Nutrition & Wellness with Mariah PA-C

“All those vitamins aren’t to keep death at bay, they’re to keep deterioration at bay.” – Jeanne Moreau

In the modern world people are beginning to look for ways to improve their health, not only with food, but with supplements. Supplements are all around us, in the form of protein shakes, vitamins, minerals, protein bars, herbal powders and collagen powders. Yet how do we know exactly which ones are the best for us.

Today we focus on multivitamins vs individual vitamins.

Vitamins were first introduced in 1912. At this time there were many nutrient deficiencies and scientists were trying to find ways to combat preventable illnesses. The discovery of vitamins, is a milestone in history and has led us to where we are today. Although research has shown vitamins do not play a crucial role in preventing some of the most common diseases, there are a few out there that are recommended to potentially improve not only health, but mood, skin and hair.

So, which ones should we use?

Now that there are multivitamins, it seems there’s no need to worry about which vitamin to choose… right? Not necessarily. Today we’re going to investigate the Pros and Cons of a multivitamin vs single vitamins. We will also touch on which vitamins are most commonly deficient in the population. Which is important for you to know, because even the healthiest people tend to be low in these vitamins and minerals.

Pros of Multivitamin Utilization

1. They are convenient
   1. Imagine trying to take 20 different vitamins per day! That would be inconvenient and gag worthy. A multivitamin is convenient in that it allows you to take tons of vitamins at once.
2. They require no thought
   1. For example, with single vitamins we have to decide on the dosage, and the brand. If you have a multivitamin all you have to worry about is the brand your taking, otherwise, dosing is specific.
3. They usually contain vitamins and minerals that are commonly deficient… and some.
   1. Multivitamins contain more vitamins and minerals than you can eat in one meal. For example, the nature made multivitamin contains >15 vitamins…

Cons of Multivitamin Utilization

1. They are not customized.
   1. Some vitamins you are already getting in abundance in your food. Therefore it is possible that you are getting too much of some vitamins and minerals which can cause toxic effects. The most common vitamins that shouldn’t be taken in excess are vitamin B12, vitamin D, most minerals (zinc, magnesium, iron, etc.),vitamin E, and vitamin K.
   2. Luckily water soluble vitamins are peed out if you ingest too much of them, but of course this is not the case if you are not drinking enough water. Therefore be sure to ingest tons of water when taking vitamins of any kind! (The B vitamins and vitamin C are all water soluble but B12 is stored in the body and has a higher chance of toxicity)
2. They may not contain the vitamins or dosages you need.
   1. Multivitamins are not all the same. Some contain a few vitamins and others contain over 20. Depending on which one you get, you may be missing out on some of the most commonly deficient vitamins and you may not get the proper dosages.
3. Some vitamins and minerals do not interact well.
   1. For example, Calcium and Zinc reduce the absorption of iron whereas Vitamin A and C increase it’s absorption. Therefore it is possible to get too much or too little of specific vitamins and minerals when consuming a multivitamin. Therefore research the company to assure they have accounted for these interactions. (See: Interaction Chart)

Now, let’s discuss some Pros and Cons of individual vitamins below.

Pros of Individual Vitamin Utilization

1. They are customizable.
   1. As you will see below, there are many vitamins that are mildly deficient in the average American diet. Therefore if you eat a healthy diet, all you’d need to do is add those vitamins and minerals that are deficient in your foods and you’ll have a very balanced diet.
   2. With multivitamins your taking high doses of multiple vitamins, or lower doses than what you would get if you took the vitamin individually. For example, magnesium is very low or non existent in many multivitamins.
   3. Just like a multivitamin, they can be thrown in smoothies, but you can customize your smoothie with individual vitamins!

Cons of Individual Vitamin Utilization

1. You have to take multiple pills
   1. This can be overwhelming especially if you do not have a nutritionist guiding you. A nutritionist or dietitian can give you advice on which vitamins and minerals to take daily. For example, B12 can be taken once per week, and Vitamin D can be taken every other day. If you don’t have guidance on a vitamin intake schedule, you may end up taking 6 vitamins per day and dosages that are too high.
2. Requires you to track diet for at least a week to determine which vitamins you are deficient in
   1. As discussed above, you will want to know where you are deficient, so using an app or food log to monitor vitamin and mineral intake is crucial in helping you develop a vitamin schedule.

So as you can see there are pros and cons to both, and depending on your life style, one may be more convenient than the other, but… which is the best path to take?

Multivitamins vs Individual Vitamins: Which is best?

Both options are great. But the option that is most beneficial will be individual vitamins.

1. Individual vitamins allow you to customize your own nutrients based on your food intake. Now if all you eat is meat, than a multivitamin is a good idea, but again, some nutrients may be missing and will need to be added to your multivitamin. If you eat a well balanced diet that includes fruits, vegetables, and whole grains, customized individual vitamins are more beneficial than a multivitamin.
2. By taking individual vitamins you will prevent interactions by taking them at different times.

More on Vitamins

If you take a multivitamins or an individual vitamin you will want to monitor vitamin levels closely to see if your levels are too high, or to see if they are increasing properly. With the interactions and risk of toxicity it is important to keep up with blood work every 8-12 weeks for about 6 months until your levels stabilize. Once stable, you should know your doses and your frequency. Then you can have them monitored yearly.

The Most Commonly Deficient Vitamins and Minerals

It is rare to be 100% deficient in America, but most of us do not hit 60% of the recommended intake of crucial vitamins. Some of these necessary vitamins are noted below, and may be beneficial for most Americans. Speak with your primary care provider before taking any supplements.

1. Zinc
   
   “Worldwide, about 1.1 billion people are zinc-deficient due to inadequate dietary intakes, according to an article published in the journal Scientific Reports.” (Read More)
   
   Used by over 300 proteins in the body to perform multiple functions, Zinc is one of the most important minerals in our body. It is utilized by the immune system, reproductive system, all cells for cell growth, for wound healing, for the senses, and for other processes of the skin. There are many things Zinc is involved in that make it worth the supplementation.
   
   If we are honest with ourselves we can admit that our American diet is not perfect, most people do not eat 3-6 fruits and vegetables per day and are surely avoiding brown rice and pastas. Therefore, most of us Americans are eating a poor diet.
   
   Being that there are no body stores for Zinc it is recommended that it is taken daily. Avoid over 50mg of zinc daily as this can become toxic over time.
   
2. Magnesium
   
   “While less than 2% of Americans have been estimated to experience magnesium deficiency, one study suggests that up to 75% are not meeting their recommended intake” (Read More)
   
   This mineral has become very popular as of recent, for menopausal women. Menopause and/or perimenopause may lead to mood changes, sweats, hot flashes and other uncomfortable effects, magnesium has been shown to improve these symptoms. Magnesium is also involved in over 300 different protein systems within the body. Some functions it supports include protein creation, muscle and nerve function, blood sugar control, and blood pressure regulation.
   
   Although a full blown deficiency is rare, the mineral itself is low in the typical American diet.
   
3. B12
   
   Vitamin B12 is well known to be low in vegetarians and vegans who are not drinking plant based milks, or supplementing weekly. But it turns out most Americans are not getting enough B12.
   
   B12 is important for your brain, skin, hair, nails, and blood cells. It is involved in basically every process occurring in your body and has been touted as an “energy” vitamin. Although it does not provide energy directly (only calories provide energy), it does help your body perform processes that promote energy in the body.
   
   This vitamin is often over consumed! B12 is stored in the body so a weekly vitamin is a good place to start. Speak wit your health care provider before taking any supplements.
   
4. Iodine
   
   Iodine was added to salt in the 1920s after deficiency in the American diet became significant. Now, salt is being reduced in diets due to the risk of high blood pressure and stroke. Iodine is the most important nutrient for thyroid function, if it is low in the diet you are at risk of thyroid disorders. Therefore Americans who avoid salt may need to consider taking an iodine supplement.
   
   Iodine is tricky in that it is hard to determine how much each individual needs, and too much of the mineral can actually lead to thyroid dysfunction… so consider using an app, such as MyFitnessPal or another to determine how much iodine you are getting in your food.
   
   
5. Fiber (not a vitamin or mineral but should be considered among your supplements)
   
   Simply put, fiber helps us poop and improves nutrient absorption. There are two types and they both keep us regular: Soluble and Insoluble fiber.
   
   Like most things that are good for us, Fiber is found naturally in Whole Foods such as fruits, vegetables and whole grains. It is not found in meats, cheeses, or dairy. This can be a problem as these things make up most of the American diet. It is recommended that the average person consume at least 25mg of fiber which is why there are now powders and tablets that are available for those who find it hard to eat a whole food diet. Without fiber you are at risk of colon diseases and general illness. Read more about how to incorporate fiber into your diet: https://nutriwellprovider.com/learn/3/.
   
6. Potassium
   
   Potassium helps your muscles function, including your heart muscle and breathing muscle.
   
   Potassium is a controversial supplement because if overused it can cause an electrolyte imbalance that may lead to muscle dysfunction or even death. Although most people do not get enough potassium in their diet, it is best to monitor your blood work in the first few months of taking the supplement to assure you are not causing an imbalance in your electrolytes. The rule of thumb is to consume 3500mg of potassium daily.
   
7. Calcium
   
   Calcium is a wonderful mineral. It allows bone building but it also is involved in blood clotting, and muscle contraction including the heart muscle.
   
   Those who do not consume enough calcium tend to develop osteoporosis in old age and are at higher risk of blood disorders and muscle deterioration as they age. Just like the other minerals we have discussed, in high amounts calcium can cause heart changes and actually lead to bone loss. Generally, starting at about 8 years old most people need about 1000mg of calcium per day. Again, monitor blood work in first few weeks of supplementation to avoid abnormal side effects.
   
8. Vitamin A, Vitamin C, Vitamin E
   
   The average American misses out on these vitamins because they are found in Whole Foods that are not commonly found in American diets. For example, vitamin C and Vitamin A are found in fruits and vegetables. Vitamin E is most commonly found in nuts.
   
   Again, if your diet is mainly composed of meats, consider a multivitamin which includes these vitamins. Be sure to have your doctor monitor your condition in the first few weeks.
   
   
9. Vitamin D
   
   Although the body has the ability to make it’s own Vitamin D from the sun, most Americans are not in the sun long enough to take advantage, and in places like Arizona the sun is avoided to prevent skin cancers and other disorders.
   
   Being that most Americans are vitamin D deficient they are at risk of skin damage, hair damage, osteoporosis, autoimmune diseases and general illness.
   
   So you may be thinking what about milk?
   
   The milk rage was huge in the 90s. During that time the dairy industry touted vitamin D and Calcium as reasons to consume milk as much as possible. Now that the industry is getting backlash for animal cruelty, many people are realizing non dairy milk alternatives contain the same or more calcium and vitamin D. The vitamin D level is so low in milk, you’d have to drink more milk than you should to get enough. Therefore it may be more beneficial to take a supplement rather than drinking milks for this vitamin.
   
   Other sources are derived from meats such as Liver, and Shark?
   
   All in all, this vitamin is one of the most important supplements to take. Recommended daily intakes are between 500-2000. To determine the best levels for you check with your primary care provider for vitamin D levels to see if you need a supplement.

So, hopefully this information give you some insight on how to choose the proper vitamins and minerals for you. It’s not a question whether vitamins and minerals are beneficial, but whether you’re taking the right ones. Remember to meet with your health care professional for further guidance.

Sources:

1. https://ods.od.nih.gov/factsheets/Calcium-Consumer/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383497/ (Iodine)
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521019/ (Zinc Info)
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509517/ (Iodine History)
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566984/ (Fiber)
6. https://pubmed.ncbi.nlm.nih.gov/28165863/ (Fiber)
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116165/

*All of the information here is from the author’s expertise backed by ongoing institutional nutrition education, and continued education via nutrition textbooks, eatright.org, and pubmed research articles that are not biased and have good accuracy. This information is not meant to diagnose or treat any condition. This information is to be read and utilized at your own will, and the author is not responsible for any outcomes that come from utilizing this information. This information may be discussed with and adjusted by your dietitian, nutritionist, or medical provider for a more personalized plan. If you have any questions feel free to contact us via the Contact Page. For sources Click Here.