Vitamins & supplements are a $43.5 billion industry and nearly 50% of Americans take them. Consumers are inundated with options and many are self-prescribing their own vitamin cocktails. But it seems that almost every month a report comes out either blessing or blasting the efficacy of vitamins and the latest offerings from this unregulated industry.
And now, a new niche … Insta-Glam online vitamins are fueling our social feeds and fit the fancy of Millennials used to ordering life online – from Netflix to Uber Eats. But, can personalized subscriptions cut down the confusion in the vitamin aisle and offer individualized wellness options?
Or are they just another marketing scam with more colorful lifestyle fluff than real value? Whose job is it to prescribe supplements anyway?
We interviewed two Chicago-based MD’s who literally wrote the book on vitamins after years of puzzled patients bringing in piles of their own supplements and asking for help. The two female physicians were among the first to harness the power of online personalization and create a next-generation vitamin subscription company called Vous Vitamin.
Vous Vitamin Co-Founders Romy Block, MD — a board-certified specialist in endocrinology and metabolism and Arielle Levitan, MD Board Certified Internal Medicine Physician — answered our questions below, derived from recent studies as well as the pages of their book, The Vitamin Solution(She Writes Press 2015):
Kim Marshall: Why do critics say that vitamins are useless?
Arielle Levitan MD: The retrospective studies that are most often referred to in this argument, I think in no way confirm that vitamins are useless. The studies were poorly done looking back at large groups of people who were taking unidentified generic multivitamins and there was no follow up to determine if they continued to take the vitamins. It is likely that the amounts of nutrients in those vitamins were not adequate or useful given the generic one-size-fits-all approach. A tailored individual approach, using scientific evidence to treat or prevent certain conditions with medically sound quantities and types of vitamins is certainly beneficial. In order to properly determine exactly what and how much of each vitamin an individual should consume, their demographics, diet and lifestyle patterns must be considered first.
KM: Is there any evidence that vitamins will stave off disease?
AL:There is much evidence that treating certain vitamin deficiencies is useful in preventing or treating various conditions. For example, Vitamin D deficiency is strongly associated with osteoporosis, muscle weakness, migraine, low energy and immunodeficiencies. Treating it has been shown to reverse or prevent these conditions and help with weight loss, blood sugar control and more. In addition, vitamin B12 has a clear link to neurologic symptoms, poor memory and attention and nerve pain. Certain vitamins can also be used in a preventive manner such as iodine for thyroid support in people who may have a lack of dietary iodine.
KM: Are there any vitamins or minerals that a larger percentage of Americans are deficient in – like Magnesium?
AL:There are many common vitamin deficiencies, these include Vitamin D, magnesium, iron and B12. Some of these cannot be accurately tested for in a lab such as magnesium as serum levels often do not reflect adequate intake or body stores.
KM: Is it true that Vit B12 is nearly worthless if taken as a pill (in cyanocobalamin form) because 99% of it is destroyed by your digestive system? Is it more effective to take in methylated form as a lozenge under your tongue or as a nasal spray or best as a B12 shot?
AL:There is much speculation in certain sectors of the industry but not much objective evidence to support this argument. It is true there is a small percent of individuals who do not absorb B12 at all via the GI tract due to something called Intrinsic Factor deficiency, but this is rare in the general population. The majority of people respond well to oral B12.
KM: Are IV Infusions safe and necessary?
AL:Rarely is there a use for IV infusions of vitamins outside of the hospital setting. In the hospital they can be used for extreme conditions and situations where oral intake is not an option, but in an otherwise healthy person their role is unnecessary and not helpful as most of the vitamins infused are rapidly metabolized and do not have a lasting effect. Additionally, there is risk of infection and other traumatic effects of inserting an IV catheter that is not justified in this setting.
KM: Taking Lots of Vitamins is OK, My Body Will Just Absorb What It Needs and the Rest Will Not Be Absorbed:
Romy Block MD: Actually, certain vitamins can be harmful in high doses. Specifically fat-soluble vitamins (those that are incorporated into the fatty parts of your cells – typically the liver — and thus hang around for a long time in your system) such as Vitamins D, E, A and K can cause toxicity if you take excessive doses. Symptoms include severe headaches, bad skin, liver function abnormalities, and many others. Almost any vitamin in high enough doses can cause problems. Don’t overdo it – getting enough, but not too much, is the goal.
KM: If I Eat a Healthful Diet, I Probably Do Not Need Vitamins
RB:While it is possible to get everything you need via diet; it is not probable. For example, people who eat a lot of fruits and vegetables get many essential nutrients (e.g. vitamin A, vitamin C, etc.) but tend to eat less of certain other nutrients (like B12 and iron found in red meat). Additionally, certain vitamins – like Vitamin D3 – are hard to come by in most diets. Consider the iodine dilemma of the healthy eater. In avoiding processed foods and using natural sea salt of kosher salt, the healthy eater may be missing out on the recommended daily allowance of iodine (found in iodized salt) – which is essential for thyroid health and metabolism.
KM: I Should Always Take the Same Vitamins
RB: If your diet and lifestyle vary significantly from month to month or day to day, your needs will naturally change. You should reevaluate your daily vitamin routine at least every six to twelve months as your health and nutrient intake evolves. Likewise, certain days may call for extra boosts in certain vitamins. For example, an intense workout or excessive alcohol intake may require more electrolytes and B vitamins to combat the losses. Feeling run down or coming down with a cold may call for Zinc and extra Vitamin C and D for immune support.
KM: My Doctor Will Tell Me What Vitamins to Take
RB:There is not often time to go through a detailed analysis of your diet and lifestyle on a routine visit. Also, many doctors hesitate to make recommendations because they are concerned about products that are not FDA regulated. Our current model of health care tends to emphasize treating conditions with prescription medication than preventing them in the first place or using more natural remedies to treat problems.
KM: Are there any downsides/health concerns when taking a multivitamin?
RB: It is important to get a vitamin that is tailored to your exact needs. We are all different and have different diets, lifestyles and health concerns, thus we should not all take the same thing. Getting a high-quality product is essential. It is best to get something with a USP or GMP seal to ensure some standards in manufacturing since the vitamin industry is largely unregulated and many products are not well made with no guarantees as to what is actually in the bottle. Taking a bad product can be dangerous as can taking too much of or the wrong vitamins.