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Do you take a multivitamin or other supplement? Do you know what’s in it? How much of it is absorbed and what is a complete waste? Are you getting your money’s worth? And do you even need a multivitamin?
More Americans than ever before are using supplements, and more than half of us include a multivitamin in our daily regimen (1). But an alarming 70% of supplement companies violate Good Manufacturing Practices set by the FDA to keep supplements safe (2, 3)! And many use cheap ingredients that aren’t very effective or even harmful.
The FDA, which regulates supplements, isn’t concerned much with whether a supplement is effective, only if they are safe. Even then, most ingredients are assumed safe until proven guilty, and then the FDA will investigate.
So how in the world can you know if you are getting a good vitamin and mineral supplement?
All multivitamins are not created equal. Neither are the companies that make them. Unfortunately, most of the brands you’ll find at your local store use low quality ingredients and poorly absorbable forms of micronutrients, not to mention fillers, dyes, and other ingredients that aren’t very good for you. Many contain corn, soy, wheat and other ingredients that trigger allergy or sensitivity reactions for many with autoimmune or other chronic conditions.
“Unlike traditional foods, when it’s rotten, the consumer will often know by taste or smell, [but] with supplements we’re swallowing them based on blind faith in the manufacturer…. [W]hen we take a look behind closed doors, less than a third of companies are doing everything they can to ensure top-notch products,” notes Dr. Pieter Cohen in a Natural Product Insider article (2).
Let’s take a look at how to know if you actually NEED a multivitamin, and tips to choose a high quality multi at a price in your budget.
How to Know if You Need a Multivitamin?
Basically, the Academy of Nutrition and Dietetics recommends you might need a multivitamin or other supplements if your diet falls short (4).
Now, this is a doozy of a statement considering the typical American diet. We’ll explore that more in a minute.
Below are some factors that put your diet at risk of “falling short.”
You are higher risk for not eating enough nutrients when you have increased needs due to things like (4):
- Growth (think babies, children and adolescents)
- Chronic disease (60% of Americans fall in this category) (5)
- Medications (55% of Americans regularly take prescription meds) (6)
- Malabsorption (60 to 70 million Americans suffer from digestive diseases) (7)
- Pregnancy and lactation
Americans fall woefully short on intakes of nutrient-rich fruits, vegetables, dairy, beans, legumes and grains according to the Dietary Guidelines.
We fail to eat enough of every subgroup of vegetables including dark, leafy greens and red/orange varieties, which are especially dense in essential micronutrients (DGA). These tables from the 2015-2020 dietary guidelines can help you visualize just how crippled our diets really are.
We don’t eat enough of many nutrients, including fiber, potassium, folate, vitamin K, zinc and vitamin D (8).
Merely 10% of adults eat the recommended amount of fruits and vegetables, our best source of fiber, vitamins, minerals and antioxidants that help our bodies function at their best (9).
So basically, if you are American, you are pretty high risk that your diet falls short.
Less Nutrient Dense Food Supply
Even when we do eat our fruits and vegetables and whole grains, current farming practices result in less nutrient dense food (8, 10, 11, 12, 13, 14).
- Soil tends to be less rich in nutrients.
- Farmers grow varieties of produce that make them uniform, pretty, and keep well on grocery store shelves, but may have lower nutrient densities and higher sugar content.
- Produce often must be picked before peak ripeness so it doesn’t spoil over the course of days and even weeks of shipping, unpacking, and display on grocery store shelves, transport home, and then sitting for days in our own shelves and fridges before they are consumed.
- Organic produce is more nutrient dense than produce that has been sprayed with pesticides and herbicides because it’s forced to develop more antioxidants to help fight off disease.
Shortcomings of Recommendations
We now understand that the nutrient recommendations we’ve relied on for years, like Dietary Reference Intakes (DRI), fall short in several ways:
- DRIs are based on an outdated “one deficiency, one disease” model. For example, vitamin K recommendations are based on normal blood clotting times only, but vitamin K is important in bone health, heart health, cancer, and more (15).
- DRIs are sufficient to prevent severe disease deficiencies, but maybe not chronic diseases. A good example of this is vitamin D. If you consume the recommended amounts of vitamin D, you won’t get a disease of weakened bones called rickets, but you may still be at higher risk for cancer and autoimmune diseases like Type 1 Diabetes, Multiple Sclerosis, Hashimotos or Grave’s Disease (15).
- Recommendations are based on levels in apparently “healthy” people without overt disease, but because these people undereat many nutrients, even their levels might not be optimal (16).
- Our bodies may mask nutrient deficiency problems for a long time through Nutrient Triage, so even so-called healthy people could have early dysfunctions from suboptimal levels (16).
Most of us are already falling short of the recommended intakes of many nutrients, but optimal intakes may be even higher than the current recommendations! Basically, we need to up our nutrient game America (by a lot)!
Which Nutrients Do You Need More Of?
The first step is to find out which nutrients you probably need more of.
Step 1: Track your diet
I recommended recording everything you eat for 3-10 days in an app called Cronometer. Cronometer is my favorite because it doesn’t just focus on how many calories and grams of fat you’re eating, but ALL your vitamins, minerals, essential fatty acids, etc. (I despise how most apps flash calories and carb counts as if that determines how healthy your diet is).
Nobody eats enough of EVERY nutrient EVERY day, so you need to track how you eat for several days. At least a week would be best, but 3 days will do.
Do not try to change how you eat at all during this time or you won’t get an accurate picture.
Next, look at your report. You can choose to view your average intakes over several days. Which vitamins, minerals, amino acids, and fatty acids are you consistently undereating? These are more likely the nutrients you are deficient in.
Step 2: Determine medication-induced deficiencies
If you take any medications, you’ll also want to check out this resource by Spectracell Labs. Many medications will cause micronutrient deficiencies that put you at risk for further health problems. Be sure that the supplements you choose include these nutrients (if it’s safe for you- check with your health provider).
Step 3: Order a micronutrient test
This step is optional, but if you want to cut to the chase, I recommend ordering a full micronutrient panel through either Vibrant America or Spectracell Labs. This can help you know which nutrients are deficient for you.
I like these labs because they test a ton of nutrients, and they are looking at whether nutrients are actually being absorbed and used by your cells, rather than just blood serum levels.
Now that you’ve got a good idea of which nutrients your body is lacking, I’ll share a word of warning:
If you try to fix your health through supplements alone, it probably won’t work. Supplements can be really important to erase existing deficiencies or boost intake where it’s hard to get enough through food, but there are so many benefits to eating real, wholesome, unprocessed food that we can never replicate in a supplement.
You can’t ignore correcting the dietary habits that got you here in the first place.
I KNOW changing the way you eat can feel overwhelming. Popping a few pills to fix everything seems appealing. If you can relate, I highly recommend a free resource I created called “Heal with Food Fast”, which includes 5 super duper simple steps to improve your diet and start feeling better right away. This is a great place to begin.
Tips for Choosing a Quality Multivitamin
Even as you improve your diet, you may still opt for a multivitamin to boost your nutrient intake. But all supplements are NOT created equal:
- One study found that more than half of supplements tested contained ingredients not even listed on the label! And nearly a third contained NONE of the ingredients listed. Not a single one! (17)
- After an outbreak of selenium poisoning, one supplement was discovered to contain twice as much selenium as was listed on the label (18).
- Many supplements imported from other countries contain toxic heavy metals like lead, mercury, and arsenic (19).
- Ingredients banned by the FDA can still be found in multiple supplements on the market, especially those for weight loss, muscle building, and sexual enhancement (20).
How in the world can you ensure you are getting a safe, high-quality, effective supplement? I’ve got several expert tips to help ensure you get a good one!
Tip #1- High Quality Forms
Many supplement companies cut corners by using the cheapest forms of each vitamin or mineral. These forms are often poorly absorbed or used by your body, and can even pose health risks for some people.
Scan the label for these “nutrient clues” that you’re getting a higher-quality supplement (3, 21, 22):
|Nutrient||Poor Forms||Better Forms|
|Vitamin D||D2||D3 (often from fish, but vegetarians can find lichen or mushroom sources)|
|Vitamin B3 (niacin)||Nicotinic acid (can cause uncomfortable flushing reaction in some even at doses as low as 50mg)||Niacinamideinositol hexanicotinamide(no flushing)|
|Vitamin E||dl-alpha tocopherol (synthetic form)||d-alpha tocopherols (natural form)mixed tocopherols|
|Folate (B9)||Folic acid (synthetic form; not well used by some; increased cancer risk for some)||Folate 5-methyl-THFL-methylfolate(natural forms)|
|Minerals(calcium, magnesium etc)||Avoid those ending in:-oxide-sulfate-carbonate-ascorbate||Look for those ending in:-glycinate-citrate-malate-picolinate|
Tip #2- Short Excipients Lists
Excipients are all those “extra” things added to your multi to give it taste, color, hold it together, suspend ingredients, and even lubricate them so they don’t stick to factory equipment. You’ll find this stuff below the Supplement Facts chart listed under “Other Ingredients” or “Contains Less Than 2%”
A simple rule of thumb here is to look for a short ingredients list.
Many excipients are not that great for you, or contain common allergens. If you are curious whether those “other ingredients” are harmful or not you can look them up on the Chemical Cuisine Glossary by CSPI.
Tip #3- Complete
Make sure your multivitamin has robust levels of a large variety of nutrients, but especially be sure it includes the nutrients you find you lack in your diet assessment or micronutrient test, as well as those likely to be depleted by any medications.
If you know you are deficient in certain nutrients, you may not find a multivitamin with high enough levels. You can always add a separate supplement to your regimen, or order a custom multivitamin through Vitamin Lab.
*Remember to check with your doctor to be sure supplements are safe with your medications, conditions, or upcoming procedures.
Tip #4- Exceptional Company
There are a handful of companies that go above and beyond in terms of creating not only SAFE supplements, but effective supplements. These are the places you want to buy from.
I’ll provide a list of high-quality supplement companies in a moment, but in doing your own research, look for companies that:
Are well-established VS obscure online
Studies have found even popular supplement brands sold by Walmart and Amazon don’t always contain what they say they do. So don’t assume because a popular store like Walmart, CVS Pharmacy or GNC is selling it, that it’s a good supplement (17, 23).
That said, larger, established manufacturers are more likely to have the equipment and resources to meet Good Manufacturing Practices (GMPs), and to test all their ingredients for purity.
It can be tempting to do an internet search for a cheaper version of the supplement you want from an obscure online company, but it’s a gamble whether you are getting what you pay for.
Bottom line: go with an established company that also meets the following criteria:
Test every batch VS skip-batch testing
Some supplement companies cut corners by only testing random samples of their products for purity and safety, called skip-batch testing. A premature baby died a few years ago from a probiotic contaminated with mold from a company that employed skip-batch testing.
Only use supplements from companies that test every batch they produce.
Use doctor- or scientist-designed formulas
This is pretty self-explanatory, but altering the complex interactions of nutrients and herbals within the body should be left to thoroughly-trained professionals, not others, no matter how well-intentioned they may be.
Use 3rd party certification
Check the label to see if they are certified by one of these third parties:
- Natural Products Association
- Consumer Lab
- USP Dietary Supplement Verification Program
- National Safety Foundation
Have no recalls or warnings
Check the Office of Dietary Supplements (ODS) website and the FDA warning letters database to make sure the company you are considering doesn’t have any recalls or warnings.
Keep in mind that the FDA can only look into a small percentage of the tens of thousands of supplements on the market today, so just because your company isn’t listed here doesn’t ensure it’s a good one.
Also remember the FDA isn’t concerned about whether a supplement is EFFECTIVE, only if it is SAFE.
High Quality Supplement Brands
To the best of my knowledge, the following companies practice high standards for quality and safety (3). But some of these companies have changed ownership recently so you may want to research if they still use high quality practices or not.
|Professional Lines (many are available through my Fullscript account at a significant discount)||Retail Lines (available at local stores or pharmacies but I can’t get you any discounts on these)|
|Biotics||Barleans (fatty acids)|
|Designs for Health||Carlson’s|
|Douglas Labs||Gaia Herbs|
|Integrative Therapeutics||Garden of Life|
|Genestra/ Pharmax||Herb Pharm|
|Pro Thera/ Klaire Labs||New Chapter|
Buyer beware: I do not recommend buying these supplements online from Amazon, Ebay, etc. There are many unscrupulous third-party sellers out there filling authentic supplement bottles with fake supplements, then selling them online for a profit.
If you see any of the “Professional” brands below being sold online, be very suspicious. Most are ONLY available through a health care provider using online dispensaries like Fullscript (what I use), Emerson Ecologics, or Natural Partners.
When I asked my Metagenics representative why I was seeing their brand on Amazon, he told me anything being sold on there is illegal. I don’t know about you, but I don’t trust anyone willing to sell me supplements illegally no matter how discounted they are.
I recommend ordering through Fullscript for a few reasons:
- You can access a huge variety of high quality brands.
- They are a verified seller of all the brands they stock. You know anything you order through them is the real deal.
- They ensure products are stored and shipped at correct temperatures so they don’t spoil.
- They allow me to pass my discount along to my clients and readers to make supplements more affordable for you.
- Free shipping on orders right to your door.
- You can choose autoship on supplements so it’s one less thing you have to remember.
*Disclosure: I am an affiliate for Fullscript and earn a small commission on anything you order through my Fullscript account. Thank you for your support.
Tip #5 | Tablet, Capsule, Chewable or Liquid Form?
Should you look for multivitamins in tablet, capsule or liquid form? Well, it depends. There are pros and cons to each, so it depends what you need.
Whichever form you choose, keep in mind a robust vitamin cannot fit all that goodness in ONE pill a day. You will most likely be taking 4-6 pills, with half in the morning, and half in the evening.
Tablets can contain more nutrients per pill, but they also contain more added ingredients to bind them together (remember all those excipients we talked about?).
Capsules may be easier for some people to swallow and digest, but they also oxidize (spoil) more easily. The capsule often contains animal products as well so if you are vegan, look for veggie caps.
What about chewables? Chewable vitamins, gummies and liquids shoulder more pressure to taste good, so they usually lack important nutrients that give undesirable flavors, and have more sweeteners and added ingredients. Basically, they are elevated candy.
Also Consumer Lab found many gummies failed a recent product test (24).
Instead of chewables, I recommend using powdered forms of supplements. If you have conditions that make swallowing pills difficult, or perhaps stomach surgery or digestive issues that makes a mass of pills not sit well, this may be a better option. Do the best you can.
If you get them from a good company, they may have some added sweeteners, but overall they tend to be more nutritious. But honestly, I’ve had a hard time finding a powdered multi that I’d recommend.
Best Multivitamin Recommendations
Below are some of my favorite supplements. You can order all of these discounted through Fullscript.com. Different multi’s include different emphases on certain vitamins and minerals, so the best multi for you may be different according to where your diet falls short.
For instance, do you get enough calcium through food? If not, it’s important to make sure your vitamin includes that.
Most multivitamins I’ve listed are robust in many nutrients, but that also makes them a bit pricier. If you find your diet is meeting most requirements, you may get away with one of the cheaper, less robust versions just fine. So long as it’s still meeting all the quality requirements we discussed above. *wink
Best Multivitamin for Men and Women
The Complete Multi by Designs for Health is what I normally use for myself and my husband.
More budget friendly: Designs for Health Twice Daily
Best Prenatal Multivitamin
Designs for Health Prenatal Pro
My absolute favorite is actually the DFH Prenatal Pro Packets, which also include supplements for bone health, and essential fatty acids. These are what I took when I was pregnant and breastfeeding, and they are pre-portioned into one daily pouch, which was super convenient.
Best Easy to Swallow Multivitamin
I cannot find a powdered multi that I like on Fullscript right now, but there is this product that features smaller, easier to swallow pills:
Ultrapreventive EZ Swallow by Douglas Labs
Best Children’s Multivitamin
This is a solid kids’ multivitamin that includes a probiotic as well. My own kids often take this one:
Vitamin Code Kid’s Multivitamin by Garden of Life
Other Supplements I Take
Probiotics: Ther-biotic Complete Probiotic
If you aren’t eating probiotic foods (yogurt, kefir, Kombucha, fermented vegetables like sauerkraut and kimchi) with most meals, or at least daily, a probiotic might be a good idea for you too.
Start with a small dose, like every other day the first week, and increase slowly. Listen to your body. If you have certain digestive problems, like SIBO (Small Intestine Bacterial Overgrowth), a probiotic might make you feel worse until you treat the overgrowth.
Fish oil: OmegaGenics® EPA-DHA 1000
If you don’t eat low-mercury seafood a few times a week, this could be good for you. Check with your doctor. Fish oil can increase bleeding risk or have other adverse effects.
Vitamin D3/K2: Vitamin D Supreme by Designs for Health
Vitamin D3 is best taken with vitamin K2. If your multivitamin doesn’t have K2, make sure your Vitamin D supplement does, like this one above.
Both my husband and I have tested low for for vitamin D levels. The further you live from the equator, or the darker your skin, the more likely you have low vitamin D. It is a very common deficiency in autoimmune and other chronic diseases, and optimizing your levels (among other healthy changes) can improve your condition.
Check for Drug-Nutrient Interactions
One last thing now that you know how to choose a quality multivitamin: always, always check with your doctor before starting a new supplement, especially if you have health conditions or take medications or other supplements, use blood thinners, or have upcoming surgery.
Just because it is “natural” doesn’t mean it’s safe.
Also do your own research. Use the free tools at WebMD and Drugs.com to double check that your prescriptions don’t interact with any supplements you are considering.
Quality Supplement Checklist
I made this handy checklist for you to use whenever you supplement shop. You can print it and take it with you to the store, or keep a copy on your phone.
More Americans than ever are taking multivitamins, but many supplement suppliers are lacking in quality and safety.
I’ve given you some tips to know if you need a multivitamin, including how to use Cronometer or Spectracell to find your deficiencies, and which of your medications can cause depletions.
The tips above help you recognize a good company, quality ingredients, the best forms for your pills, plus unhealthy additives to avoid. I’ve even included lists of quality companies and links to my favorite discounted supplements on Fullscript.
Download the free checklist to use next time you supplement shop, and get free access to professional supplement brands through my Fullscript account.
Happy supplement shopping!
How can I help you heal?
Sources Not Linked
3. Morrow, K. (2017). Dietary Supplements: Science, Art, Practice and Principles
[Webinar]. Retrieved from https://www.ifnacademy.com.
8. Bagnulo, J. (2018). Food as Medicine: Origins, Healing Foods and Dietary Therapies
[Webinar]. Retrieved from https://www.ifnacademy.com.
16. Boham, E. (2017). Conventional Labs and Functional Blood Chemistry Interpretation
[Webinar]. Retrieved from https://www.ifnacademy.com.