Which Vitamins Do You Really Need?
We all need vitamins, but that doesn’t mean you need to take a vitamin. This week, science gave us another brick for the giant “vitamin pills are useless for most of us” sign that’s been under construction for a while. (It’s a metaphor, but I imagine it as something like the Hollywood sign, except nobody looks at it because they’re all busy shopping for vitamins in the valley below.)
Vitamin pills may be necessary if you have certain health conditions. For example, if you’re pregnant, it’s a good idea to take a prenatal vitamin that includes folic acid. If you’ve been eating nothing but ramen all semester, you might want to stock up on Emergen-C. But if you just have a vague sense that you’d like to be healthier, vitamins aren’t likely to help you, and they might hurt.
Don’t we need vitamins?
Yes, but we get most of them from food, and others from the sun (that’s vitamin D) and from our gut bacteria (like vitamin K). Even if you eat a pretty crappy diet, chances are you’re still getting plenty of the good stuff. The flour that makes most bread, pasta, and cupcakes in the US has been fortified with certain vitamins and minerals. Even your greasiest cheeseburger has plenty of B vitamins and other important nutrients. Add a few veggies to the mix and you’re not doing too shabby.
What are vitamins, anyway?
You’ve heard of macronutrients—fat, protein, and carbs—but then there are micronutrients. We only need our micronutrients in small quantities, but without certain important ones, our bodies don’t work. Without vitamin C, for example, we can’t make the collagen that keeps our skin healthy and our teeth from falling out. Many of the vitamins have letter names (A, B, C, D, E, and K, don’t ask) but a few of the B vitamins go by other names instead: vitamin B1 is better known as thiamin, and B9 is folate or folic acid.
Vitamins are micronutrients that our body doesn’t make on its own, so we can’t get them from food. Vitamins are organic molecules, made of carbon and other atoms connected together. Contrast those with minerals, which are also essential micronutrients, but minerals are just straight-up elements off the periodic table: iron, calcium, sodium, and so on.
Your typical “multivitamin” contains both vitamins and minerals. (You’ll also see other ingredients in the supplement aisle that are neither vitamins nor minerals, but that’s a story for another day.)
So why doesn’t taking extra vitamins help us?
First of all, if you’re already getting most of the vitamins you need from food, it’s easy to get too much of those vitamins if you get another dose from a pill. Too much vitamin A can increase smokers’ risk of lung cancer, for example.
Studies of vitamins are also tricky to do. Maybe people who eat foods rich in a certain vitamin (say, carrots) are healthier than those who don’t, but that’s not a guarantee that the vitamin A in the carrots is the reason why. Maybe it was something else in the carrots, or the way the vitamin interacted with other nutrients—or it might just be that people who eat their veggies are healthier in the first place, and the vitamin had nothing to do with it.
It turns out that many vitamins that look like they’ll improve our health often turn out not to have that effect, as Liz Szabo reported for Kaiser Health News. In 2013, a group of doctors wrote an appeal titled, “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” A 2012 review concluded “[F]or the majority of the population, there is no overall benefit from taking [vitamin and mineral] supplements. Indeed, some studies have shown increased risk of cancers in relation to using certain vitamins.”
This week’s study found that taking several popular vitamins didn’t make people any less likely to get heart disease or to die early. One vitamin, folic acid, might help some people avoid heart disease, but others (antioxidants and niacin) seem to increase the risk. Bottom line: “Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks.”
In other words, you should take vitamins if you need them for a reason, but it isn’t necessary for most of us to pop some pills “just in case.”
But everybody’s taking them!
They sure are! And with my search history, about all I see when I scroll down Facebook and Instagram are ads for fashion vitamins (that’s what I’ll call ’em) Ritual and Care/of. Both paint a picture of vitamin and mineral supplements as necessary but oh so confusing. “No overwhelming aisles of fine print,” Care/of says. “No more cobbling together a complicated regimen or neglecting your nutrition because of information overload,” Ritual promises.
These companies, and hundreds more, craft their pitches to imply that of course vitamins are necessary. And if you have any health problem whatsoever—you’re tired, let’s say—your friends may suggest you take a certain vitamin or supplement. Babe magazine sums up the appeal: “Here at babe, we’re constantly talking about how to make ourselves better. You know, without doing any work at all.” Popping a vitamin is easy, and it makes you feel like you’re doing something important for your health.
What if I really do need vitamins?
Okay, you might. Some of us do. But you won’t know that just from feeling some vague, could-be-anything symptoms like tiredness. And if you have any health issues that make you feel like you must do something right away, it’s probably worth checking with an actual medical professional to see why you’re having those symptoms. Maybe vitamins will help, but maybe you’ve got something else going on.
According to the CDC’s report from 2012, here are the most common vitamin and mineral deficiencies in the US:
Vitamin B6 (pyridoxine): About 10 percent of Americans don’t get enough. This deficiency is most common in people who don’t get enough food in general (due to food insecurity or restrictive dieting) and people with alcoholism. It’s in a lot of foods: chickpeas, tuna, chicken, and fortified cereal (that is, most cereal) are among the top sources.
Iron: The main way we lose iron is through menstruation, so most guys are off the hook here. Iron deficiency is an issue for 9.5 percent of women aged 12 to 49. Children aged 1 to 5 also need to make sure to get enough iron as they grow—about 6.7 percent of kids in this age range are deficient.
Vitamin D: There is some controversy over whether low blood levels of vitamin D actually mean you’re deficient. The CDC counts 31 percent of non-Hispanic black Americans as not having enough vitamin D, alongside 12 percent of Mexican-Americans and 3 percent of non-Hispanic whites.
Vitamin C: While actual scurvy is rare, about 6 percent of Americans over age six don’t get enough of the vitamin.
Deficiencies in vitamins B12, A, E, and folate are the next most common, each affecting less than 2 percent of the population. If you think you have an issue, consider talking to your doctor or a registered dietitian. The answer may or may not be pills, though—remember, vitamins come in food, too, and there are plenty of reasons to eat a healthy diet.
