Should I take vitamins?

November 12, 2017 9:58 AM

I know people have varying opinions about this, but is there an actual fact-based answer?

I'm a 50something woman whose bestie -- slightly more woo than me, but not super-woo -- said, "Start taking vitamins!" So I randomly picked up, at her advice, a Trader Joe's brand multi-vitamin for older women + turmeric. (Friend advised the turmeric because I recently started up a new kind of exercise and she said it'd help me with inflammation related to muscles being used that had rarely been used before.)

Now it's a couple months later and I'm getting to the end of these bottles of vitamins. I feel neither better nor worse. I haven't experienced any injuries from my new exercise, which I'm grateful for, though I have no idea if it's related to the vitamins.

What should I be thinking about if I'm deciding whether or not to continue with these vitamins? Or is there some other vitamin combo I should be taking? I'm ***terrible*** about taking pills and keeping up with a regimen, so I'm not, under any circumstances, going to get into a ten-vitamins-a-day kind of habit. If I continue, it'll be one or two per day, max.

posted by BlahLaLa to Health & Fitness (31 answers total)

My personal feeling is that taking vitamins is like knowing how to do ballroom dancing or having an in-depth knowledge of Robert's Rules of Order. It probably isn't going to hurt you, and one day it may even help you.

As far as brands, a nutritional scientist I trust (Chris Kresser) says that the Carlson brand goes to some length to make sure their formulations are actually "bio-available" and will be absorbed by your body instead of just passing through without effect. And also that the liquid drop versions are more likely to be beneficial than the pill forms.

But in the USA, the whole industry is unregulated, so there is no guarantee that any of them work. I resentfully take Vitamin D every day, and dip into other supplements as needed. But there is a whole lot of price inflation for some brands, and even scientists you trust eventually start selling their own expensive supplements-- it is just a whole tangled mess. If you can afford it, keep on taking them, but also maybe also try to eat a lot more unprocessed foods and fresh leafy vegetables.

As far as "facts", there are so many different studies, often of dubious methods, and often funded by the vitamin companies themselves. I really believe in tracing back the science on these things, and a few of of the researchers/advocates that I personally trust, who do let you look at the facts, and who do encourage you to do your own research are Chris Kresser, Loren Cordain, Robb Wolf, and Terry Wahls. Other people will hopefully chime in with their trusted experts.
posted by seasparrow at 10:12 AM on November 12, 2017 [3 favorites]

It depends. I think that most people could benefit from a good multivitamin, particularly if their diet isn't great. Depending on where you live, you could also be deficient in vitamin D, which is an extremely important vitamin. You can have it tested by your doctor. I live in the northeast and have mine tested regularly. I take it every day
posted by kbbbo at 10:17 AM on November 12, 2017 [1 favorite]

Informationisbeautiful.net has an interesting visual representation of scientific evidence for various supplements.
posted by yes I said yes I will Yes at 10:18 AM on November 12, 2017 [13 favorites]

I had to take nutrition classes recently as part of my care for diabetes. My layman's understanding - with that as the most recent contact with a nutritionist - is that you should only take vitamins as directed by a medical professional. Most of them are useless in quantity, and some can build to toxic levels if you have too much.

WebMD has more specific information about that.

As kbbbo mentions, vitamin deficiency should be something that comes up on blood tests - I know someone who was on 50000 IU vitamin D for awhile, for instance.
posted by mordax at 10:19 AM on November 12, 2017 [2 favorites]

I take vitamins but I have specific deficiencies. I don't know what's right for you - it's different for everyone. Your friend is on the wrong track with what she says about inflammation and exercise though. Turmeric is great for general inflammation, but when it comes to exercise inflammation/injury in the muscles is actually what precipitates muscle growth. I've seen studies that using too many antioxidants or Ibuprofen after exercise can interfere with this process. It's doubtful a multivitamin would be powerful enough to cause issues with your routine, but just wanted to put it out there.
posted by decathexis at 10:25 AM on November 12, 2017 [1 favorite]

If your diet is relatively varied, you probably don't need a multivitamin.

Unless you spend a lot of time outdoors, you would probably benefit from a Vitamin D supplement. Most people in a lot of parts of the world would benefit from it. I take this one. Otherwise, if you eat a varied diet, including oily fish (unless you're vegan), you should be basically covered. The second-most-common deficiency is probably B-vitamins, but unless you drink a good deal of alcohol or have other issues / underlying deficiencies you probably don't need a supplement. (You might if you are vegan, but this varies depending on diet.)

If you are interested in trying turmeric, it's often better to cook with it than take it in pill form, because the human body can't do much with curcurmin on its own. Heat and the presence of piperine help make it more bioavailable, so just make some nice curries instead, or sip on this instead of tea or coffee (it's really tasty, actually!) or add turmeric into rice along with black pepper when you're cooking some (which gives a lovely golden colour to your side dish!).
posted by halation at 10:49 AM on November 12, 2017 [1 favorite]

The Science Vs. podcast just had an episode on this. I'm taking prenatal right now and will continue to take some kind of multivitamin and vitamin d supplementation that that's not required.
posted by emkelley at 10:58 AM on November 12, 2017 [1 favorite]

My doctor recommends Vitamin D for pretty much everyone, since most people really don't get enough from sunshine. Most young healthy people probably don't need vitamins if they have any kind of decent diet. The vitamin and supplement industry in the US has no accountability and publishes so much bullshit it's not even funny. For the most part, unneeded vitamins and supplements just cost you money and then you excrete them in urine. I'm 62 and find that I need to eat meat several times a week to get adequate B12, and I make muffins with dried fruit and walnuts to increase magnesium, otherwise I get muscle cramps.
posted by theora55 at 11:02 AM on November 12, 2017 [1 favorite]

This heavily-referenced meta-analysis of vitamin research published in the International Journal of Preventative Medicine a few years back may be the kind of analysis you're looking for.
posted by eschatfische at 11:06 AM on November 12, 2017 [7 favorites]

Nthing vitamin D. Based on a blood test, my levels are/were ultra low, even after a fairly outdoor summer. Been taking itow for a few month and definitely can tell a difference. But get a blood test and prescription product, not otc cheapo.
posted by 15L06 at 11:50 AM on November 12, 2017

Forgot, getting another test this Wednesday to check levels, but am sure it helps as i feel better.
posted by 15L06 at 11:52 AM on November 12, 2017

Get some bloodwork to see if you're deficient in anything before launching into a vitamin regimen. As other posters have mentioned, you are most likely deficient in vitamin D, and it's good to get advice from a doctor on the exact dosage that's right for you.

As for remembering to take meds, get a pill box! I'm horribly forgetful, but some routine bloodwork revealed that I'm quite anaemic (!!) and my vit D levels are quite low. I was also recently prescribed regular meds for another health issue, so I grabbed a pill box off Amazon to manage all the pills and it's been great. I fill it every Sunday, and it's a great visual reminder to take my daily meds and supplements.

A nice bonus: if you are a bit deficient in something, getting those levels back up feels really tremendous. But get some bloods done first to see if, and what, you need.
posted by nerdfish at 12:33 PM on November 12, 2017

Strictly anecdotal, but I've heard the same from many others:

I used to use vitamins, Chinese herbal teas, and other supplements. None ever made a lick of difference. I gradually weaned off all that stuff, to no observable effect. I also stopped buying bottled water, and started drinking tap (caveat: I fill up a glass pitcher with water I've allowed to run till cold, so it's all fresh water that hasn't been sitting in my pipes, and I don't need to wait for that each time I pour myself a glass). No noticeable change there, either.

My life is now cheaper and simpler, and my health and vitality are the same as ever. You know what does make a diff to health and vitality? I walk up a hill every day. And feel better in all sorts of ways.
posted by Quisp Lover at 1:28 PM on November 12, 2017 [7 favorites]

I was recently diagnosed with osteopenia (precursor to osteoporosis) and doc said to start taking a bone health vitamin. I have a friend who's a chiropractor and she got me what she thinks is a good one, and also an ADK combo pill, so I take those as and when I remember (like you, I'm really bad at taking pills on a regimen). Also, when I take them regularly, I can't tell any kind of difference in my achy joints, so who knows.
posted by MovableBookLady at 1:46 PM on November 12, 2017

Yes, blood tests - then, go from there.
posted by heyjude at 2:15 PM on November 12, 2017 [1 favorite]

I found this book really helpful when I was pondering the same thing last year (it is also fascinating and depressing in equal measure). The information on vitamins and other supplements started around page 103 in the Kindle version. I took quite a few notes, so to summarize its stance on vitamins:

The only dietary supplements currently believed to be of actual, proven value are:

- omega-3 fatty acids
- calcium
- vitamin D
- folic acid during pregnancy

Most Americans consume about 1.6 grams of omega-3s every day, well above what is needed to maintain heart health. People who don't eat any sources of omega-3 fatty acids (fatty fish like salmon, canola oil, flaxseed, walnuts) are often advised to take a supplement containing 500 mg a day, but no more. (By contrast, I took a look at my bottle of fish oil and it's 1200 mg per capsule and the suggested dose is TWO of them each day, so...yeah.)

Calcium is only recommended for postmenopausal women who don't get enough in their regular diets. Calcium is also found in some fortified foods like juice, cereal, tofu, etc. So again, pretty hard not to get enough of this naturally.

Vitamin D, you are supposed to get 600 IU (though it was unclear whether this is daily or weekly), which can be done by getting 10-15 minutes of sunlight twice a week. Many foods are also fortified with vitamin D, like milk, bread, cereals, orange juice, yogurt, etc. Because most people get sufficient amounts through food and sunlight, it's not recommended to take supplemental vitamin D. And the main reason we are supposed to have it is bone density rather than seasonal depression. The only people who are supposed to get vitamin D in supplement form are babies who are exclusively breastfed babies because it isn't contained in human milk, and for obvious reasons, they don't sit out in the sun. Also, people over 65 should take 800 IU daily because it's been demonstrated to reduce risk of bone fractures (see also: calcium).

Related: The Vitamin Myth: Why We Think We Need Supplements
posted by anderjen at 2:27 PM on November 12, 2017 [7 favorites]

Paul Offit took a look at the evidence and comes down whole heartedly on the side of Nope.
posted by basalganglia at 2:29 PM on November 12, 2017

Informationisbeautiful.net has an interesting visual representation of scientific evidence for various supplements.

Some of the studies cited there pertain to the effects of supplements on people without a known deficiency. I've had someone use this infographic to try to convince me that it's impossible for someone with a normal diet to be deficient in anything, and I'm wrong to take a (doctor-recommended) supplement for something I've had a long-standing deficiency in.

You probably don't need a multivitamin, per se, but there's a possibility that you may have a specific deficiency that you can't easily resolve with diet or lifestyle changes, or that might be linked to some other health condition. Only your doctor can give you the information you need to make a sound decision about supplementation.
posted by blerghamot at 2:36 PM on November 12, 2017 [2 favorites]

My understanding is that the preponderance of research suggests that for healthy people with a varied diet, multivitamins are likely useless and potentially harmful. This editorial from a respected medical journal summarizing several studies published in that same issue as well as other evidence is a bit polemical and a few years old, but gives a good overview of that perspective. The takeaway is that taking vitamins makes sense if you have a significant dietary restriction or a documented deficiency but not otherwise. I’d say, skip that vitamin with a clean conscience.
posted by reren at 2:40 PM on November 12, 2017 [1 favorite]

I am a medical student, though IANYMS. What they teach us is that vitamins are not really necessary if one eats a standard healthy diet. Vegetarians and vegans should supplement iron and B12. Though it is not a vitamin, people with high triglycerides should consider fish oil. That said, for a fascinating look at dietary recommendations for various illnesses, look at nutritionmd.org. The paper version of the site is called the Nutrition Guide for Clinicians and is a fun read.
posted by 8603 at 4:41 PM on November 12, 2017 [1 favorite]

The only vitamin my doctors have consistently recommended is vitamin D and it’s the only supplement that’s had a measurable positive effect on my health.
posted by lydhre at 5:05 PM on November 12, 2017

Vitamin D is probably one you'd should take. Many are deficient, and you can take a blood test to determine if you are too. Here's information on Vitamin D: https://www.health.harvard.edu/staying-healthy/time-for-more-vitamin-d

If you're eating a plant-based diet, you should consider taking a B12. Some people also include K3 and DHA in that as well. These are harder to consume via plant sources.
posted by vivzan at 6:49 PM on November 12, 2017

Some people also include K3

Correction. That should be K2.
posted by vivzan at 6:58 PM on November 12, 2017

Did not read the thread, so excuse me if this has been mentioned. Vitamins A, D, E, and K are fat soluble, meaning they're stored in fat and can build up to toxic levels in your system. It can be very dangerous to let the levels of these vitamins get too high. You need to be monitored if you're going to take any of them regularly.

B and C are water-soluble, so the likelihood of them reaching toxic levels is nearly non-existent, but if you take them when you don't need them you will literally just pee them out, which would end up being a big waste of money. I heard someone describe it as "very expensive urine" once.

Vitamins are great, but they need to be done under the supervision of a doctor.
posted by Amy93 at 7:22 PM on November 12, 2017 [1 favorite]

My understanding is that most vitamins are just a tool for making your pee expensive. As above, the few useful ones are omega 3s, vitamin D, folic acid if you might want to be pregnant (it has to build up over time and be present at conception to properly prevent the neural tube defects which develop very early) and maybe calcium (but not if you’re at high risk of kidney stones.) So for sure talk to your doctor.

This is a really helpful and interesting summary of some supplement research.
posted by blnkfrnk at 8:03 PM on November 12, 2017

You're 50-something, so it wouldn't be unusual for your stomach to have a reduced ability to absorb dietary B12. But as others have said, your doctor can order tests to determine if you actually need to take supplements.
posted by mumkin at 9:32 PM on November 12, 2017

Yeah, I'm on vitamin D because the government of Canada tells me to and I'm on B12 because my blood test results told me to.
posted by sebastienbailard at 11:13 PM on November 12, 2017 [1 favorite]

I feel neither better nor worse.

That would seem to me to be a valuable experimental result, and the factor most worth paying attention to.

I'm ***terrible*** about taking pills and keeping up with a regimen

Then I would strongly recommend that you conserve your keeping-up-with-a-regimen power against the day you actually need to use it for something that improves your quality of life more than making your urine more expensive does.
posted by flabdablet at 7:47 AM on November 13, 2017

Came to recommend the Information is Beautiful graphic but see it's been mentioned. The best thing about that graphic is that it shows how a supplement might have quite a lot of science behind its effectiveness for one particular thing, but be completely bogus on other claims. No need to throw the baby out just because the bathwater doesn't cure cancer.

Anecdotally, a cheap daily B-complex vitamin seems to improve the condition of my hair. It took me about three months to notice that.

I began taking a B-complex vitamin on a doctor's recommendation and also noticed this; additionally, my nails grow absurdly quickly and sturdily after a lifetime of being thin and brittle. The doc didn't recommend this based on a blood test but just on an evaluation of my diet and my specific complaints. Since it has improved things so much, it seems likely that I had an actual deficiency.
posted by We put our faith in Blast Hardcheese at 8:40 AM on November 13, 2017

Epidemiologist/toxicologist chiming in. The average American doesn't need to take vitamins or supplements. Taking megadoses of vitamins, as is common in many if not most commercial vitamin preparations, can do real harm. This really, truly is a question to discuss with your doctor, and if you do start taking any vitamins or supplements you should keep a good list of them that you can share and discuss with your doctor.

If you have any questions, feel free to MeMail me.
posted by late afternoon dreaming hotel at 9:19 AM on November 13, 2017 [2 favorites]

I think of multi-vitamins (and minerals) as the Bar's Leaks to the radiator that is the human system. If you're not getting enough vitamins from fruits and vegetables, pill-form vitamins will "plug the holes", so to speak.

Most multi-vites have enough "D" to meet the daily requirement.
I take a daily multi, and I'm rabidly anti-woo.

You write:
I haven't experienced any injuries from my new exercise, which I'm grateful for, though I have no idea if it's related to the vitamins.

Vitamins don't care about that sort of thing, and don't "repair" it.
posted by BostonTerrier at 1:06 PM on November 13, 2017