Get Supplement Savvy

How to choose the right multivitamin for you.
By Pamela Bond

So you don’t eat the recommended five to nine servings of fruits and vegetables every day. Who does? Besides, if you’re like a third to a half of your compatriots, you’re taking a daily multivitamin to make up for any nutritional gaps you may have. Oh, you’re not doing that either? Well, don’t let those vitamin-laden shelves intimidate you. Here’s how the experts respond to the most common questions about taking supplements.

How do I know I’m buying a high-quality multi?
You can choose brands you trust—or get recommendations from a naturopath, nutritionist, or holistic doctor. But if you want to be sure, look on the label for the USP (United States Pharmacopeia), NSF (National Sanitation Foundation) International, or Consumer Lab seal. These symbols indicate the product has passed independent tests that confirmed it contains the ingredients listed on the label and in the amounts noted. A new FDA rule, which goes into effect in 2010, will require all companies to verify ingredients through testing, but for now, shop the seals.

Are cheap vitamins just as good?
“Price and quality don’t necessarily correlate,” says Mark A. Moyad, MD, MPH, the Jenkins/Pokempner director of preventive and alternative medicine at the University of Michigan Medical Center in Ann Arbor. Instead, you have to look on a case-by-case basis to make sure the vitamins come in a well-absorbed form and in sufficient amounts (see “The Major Players” below).

Also, check to see how many “extra” ingredients the vitamin has: artificial colors, sugars, and excipients (a catchall term for fillers, binders, and lubricants that help in the manufacturing process or impact the dissolvability of a vitamin). Avoid excipients like dicalcium phosphate, magnesium stearate, and palmitate, which inhibit absorption, and lactose if you’re allergic. Instead look for the safes ones: cellulose, silicon dioxide, titanium dioxide, and magnesium citrate. Generally speaking, health-food store brands have fewer and safer excipients than drugstore or discount brands.

Should I choose “natural” or “synthetic” vitamins?
Let’s assume natural means that the vitamins are obtained from a plant, food, or animal, while synthetic vitamins are manufactured in a lab. The source doesn’t seem to make any difference for some nutrients. Vitamins C and B6 have similar bioavailability, be they natural or synthetic. That’s not true for fat-soluble vitamins, however. Natural vitamin E (d-alpha-tocopherol), for example, is more bioavailable than the synthetics (dl-alpha-tocopherol or all-rac-alpha-tocopherol). Also, natural-source beta-carotene, which comes from the algae Dunaliella salina, benefits you more than the synthetic version, because it contains small amounts of other free radical-fighting carotenoids, like alpha-carotene. The same holds true for tomato-derived lycopene, which has small amounts of related antioxidants, while the synthetic form contains only lycopene.

Is it better to get my vitamins from food or from pills?
“The food source is important,” says Carolyn Dean, MD, ND, telephone wellness consultant and author of The Magnesium Miracle (Ballantine, 2007). “That’s how the body is designed to absorb nutrients.” Indeed, several studies on various vitamins have shown that people often benefit more from a dietary source of the nutrient than from a supplement. But, Dean adds, 100 years ago we had 500 mg of magnesium in our daily diet. Now we have 150 mg because over-farming has depleted our soil of its nutrients. What’s more, produce travels on average 1,500 miles to get to your table, yet its nutrients start to degrade the moment it gets picked. So even if you ate the recommended five to nine servings of fruit and vegetables a day, you may still come up short on nutrients.

Your best bet: Choose locally grown organic produce (which studies have shown has more antioxidants) that’s either fresh, frozen, or canned (all of which slow the loss of nutrients). Then take a multivitamin as your nutritional safety net.

Does the body absorb capsules more effectively than tablets?
Rumor has it that capsules and liquid preparations dissolve more easily in the stomach. But a properly made tablet should break down just fine. (You might want to conduct “The Acid Test” below to determine the dissolvability of your multivitamin.) Plus, tablets can carry up to twice the amount of ingredients as capsules and are usually less expensive. Still, tablets tend to contain more excipients (to standardize the size and color of the tablets). And anyone with digestive problems (Crohn’s disease, irritable bowel syndrome, or just an easily upset stomach) may have better luck taking liquid preparations or soft- or hard-gel capsules because they’re more easily broken down. Vegetarians, take note: Although some supplement capsules come from vegetarian sources, most contain animal gelatin. If that’s an issue for you, read the label carefully or call the company.

Do I need to divide my dose by taking pills throughout the day?
If you take a simple multivitamin, a one-a-day pill should suffice. If you opt for a multivitamin/multimineral formula, you’ll likely have to down more pills each day or take minerals as separate supplements to get your daily quota. The reason for this is that many mineral supplements are “chelated,” a process that binds the mineral to an amino acid, which the body more easily recognizes and absorbs. The mineral-amino combo then becomes too big to fit into a standard one-a-day. Additionally, with certain nutrients like calcium, your body can’t use much more than about 500 mg at a time (and doesn’t excrete it readily). So you must divide your total daily dose into 500 mg allotments, and take them two or three times a day.

For minerals, keep in mind, too, that carbonates, gluconates, oxides, and sulfates are generally not well-absorbed. Instead, opt for forms such as mineral citrate, glycinate, aspartate, malate, fumarate, succinate, ascorbate, and picolinate.

How do I maximize absorption?
Vitamins just make your urine expensive, right? Well, yes and no. The body does excrete excess water-soluble vitamins, but not before it uses what it needs to take care of basic functions and to fend off disease—especially if taken at mealtime, when your body normally gets vitamins and minerals. Food activates stomach acid, which breaks down the multivitamin and helps you absorb its elements. Plus, taking two nutrients together can have a synergistic effect and increase absorption. For example, vitamin C helps the body better utilize iron from plants, and vitamin D boosts the absorption of bone-building calcium. Taking your vitamins with meals also makes for a happier stomach: “The No. 1 reason people quit taking their multivitamin is gastro-intestinal upset,” says Moyad. “Taking it with food softens the blow, and you won’t suffer bloating or pain.”

Should men and women take different vitamins?
According to Moyad, you can choose between two multivitamins: an iron-free pill for men and postmenopausal women or an iron-inclusive pill for premenopausal women. Other than that, the nutrient requirements for men and women are pretty similar, says Shari Lieberman, CNS, FACN, author of The Real Vitamin and Mineral Book (Penguin, 2007). Formulas that contain herbs, however, usually differ for men and women, says Lieberman. For example, a men’s formula may have saw palmetto for prostate health, and a women’s formula may have cranberry extract for urinary tract health.

How do I know my vitamins are working?
You may not. “Multivitamins are for long-term chronic disease prevention,” says Moyad. “You should feel the same or a little better.” If you can’t stand not knowing, ask your doctor to run blood tests before and after you take a multivitamin to measure your net gain (or loss) of nutrients.

Pamela Bond downs her horse pill with oatmeal each morning.

Quick tip: If large calcium pills are hard to swallow, try a chewable option.

The Acid Test
Certain multivitamins have a reputation for passing right through the body intact. This simple “acid test” lets you find out if your multivitamin dissolves properly. If it does not dissolve during the test, it likely will not break down in your body, and you are literally wasting your money.

1. Place approximately 1 cup of white vinegar in a small bowl, and warm it to around 98 degrees by placing it inside a larger bowl of hot water to which you can add more warm water to keep up the temperature. (The goal is to keep the vinegar reasonably close to body temperature for half an hour.)

2. Drop your multivitamin into the bowl of vinegar, and gently shake the cup every five minutes. Do not touch the tablet.

3. The tablet should dissolve within 30 minutes (the United States Pharmocopeia standard) to one hour.

Source: Adapted from supplementquality.com.