Should You be Taking Vitamins?

April 20, 2007

Each year, Americans spend billions of dollars on vitamins and supplements.  It’s easy to get confused.  As a physician, I’m frequently asked by patients if they should be taking vitamins or supplements.  Let’s walk through some basic facts on common and popular vitamins.  Now remember that only your doctor can answer for you individually as to what you should or should not be taking, but here are some general recommendations, with a special emphasis for certain health conditions:

Vitamins are not a substitute for eating healthy – Fruits, vegetables, and whole grains are a major source of vitamins, but realistically, people do not always eat healthy enough to get all the vitamins they need.  We are often overfed but undernourished, meaning the food choices we’re making are not the best.  So, I often recommend to patients to take a multivitamin – especially if their diet is not as good as it should be, or as they get older. When shopping for a multivitamin, it’s important to read the label of the product – look for products that provide approximately 100% of the RDA- Recommended Dietary Allowance- for all vitamins and minerals.  Keep in mind that more is not always better and there are some products with very high doses. Consuming too many vitamins can be dangerous – so aim for the correct balance.

For those patients – especially women - that have osteoporosis or a family history of osteoporosis, they might want to consider vitamin D and calcium.  Vitamin D is important, especially if you live in a place where the sun seldom shines. Vitamin D deficiency is becoming more common.  This is not a surprise since vitamin D is a rather difficult vitamin to consume in adequate quantities.  Some of the best food sources include fortified milk and many fish, such as salmon, mackerel, and tuna.  In addition, this is the only vitamin we can make through our exposure to UV light, but this sometimes just isn’t enough, particularly in northern regions, when the sun may not be as strong or it’s impossible to get outside because of poor weather.  Adequate intake range is around 200 IU’s/day.  Now if you do spend time in the sun, it is essential that you wear sunscreen, with a minimum of SPF 15.

Do you remember hearing your parents tell you to “drink your milk so you can grow big strong bones.”  Well, our parents weren’t too far off in their recommendation: milk is a great source of the mineral calcium, which is crucial for bone health. Aside from milk, we can calcium from dairy products, such as yogurt, cheese, as well as some green leafy vegetables.  And keep in mind that even if you are supplementing with a multivitamin, they typically have low amounts of calcium so check the label and see what % of RDA it is. Aim for around 500-1000 mg calcium.

If you are pregnant, you might want to consider taking folic acid. Folic acid is an important B-vitamin, especially for pregnant women.  It’s been show to reduce neural tube defects.  So if you are a woman of child-bearing age, you may want to consider supplementation.

If you have heart disease, you might want to consider enriching your diet with Omega –3 fatty acids.  The American Heart Association recommends 2 meals of fatty fish per week. Examples of fatty fish include salmon, tuna, mackerel and trout. Some patients might benefit from omega-3 supplementation, especially if they do not eat fish or if they have heart disease.  There’s good evidence that omega-3 fatty acids can help prevent additional heart attacks in those people who have heart disease, as well as help lower triglycerides.   The omega-3 fatty acids you want to consume are called EPA and DHA. So be sure to look for these on the label and just not total omega-3. Patients with coronary heart disease should consume 1000 mg EPA and DHA daily from either oil fish or supplements.  Patients with high triglycerides might benefit from taking 2000-4000 mg of EPA and DHA daily. 

Now that you know which ones you might want to take, here’s some Helpful Hints - Since absorption is key to vitamins, be sure the pill dissolves well and you take it after eating a meal. Otherwise, you will just pass it out in your urine…and that would be a waste…no pun intended.  Also, store your vitamins in a dark cool place – you can even put them in the refrigerator – so they don’t break down as quickly.

If you are already taking vitamins, be sure to tell your doctor.  Some vitamins may affect medications you are taking.

Remember, a pill is not a substitute for a healthy lifestyle – you need to eat well-balanced meals consisting of fruits, vegetables and whole grains and be active for at least 30 minutes a day.

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Related Links:

About Dr. John Whyte

What's in Your Medicine Cabinet?

Nutrition Advice from Discovery Health Experts

More About Recommended Daily Allowance (RDA)

Comments

[Sharon]

Many doctors and scientists disagree with the currently recommended dosage of vitamin D believing it is way too low. People should have their levels tested. If you are interested in reading more please check out http://vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml?gclid=CK3n6cf0xpkCFRAhDQodNV0Vtw

[Neeraj Kulkarni]

Hi,
A nutritionist mentioned to me that vitamins pills should not be consumed immediately after drinking milk or eating milk products. One has to wait at least 30 mins before taking a vitamin pill after consuming milk products.

Is this is true?

-Neeraj

[D. Ruse]

Persistant Mal de Debarquement does not get better on its own and it is not as rare as once thought. Survey data is showing occurances that have lasted 40 years. Most physicians are unaware of this debilitating syndrome so people need to seek help at large medical facilities and teaching hospitals.

[Dr. John Whyte]

I am not aware of any vitamins that have been proven to treat Mal de Debarquement Syndrome. Most often, the syndrome is self-limited, meaning it will slowly get better on its own. If you continue to have a sensation of movement, I would recommend seeing your physician to be evaluated for any other possible causes. Also, your physician may be able to prescribe some short-term medications which may help your symptoms.

Dr. Whyte

[Michaela]

HELP!!! what about overweight people? i feel kind of embaressed, but i need help! can you post something about children and obeisity? dieting is obviously easier said than done. PLEASE HELP!!

[Cynthiya]

Are there any good vitamins for someone to take that has Mal de Debarquement Syndrome to help with the constant dizziness?