There's More to The Story: Multivitamin Edition

By: Nick Sienkiewicz, DPT, CSCS

I think calcium supplementation can be a game changer for many. I personally have calcium in my supplement repertoire currently in the form of a blend. The purpose of the calcium edition of “There’s More to the Story” was simply to do just that; make people aware of the nuances as it relates to calcium and potential supplementation for humans. Blanket calcium supplement recommendations have become a commonality within our healthcare industry in recent years, so it warrants a deeper dive. There’s no doubt calcium deficiency has become more of a concern worldwide, yet the increase in calcium supplementation has not seemed to resolve the calcium depletion issue. There’s always more to the story that needs to be investigated. As it relates to calcium, we must make sure vitamin D and essential fatty acid status are in order before blindly supplementing calcium. For example, the way that I’m currently supplementing calcium is via VerVita Matrix Synergy, which has calcium along with vitamin D and essential fatty acids (among other compounds) all in one capsule. I am not saying everyone who has a calcium issue needs to utilize this specific supplement. Rather, it is an example to show that calcium supplementation will be better accessed by the human body when combined with vitamin D and essential fatty acids. Along the same accord, we need to be sure stomach acid is adequate before adding a calcium supplement into our protocols. Additionally, we need to consider the multi-factorial nature and complexity of the human body. As discussed last week, environmental factors, such as EMF radiation and lead exposure, can displace calcium, so we must respect these potential influences in our lives if calcium supplementation has been recommended by a provider. Ultimately, we must understand that there are trade offs to everything, and nothing happens in isolation within the human body. You know your body best! If a healthcare practitioner is recommending something, and you try it but experience no changes or even negative effects, it may not be what’s right for you. In this instance, you need to look deeper and peel back more layers because there’s clearly more to your story!

I apologize for the lengthy reiteration of last week’s blog. I just felt compelled to clarify my statements made last week! Now, let’s get into this week’s rendition and discuss the more extensive story behind multivitamins.  Multivitamins can certainly be beneficial and have helped many people on their health journeys in recent years. As mentioned in relation to calcium, the soils and our food supply are more micronutrient-depleted than ever before. This is the basis for multivitamins posing notable benefits. Multivitamins aim to help to fill in the nutritional gaps that are being generated by the modern diet. Nevertheless, the supplement industry has become so saturated, and multivitamins tend to be at the forefront of marketing. Since multis have been one of the greatest sources of sales for supplement companies, the substructure of these products has taken a hit. In an attempt to maximize profit margins, quantity has been emphasized over quality unfortunately. We are currently in a time where a particular multivitamin may be totally ineffective for the human body due to poor quality, or even worse, possibly detract from health because of this impurity. Here are some of the big points involved in the bigger picture with regard to multivitamins:

The amounts and ratios of specific vitamins and minerals are often all over the place, with some significantly higher than recommended daily intakes.

The human body strives to return to homeostasis, meaning a balanced state. There are some vitamins that are essential, indicating we need to obtain them from food and other external sources. These micronutrients need to maintain certain balances within the body, just like I discussed with calcium and vitamin D. Many supplement companies will increase the dosages of the essential vitamins, like vitamin C, to make it appear “better.” However, more is not always better. An increased amount definitely could be needed in some instances, but does not automatically make the product higher quality because of a more potent dose of a specific nutrient. Furthermore, many multis will have significantly higher doses of water-soluble vitamins, such as B vitamins. This is because it is relatively safe to add more than the daily recommended intake of water soluble compounds because you will just excrete most of the excess in your urine, whereas fat-soluble vitamins will be stored in the fat cells. Even though it is largely safe to consume 1,000% of the daily recommended dosage of a B vitamin, it still increases stress on the digestive process (and other systems, like the liver) when consuming more than your individual body needs. Truly knowing your body’s specific micronutrient needs quantitatively can be challenging, as it would require regular testing for accuracy. Consequently, I opt for human intuition above all in this regard. If a particular multivitamin does not make you feel good, then it is not for you, and this concept may be underpinning that reason. 

The forms of particular vitamins in many products are typically inferior for appropriate absorption and utilization by the human body.

This is a huge concern with many multis on the market. If you go into the supplement section at a store and look at the ingredient labels of various multivitamins, you would see a plethora of scientific names next to the corresponding micronutrient. This is the form of the vitamin or mineral, and directly impacts how it is absorbed and processed in the body. I obviously won’t go into every particular vitamin here, but let’s discuss the two big ones as it relates to this topic: vitamin B12 and folate. Vitamin B12 is known as cobalamin. It is pivotal for many functions in the body, and will be found in most multis. The form in many of these products is cyanocobalamin. This means the cobalamin vitamin is attached to cyanide. Yes, you read that right… The same cyanide that is referenced in the phrase, “cyanide poisoning,” is being utilized for your vitamin B12 in your multivitamin that is marketed as health-promoting. The main reason for using cyanide is that it’s cheap and such a small amount of cyanide that it “technically” poses no acute threat to human health. Now, I don’t know about you, but I don’t like ANY amount of cyanide in my system, so I would always opt for a multivitamin with another form of B12, like methyl-cobalamin or hydroxy-cobalamin. Even though the amount of cyanide is minuscule, the thought of taking a multivitamin with cyanocobalamin daily for years makes me a little weary about potential cyanide accumulation over time, especially in our already toxin-riddled modern world. Additionally, the latter-mentioned forms are more highly absorbed and assimilated than cyanocobalamin anyway, so it doesn’t even make sense from an effectiveness standpoint. Folate is another B vitamin (B9) that is crucial for optimal health. The form utilized in most products nowadays is folic acid, so much so that the term “folic acid” has actually become synonymous with folate. In reality, they are different forms, with folate being the natural one and folic acid being the synthetic derivative. Unfortunately, folic acid is poorly absorbed compared to folate (look for methylfolate on the ingredient label for folate) in general. Furthermore, a large percentage of the population can’t even convert folic acid in the usable folate due to genetic variations. These individuals may actually feel sick when taking a supplement with folic acid instead of folate due to accumulation of a non-usable substance in the body. You can find this information out with certain genetic testing, which is worthwhile for sure, but you could also take added precaution and search for a multivitamin with natural folate rather than the synthetic variation. For a few other particular vitamins, the more optimal forms to look out for include pyridoxal-5-phosphate (vitamin B6), retinol (vitamin A), cholecalciferol (vitamin D3), and menaquinone-7 (vitamin K2). 

Periodic rotation of different multivitamin brands can help to assure a more balanced assimilation of micronutrients.

Once you’re getting the right forms and quality of specific nutrients, you can begin to think about quantity. Most multivitamins on the market contain roughly the same vitamin and mineral profiles, but there are tenuous nuances. For example, B vitamins will be found in most products, yet CoQ10, another extremely valuable nutrient, is only contained in some. These variations lead to subtle differences in the effects and accumulation of micronutrients within the body. For this reason, I believe rotating different high-quality multis serves as a more effective practice. In that way, you cover more bases and fill more gaps in the long run. 

The culture around multivitamins often conveys the notion that if you consume the supplement then you are covered.

This is the most important thing as it relates to multivitamins. They can certainly support the filling of nutritional gaps, but should and truly can never replace your dietary choices. Striving for a micronutrient-rich diet based on whole foods should be the goal for every human. Multivitamins are a great option to support this endeavor. They are by no means a standalone product though. Establishing a solid foundation of nutritional choices and behaviors is paramount!

Ultimately, multivitamins can be an impactful aspect of your health routine if used appropriately. Opt for highest quality possible. There are so many brands out there. Thorne, VerVita, Quicksilver Scientific, Seeking Health, Pure Encapsulations, and Vital Nutrients are all brands with great multivitamin options. Although potentially beneficial, multis may not be necessary in all cases. You have to identify your unique individual factors to determine if a multivitamin is right for you!

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 Let's thrive together,

Nick

*Disclaimer: This is not medical advice. The information is meant to be educational in nature. It is not intended to diagnose, treat, prevent and/or cure any disease or health condition. Simultaneously, the information is not stating that any supplements or methods mentioned can replace medications or any interventions prescribed by your healthcare provider. Please speak with your own healthcare provider before beginning any new supplements or making changes that may affect your health. By utilizing any of this information, you are assuming responsibility for your own health decisions and actions.