June 12, 2018

Vitamin supplements, do I need them?

By dryeongs

Photo by pina messina on Unsplash

Vitamin supplements. Are they necessary for good health? Will they help you to feel better, make your immune stronger, make your hair shinier and all those other good things they promise on the bottle?

One of the most common questions I encounter as a GP is “Doctor, do you recommend any vitamins to help with my ____ (insert problem here- stress/low energy/low immune system, etc)?”

What I’m about to say might sound semi-controversial.

I think the success of multivitamins and supplements is one of the biggest wins for marketing in our day and age.

Now, don’t get me wrong- there are some special circumstances where a multivitamin or vitamin supplements may be warranted:

Pregnancy. During pregnancy, your requirements for vitamins and minerals increase due to your developing baby’s needs. Your body will always prioritize the baby’s needs over your own, and this can lead to deficiencies, particularly iron. Furthermore, studies firmly conclude that folate supplementation is very important in the early stages of fetal development to prevent neural tube defects (like spina bifida). I always recommend women take a pregnancy multivitamin as soon as they find out they are pregnant, or even better, during preconception planning.

Specific vitamin deficiencies due to disease. For some patients, vitamin supplementation is very important. For example, patients who have the autoimmune disease pernicious anaemia are unable to properly absorb Vitamin B12, so they need regular supplementation with Vitamin B12 for energy and blood cell production. Other patients may also have trouble absorbing certain vitamins and minerals due to surgery to their gut, such as for cancer.

Specific vitamin deficiencies due to diet. In particular, vegetarian and vegan patients may have deficiencies such as iron and Vitamin B12. In particular, I find many vegetarian women are low in iron due to their periods, which is not adequately replaced by their diet. In fact, many women, especially those with heavy periods, tend to be iron deficient. For these women, regular iron supplementation is important. For vegans, Vitamin B12 is only found in animal products. Other patients that may have dietary deficiencies include patients who are dependent on alcohol, which does not contain vitamins, older patients or patients with social issues who may not be eating well. For these patients, supplementation with a multivitamin may be a good idea.

Are vitamins just an expensive waste of time?

Photo by Jonathan Perez on Unsplash

Specific deficiencies due to ethnicity/culture. This can include patients who are on specific diets for cultural or religious reasons as above. This also includes patients with darker skin or who tend to cover up their skin with clothing more often, as these patients often have Vitamin D deficiency and require Vitamin D supplementation for good immune and bone health.

There may be other patients outside of these groups for whom vitamin supplementation is also necessary as well. But for the large majority who eat normal, well-balanced diets and are generally healthy? Here’s the secret.

Vitamin supplementation is not necessary to improve your health.

Many patients come to me worried that their diets are unknowingly deficient in something. They want to take “vitamin insurance.”

The truth is, if you eat a well-rounded, balanced diet from each of the different food groups, if you eat plenty of brightly-coloured fruits and vegetables, lean meats, fish, wholegrains and drink plenty of water- you’re probably already getting all the essential vitamins and minerals that you need.

For a long time, most researchers believed that taking excessive multivitamins didn’t cause harm. As majority of these vitamins are what is called water-soluble, it was thought you would simply urinate any excess. However, I recently stumbled across a study that found a correlation between excessive intake of Vitamin B6 and Vitamin B12 and lung cancer in male smokers. You can read more details here. While this study was an epidemiological study, so it cannot show causation, it does suggest that perhaps, vitamins may not always be as innocent as we might think they are.

Furthermore, those things are expensive! Rather than spending $30 a pop on so-called vitamin insurance, it would be a much better idea in the long run to invest in setting up good life-long dietary habits. Even though vitamins contain the synthetic form of the vitamins found naturally in our food, the way we absorb it is completely different, and there is no guarantee that your body will respond to a tablet form of the vitamin in the same way as taking it in naturally in food. It is always better to consume vitamins via food rather than tablets.

The other reason patients enquire about vitamins is that they want something to “strengthen” their immune system and protect them from catching coughs and colds.

Once again, there is no need for expensive tablets. While there is some evidence for supplements such as echinacea, this evidence is patchy. Have a read of this article from a great website that I often go to when I want to know if there is any scientific evidence for a health claim.  While it’s probably not harmful, it is always better to set up good habits to increase your defenses come Winter time. Click here to find out how I, as a GP and constantly exposed to germs, stay well in Winter.

The truth is, at least right now, there is no magic pill to make your health instantly better. Your health and wellbeing, like everything else in life, takes a little bit of work. But the payoff is definitely worth it.

If you are concerned about might experiencing a vitamin deficiency or you belong to one of the groups I mentioned above, please see your GP for advice, or you can check out my contact details to see me for a consultation.