamins can increase energy
• Better immune support – vitamins C, D and E, and minerals zinc and selenium play a role in immune function.
• Brain health and cognitive function – nutrient deficiencies, particularly B vitamins, have been linked to cognitive decline.
• Healthy aging – as we age, absorption of nutrients can reduce.
• Skin, hair and nail support – biotin, vitamin C, vitamin E, and zinc all support skin elasticity, nail strength and hair health.

How to Choose a Quality Multivitamin

The key to getting benefit from your multivitamin is ensuring you're buying a good quality one and not all supplements are created equal. 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 dietary 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). This can be a waste of money and in some cases even harmful to your body.

• Two specific nutrients you should look at on a multivitamin to indicate quality are magnesium and calcium. If it contains calcium carbonate and/or magnesium oxide— it's not a good quality multivitamin. Calcium carbonate can 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.
  
  
• 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.
  
  
• Avoid multivitamins that contain folic acid. Folic acid is synthetic and not the active form of folate. It isn’t biologically active until your body converts it into 5-MTHF (5-methyltetrahydrofolate). This process depends on enzymes, particularly one called MTHFR.
  
  Up to 40–60% of people have a variant in the MTHFR gene, which can slow down or impair conversion of folic acid into its active form. If you are unable to metabolize folic acid, it can accumulate in the blood and potentially be harmful to your body.
  
  
• Look for a multivitamin that contains methylcobalamin as the form of B12. Similar to what I mentioned above with folate- methylcobalamin is the active form of B12. Your body requires the MTHFR gene to convert cobalamin to methylcobalamin.
  
  
• Dosage Requirements: Getting the optimal essential vitamins and minerals requires at least two capsules or tablets per day. High quality vitamins and minerals would physically not fit into just one capsule or tablet. If a multivitamin only recommends one capsule/tablet per day that's likely another sign of poor quality.

What to Avoid In A MultiVitamin and What Is Safe:

Often there are fillers and other additives in multivitamins, which can also make many supplements 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 has extra benefits. Not only is it a great multivitamin, but it also includes additional nutrients for immune support, mild detoxification and mitochondrial health (cellular energy). This product is great for anyone looking for those extra advantages but especially for individuals experiencing a lot of fatigue, 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
• Fruit sources

Our Recommended Options For Children's Multivitamins

• 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 vitamin and mineral 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

Davis DR, Epp MD, Riordan HD. Changes in USDA food composition data for 43 garden crops, 1950 to 1999. J Am Coll Nutr. 2004 Dec;23(6):669-82. doi: 10.1080/07315724.2004.10719409. PMID: 15637215.

Vyas CM, Manson JE, Sesso HD, Cook NR, Rist PM, Weinberg A, Moorthy MV, Baker LD, Espeland MA, Yeung LK, Brickman AM, Okereke OI. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr. 2024 Mar;119(3):692-701. doi: 10.1016/j.ajcnut.2023.12.011. Epub 2024 Jan 18. PMID: 38244989; PMCID: PMC11103094.

Sarris J, Mehta B, Óvári V, Ferreres Giménez I. Potential mental and physical benefits of supplementation with a high-dose, B-complex multivitamin/mineral supplement: What is the evidence? Nutr Hosp. 2021 Dec 9;38(6):1277-1286. English. doi: 10.20960/nh.03631. PMID: 34530623.