With a balanced diet, vitamins aren’t usually needed

If people eat a balanced diet, they don’t need to take vitamins, health professionals said.

Medical Center Hospital Clinical Nutrition Manager Mia Gibson said taking too many vitamins isn’t a good thing.

Many times people think that if taking some vitamins is good, taking a whole bunch is better.

“It is possible to take too much,” Gibson said. “Some of our B vitamins, if we take too much, it will just be eliminated in the urine. Some of these fat soluble vitamins and minerals can build up in our body and have toxic effects,” Gibson said.

Taking too much of a fat soluble vitamin, like A, D, E and K can cause harmful effects like liver damage, or bleeding in some cases, Medical Center Ambulatory Care Pharmacist Rachel Weiland said.

She added that there are drug interactions to be aware of such as Vitamin K and Warfarin, which is a vitamin K antagonist. Warfarin is a blood thinner.

For calcium, there are different types available over the counter. If someone is taking a drug like Prilosec, Nexium or Zantac that curbs acid, some types of calcium are not going to be absorbed well because the calcium needs the acid.

“If you have calcium carbonate, which is the cheaper version, then your stomach needs to have acid so you need to be eating with it. You also need to not be on one of those drugs, so if you are on one of those drugs then you should switch to calcium citrate, which is a little more expensive but it doesn’t rely on acid for absorption,” Weiland said.

There are special circumstances when vitamin deficiencies are seen with a doctor’s diagnosis or lab tests, Gibson and Weiland said.

Weiland said vitamin deficiencies can be detected from lab work, so people shouldn’t guess.

Gibson said doctors should ask their patients what vitamins they are taking in addition to the medications.

Gibson noted that the U.S. Food and Drug Administration regulates medications. Supplements fall under the Dietary Supplement Health and Education Act.

“If you’ll notice on every vitamin, there’s going to be a little disclaimer. ‘These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.’ Every vitamin says that. They’re not regulated. A lot of times, it’s up to the companies to make sure of the purity and the regulations,” Gibson said.

The USP, or U.S. Pharmacopeial Convention, seal tells you the manufacturer has gone above and beyond, Gibson said.

But Weiland notes that there are few brands that have the USP designation. Examples are Nature Made, Kirkland, which is the Costco brand, and TruNature.

“At the end of the day, the most effective vitamin is the one that you will actually take. For example, if you can’t swallow pills, then you shouldn’t choose a tablet or capsule form of a vitamin,” Weiland said in an email.

“With that being said, there are pros and cons to every type of vitamin. Gummy vitamins of course taste great, but they have extra sugar, I’ve seen gummy multivitamins with as much as 8 grams of sugar per serving. You may absorb more from a liquid vitamin than a capsule vitamin, but liquid vitamins are usually less stable, meaning they break down faster within the bottle. Many liquid vitamins need to be shaken before use to make sure the ingredients are distributed evenly, and have sugar added for taste. They are also usually more expensive than their capsule counterparts. Weigh the pros and cons of different supplement types before choosing what’s best for you,” Weiland added.

Gibson advises people to talk to their doctor if they are going to take a vitamin, choose one that has undergone more testing and look for 100 percent because people don’t need more than that.

“Just take one multivitamin,” she said.

The only times Gibson said she has taken vitamins is when she was pregnant or considering becoming pregnant.

“What I do to try and eat nutritionally is I try to include a fruit and vegetable — at least one of those if not more — at every meal. You can have vegetables for breakfast. They are high in fiber and that’s where a lot of vitamins come from,” Gibson said.

More Information
  • People can put fish oil in the freezer to prevent fishy burps, Medical Center Hospital Ambulatory Care Pharmacist Rachel Weiland said.
  • Look at the EPA and DHA content because those have cardiovascular benefits.
  • For general heart health, you want one gram of that combination, Weiland said.
  • If you want to lower triglycerides, you need 2 to 4 grams, usually closer to 4.
  • If you look at a supplement and it says 1,000 or 1,200 that’s not all EPA and DHA. Consumers should look at how much is EPA and DHA.
  • “Usually it’s like a third of that,” Weiland said.
  • One gram is the equivalent 2.5 to 3 ounces of salmon.
  • With canned tuna, 4 ounces of the regular type, or 12 ounces of light tuna are good. A lot of the fish oil is taken out of the light tuna, so more tuna is needed.
  • Theoretically, Weiland said, krill oil should be good for cholesterol because it has astaxanthin in it. “It’s good in really high amounts,” Weiland said.
  • However, the amount you need for cardiovascular benefit would be unrealistic and very expensive, Weiland said.