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Over 70% of Americans take a dietary supplement every day. Out of these, multivitamins are the most consumed supplement in the world. They have increased in popularity in the past few decades, and are available in various forms including tablets, capsules, powders, liquids, and gummies. According to the National Institute of Health, they contain at least three vitamins and one or more minerals. In most cases, however, you can find about 26 different vitamins and minerals that provide 100% of the Recommended Daily Allowance (RDA) of these micronutrients. Despite widespread consumption, is this truly necessary to take every day? Deciding whether you should take a multivitamin will likely depend on your nutritional needs, which can vary based on age, pregnancy, health status, and dietary habits.

Reasons to Take a Multivitamin

Age

Older adults are at a greater risk for vitamin and mineral deficiencies due to age-related immune system decline. In a study with adults aged 55 and older, taking a multivitamin for 12 weeks improved vitamin C and zinc levels and decreased the length and severity of illnesses compared to those taking a placebo. In addition, older adults struggling with chewing or swallowing food or those experiencing appetite changes due to multiple medications may also benefit from multivitamin supplementation to fill nutrient losses. Some nutrients like vitamin B12 are more difficult to absorb with age. Therefore, it may be helpful for older adults to take a daily multivitamin to support immune function and prevent age-related nutrient deficiencies.

Pregnancy

Being pregnant is another reason to take a multivitamin. Getting enough folic acid and iron is especially important for increasing the chance of healthy birth outcomes. One study discovered that pregnant women supplementing with multivitamins led to better birth outcomes than those taking iron with or without folic acid. Similarly, another study with pregnant adolescents supplementing with a multivitamin resulted in a decreased risk for low birth weight, preterm birth, and early gestational age than iron and folic acid alone. Thus, taking a prenatal multivitamin can be particularly helpful for pregnant women, especially in the first few weeks of conception. Since pregnancies are often unplanned, the Centers for Disease Control and Prevention recommend all women of childbearing age (ages 15-45) consume 400 micrograms of folic acid every day.

Malabsorption Issues

Any condition interrupting digestion can also increase the risk of absorption of one or several nutrients. For example, those with medical issues such as celiac disease are at risk for nutrient deficiencies such as iron, vitamin D, and zinc. Other malabsorption issues are due to surgeries that involve the removal of digestive organs or illnesses causing excess vomiting or diarrhea. Additionally, being on a restricted diet (vegan, vegetarian, low-carb) or avoiding certain foods due to intolerances or diseases may increase the risk for specific nutrient deficiencies. These are reasons why healthcare professionals may recommend long-term multivitamin supplementation.

Certain Medications

Some medications may lower levels of some vitamins and minerals in the body. For example, some blood pressure medications can reduce magnesium, potassium, and calcium. Taking single-ingredient supplements to target missing nutrient gaps may be more beneficial than taking a multivitamin to avoid any interactions with medications. For this reason, consulting with a healthcare professional before starting a supplement regimen can help understand nutrient losses and appropriate doses.

Reasons Not to Take a Multivitamin

While there are certainly situations where multivitamin use can improve health outcomes, there are other situations where it may not be necessary. There is recent evidence from large clinical studies that a cocktail of essential vitamins and minerals does not deliver additional health benefits in well-nourished adults. Consuming a healthy diet and supplementing with a multivitamin supplement can lead to an excess intake of many nutrients. In some cases, taking too much of one nutrient may even be harmful. For example, smokers should avoid multivitamins with large amounts of beta carotene or vitamin A, as these nutrients may increase the risk of lung cancer. Furthermore, men tend to store more iron than women. If they regularly consume iron-rich foods, it may be best for men to take a multivitamin without iron to avoid cumulative doses.

It is important to remember that a multivitamin supplement cannot replace the myriad of micronutrients found in a well-balanced diet. Is it worth taking as part of a healthy lifestyle? Start by asking yourself why you would consider taking a multivitamin. If the reason is diet-related, begin focusing your efforts there. Multivitamins can fill nutritional gaps related to deficiencies due to age, pregnancy, or medical conditions impairing absorption. However, taking them to get an “extra” boost nutrients while consuming an unhealthy diet is unlikely to deliver any health benefits and if you feel better, it is probably a placebo effect. On the other hand, those already consuming a well-balanced diet will not benefit from taking a multivitamin compared to those with specific nutrient deficiencies.