Should you Take a Multivitamin?

A recent report on mulitivitamins in the Annals of Internal Medicine grabbed the media’s attention with its title ‘Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements’. In this report, the authors concluded that based on the review of three trials, there was no clear evidence of a beneficial effect of supplements on all-cause mortality, cardiovascular disease, or cancer (1). Their message is this: “Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.”

One of the most asked questions we hear from our patients at the PCOS Nutrition Center is whether or not women with PCOS should take a multivitamin, so I thought it would be helpful to write a blog post about the answer.

Supplements Shouldn’t Replace Food

When I was a dietetic student I was taught that the majority of people can meet their daily nutrient requirements by eating a variety of whole foods and don’t need a daily mulitivitamin. Now, as a college professor myself, I still believe this and educate my students about it. A pill can’t substitute for the fiber content or the numerous health benefits whole foods provide.

But the reality is most people don’t eat a diet that includes at least half of whole grain foods or the 9 to 13 servings of fruits and vegetables needed each day. And for the one out of 6 Americans facing food insecurity at some point in their lives, meeting these nutrient requirements through food is next to impossible.

Supplements Prevent Deficiencies

In some cases, it’s clearly beneficial to take a multivitamin to prevent a deficiency. Take women who are trying to conceive. Taking a multivitamin or prenatal vitamin helps ensure an adequate amount of necessary nutrients for fetal growth like folic acid and omega-3 fats, both crucial for fetal brain development.

Vegans need to supplement their diets with vitamin B12. People who take metformin, birth control pills or heart burn medications should also take B12 to prevent a deficiency. People with certain types of anemia may require iron supplementation. Multivitamins can help prevent nutrient deficiencies in those that are malnourished due to poverty or food insecurity.

Women with PCOS Have Nutrient Deficiencies

While I do think that most individuals who eat a healthy diet that meets their nutrient requirements, don’t need a multivitamin, I do think women with PCOS would benefit from taking one. The reason is because women with PCOS have been shown to be at a higher risk of nutrient deficiencies.

For example, one study found the risk of PCOS for women with magnesium deficiency was 19 times greater than for those who had normal magnesium levels (2). Magnesium is a mineral that plays a role in insulin and blood pressure regulation.

It’s believed that women with PCOS have altered metabolism of inositol, which may contribute to insulin resistance (3,4). Low vitamin D status is highly prevalent among the PCOS population (5). Some women with PCOS experience heavy menstrual cycles and may need extra iron.

Supplements Don’t Treat Disease

The report in the Annals of Internal Medicine was focusing supplements and their ability to treat diseases. But supplements aren’t intended to treat disease. The roles vitamins and minerals are involved in include maintaining normal cell function, metabolism, growth and development, and act as essential cofactors in hundreds of enzyme reactions throughout the body.

Vitamins and minerals may improve certain aspects of medical conditions such as insulin sensitivity in PCOS, but they won’t cure PCOS or any other disease. Multivitamins and any other dietary supplement shouldn’t replace food, especially whole foods which can help heal PCOS. But they can improve many aspects of the condition and maintain good health. (If you’re interested in learning more about which supplements can be good for PCOS, watch our webinar or schedule an individualized nutrition counseling session).

Shopping For a Mulitivitamin

When looking for a multivitamin, look for a high quality one. And more isn’t necessarily better. Don’t purchase multivitamins that have over 100% of the daily value (DV). Vitamins A, D, E and K are stored in fat and can be dangerous in high amounts. A woman’s only multivitamin typically contains more iron and folic acid and are most appropriate for women of reproductive age.

Need other supplements to help you manage PCOS? Visit our supplements store for a variety of medical-grade supplements specifically formulated for women with PCOS.

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References

1.Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER III. Enough is enough: Stop wasting money on vitamin and mineral supplements. Arch Intern Med 2013;159:850-1.
2. Sharifi F, Mazloomi S, Hajihosseini R, Mazloomzadeh S. Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance. 2 Gynecol Endocrinol. 2012;28(1):7-11.
3. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metabol synd related disorders. 2010;8(2):127-136.
4. Cheang KI, Baillargeon JP, Essah PA, et al. Insulin-stimulated release of D-chiro-inositol-containing inositolphosphoglycan mediator correlates with insulin sensitivity in women with polycystic ovary syndrome. Metabolism. 2008;57(10):1390-1397.
5. Wehr E, Pilz S, Schweighofer N, et al. Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome. Europ J Endocrinology. 2009;161(4):575-582

 

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