Most of us want to get healthy and stay healthy. Whether you have a specific health or fitness goal or your goal is to achieve that nebulous thing, “wellness,” chances are you’ve thought about taking a multivitamin before. About a third of American adults say they take multivitamins, according to the National Institutes of Health.
That’s not really surprising. After all, there’s a massive industry devoted to making you think that nutritional supplements are important—even though plenty of research suggests that taking vitamins isn’t helpful unless you’re addressing a specific deficiency in a doctor-monitored way. That industry’s reach goes far beyond the aisles of health food stores: Companies now advertise vitamin subscriptions on popular podcasts and on Instagram, and there are a host of multi-level marketing businesses devoted to shilling supplements. Given that these businesses depend on their grand claims to make money, their advice about supplements isn’t exactly trustworthy.
A big reason the $40-billion supplement industry is able to advertise multivitamins as if they’re essential and even potential cure-alls is because the federal government has few ways to regulate it. In February, the Food and Drug Administration (FDA) warned some supplement-makers to stop making wild claims about their products while telling Congress to smarten up and enshrine more comprehensive consumer protections for vitamins and supplements into law. Until Congress steps in, people will have to look elsewhere for advice.
Here’s what you need to know.
Do I need to take a multivitamin?
The answer to this question is usually no: unless you’re pregnant or trying to get pregnant, nobody needs to take multivitamins. “I wish I could say that they’re useful,” says Beth Kitchin, an assistant professor of nutrition sciences at the University of Alabama at Birmingham. But “we really don’t see any big benefits from multivitamins,” she says. (Pregnant women need higher amounts of folic acid, iron, and other nutrients than the general population, which is why medical groups recommend they take prenatal multivitamins.).
A meta-analysis of 45 years of research into the possible heart health benefits of multivitamins, published last year, supports her statement. The research looked at more than 2 million patients over a long time, and the team found no evidence that multivitamins helped with heart health. A study published this month in the Annals of Internal Medicine used data from more than 27,000 people and found that taking multivitamins wasn’t associated with living longer, but getting enough nutrients from food sources was linked to a lower risk of dying early. Other studies have suggested a link between multivitamin use with a lower risk of prostate cancer recurrence, and with a lower risk of having a child with autism spectrum disorder. But nothing has conclusively demonstrated the link between multivitamins and any of these things. A large trial going on at Brigham and Women’s Hospital in Boston may shed some light on these questions some time in the next decade, but there’s currently no good evidence that multivitamins themselves are helpful.
That’s not to say that the nutrients contained in a good-quality multivitamin aren’t the real thing: Some people may need to take particular vitamins geared at addressing a specific deficiency, under the care of a doctor, but the evidence suggests that you’re not doing much for your overall health by taking a daily multivitamin.
Still, it’s possible they may have some small effect. Kitchin says that if her healthy patients want to take a multivitamin, she’s OK with it, as long as they don’t give the pills too much significance. “Sometimes the things we do for our health are just to make us feel better,” she says. But she tells these patients there’s no conclusive evidence that the pills are doing anything specific at all.
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Got it. But if I still want to take a multivitamin despite this, how should I choose one?
When it comes to picking a multivitamin, buyer beware. “Dietary supplements, they get away with a lot,” Kitchin says. The FDA has some jurisdiction but “it’s pretty light,” she says. According to the 1994 Dietary Supplement Health and Education Act (read more on it here) the FDA has to evaluate whether drugs are safe, while supplement-makers just have to provide limited evidence about whether their product is safe and effective. That and the agency’s already overworked, says Kitchin, while the supplement market is ever-growing.
Given the lack of oversight, she has a few suggestions for anyone who still wants to take a daily multivitamin. The two big ones: don’t spend too much, and don’t take something that’s going to actively harm you.
“You can get really decent multivitamins at low cost,” Kitchin says. Drug stores and big box stores carry multivitamins that are as likely to be helpful as high-end ones sold at specialty stores, she says. Those more expensive pills won’t offer more benefits: certainly not the kinds of Alzheimer’s- or cancer-preventing benefits that the FDA admonished some supplement-makers for touting in February.
Then there’s supplement safety. Because of the lack of oversight, there’s a lot to watch for here. Even though vitamins are often sold in the pharmacy section of stores and the packaging looks like medication packaging, they’re not regulated the same way at all by the FDA and it means you need to be careful. “I think it’s really challenging for consumers,” Kitchin says. She suggests looking for a ”USP verified” seal on the bottle. It means that the product has been evaluated by the United States Pharmacopoiea and found to be safe. USP also has a website highlighting the supplements it certifies, if you want to start shopping at home.
When it comes to the nutrition your body needs, Kitchin cautions it’s also possible to have too much of a good thing. “I always tell [patients] to be very careful not to buy supplements that have super-high doses of nutrients.” Look at the daily values listed on the bottle and avoid multivitamins that contain more than 100 percent of the recommended daily value (RDV) of any specific vitamin, she says. If you’re eating food, you’re already getting nutrients that way, and you can really hurt yourself by overdosing on certain vitamins, specifically fat-soluble vitamins including vitamin A and D or mineral supplements like iron.
As long as you steer clear of the untested and/or pricey options, you’ll probably be able to find a multivitamin that works for you—or at least, doesn’t harm you.
Is there another way to make sure I’m getting the nutrients I need?
A conversation with your doctor will help you figure out if you should be taking any specific supplements: vitamin D and calcium are common ones that some people need, Kitchin says. But, in general, if you’re concerned that you might not be getting all the nutrients you need, you could just look at your diet rather than taking a multivitamin. “We always like to take the pill that solves everything,” says David Jenkins, a professor of nutritional sciences at the University of Toronto in Canada and a physician at St. Michael’s Hospital in Toronto. But no such pill exists. Thankfully, it’s possible to get everything you need from your diet. (It may take more planning if you’re vegetarian or vegan, but it’s still possible.)
Jenkins has been working in the nutrition field for more than 40 years, but more recently, he’s come to advocate for a plant-based diet. Instead of spending extra money on supplements and extra time picking them out, he suggests, “cut down on your red meat, increase your green leafy vegetables, your legumes, your pulses, your seeds.” Maybe even try some meat alternatives such as tofu or veggie burgers, he says, as many of those are fortified with extra nutrients like Vitamin B12, which is sometimes hard for non-meat eaters to get. Kitchin’s main suggestion for shaping your diet is simple: make sure you’re eating a variety of foods.
As always, if you have concerns about a specific deficiency or a specific health issue, go see your doctor and a registered nutritionist. They can figure out what’s wrong and help you fix it, whether with supplements or a change of diet. But if something is actually wrong, multivitamins probably won’t help.
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This article originally appeared on VICE US.