Back- Is your multi helping or hindering?
- Confused about how to choose a multivitamin?
- Ever heard of multivitamins containing or being made from petrochemicals?
- Ever heard of the ‘blended standard’[2],[3]?
- Did you know that most multivitamin products (BOTH retail and therapeutic) are actually synthetic products?
In light of a recent article in the New York Times where 4 large well known retailers were found to be selling retail products that actually did not have the ingredients stated on the label[4], my hope in writing this article is that I can in some way impress upon you the need for quality in choosing products that you decide to ingest.
Having said this, did you also know that the American Medical Association made a revised policy publication in 2002[5] recommending that “given our nutrient-poor modern diet, supplementation each day with a multiple vitamin is a prudent preventive measure against chronic disease”. However, taking a multivitamin/mineral product is NOT a substitute for eating a nutritious whole food diet.
But when choosing a multi, my clinical experience suggests there is one simple ‘rule of thumb’…
- you get results equal to what you pay for, AND
- what your body can absorb!
Essentially, my formula for a beneficial multivitamin/mineral product looks like this –
| 1. | Quality – big amounts | |
| + | 2. | Bioavailability – liberal amounts |
| + | 3. | Synergy and balance – adequate amounts |
| + | 4. | Potency – levels of… |
| = | 5. | RESULTS for YOU! |
NOW, if you think this is a load of baloney, and you’re not interested in doing something seriously positive for your health, then DON’T read on. BUT, if you are currently using a multivitamin/mineral formula, and you are interested for your health’s sake, then please DO read on.
I often see clients in clinic who tell me that they’ve been taking a multivitamin product and they can’t understand why they don’t ‘feel any better’. Ironically, they are also sometimes reluctant to accept information from me trying to explain the benefits of different types of multi’s, their ingredients, clinical application and health outcomes that they can and SHOULD expect.
So here are my criteria I use in assessing products that I believe will get the best results for YOU, and my clients (apologies if this sounds a bit technical). Look for…
- Quality & Safety – quality and safety is everything!
- Does the company follow GMP (Good Manufacturing Practises, a global standard)?
- Where do they source the ingredients?
- Are ingredients based on petrochemical residue?
- Do they have a quality assurance program in place? Is this information freely available on their website?
- Will someone from their technical team freely speak with me and answer my questions? (And yes, for my peers who know me, they know that I am not afraid of calling these companies and asking the hard questions. After all, I’m staking my reputation on getting my clients the results they want!)
- Is there evidence of recent research or clinical trials (preferably in Australia)?
- Who owns the product or the company making the product? (See below to find out why!).
- Does your product actually contain what is stated on the ingredient list[6]?
- Bio-availability – you are what you absorb! Bioavailability is a term that refers to how well your body can use the nutrients contained in the product. The key here is to look at the form of the ingredients, as certain nutrients need to be in a particular form to be well absorbed . Here are some examples to watch out for –
- Magnesium oxide, a common ingredient in many products appears to be the least absorbable and therefore the least bioavailable[7]. It can also produce a laxative effect, which may hinder Zinc absorption (vital for taste, smell, enzymes, immune function, neurological function, etc.) – check yours now! Better forms of magnesium are magnesium orotate or magnesium citrate… also more expensive!
- Vitamin E occurs naturally as a complex of 4 tocopherols and 4 tocotrienols – how many does yours have? Vitamin E, usually labelled as dl-alpha-tocopherol /tocopheryl in many products, is a synthetic form and does not have the same action as the natural form[8] – D-alpha tocopherol.
- Vitamin C (also known as ascorbic acid or sodium ascorbate or ascorbyl palmitate), essential for helping produce energy, collagen as well as being a vital antioxidant, actually exists in nature as a complex with enzymes, flavonoids and phytonutrient co-factors that make it more bio-available than synthetic ascorbic acid[9]. Does yours contain any flavonoids, which are known to increase the absorption of vitamin C by up to 35%[10] such as quercetin, hesperidin, rutin?
- As a last point of mention, in relation to vitamin B’s, if you have a history of digestive issues, malnutrition, leaky gut, IBS or IBD, or undiagnosed ceoliac disease, there may be a good chance you will not be efficiently absorbing these vital nutrients. Research suggests that you may need an entirely different form , called the activated form or precursor form of these nutrients to be absorbed at all. For example, vitamin B6, usually included on labels as pyridoxine hydrochloride, may need to be in the activated form as pyridoxal-5-phosphate to be utilised by your body[11].
In the interest of disclosure, you may find it interesting that –
The TGA only approves the synthetic form of vitamin B12 (cyanocobalamin) for therapeutic use in Australia. In the US however, where I practised for 5 years as a clinical nutritionist, the natural and more biologically active forms of methylcobolamin and hydroxycobalamin are available to consumers. And yes, the cyanocobalamin form does produce small amounts of cyanide in its metabolism, but cyanide also naturally occurs in many fruits and vegetables.
- Synergy – is the product complete and balanced?
- Does the product contain the full range of common B vitamins (1,2,3,5,6,9 and 12), or is it missing one of them? The full range of Vitamin B’s work together in the body but if one of them missing, it is like expecting your car to go with only 3 wheels[12].
- Does it contain antioxidant co-factors such as alpha-lipoic acid, co-enzyme Q10, bioflavonoids? Quite often multi’s don’t include these more expensive ingredients such as co-enzyme Q10 (a vital nutrient in the production of energy and your cellular functioning).
- Potency – refers to the amount of the nutrient required to produce an effect. Generally, retail products contain significantly less of the nutrients than therapeutic brands. For example, vitamin B’s, which are essential nutrients for making energy, DNA, neurotransmitters, lots of enzymes, enzymatic processes, and neurological function (amongst others), usually have between 2mg and 30mg in retail products, for vitamins B1, B2, B3, B5 and B6. This compares to 50mg and upwards in therapeutic products. Similarly, for vitamins B9 (folic acid) and B12, retail products can have as little as 2mcg versus 400mcg+ in therapeutic products. Be aware, that you may be paying good dollars and getting ‘peanuts’!
- Results – how are you measuring results?
- Did you feel a difference in energy levels? Do you still experience fatigue that prevents you from living a life of vitality and quality? Are you still fatigued?
- Did your skin clear up? What continuum are you using to actually measure results?
- Were you so malnourished that even a little bit of something made you feel a bit better, but is that actually what normal should feel like for you?
- Were you able to walk 100m without feeling like you’ve drained your tank versus only being able to walk 15m and feeling wiped out?
- Have your moods normalised? Did you get the desired effect of reduced PMT before your last period?
- Has your acne disappeared? Do you still have rough skin on your fingers, palms and your feet?
- Do you still have achy joints and muscles? Are you now able to lift a 2kg dumbbell without feeling like you don’t have to use all your reserves?
- Are you still bruising easily?
- Have your digestive symptoms eased up?
There are so many variations to measuring results, however, the above are all common questions I ask clients in my own practice. So maybe you might want to ask yourself the same questions. After all, you don’t want to be wasting your time and hard-earned money!
Now, if you have reached this point and you’re still not convinced, a simple and very general test is to put a product sample in a glass of water and time it for one hour. If it looks the same in one hour and hasn’t broken down – you’ve wasted your money! If it’s completely broken down, discoloured the water and you can drink it without choking on ‘big bits’, then you’re probably onto a winner.
Some other things to keep in mind when choosing a multivitamin –
- Supplements, serve to ‘fill in the gaps’ especially in times of stress, poor vegetable/fruit options for purchase (i.e. if they are chemically laden), choices are limited, or there is some condition that does not allow you to eat a wide range of whole foods or completely absorb nutrients from food. (If you need a refresher on what is a Whole Food Diet, please see my article here).
- Did you know that some retail multivitamin products are ‘owned’ by pharmaceutical companies, for example, Centrum is now part of the Pfizer Corporation, a pharmaceutical manufacturer. Similarly, Sanofi-Aventis, another pharmaceutical manufacturer, owns the popular retail ranges known as Ostelin, Nature’s Own, Bio-Organics, Golden Glow, MicroGenics and Cenovis.
- There have been previous arguments suggesting that ‘vitamin studies’ and their use is worthless, however, many of the studies have used isolated synthetic ingredients, low quality products that use synthetic ingredients and also contain toxic fillers, had conflicts of interest, or simply used such low doses that did not actually achieve therapeutic levels for results[13],[14]. Hence, my argument for checking the quality, bio-availability and potency. I encourage you to do your own research.
- There are conditions and cases in which it is not advisable to take vitamin products, and in fact, can be quite unsafe to do so, however, a trained healthcare professional will be able to advise you.
- Multivitamin products can produce amazing results despite their ‘one size fits all’ design. However, the skill comes in choosing the right one for the right person for the right outcome, or even potentially a combination of products that can get the clinical results you want.
Most people remain blissfully unaware of the technical aspects of choosing a multi-vitamin, let alone ever considering that their favourite multi contains ingredients made from petrochemicals or coal tar residue. Hopefully, this article has made you aware of the fact that industry respected leaders have attempted to ‘standardise’ criteria for the assessment of effective quality products based on clinical evidence; but also, that this article has sparked a sense of curiosity about whether what you are taking is actually good for you, and whether it is actually giving you the results you want.
Lastly, I am not affiliated with any one company or supplier for products and I have not been paid to write this article. This article is provided for public education purposes only and the way I choose to practise is with impartiality, independence and focused on client outcomes. If you know of a product, or believe that there is a product I should research or try in a clinical setting, I would be happy to hear from you. Please send your information and contact details (optional) to Sarina as I always like to credit my sources.
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Citations –
[1] The term ‘multivitamin’ is used interchangeably throughout with ‘multi’, multivitamin/mineral product, or product.
[2] MacWilliam, L. Comparative Guide to Nutritional Supplements, 4th Edition, Professional Edition
[3] The Blended Standard – a list of eighteen different health criteria against which industry leaders and independent published authors in their respective scientific, medical and naturopathic fields, have made recommendations for nutrients and the required amounts to achieve health outcomes. For more information look at http://www.comparativeguide.com/~nutrisea/index.php?option=com_content&view=article&id=53&Itemid=9#Blended_Standard and http://www.comparativeguide.com/index.php?option=com_content&view=article&id=50&Itemid=8
[4] http://well.blogs.nytimes.com/2015/02/03/sidebar-whats-in-those-supplements/?_r=1
[5] Fletcher, Dr R & Fairfield, Dr K, Journal of the American Medical Association, June 19, 2002
[6] http://well.blogs.nytimes.com/2015/02/03/sidebar-whats-in-those-supplements/?_r=1
[7] Braun & Cohen, Herbs & Nutritional Supplements, 3rd Edn, 2010, p686
[8] Ibid, p1002
[9] http://www.ncbi.nlm.nih.gov/pubmed/3414575
[10] Osiecki, H, The Nutrient Bible, 9th Edn,
[11] http://autisme-montreal.com/wp-content/uploads/2014/09/Woody-McGinnis-MD1.pdf, p5
[12] Please note, in certain clinical cases, a single vitamin in the B group may need to be prescribed, however, this should only be conducted under the care of a qualified healthcare professional.
[13] http://search.ebscohost.com/login.aspx?direct=true&db=awh&AN=7584844&site=ehost-live
