Why Your Multivitamin Sucks

courtesy of Detroit Sunrise
courtesy of Detroit Sunrise

Getting your daily alotted amount of vitamins and minerals is important but it’s very difficult to do with a single pill.

The last ten years of research on the long-term effect of your multivitamin paints a consistent picture: it doesn’t do much.

And it doesn’t do much for the same reason multivitamins are appealing:  you can’t put all the biologically active forms of the nutrients your body needs inside one pill, convenient as the thought may be.  Naturally occurring forms of vitamins are usually too unstable, too light, too pungent, or too expensive to get inside a One-A-Day.

Supplementation for particular nutrients is a good idea, but it’s best to itemize the things you need.  Taking a multi-vitamin for everything is like using shampoo and conditioner from the same bottle.  Convenient, but self-defeating.  To get maximum effect they have to be applied separately.

When you look on the back of a label of a vitamin you’ll typically see the list of vitamins and the specific forms used to provide them.

It’ll go something like this:

  • Vitamin A (as beta-carotene) 
  • Vitamin D (as ergocalciferol)
  • Vitamin E (as dl-alpha-tocopherol)

And so on.

The vast majority of people pay no attention to the particular forms used and only focus on the DV% provided for each.  That’s a big mistake.  The differences in these forms is subtle but vast for what goes on inside your body.  It’s the difference between chicken salad and chicken shit.  The details matter, but industry chugs along pumping out low-grade vitamin analogs that no one pays attention to.

This makes a lot of sense since getting the right form is expensive and hard.  There’s a manage-a-trois of details that have to be sorted out if you commit to using the best forms of a vitamin instead of biologically inert metallic ruffage.

No business wants to increase its cost structure if it doesn’t have to, so the ultimate solution to this issue is consumers who know what they’re doing and demand better.

Here’s a guide to what you should be looking for when you take a vitamin.

Vitamin A

What’s often used: retinol palmitate, retinol acetate, beta carotene.

What’s best: retinol palmitate.

When you consume vitamin A you can get it in two ways: the actual vitamin A that your body uses, and through beta-carotene, which is a carotenoid that your body converts to vitamin A.

For many people vitamin A through beta-carotene is sufficient, but it’s not the best.  People vary as much as six-fold in their ability to convert beta-carotene to real vitamin A.  Beta-carotene is also a water soluble compound while vitamin A has to be absorbed in fat for it to be used.  (This is also why real vitamin A can be toxic at certain levels but beta-carotene is not.  If you take too much you just piss it out).

In supplements preformed vitamin A comes as retinol palmitate and retinol acetate.  They’re very similar, but palmitate is what your body uses to carry vitamin A naturally and it’s the most stable when complexed with other vitamins.

You’ll sometimes see a vitamin A palmitate/beta-carotene blend.  These are usually okay too.

Vitamin D

What’s often used: D2 (ergocalciferol), D3 (cholecalciferol)

What’s best: sunlight (by far), D3 (cholecalciferol)

When you walk in the sun your body produces vitamin D3 sulfate underneath its skin, which plays an important role in regulating up to 3,000 different genes in your body. That’s important stuff.

When you supplement with vitamin D2 that number drops to about 3 dozen.  D2, aka ergocaliferol, is almost entirely inert and produces such a pathetic fraction of the activity of real vitamin D that it doesn’t deserve its name.

The only reason D2/ergocaliferol can freeride on the vitamin D name is because it was discovered that for people with rickets (a disease caused by vitamin D deficiency) both D2 and D3 will alleviate the condition.

So in the absolute lowest common denominator D2 gives a lil’ bit of vitamin D effect.  But once you go beyond that the cupboard is empty.

D3 is still inferior to sunlight,but is biologically active enough that people looking to improve their vitamin D levels would do well to take it as a supplement.

Just remember to take it with vitamins A, E, and K, which usually work alongside vitamin D to make your body tick.

Vitamin C

What’s often used; ascorbic acid, ascorbyl palmitate, calcium ascorbate

What’s best: they’re all about the same.

Vitamin C is the one nutrient where the vitamin-industrial complex gets a free pass.  The vitamin C in a pill is chemically identical to the vitamin C in your body and it seems to be absorbed pretty well by the body.

The only difference between these three is that ascorbyl palmitate is soluble in fat, which means it can be digested with less stomach acid and thus might be easier on the stomach for some.

Vitamin E

What’s often used: d-alpha-tocopherol, dl-alpha-tocopherol

What’s best: d-alpha-tocopherol

In organic chemistry it’s a well-accepted fact that the same molecule can have different geometries, which affects how that molecule can behave in reaction.

Vitamin E has eight different geometric shapes, but your body only uses one:  d-alpha-tocopherol.  Everything else is ruffage.  Naturally occurring vitamin E only comes in this form but synthetically derived vitamin E is a mixture of all 8, which means only 12% of this vitamin E is used by the body.

Clinical studies that’ve tested the differences in absorption of the different types of vitamin E show a pronounced effect in how your body uses each.  A clinical study done in 1988 found that naturally occurring vitamin E was absorbed twice as well by the body.

Vitamin B1 (aka Thiamin)

What’s Often Used: thiamin/thiamine mononitrate, thiamine/thiamin hydrochloride

What’s best: thiamin cocarboxylase/thiamin pyrophosphate

Almost ALL supplemented forms of vitamin B1 will be in the form of thiamin (the base of the vitamin) complexed with a nitrate or hydrochloride molecule.

Neither of these is what your body actually uses as vitamin B1.  Your body turns either of these into thiamin pyrophosphate (also known as thiamin cocarboxylase) which is the real vitamin B1.

This process is pretty efficient, but it also requires magnesium, ATP and an enzyme called pyrophosphokinase.  Lots of people are deficient in magnesium which makes their conversion of vitamin B1 less effective.

I don’t know of a single multivitamin that uses thiamin cocarboxylase in its formula.  I’m not sure if that’s because it’s not stable, too big or too expensive, but if you want the real thing you’ll need to buy it separately.  You can get some here.

Vitamin B3 (aka Niacin)

What’s often used: niacin, niacinamide

What’s best: Neither one is particularly better, but they behave differently at high doses.

Technically niacin is what’s used by your body, but niacinamide (or nicotinic acid) is what your body stashes away if it has more niacin than it needs at the moment.

Vitamin companies split 50/50 in which one they use and at normal dosages it does not make a large difference.  Some will use a combination of both which might be slightly beneficial.

At normal doses in normal conditions the two are interchangeable.  They can both be used to treat deficiency.  However at high dosages their effects begin to separate.

There are some reports that you can take vitamin B3 to improve cholesterol.  That’s only is you use niacin.  At high doses niacinamide can affect your insulin sensitivity in ways that niacin doesn’t.

Vitamin B5 (aka pantothenic acid)

What’s often used: calcium pantothenate, pantethine

What’s best: pantethine

True vitamin B5 is a compound called d-pantothenic acid.  Unfortunately you rarely get this over the counter because it’s unstable and an unsettling yellow color.

What’s usually used in its place is d-calcium-pantothenate which is more stable.

And to be fair, it’s not that bad.  Your body uses d-calcium-pantothenate about 92% as effectively as pure vitamin B5.

What’s a little better is pantethine, which is more biologically active because its sulfate group is used in a lot of enzymes that require pantothenic acid.

Vitamin B6

What’s often used:  pyridoxine hcl

What’s best: pyridoxal-5-phosphate

Like b1, your body takes pyridoxine hcl and converts it into pyridoxal-5-phosphate which is the real stuff.

And like b1, this process is usually efficient but can be slowed down if you’re deficient in other minerals and vitamins that work in conjunction with B6 to get the job done. Under typical conditions there’s not a huge difference between the two, but if you’re sick or under stress your body will have a preference for p-5-p.

Vitamin B12

What’s commonly used: cyanocobalamin, methylcobalamin

What’s best: methylcobalamin

The most popular form of vitamin B12 is cyanocobalamin which cannot be found in nature and is only made in a lab.  Methylcobalamin is the naturally occurring form.

However, given that your body requires so little B12 on a day-to-day basis (5 mcg, which is about a speck of dust) the differences between these two is not clinically significant.

Folic Acid (or Folate)

What’s often used: folic acid

What’s best: folate, or any form of folate that has the (L)- designation in front of it.

Folic acid and folate are treated as the same thing on food labels, but they’re not.

Folate is what’s used inside your body, and folic acid goes down a very different yellow brick road than folate once it enters the body, and that’s not a good thing.

You can actually get sick on folic acid, OD on it, and people who can’t stop popping folic acid pills might even give themselves cancer.

Like vitamin E, folate has to have a specific geometry in order to be used by the body, and this form is designated by the letter L.

This form can take a number of different names including:

  • L-methylfolate
  • Metafolin
  • 5-methylfolate
  • L-5-MTHF

These are all fine, but it’s best to make the L-geometry is being used.  The other geometrical form of folate is the D- form and that’s no good at all.

If your label just reads “folic acid” or doesn’t make a distinction you can usually bank on it being the lesser of the two forms.

And too much folic acid without vitamin B12 won’t do you much good.  The two are like tweedle-dee and tweedle-dum in your body and having large amounts of one and not the other is not good for your body’s balance.

Vitamin K

What’s often used: vitamin k1 (phytonadione)

What’s best: a mix of k2 (menaquinone) and k1

Vitamin K comes in two forms, appropriately titled K1 and K2.  For a long time it was believed that K1 was the “superior” form since it did all that stuff associated with blood clotting and circulation.  Your body can also convert K1 to K2 so K2 was considered the red-headed stepchild of the two and not worthy of dietician’s attention.

Turns out that K2 is so unique from K1 that it’s almost a mistake to consider them the same nutrient.  K2 protects you from prostate cancer, heart disease, and builds your teeth.  K1 doesn’t do any of this.

In your diet K2 is found in the odd bits of the animal that society has deemed to uncultured to serve for mass consumption.  The feet, organs, blood, etc.  When our ancestors scraped together whatever part of the animal they could get and put it into a hoagie they were giving themselves copious amounts of K2 that are largely missing today.   If eating animals gizzards just isn’t your thing then go with natto or fermented foods.

The minerals copper, iron, zinc, magnesium, calcium, selenium, manganese, chromium and molybdenum

What’s often used: bound to oxide, sulfate, citrate, aspartate, picolinate, gluconate, or amino acid chelate.

What’s best: bound to a salt (citrate, aspartate, picolinate), gluconate, or amino acid chelate.

These minerals differ in their charges, uses in the body, and required daily amounts you need to thrive.  But the fact that they’re metallic ions gives them common properties that can be generalized for all of them.

The key to a useful mineral supplement is that they dissolve well in water (or your GI tract) so the mineral can then travel to wherever it needs to be.  This usually requires a form of the mineral that’s much less dense than what you find in a typical multi.

Because of space constraints most vitamins use the oxide forms of these minerals which are dense and not soluble in water.  They’re not much different than metal filings.  They do nothing in your body.

Sulfates are also commonly used, but they suffer from the same problems and give some people stomach problems to boot.  Minerals bound to a salt (like chloride, citrate, aspartate, or picolinate) or gluconate are usually better bets.  They’re light, fluffy, and naturally dissociate in your body, allowing the minerals to do their work.

If you can afford it the best way to go is usually a mineral complexed with an amino acid chelate.  When minerals are doing work in your body they’re in chelated form, and a chelated mineral supplement means it’s been complexed with an amino acid to put it in chelated form, making it easier for your body to use.

Comparison Table

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9 thoughts on “Why Your Multivitamin Sucks”

    1. Viet, Ed,

      Yes I can make some recommendations. I am out of town right now and don’t have time to go into detail but I will circle back to this later.

      Jonathan

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  1. “If you can afford it the best way to go is usually a mineral complexed with an amino acid chelate.”

    So, as far as a multi-mineral supplement, do you have a recommendation?

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  2. […] Most people have vitamin deficient diets and the bulk of their vitamin intake comes from supplementation, either via fortified foods or a multi-vitamin.  However, getting vitamins this way almost guarantees you’re consuming vitamins in sub-optimal form with little regard to how your body actually uses them.  I’ve written before explaining how the very thing that makes multi-vitamins conveient is what makes them ineffective. […]

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