One a Day or NOT!


To B12 or Not to B12? That is the question….

Recently, a famous “TV Doctor” said it is not a good idea to take multivitamins, or any supplements on a daily basis. But, according to the Centers for Disease Control (CDC) most Americans don’t get enough vitamins and minerals in their daily diet. A 2011 survey found that only 11% of. adults in the US meet the USDA guidelines for fruit and vegetable consumption, which would. explain why one in three adults reports taking a multivitamin. However, nutrition experts say it’s always better to get vitamins, minerals, protein, fiber, etc. from food. Well that seems obvious doesn’t it? Our bodies were designed to eat natural foods, not pills, and plants can offer other balanced nutrients (like antioxidants) that pills just don’t have. Plus, you can’t overdose on the vitamins in foods. However, taking too much supplemental iron, vitamins A, D, E, or K, though, can be toxic. That’s an important reason to check with your doctor before taking any supplements.

First and foremost, you should try to eat right. Get lots of fruits and vegetables. Eat whole grains. For protein use low fat dairy, seafood, eggs, lean meats, and beans. These foods are all “nutrient dense” and will help you meet your body’s needs. But, if you still think you aren’t getting enough of something, first you need to know how much of a given nutrient you need, as well as how much you’re getting from your diet. You can check out this website to determine how much of each nutrient you should be getting for your age and gender. Then keep a food diary on paper or online (there are even mobile apps now).

But, before you add anything you MUST talk to your physician. He or she may even order a blood test to get your exact level before determining a dose of any vitamin, mineral, or supplement to start you on. Some vitamins (A,D,E, and K in particular) can cause devastating effects if you take too much, so your physician may even want to check your blood again in a few weeks or months to be sure you are at an appropriate level.

If you are not getting enough vitamins or minerals, the cause can vary. Skipping a single meal won’t affect your nutrition, especially if you get an appropriate number of calories in your whole day. But if you skip meals to save calories, you may be missing nutrients as well. In addition, not eating enough fruits, vegetables, and whole grains can cause nutrient depletion. If you are low on these food groups, you may need to take a multivitamin, but also consider improving your diet. If you are on a low calorie diet, or are a strict calorie-counter, you might not be getting enough nutrients, especially if you’re severely restricting calories. Make sure that the foods you do eat are nutrient-dense. Most nutrient-dense foods, such as fruits and vegetables, are also lower in calories per serving than other foods. You might also want to take a multivitamin to supplement across the board.

Vegetarians generally eat more fruits, vegetables, and whole grains and have lower-fat diets than the general population, but you may be missing out on calcium, especially if you also avoid dairy products. If you’re between 19 and 50, you should get at least 1,000 mg of calcium from green leafy vegetables and other foods and 600 IUs of vitamin D daily, or consider taking supplements to make up the deficiency. Women over the age of 50 and men older than 70 should get at least 1,200 mg of calcium daily, and both men and women older than 70 should get 800 IUs of vitamin D every day. Vegans, who give up all animal products including milk and eggs, may also need vitamin B12 supplements—2.4 mcg for adults, 2.6 mcg for pregnant women, and 2.8 mcg for nursing mothers. Also, if you can’t or won’t drink milk you can find other dietary sources of calcium and vitamin D, such as Lactaid or low-fat yogurt. You might also consider a calcium and vitamin D supplement as outlined above if you’re falling short of your needs.

If you get limited exposure to sunlight, wear long robes and head coverings for religious reasons, or are dark-skinned, you may be missing some vitamin D. The body needs sunlight to develop vitamin D on its own, and people who have limited sun exposure or who are dark-skinned are less likely to have sufficient vitamin D levels. You can correct this imbalance by getting your recommended daily allowance of vitamin D through food or vitamin D supplements.

If you’re pregnant your body has increased nutritional needs like additional folic acid, iron, and calcium; folic acid. These help prevent devastating neural tube birth defects. Take a prenatal vitamin before you get pregnant and during your pregnancy to ensure that you and your baby get enough of the nutrients you both need; it should contain at least 600 mcg of folic acid.

Finally, if you’ve had weight-loss surgery, changes in the intestinal tract make it virtually impossible to absorb sufficient proteins, vitamins, and minerals from food. You will need to take nutritional supplements every day for the rest of your life; these may include a multivitamin, special versions of vitamins A, D, E, and K, and supplemental iron and calcium. Check with your doctor to see which supplements you should be taking.

We all have changing nutrition needs as we age. For example, women have a greater need for calcium and vitamin D after menopause, and men tend to need more protein after about age 50 to prevent muscle loss. The more medication you take, the more nutrient starved you could be as well. However, some supplements interact with prescription medications, so the decision to take a multivitamin is highly individual. Your need for supplements depends on your diet, as well as any health conditions you have that increase the demand for certain nutrients or affect their absorption. Always check with your doctor and pharmacist before you start taking any kind supplement to be sure it will be safe.

Be Well, Be Wise,


Dr. Rebecca Wise

Wise Words…. is a general medical information column from Dr Rebecca Wise. Dr. Wise has a master’s degree in education as well as her doctorate in pharmacy. She is an assistant professor and ambulatory care specialist at a Medication Therapy Management (MTM) clinic in Erie, PA.

Soon to be released is Dr Becky’s new website which will address women’s issues, watch for it:

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