Food as Medicine, Lifestyle Medicine

Are Multivitamins Essential, Harmful, or Frilly Extras? How to Decide

As doctors, we’ve long told our patients that if you’re eating a varied diet that includes healthy selections from across the food groups, you probably don’t need to take a daily pill — save your money. But, the evidence is yelling — telling us that Canadians aren’t getting the nutrients that they need for optimal health and wellness.

Canadian statistics reveal that the population suffers from a range of vitamin and mineral deficiencies. Some of the most common culprits are:

  1. Magnesium: 34% lack adequate intake

  2. Vitamin D: 32% are deficient

  3. Calcium: 26.5%-86.9% aren’t getting what they need, with prevalence increasing as age advances

Many Canadians also lack adequate Zinc, Vitamin C, Folate, Vitamin B6 and Vitamin B12. Iron deficiency is common in pre-menopausal women, affecting 16-19% in this group. And, don’t think the summer sun provides you with all the Vitamin D you require — 40% of Canadians are below cut-offs in the wintertime, and 25% remain so during the summer months.

Signs You Need a Supplement

These are the symptoms you might experience if you’re lacking in one of the above vitamins or minerals.

Magnesium: Muscle cramping or weakness, heart palpitations, fatigue and sleep disturbance. Low magnesium is also associated with high blood pressure, insulin resistance, metabolic syndrome, asthma and migraine headaches. In severe cases, it can cause life-threatening heart arrhythmias (irregular rhythms).

Vitamin D: Poor bone growth including osteoporosis and risk of bony breaks or fractures, muscle weakness, low mood. Too little Vitamin D can also contribute to calcium deficiency, since Vitamin D helps absorb calcium. Over the years, research has hinted at an array of other health benefits that may be linked to Vitamin D such as improved heart health, immune boosting effects and lowered cancer risk. Harvard Researchers are presently undertaking a study to help solidify its benefits.

Calcium: Muscle cramping, numbness in hands and feet or around the mouth, depression or anxiety. Calcium is also essential for bone development. In severe cases, too little calcium can cause seizures.

Where to Find these in Foods

Want to increase your dietary intake to get the vitamins and minerals you may be lacking? Here are some nutrient-rich options for each of the above:

  • Magnesium: Legumes, nuts, seeds, fish, quinoa (and All Bran cereal)
  • Vitamin D: Certain kinds of fish such as salmon and trout, milk and egg yolks. Some food and beverages in Canada are fortified with Vitamin D.
  • Calcium: Milk and dairy products, leafy greens, some fish.

Too Much of a Good Thing

What are the harms of taking a multivitamin? Multivitamins also have large safety margins in Canada, so provided you’re taking one as directed, you shouldn’t be at risk of toxicity. Problems typically arise if someone is taking multiple supplements.

In general, minerals and the fat-soluble vitamins (A, D, E, and K) are the ones that can build up in the body and cause harm. Other vitamins are water soluble and typically flushed out of the body if you overdo it. Upper limits for vitaminsand minerals are listed, so if you’re taking supplements in addition to a daily multivitamin or have a diet that is high in a particular food or food group, it’s worth a review to ensure you’re not getting too much.

Of note, there has also been concern regarding too much calcium supplementation increasing a woman’s risk of heart attack or stroke. The bottom line? The guidelines recommend aiming for 1200-1500mg of Calcium daily combined through diet and supplement. If you meet this minimum requirement through diet alone, grab a multivitamin that doesn’t contain calcium.

Finally, men and postmenopausal women should pick up a multivitamin without iron. Supplementation of this mineral is generally only required for premenopausal women to replace menstrual losses.

Doctor’s Orders

Although many Canadians can benefit from the use of a multivitamin, some will meet their recommended daily intake of vitamins and minerals through diet alone. If you think you’ve got your bases covered through food sources alone and you don’t have any signs or symptoms that make you suspect you’re deficient, you may not need the help of a supplement. Otherwise, in most cases, you can’t go wrong with a good daily multivitamin (with minerals).

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