The Vitals on Vitamins: What You Need to Know


The vitamin market is booming. Grocery stores have filled aisles, and chain retailers have stores filled to the brim. Products are marketed by gender, age, and desired effects, from pink bottles for perimenopausal women to character gummies for children.


Equip yourself to make informed decisions about vitamin use for yourself and your loved ones.


Adequate Vitamin Intake

Historically, vitamins were used as an intervention in the presence of a vitamin deficit. More commonly today, vitamins and other dietary supplements are used by mainstream consumers based on positive beliefs about the products.


For example, researchers found that 61 percent of individuals thought that supplements were scientifically proven to help, and a near 50 percent believed that they were an easy method to help stay healthy.[1] These assumed beliefs conflict with public health guidelines that state vitamin and supplementation use by most individuals is not warranted or recommended.


Instead, most persons of any age can get all the needed vitamins and nutrients from food.

For select individuals, vitamin supplementation may be recommended, such as those with nutritional deficits that may include certain chronic diseases, food allergies, restrictive diets, and impaired physical or development growth. In addition, special populations may have unique needs, such as exclusively breastfed infants requiring iron supplementation.


The Underregulated Vitamin Market

In the United States, vitamins are regulated as dietary supplements, not medication. Therefore, the United States Food and Drug Administration (FDA) does not approve supplemental products before hitting the shelves. In short, vitamins do not receive the higher standard evaluation for safety and effectiveness as medications do.[2]


In a study published in 2017, researchers found that many ingredients in multivitamins were present in larger amounts than what was shown on the product label. In addition, the amount of vitamin ingredients was inconsistent between individual products.[3]

Irregularity in vitamin quality is a concern for individuals who consume too much inadvertently or too little in the presence of a vitamin deficiency.


Toxicity

Vitamin toxicity, called hypervitaminosis, can occur when excessive amounts of a vitamin enter circulation in the body. Toxicity risk increases with vitamin supplementation. Around 50,000 cases of vitamin toxicity are reported annually to the United States Poison Control Centers.[4]


Toxicity can result in many issues, from stomach upset to hair loss, fatigue, and nerve damage, depending on which vitamin(s) is in excess, how much is circulating through the body, and various other factors. Though rare, heart problems and life-threatening conditions may also occur.


Selecting a Vitamin

If vitamins are deemed safe and beneficial for you by your healthcare provider, consider shopping at a non-commercial site. Examples of non-commercial sites include the National Institutes of Health (NIH), the FDA, and the United States Department of Agriculture (USDA). In addition, avoid retailers that heavily focus on marketing and may have compromised interest.


Preparations of vitamins and supplements are influenced by digestive breakdown and absorption. Additional factors, such as coating and competing foods at ingestion, may also impact the amount of vitamins or supplements available to the body.


Chewable tablets and vitamin gummies are beneficial for optimal absorption as digestion begins with chewing, aiding digestion and vitamin availability to the body faster than a non-chewable tablet or capsule may offer. However, gummies typically have added sugar and may be a reason to select a tablet instead.[5]


Gummies are appealing with taste and texture for both adults and children, which can enhance adhering to routine supplementation. Conversely, it may also be risky if an individual perceives it as candy and gobbles up more than recommended or an unsafe dose. Chewable vitamins are generally favorable compared to other formulations, but additional research is needed.[5]


Liquid vitamins may be preferred in children when swallowing non-chewable tablets or capsules is not feasible. In adults with absorption issues, such as an individual who has had gastric surgery, liquid may also be a better option. The downfall in liquid formulations is ingredient stability and loss of the active ingredient over time. Pills are generally the most stable formulation of vitamins, with gummies trailing.


When selecting a vitamin, identify your personal preference, ask your professional healthcare provider, and look for sources that demonstrate a higher quality standard when compared to others in the market. For example, some companies perform additional quality testing and have published data.


Consult a Healthcare Provider

Suspect that you may be missing proper amounts of a specific vitamin? Chat with your trusted healthcare provider for individualized recommendations based on your personal health history.

[1]Lentjes M. (2019). The balance between food and dietary supplements in the general population. The Proceedings of the Nutrition Society, 78(1), 97–109. https://doi.org/10.1017/S0029665118002525 [2]United States Food and Drug Administration. (2022). What you need to know about dietary supplements. Retrieved on May 23, 2022 from https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-dietary-supplements [3]Andrews, K. W., Roseland, J. M., Gusev, P. A., Palachuvattil, J., Dang, P. T., Savarala, S., Han, F., Pehrsson, P. R., Douglass, L. W., Dwyer, J. T., Betz, J. M., Saldanha, L. G., & Bailey, R. L. (2017). Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database. The American journal of clinical nutrition, 105(2), 526–539. https://doi.org/10.3945/ajcn.116.134544 [4]American Association of Poison Control Centers’ National Poison Data System. (2021). Annual reports. Retrieved on May 23, 2022 from http:/www.aapcc.org/annual-reports. [5]Wagner, C.L., Shary, J.R, Niettert, P.J., wahlguist, A.E., Ebeling, M.D. & Hollis, B.W. (2019). Bioequivalence studies of vitamin d gummies and tablets in healthy adults: Results of a cross over study. Nutrients, 11(5):1023. doi: 10.3390/nu11051023

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