multivitaminI’m not a “supplements” doctor.  I know many naturopathic patients who have had the experience of coming home from a visit with a bagful of pills and potions.  I’m not like that. My long-term goal as a physician is always to treat the underlying cause so we can permanently restore health.  When that happens my patients no longer need to be on a supplement regime, they can use diet and lifestyle to maintain their health. (With maybe an occasional multivitamin and probiotic – because if you have a refrigerator, you probably need a probiotic.)  That said, getting people back to restorative health can take some work, and by the time they arrive in my office they are usually in need of some type of support.

So here’s the deal: as in life, with supplements you pay for what you get. I would rather my patients throw their Costco multivitamin in the garbage and not take anything at all.  It sounds rather harsh, but I cannot in good faith have my patients take something that I know is harmful.

In the last few years several studies have shown an increased risk of death when taking multivitamins.  Yikes.  Here is one study in older women. Here’s another that shows cancer deaths are increased. Here’s one that shows that women who take calcium have a higher risk of cardiovascular disease (heart disease, heart attack and death).  And here is an older, landmark study that showed that taking beta-carotene causes increased risk of death in smokers.

Yet, in many other studies multivitamins or single vitamins have been shown to decrease certain cancers, prevent neural tube defects (and autism!), reduce the risk of heart disease, decrease the risk of osteoporosis, and on and on.

Okay, so what’s going on here?

The first thing you should know is that where a vitamin comes from is very important.  In the beta-carotene study the researchers were shocked to discover that supplemental beta-carotene was associated with higher death rates.  They were studying it because they knew that smokers who consumed high levels of beta-carotene in their diets were much, much less likely to die.  So what gives?  Well, the supplement they manufactured for the study was synthetic.  It is simply not processed in the body the same way as natural beta carotene.

The second thing you should know is that many molecules have chirality, or “handedness”.  Technically your left hand is identical to your right hand – but they aren’t, right?  One is a mirror image of the other.  In nature most molecules are “left” handed.  But when molecules are made in a laboratory it is difficult to sort out the left from right handed molecules.  Both end up in the supplement, and where one may prevent a disease, the other may cause it!

You should also be aware that there are many different forms of vitamins and minerals.  Some are better absorbed, some are better utilized and some are the equivalent of flushing the vitamin straight into the toilet.  Vitamin B-12, for example, can come in cyanocobalamin or methylcobalamin.  Methylcobalamin is much better utilized by the body, but most multivitamins only contain the cyano type.  Folic acid can also come in a 5-methyltetrahydrofolate form (say that 3 times fast), which is absolutely essential for the ~20% of the population with an MTHFR gene defect (come see me if you want to get tested).  Iron in the form of ferrous sulfate is fine for “normal” people, but people with gut dysbiosis tend to get dramatically worse on it.  Instead I advise using iron picolinate which greatly increases absorption.

Finally, there are the fillers.  Titanium dioxide, polyethylene glycol, modified food starch, hydrogenated palm oil, modified corn starch (GMO), Red No 40 Lake, Blue No 2 Aluminum Lake, Yellow No. 6 Aluminum Lake are all found in the most popular brand of vitamin.  Many food dyes are carcinogenic, and for the majority of my sensitive patients they aggravate the nervous system (causing ADHD, migraines and other symptoms). Other fillers are cheap additives to fill space and hold the tablet together.

So skip the multivitamins that contain these types of fillers or synthetic versions of the vitamins.  See a nutritionist or naturopathic physician to get a personalized recommendation for a multivitamin as each person can benefit from a slightly different formula.

Here are some of Dr. Erika’s favorites.  They all contain the correct “handedness,” and are forms that are absorbable and useable by the body. Remember though, that each person may need something slightly different, you should always check with your doctor first.

Babies/toddlers: VitaSpectrum by Klaire labs or Pediatri Vite by Genestra/Seroyal.  (Note: I do not believe that most breastfed babies need a multivitamin).  These do not contain iron – have your child’s iron levels checked before adding a liquid iron, or food-based iron (no need to supplement iron if they have good iron levels).

Kids: Pure Pals or Pure Pals with Iron by PURE encapsulations.  Kids this age usually do need iron, though you may want to consider the iron-free formula for kids who have digestive complaints or are on the autistic spectrum.

Women of childbearing age: Thorne Basic Prenatal multivitamin, or New Chapter Organics Perfect Prenatal Multi.

Postmenopausal women: Vitanica’s Senior Symmetry (even though you’re not a senior yet, it has the best formula!), or Meta-Fem by Thorne.

Men under 40: Clinical nutrients for Men by Integrative Therapeutics.

Men over 40: Al’s Formula by Thorne, or Clinical Nutrients 50+ by Integrative Therapeutics.

Athletes, or anyone undergoing intensive detoxification: Nutrient 950 by Pure Encapsulations, or another personalized multivitamin (depending on their specific biochemical needs).  This has very high levels of active nutrients, which are needed for anyone under oxidative stress.  Anyone who has been exposed to heavy metals, pesticides or is doing a detoxification program should be on a similar high-level multivitamin.

These companies literally test every single batch that comes off the assembly line for purity and potency, and that is why Dr. Erika trusts them.  Yes, these are physician-grade products, so that means they are not available over the counter.  Lots of naturopathic physicians, chiropractors and nutritionists sell these in their office (you can call them).  I highly recommend NOT buying from Amazon or another online retailer that you do not know – there are a lot of fake versions of these products floating around.

So seriously, skip the Centrum!

Related posts:

You can follow any responses to this entry through the RSS 2.0 You can leave a response, or trackback.

47 Responses

  • Amanda says:

    Hi Dr. Erika. Can you share if/why you believe titanium dioxide should be avoided? (internally and/or on skin)
    Thanks!

    • Hi Amanda (hope you are well!),
      Titanium dioxide is supposed to be “inert.” Vitamin manufacturers add it as a coating to their pills to protect against oxidation that may damage the vitamins. I heard one person say that all the titanium dioxide in multivitamins ends up straight in the toilet (that’s good).

      In my practice, though, I’ve seen several people who are very sensitive to titanium dioxide – they usually notice this on their skin when they use sunscreen containing it. It makes me nervous about putting it in a multi because it can be hard to tell if a person is sensitive to the titanium dioxide or another ingredient in the multi.

      As a naturopathic physician I generally see people who are more sensitive than the rest of the population, so this is why I use caution.

  • Carmella Mckinzey says:

    ß-Carotene is a strongly-colored red-orange pigment abundant in plants and fruits. It is an organic compound and chemically is classified as a hydrocarbon and specifically as a terpenoid (isoprenoid), reflecting its derivation from isoprene units. ß-Carotene is biosynthesized from geranylgeranyl pyrophosphate..^^,

    Our new web portal
    <http://healthwellnesslab.com/

  • Nat says:

    Dr. Erika,
    Thank you for the helpful post. I’ve been going crazy trying to find the best prenatal vitamins to take. I keep finding issues with all of them (too much lead, silica, potentially harmful folic acid instead of folate, etc.). I see that one of the prenatals that you recommend is New Chapter Organics Perfect Prenatal Multi. What are your thoughts on the high Vitamin A content of this prenatal? I keep reading that Vitamin A should be avoided during pregnancy and this multivitamin seems to be one of the worst offenders as far as its Vitamin A dosage goes.

    I would appreciate your input.
    Thanks!

    • You’re welcome!

      To be honest, I think the vitamin A hype is a little overblown. My prediction: vitamin A deficiency will be the new vitamin D deficiency and in a few years we will realize how important vitamin A really is.

      But that said, we know that vitamin A causes fetal malformations in pregnancy. It is usually in a dosage of greater than 25,000 IU per day. Most prenatals have less than 10,000 (as does New Chapter Organics). New Chapter’s multi also has it in 100% beta-carotene form which is virtually impossible to cause vitamin A toxicity with (though, some people are poor converters of beta carotene to vitamin A, so this may not be best for them)

      Hope this helps!

  • Lauren says:

    Dear Dr. Krumbeck,

    I too am on the hunt for a safe and beneficial pre-natal vitamin. I really appreciate your post, and I respect your work here because you are drawing attention to some of the significant issues with many commercially available vitamins and supplements (methylcobalamin > cyanocobalamin, etc). I was excited to see you recommend Thorne’s prenatal, as I hadn’t come across it before and I hoped that perhaps it would be the one. But I just have a quick question about it: half of its Folate comes as Calcium Folinate. From information from the NHS here in the UK, and a few other sites around (WebMD, etc), I was under the impression that Calcium Folinate was very *bad* for pregnant women to be taking. But my research into the various B9-related vitamins and supplements (folic acid, folate, folinate, folenic acid, L-5-methyl-tetrahydrofolate, calcium folinate…) has me a bit confused to begin with…I have a grip on the difference between folic acid and folate, but where does calcium folinate fall within the spectrum, and why is it controversial for pregnant women?

    Second question (which may be falling into the paranoid?): I thought I had struck gold when I found New Chapter’s Perfect Prenatals a while back, but then I read that New Chapter was sold to Proctor & Gamble (infamous megachain with a bad reputation for using cheap and toxic ingredients without changing labels, the whole Monsanto debacle of “Food, Inc” lore, etc) in 2012. I’m just concerned that New Chapter will lose what is so great about it: quality ingredients. What kind of risk do you think there is that they will just keep the packaging the same since the Perfect Prenatals are so well-regarded and have such a large following, but secretly alter what’s inside? Should I even be worried about that?

    Right now, the highest-scoring prenatal on my spreadsheet is Pure Encapsulations Prenatal Nutrients. But I believe they use Folic Acid. I know we should be trying to get lots of natural Folate from foods, but when it comes to a prenatal, what is your take on Folic Acid vs. Folate?

    Thanks so much for your help!

    – Lauren

    • Good questions Lauren.

      I hadn’t heard about New Chapter being sold to Proctor & Gamble – thanks for letting me know. I have no idea about the quality now… Sigh.

      Actually a 50/50 of 5-MTHF and folinic acid (calcium folinate) is what Dr. Ben Lynch of MTHFR.net recommends for a folic acid supplement. I’m not sure why some sites are saying Folinate is a bad thing…

      I definitely rate Thorne’s product higher than Pure Encaps prenatal – honestly I love Pure Encaps, and they have switched most of their folic acid to 5-MTHF, so I’m not sure why they haven’t yet for their Prenatal.

      I think the truth about this whole thing is that we still don’t know what is “good” and what is “bad” (and what is good and bad for some people and not others.) The best thing to do is to eat copious amount of fresh leafy vegetables to ensure you are getting appropriate amounts of folate.

      I’m not sure this truly helps, but I hope so!

      -Dr. Erika

      • Lauren says:

        Thanks so much for your quick reply. I’ve done a bit more poking around and would be very grateful if you might share your thoughts on a couple more questions…

        1. In the debate about folinate or folate supplements as opposed to folic acid supplements, what is the general consensus now about folic acid? Is it that folate–being more like the natural folate we would get from foods–is more absorbable by more people and therefore likely to bring more benefits, or is there something actually wrong with folic acid that would make it harmful/not beneficial? If I were to try to cover my bases and divide up my recommended prenatal B9 into 3: taking a half dose of the Thorne and so getting 250mg from L5, 250mg from Calcium folinate, and a separate supplement to get 400 from traditional folic acid, and then aim for lots of leafies…is there anything theoretically inadvisable about this plan (I know you can’t officially advise)? Is there anything in the literature to suggest that folic acid might *counteract* or cancel out the folate/folinate?

        2. Switching gears to my husband’s multi. Good heavens is it difficult to find a mens multi (read: no iron) that contains the right forms. The Clinical Nutrients multi you recommended seemed ok but it has its B12 as cyanocobalamin. The best I can find seem to be either Thorne Basic Nutrients or Pure Encapsulations Nutrient 950 Without Iron. I’m really impressed by these (in either case I think he should halve the dose), but the only thing that seemed strange was just how high the Vitamin E content was…even halving or thirding the dose it’s still over 100iu. I can’t seem to find any support for that high of Vitamin E–especially not for men! Am I missing something??

        Thank you so much for your help!
        Lauren

      • Hi Dr. Erika,

        I stumbled upon your website via a blog post by Wellness Mama. I was excited to see that you’re in Montana! I live in Livingston, but am so grateful to have your website as a resource. I’ve had Pure Encapsulations pre-natal vitamin bookmarked for a while and noticed they recently changed their formula to include 1 mg of folate from folic acid and Metafolin® L-5-methyltetrahydrofolate (L-5-MTHF) instead of Folic Acid. What are your thoughts on this specific kind of folate? So many brands offer different types of folate in their formulas and I just don’t know how to differentiate them.

        Thank you!

  • Erin says:

    Hi Dr. Erika,
    Do you have recommendations as to good brands of probiotics for toddlers?
    Erin

  • Mandy says:

    There is also a Canadian brand called Trophic that has some multis containing the non-synthetic folic acid and methyl cobalamin. They are available locally and I am very happy with them.

    For now, I’ll finish the prenatal I bought recently before reading about all this (it’s another Canadian brand, Sisu, better than most, though) and try to get Thorne Basic Prenatal.

    For hubby, he’s on Jamieson 50+ now, but it’s almost gone… just ordered three months’ supply of Fertilaid for Men & Count Boost (all vitamins). They contain folic acid and probably cyano b12, but I have heard many good things, and it’s only temporary, once we have a baby that sticks around longer than 12 weeks, I’m thinking of Thorne Al’s or Trophic One per Day for him.

  • Thanks for sharing such a nice information. If anyone looking for best multivitamin products then he or she can get idea from Sutherland & Yale.

  • Dany says:

    Hi! I love ur article on multivitamins! I’been looking for a good multivitamin for my dad who is 63, workaholic and and has been feeling very fatigued lately. Have you heard about Integrative Therapeutics? I’ve read wonderful reviews and theres a multi for men 50+. I will truly appreciate ur opinion 🙂 thankyou

    • Hi Dany,

      I’m not sure how this comment ended up in the Spam filter! Sorry for the late reply!

      Yes, Integrative Therapeutics is a great company. Some of their tablets are coated with titanium dioxide, though, which I’m not a huge fan of (they may have changed that recently, I would have to check). I would still recommend Nutrient 950 for fatigued men, but get the kind without iron. Thorne also has “Al’s formula” for older men, which is excellent. Of course, check with a doctor first, because not all vitamins are good for men – particularly iron, and in some cases copper and iodine.

  • Suzanne says:

    I read on one of your blog posts that you recommend turmeric so I’d like to take a supplement. Do you have any brands that you recommend? I’m breastfeeding so I have to make sure it’s safe for the baby. Thanks! Love your website!

  • Kevin says:

    Oh dear i just bought a Centrum adult(365 TABLETS!). Because I’m looking for a cheap multivitamin I don’t know what to do after reading your blog doc? Is Centrum really that bad?

  • vincent says:

    hi doc im a 33yo male smoker. i dont consume any sorts of
    vegetables in my diet, be it leafy, carrots or tomatoes etc. is
    it safe for me to consume centrum silver multivitamin as i been
    told that smokers are not suitable to consume multivitamins
    with beta-carotene?

  • Suzy says:

    Is it a good idea to bring up a baby as a vegan and use Centrum as a vitamin supplement?

  • Suzanne says:

    Hi. My three year old refuses to take any chewable kids vitamins but loves the gummy type. Do you have any recommendations for this type of children’s vitamins? Thanks!

  • Andreas says:

    Hi and thanks for this very intreresting article. I do wonder as you recommend the Pure Pals, the one I found has the folic acid. Is this not the synthetic one?

    Also wonder why you should choose a multi without Iron for children with autism spectrum?

    Thanks.

    • I know, I only use Pure Pals for kids not on the spectrum and without MTHFR. Mostly, though, I don’t have kids on a multivitamin unless they are poor eaters. I would rather they get their vitamins from food. I wish Pure Pals had Folic Acid, but I believe it does not store well.

      Iron typically feeds dysbiosis which can be a big problem for kids on the spectrum.

  • kerry says:

    Hello,

    Can you recommend an online website that does Vitamin D testing and the Mthfr gene defect? It is so costly to get it done through a regular doctor’s office and insurance seems to not cover this.

    Thank you,

    Kerry

  • Rebecca says:

    Hi,

    Am TTC and found a Prenatal from Garden of Life brand that is new to their brand I believe. It’s called “Kind Organics Prenatal Multi.” Here is a link to it, wondered if you would look at it and tell me how it compares to your Thorne and New Chapter recommendations?

    http://www.vitaminshoppe.com/p/garden-of-life-kind-organics-prenatal-multi-90-tablets/gu-1204#.VQNLEJUg_IU

    Thanks!

  • Jennifer says:

    Hi Dr. Erika! Ive been taking Centrum Women for a while now (im 33yo). Ive been wanting to find a new good brand of multivitamin. Do you have recommendations ? ive heard a lot of bad things about centrum. I take a separate vitamin D though from a better brand that just has olive oil as the main ingredient. Thanks!

  • Ravi says:

    Hi

    I can’t take tablets so I would like to know what you think of Centrum Fruity Chewables Tablets. I don’t think they look that bad?

    http://www.amazon.co.uk/Centrum-Fruity-Chewables-Tablets-Pack/dp/B0081T4YYK/ref=sr_1_1?ie=UTF8&qid=1426943654&sr=8-1&keywords=chewable+vitamins

    I would love to hear from you.

    Thank you

  • Caroline says:

    So I have a question. I am a 19 year old female and I have the MTHFR gene and typically have pretty bad panic attacks around the time in my cycle when estrogen is highest. My periods are so irregular however, that it is really hard to tell if the panic cycle is from the estrogen level or something else. Last week I started taking centrum chewables because my doctor told me I should be taking a multivitamin but all of them are so hard to swallow (I have difficulty swallowing pills so I usually crush them up). I was wondering if you think that me starting to take the vitamins has caused this cycle of panic attacks this week. I started taking them about 10 days ago and the panic cycle set in about 5/6 days ago. Thanks!

  • cmw says:

    I’m a 37 year old male that has smoked on and off for 20 years . About 5 foot 10 inches and weigh about 170 pounds. Was wondering what is a good vitamin or multi vitamin to take.

  • Yemi says:

    Hello Dr. Erika,

    I found your website by happenstance and was intrigued by how strongly you supported the Clinical Nutrients multivitamin for men under 40. I’m going through diet changes, eating vegetables, salads, meat, and green juices and think I probably need a multivitamin somewhere in there. I’m just unsure of which one to buy, and where to buy it, thanks to your warning about buying online.

    What is your take on Thorne Research’s Basic Nutrients V Multivitamin? I also have had before, and still take Amazing Grass Green Superfood, what about that instead of a multivitamin?

    Thank you.

    • Hi Yemi,

      In general the Thorne products are excellent. I would still consult a naturopathic physician or nutritionist first – but generally the Basic Nutrients are excellent. So is Al’s Formula which is for Men (though this is intended for men over 40).

      In general – if you are healthy and eating vegetables and drinking green juices – you probably don’t need a multivitamin!! I always recommend patients to get their nutrients from food first.

  • Roxane says:

    Hi,

    Why do you specifically recommend “prenatal” multivitamins for women of child-bearing age? If I don’t intend to have children in the next years, can’t I use any other multivitamins?

  • Lisa says:

    Hi Dr. Erika, while I was doing some research about the good quality supplements for myself and family, I am glad I found you. I am a 55 years old woman with : Multinodular Goiter with thyroid function tests normal , A suggestion of possible mitral valve prolapse on the resting echo images and arthritis all body joint aches. I don’t take any medication at all , even doctors are not suggesting me to take any . I just drink organic herbals tea, no junk/fast food and drink a lot of water. ( Some of the multivitamins/minerals has Iron , Iodine , Chromium , Cooper and Calcium . Do you think should I take one or not of these supplements that are included on the multivitamins bottle ? )
    ( Should I take extra separated Magnesium supplement like magnesium glycinate or taurate ) ? If is said on the bottle take 3-6 daily should I take 4 ( two in the morning two in the evening) ?
    Could you please help to decide which one of these supplements of Multivitamins and Turmeric supplements it good, healthy and safe to take ?
    Could you please recommend to me best brand of multi ( for men too ), turmeric or MSM supplements you know ?

    I’m sorry to write so long. Thank you so much for your consideration time.
    1. THORNE RESEARCH – Basic Nutrients V (w/ Copper, w/o Iron & Iodine) – 180 caps ( How about other ingredients ) ???
    2.NutriGold Whole-Food Women’s Multi Gold – 90 Veggie Capsules – Organic WholeFood Multivitamin Supplements with Minerals (With Iron For Women)
    3. Nordicks Natyrals Pro Omega Lemon 1000 mg.
    4.Turmeric Curcumin Supplement with BioPerine Black Pepper Extract – 500mg Capsules – 95%… from Healthzone Naturals
    5. Bio Thrive Labs Turmeric Curcumin – Powerful Pure Natural Antioxidant, Anti-Aging and Anti-inflammatory,… from Bio Thrive Labs 6. Turmeric Curcumin Capsules -with BioPerine Black Pepper Extract, Aids… Purely Holistic 7. Nutrigold Turmeric Curcumin Gold (Features C3 Complex w/ BioPerine), 500 mg,   ( How about the rice floour, or rice concntrate of other ingredients in these turmeric supplements ) ?

  • Pingback: Multivitamin Guide [Tentative] : The Hearty Soul

  • Lauri Gador says:

    I read your article about vitamins, I take Metafem by Thorne, and I do purchase it from amazon. It’s the same exact bottle I can purchase from my bio-identical hormone pharmacists office, but at a better price. You just have to be careful and read labels

    • Hi Lauri,

      Yes, but Thorne makes us providers sign an agreement that we will NOT sell Thorne products on Amazon, so those are being sold illegally. Or, perhaps, they are “knock-off” Thorne products. I have had a colleague whose patient broke out in hives after using a Thorne product sold on Amazon, so there are knockoffs present. They are in identical bottles, unfortunately.

      I always tell my patients that they don’t have to buy from me – they can use our local pharmacy or another ND’s office, but I do want them to buy locally (or directly from Thorne, as they offer a program for that too). I am very concerned with this illegal sale.

  • Paloma says:

    Hi! I know this is an older post but I need to ask if Thorne prenatals are synthetic prenatals?

  • d paul says:

    i see you all talking about synthetic supplements and why to choose this brand over that brand and yet everyone of the suggestions here are synthetic. pure synthetic. lab made. none are made from whole food without yeast fermentation. how is “high grade pharmacy isolated vitamin” any better than centrum? It’s still isolated vitamin not found in that form in nature.



Leave a Reply

Your email address will not be published. Required fields are marked *