I blogged last year about my confusion with buying multi-vitamins. It comes down to knowing how much vitamins to take and how much is too much. I’ve found a good reference. Consumerlab.com is a free resource available to Oxford Healthcare members… of which I am.
I got the Puritan Mega Vita Min tablets today with my 10% Oxford discount. (hint: if you call them on the phone, they don’t verify your Oxford membership)By taking them, I hope to live forever. I’ll get back to you in a century or so to tell you if it works.
Here’s the Consumerlab research:
Multivitamins/multiminerals are America’s most popular dietary supplements. Referred to as “multis,” the ingredients vary widely by brand. There are no established standards on what multis should contain.
One reason for not having uniform standards is that people’s diets and their needs differ. Nutrient requirements and cautions vary depending on age, gender, health status, use of substances such as alcohol or tobacco, and medications taken.
Many new and revised recommendations have been issued by the Institute of Medicine, including a major update in January 2001 (see ConsumerTips™ in this report). However, The U.S. Food and Drug Administration (FDA) has yet to require product labeling to include much of this new information in the “% Daily Value” listing that appears in the “Supplement Facts” panel.
Products also can remain on store shelves for months or even years before being replaced with newer versions. Consequently, even if a manufacturer has re-formulated its product to meet new recommendations, consumers may still be buying the older version.
In addition to selecting a product that appears to have the right ingredients, one should be confident that it: contains what it claims; breaks down properly once in the body so its ingredients can be effectively utilized; and is free of impurities. Neither the U.S. government nor any agency is responsible for routinely testing multis or other dietary supplements for their contents or quality.
ConsumerLab.com, as part of its mission to independently evaluate products that affect health and nutrition, purchased many of the leading multivitamin/multimineral products sold in the U.S. and tested them for their quality and evaluated them against the most recently recommended Dietary Reference Intakes (DRIs).
Quality Concerns and What CL Tested For:
For more detailed information on the potential benefits of multivitamin/multimineral supplements as a whole, see ConsumerTips section of this report and the General Nutritional Support article in the Natural Products Encyclopedia.For information on nutritional depletions caused by specific drugs, see the Drug Interactions section of the Natural Products Encyclopedia.
Multivitamins/multiminerals are among those supplements most likely to have quality problems. They contain multiple ingredients and, therefore, more possibility for error. Multis have been known to be short on some ingredients, fail to dissolve properly, and be contaminated with heavy metals.ConsumerLab.com tested products for their amounts of several common labeled ingredients: folic acid, calcium, and vitamin A (retinol and beta-carotene). Not all of the products were labeled to contain every one of these ingredients. Therefore, some were alternatively tested for other ingredients — such as Vitamin C (ascorbic acid) in the absence of folic acid, and iron or zinc if calcium was not present (see Testing Methods and Passing Score).Products also were tested to determine if they: disintegrated properly in order to dissolve and be absorbed in the body; and did not contain potentially harmful levels of lead, a contaminant of some mineral-based products.
Products had to pass testing on all of these criteria to be considered APPROVED. In addition, ConsumerLab.com reviewed the levels of vitamins and minerals to determine if any product provided doses high enough so as to carry a risk of adverse side effects. Those that exceeded upper tolerable limits (ULs — see discussion below) are footnoted.
Testing & Results:
Only 14 of 24 multis and fortified waters selected by CL passed testing. Also 20 additional products passed but were tested at the request of their manufacturers or distributors through Voluntary Certification Program (each product indicated with an asterisk). Three pet supplements also were tested, of which one failed. The reasons why products failed are indicated in the table and summarized below by category of multivitamin/mulitimineral supplement.
- General (Adult): Theragran-M Advanced Formula High Potency contained over 3 mcg of lead per daily serving, exceeding the State of California’s lead limit. Although not dangerous alone, this product unnecessarily contributes to daily lead exposure. Polaris CustomPak Supplements, AM Pak contained less than half of its claimed folic acid, a particularly important vitamin for women of childbearing age that also may help reduce the risk of heart disease.Fourteen other products passed. One of these fourteen, Juice Plus, is made with whole-food concentrates and did not claim specific amounts of nutrients. However, it is advertised as containing the same amount of certain vitamins as found in servings of specific fruits and vegetables. This allowed ConsumerLab.com to determine reference values (see Compare Vitamins Compare Vitamins for actual values).
- Women’s: Futurebiotics Advanced Women’s Formula contained less than eighty percent of claimed vitamin A. Avon VitAdvance Women’s Complete II contained only three-quarters of the claimed folic acid. Six other products passed.
- Prenatal: New Chapter Perfect Prenatal could not fully dissolve — suggesting that it would not completely deliver its nutrients in the body. It also contained twice its claimed amount of folic acid. Two other products passed.
- Men’s: Two products passed and none failed.
- Senior’s: Drinkables Liquid Multi Vitamins for Seniors had less than 20% of its claimed manganese and was also low on vitamin A and folic acid. Five other products passed.
- Children’s: L’il Critters Gummy Vites1 contained a high amount of lead and was missing half of the folic acid claimed. Lead is of particular concern to children as low amounts can affect mental functioning. Four other products passed.
- Vitamin Waters: Three popular brands had less vitamin C than claimed. The product missing the most was Glaceau Vitamin Water multi-v, that had less than 20% of its claimed vitamin C and less than half the vitamin A. The other two found low in vitamin C were Fruit2O Plus Citrus Energy Booster and Aquafina Essentials (watermelon flavor). One vitamin water passed the testing.
- Pet: Doctors Foster & Smith Vita-min Tabs For Cats contained only two-thirds of its claimed vitamin A. Two other products passed.
Some products tested contain certain nutrients at doses above the tolerable upper intake levels (ULs) established by the Institute of Medicine for certain groups of people. Adverse effects — such as: diarrhea from vitamin C; skin tingling, burning and flushing from niacin; and bone weakening from vitamin A — may occur when these levels are exceeded for long periods of time. More serious toxicities would not be expected at the doses in these products. Products that exceed the upper limits are footnoted.
RESULTS OF CONSUMERLAB.COM TESTING OF MULTIVITAMIN/MULTIMINERAL SUPPLEMENTS
Click on for additional information on the productClick on beneath a product name to find a vendor that sells it.
To find retailers that sell some of the listed products click here. = Product passed optional Athletic Banned Screening Program
For comparisons of the ingredients in the products see separate tables: Compare Vitamins, Compare Minerals, and Compare Other Ingredients
Products Were Evaluated)
Contained Claimed Amount of Nutrients
Did Not Exceed Accept-able Level for Lead Able to Break Apart Properly (Applies only to tablets and caplets)
Advanced Formula® Centrum® High Potency Multivitamin/
Dist. by Wyeth Consumer Health APPROVED
Centrum® Performance® Complete Multivitamin Supplement, Specially Formulated with Ginseng, Ginkgo, and Higher Levels of Five Essential B Vitamins*
Dist. by Wyeth Consumer Health APPROVED **
Geritol Complete® High Potency Multi-Vitamin Plus Multi-Mineral Dist. by GlaxoSmith-Kline Consumer Healthcare, L.P. APPROVED
Juice Plus+® Orchard Blend; Juice Plus+® Garden Blend Dist. by NSA APPROVED
Nutrilite® Daily, Multivitamin and Multimineral* Dist. by Access Business Group International LLC APPROVED
Nutrilite® Double X® Multivitamin Multimineral* Dist. by Access Business Group International LLC APPROVED **
Pharmanex® LifePak® Dietary Supplement, New! Anti-Aging Formula * Dist. by Pharmanex, LLC APPROVED **
Also Approved for Alpha Lipoic Acid, B Vitamins, Vitamin C, and Vitamin E
Polaris™ Your guide to Optimum Health™ CustomPak Supplements, AM Pak Dist. by Custom Nutrition Service NOT APPROVED **
Low in folate
Puritan’s Pride® Mega Vita Gel* Mfd. by Puritan’s Pride Inc APPROVED **
Puritan’s Pride® Inspired by Nature™ Mega Vita-Min™ Multivitamin/
Mfd. by Puritan’s Pride Inc APPROVED **
Puritan’s Pride® Ultra Vita-min* Mfd. by Puritan’s Pride Inc APPROVED **
Theragran-M® Advanced Formula High Potency Multivitamin/
Mfd. by Bristol-Myers Squibb Co. NOTAPPROVED **
Exceeded limit for lead (3.5 mcg lead in 1 unit dose)
Twinlab® Daily One Caps™ Without Iron, Higher Potency Multi Vitamin & Mineral Supplement
Dist. by Twin Laboratories Inc. APPROVED **
Vitamin World® Green Source™ Multi-Vitamins & Minerals with Whole Food Concentrates, Vegetarian Formula Dietary Supplement* Mfd. by Vitamin World, Inc. APPROVED **
Vitamin World® Naturally Inspired™ Mega Vita-Min™ Multivitamin Multimineral Supplement* Mfd. by Vitamin World, Inc. APPROVED **
Vitamin World® Naturally Inspired™ Time-Release Mega Vita-Min™ Multivitamin Multimineral Supplement* Mfd. by Vitamin World, Inc. APPROVED **
Avon VitAdvance Women’s Complete II Balanced Multivitamin/
Dist. by Avon Products, Inc. NOTAPPROVED
Low in folate
Futurebiotics Advanced Women’s Formula Multi Vitamin Energy Plus® Daily Multinutritional Vitamin & Mineral Mfd. by Bristol-Myers Squibb Co. NOTAPPROVED **
Low in vitamin A
GNC Women’s, Women’s Ultra Mega® without Iron Dietary Supplement, ChloraSeal® coating, timed-release Dist. by General Nutrition Corporation APPROVED **
Nature Made® Essential Woman Complete Multivitamin/
Dist. by Nature Made Nutritional Products APPROVED
One a Day® Women’s Multivitamin/
Dist. by Bayer Corporation APPROVED
Rainbow Light® Just Once® Naturals Women’s One™ Multivitamin*
Dist. by Rainbow Light Nutritional Systems APPROVED
Walgreens, The Brand America Trusts®, Woman’s Way® Scientifically Formulated for Active Women, High Potency Multivitamin/
Multimineral Supplement with Calcium USP
Dist. by Walgreen Co. APPROVED
Women’s MultiStart™ Dr. Michael Murray Formulated, VitaMin-A-Day for Women, Natural Factors® Mfd. by Natural Factors APPROVED **
New Chapter® Perfect Prenatal™ Whole-Food Probiotic Multi-Vitamin, Mineral, Live Active Culture & Herbal Complex Dist. by New Chapter, Inc. NOTAPPROVED
High in folate
Did not disinte-
Rainbow Light® Just Once® Naturals Prenatal One™ Multivitamins*
Dist. by Rainbow Light Nutritional Systems APPROVED
Stuart Prenatal® Multivitamin/
Dist. by Integrity® Pharmaceutical Corporation APPROVED***
Opti-Men, More than a Multi Mfd. by Optimum Nutrition APPROVED***
Rainbow Light® Just Once® Naturals Men’s One Multivitamin* Dist. by 2003 Rainbow Light Nutritional Systems APPROVED
AARP Health Care Options® Pharmacy Services Formula 502 Seniors Vitamins and Minerals Supplement Dist. by United HealthCare Products, LLC APPROVED
Centrum® Silver® Specially Formulated Multivitamin/
Multimineral Supplement for Adults 50+*
Dist. by Wyeth Consumer Health APPROVED
Drinkables® Liquid Supplements, Liquid Multi Vitamins for Seniors Dist. by Remington Health Products, LLC NOTAPPROVED
Low in Vitamin A, folate and manganese
Puritan’s Pride® ABC Plus® Senior, with Lutein and Lycopene, Multi-Vitamin Multi-Mineral Formula, Iron Free Formula Dietary Supplement* Mfd. by Puritan’s Pride Inc APPROVED
Rainbow Light® Just Once® Naturals Active One™ Senior Multivitamin* Dist. by Rainbow Light Nutritional Systems APPROVED
Unicap Sr.® Dietary Supplement Dist. by Pharmacia & Upjohn Consumer Healthcare APPROVED
Enfamil™ PolyViSol® Multivitamin Supplement Drops, for Infants & Toddlers Dist. by Mead Johnson Nutritionals APPROVED **
Flintstones® Complete with Calcium, Iron & Minerals, New! Improved Formula Dist. by Bayer Corporation APPROVED **
L’il Critters™ Gummy Vites® Dietary Supplement1 Dist. by Northwest Natural Products® Inc. NOTAPPROVED
Low in folate
Exceeded limit for lead (1.25 mcg lead in 1 unit does, 2.5 mcg lead in 2 unit dose)1
Nutrilite® Kids Chewable Multivitamin/
Dist. by Access Business Group International LLC APPROVED **
Sundown Kids™ Complete Children’s Multiple Vitamin and Mineral Supplement, Super Heroes™* Mfd. by Sundown, Inc. APPROVED **
Aquafina® Essentials™ enhanced water beverage, Watermelon Flavor Mfd. by Pepsico Inc NOTAPPROVED
Low in vitamin C
Fruit2O Plus™ Citrus Energy Boost Dist. by Veryfine Products, Inc. NOT APPROVED
Low in vitamin C
Glaceau Vitamin Water™ multi-V Dist. by Energy Brands Inc. NOTAPPROVED
Low in vitamin A & C
Propel® Fitness Water, Vitamin Enhanced Water Dist. by The Gatorade Company APPROVED
Doctors Foster & Smith Vita-min Tabs For Cats Dist. by Drs. Foster & Smith, Inc. NOTAPPROVED
Low in vitamin A
Pet-Tabs® Supplement A Highly Palatable Vitamin-Mineral Supplement Dist. by Virbac AH, Inc. APPROVED
Vita Chews Daily Multi-Vitamin with Minerals Flavored Pork Liver Tablets For Dogs Dist. by 1-800-PetMeds APPROVED
*Tested through CL’s Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review.
NA — Not applicable.
**Exceeds the UL for one or more nutrients. See Compare Vitamins and Compare Minerals tables for details. ***The status of this product has been updated to Approved. Some of its vitamin A content is in the form of beta-carotene. In originally evaluating this product, CL used a 3:1 conversion factor for beta-carotene to vitamin A as recommended by the World Health Organization for supplements. However, CL has learned that a 2:1 ratio is recommended by the Institute of Medicine for supplements and is more commonly used by manufacturers.
1Note: On May 14, the manufacturer of this product issued a release stating it has “had independent laboratories test product currently in retailers and they have found that Li’l Critters Gummy Vites is well below all state and federal standards and limits.” Consumers should be aware that the manufacturer’s tests were not performed on the lot tested by CL — which has an expiration date of 9/05 and may still be in use and available in stores. The manufacturer’s tests were performed on more recently produced lots having ’06 expiration dates and have not been tested by CL.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time. So be sure to check labels carefully when evaluating the products you use or buy. If a product’s ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested. The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information provided to it by third parties. Liability to any person for any loss or damage caused by errors, omissions, or inaccuracies in this report is hereby disclaimed. Copyright ConsumerLab.com, LLC, 2004. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.
In addition to product quality, a critical issue for multivitamin/multimineral products is whether the type of ingredients and amounts are right for the person taking the product. Although by no means comprehensive, below is useful reference information about ingredients often found in multis.
As required by the FDA, dietary supplements must show on their labels or packaging the percent of the Daily Value for certain vitamins and minerals contained. However, the percentages given may not reflect the latest Recommended Dietary Allowances (RDAs) or Adequate Intakes (AIs). Nor are products required to provide information indicating whether their ingredients may exceed Tolerable Upper Intake Levels (ULs) for the individuals for whom they are intended and many do exceed these ULs.
These values (RDAs, AIs, and ULs) are collectively known as Dietary Reference Intakes (DRIs) and are established by the Institute of Medicine of the National Academies. A Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is thought to be sufficient to meet the nutrient requirement of nearly all healthy individuals in a particular life stage and gender. An Adequate Intake (AI) is similar to an RDA but is more of an approximation used when there is not sufficient information to develop an RDA. A Tolerable Upper Intake Level (UL) is the highest level of daily intake of a nutrient that is likely to pose no risk of adverse health effects for most people. As intake increases above the UL, the risk of adverse effects may increase. Like the RDAs and AIs, the ULs vary according to one’s age, life stage, and gender. Individuals are advised not to regularly exceed the UL unless medically recommended and supervised.
Most products will list the amount of each claimed ingredient. The information provided below can help one determine whether such amounts are appropriate. Keep in mind that 1,000 mcg (micrograms) is the same as 1 mg (milligram), and 1,000 mg equals 1 gram. IU stands for International Units and is used for certain ingredients measured by their activity rather than weight.
Note that where the text below describes what the vitamin does in the body, or describe symptoms of severe deficiency, this does not necessarily indicate the benefits to be obtained by taking that vitamin. For example, vitamin A is necessary for vision, but if you are not severely vitamin A deficient, taking more vitamin A will not enhance your vision. Since few people today are severely deficient in any nutrient, the actual benefits of nutrient supplementation are more related to problems caused by marginal deficiency, but these are seldom clear at the current state of knowledge.
Vitamins and minerals are often used in another way rather than to correct marginal deficiencies: they are proposed for use at doses much higher than nutritional needs in hopes of providing a benefit that may be unrelated to the nutrient’s ordinary function in the body. There are a great many of these proposed “megadose” uses. For more detailed information, see the links to Reviews of specific vitamins and minerals as well as articles in the Natural Products Encyclopedia.
- Vitamin A is necessary to maintain good vision and skin. In supplements, “Vitamin A” usually refers to retinol (including retinyl palmitate and retinyl acetate) as well as beta-carotene. Retinol is found in animal-derived sources such as dairy foods and liver. Beta-carotene comes from fruits and vegetables, such as carrots and spinach. It is thought that beta-carotene is converted in the body into vitamin A based on the body’s need for vitamin A and, therefore, may be a safer form of vitamin A to avoid potential overdosing. While supplement labels generally combine beta-carotene and retinol in calculating their vitamin A content, many will also note the percent of vitamin A that is contributed by beta-carotene.Recommended amounts of vitamin A are discussed below:
- Be aware that the amount of vitamin A in supplements is usually shown in IUs. Labels may alternatively (and actually more correctly) list their vitamin A content in micrograms (shown as mcg). The microgram equivalent of one IU of vitamin A depends upon the form of vitamin A. For the “retinol” form, 0.3 mcg equals 1 IU. For the “retinyl acetate” form, 3.44 mcg equals 1 IU. For the “retinyl palmitate” form, .55 micrograms equals 1 IU.
- The RDA for vitamin A is 1,000 IU for children 1 to 3 years old, 1,333 IU for those 4 to 8, and 2,000 IU for those 9 to 13. For males 14 years and up, the RDA is 3,000 IU. For females 14 years and older, 2,333 IU is recommended. These amounts can be obtained from the food sources mentioned above.
- Too much vitamin A can be a problem. The most important risk involves pregnant women: vitamin A given in modestly excessive doses can cause birth defects. Much higher doses of vitamin A can cause other forms of harm, such as abnormalities in the liver, central nervous system, bone and skin. The UL for daily intake should not exceed 2,000 IU for children 1 to 3 years old, 3,000 IU for those 4 to 8, 5,666 IU for those under 9 to 13, 9,333 IU for those 14 to 18, and 10,000 IU for adults. However, these ULs apply only to vitamin A consumed from supplements, fortified foods, and animal sources, and does not include vitamin A as beta-carotene or intake from fruits and vegetables.
- One must be aware that some products, especially those designed for a broad range of individuals may exceed the ULs for certain subgroups. For example, a multivitamin for “children” may be appropriate for older children but exceed ULs for younger children.
- B Vitamins: (See ConsumerLab.com’s B Vitamin Product Review for more information).
- Thiamin (B-1) assists nervous function. It is found in yeast, peas, beans, enriched flour and whole grains in large enough amounts that supplementation is normally not necessary. The most important exceptions are individuals with alcoholism or congestive heart failure, who may become thiamin deficient. The RDA is 0.5 mg for children 1 to 3, 0.6 mg for those 4 to 8, and 0.9 mg for those 9 to 13. For males 14 years and older the RDA is 1.2 mg. For females 14 to 18 the RDA is 1.0 mg, and it increases to 1.1 mg for those 19 and older. However, the RDA for pregnant or lactating women is 1.4 mg. ULs have not been established for thiamin, and it is believed to be safe even at very high doses.
- Riboflavin (B-2) maintains vision and the skin. Although found in many vegetables and nuts, as well as enriched flour, some supplementation may be needed in children and the elderly. The RDA is 0.5 mg for children 1 to 3, 0.6 mg for those 4 to 8, and 0.9 mg for those 9 to 13. For males 14 years and older the RDA is 1.3 mg. For females 14 to 18 the RDA is 1.0 mg, and it increases to 1.1 mg for those 19 and older. However, the RDA for pregnant women is 1.4 mg and for lactating women it is 1.6 mg. Much higher amounts (400 mg per day) have been suggested in the prevention of migraines. ULs have not been established for riboflavin; this is believed to be a safe nutrient even at high doses.
- Niacin (B-3) helps release energy from carbohydrates. It is available in the diet from enriched white flour, as well as from peanuts, fish and meat. The RDA is 6 mg for children 1 to 3, 8 mg for those 4 to 8, and 12 mg for those 9 to 13. For males 14 years and older the RDA is 16 mg. For females 14 and older the RDA is 14 mg. However, the RDA for pregnant women is 18 mg and for lactating women it is 17 mg. High doses of niacin may cause harmless but unpleasant flushing of the skin, including reddening, burning, tingling, itching and pain. At very high doses, liver inflammation can also occur. The UL for niacin applies only to that consumed from supplements and fortified foods (other food sources are not included) and is 10 mg for children 1 to 3, 15 mg for those 4 to 8, 20 mg for those 9 to 13, 30 mg for those 14 to 18, and 35 mg for individuals 19 years and older. Doses of niacin far above the ULs can improve cholesterol levels. Niacin should only be used in this way under medical supervision.
- Pyridoxine (B-6) is important in many aspects of metabolism and in maintaining the immune and nervous systems. B-6 is widely available in the diet, but marginal deficiency is believed to be relatively common in the developed world. Inadequate B-6 may raise blood levels of the substance homocysteine, and elevated homocysteine may in turn increase risk of cardiovascular disease. On this basis, B-6 supplements have been suggested as a means of helping to prevent cardiovascular disease, but efficacy has not been proven. The RDA is 0.5 mg for children 1 to 3, 0.6 mg for those 4 to 8, and 1.0 mg for those 9 to 13. For males 14 to 50 the RDA is 1.3 mg, and for those 51 and older it is 1.7 mg. For females 14 to 18 it is 1.2 mg, for those 19 to 50 it is 1.3 mg, and for those 51 and older it is 1.5 mg. However, the RDA for pregnant women is 1.9 mg and for lactating women it is 2.0 mg. The UL for B-6 is 30 mg for children 1 to 3, 40 mg for those 4 to 8, 60 mg for those 9 to 13, 80 mg for those 14 to 18, and 100 mg for individuals 19 years and older. Intake of B-6 above these levels can cause toxic effects, such as nerve damage. B-6 supplementation at a high but still safe dose of 30 mg daily has shown some promise for treating morning sickness. Other proposed uses of high-dose B-6, such as PMS, autism and asthma, lack reliable scientific support.
- Folic acid (Folate, Folacin or B-9) is known to reduce the risk of certain birth defects in offspring. Furthermore, adequate folate, along with vitamin B-6 and vitamin B12, are necessary to keep homocysteine levels low (see B-6 above). Good natural sources of folic acid include dark green leafy vegetables and oranges. Because folic acid is added to enriched grains and some other foods, most people get sufficient folic acid from their diet. Nonetheless, supplements are generally recommended for women who are pregnant or may soon become pregnant. The RDAs are shown below. It is important to know, however, that these RDAs are based on intake from regular food sources. Folic acid from supplements and fortified foods is actually absorbed twice as well as that from regular food sources. Consequently, if one is relying on supplements or fortified foods to reach the RDA, they only need one-half the amount listed in the following RDAs: 150 mcg for children 1 to 3, 200 mcg for children 4 to 8, and 300 mcg for children 9 to 13. For individuals 14 years and older the RDA is 400 mcg. However, the RDA for pregnant women is 600 mcg, and for lactating women it is 500 mcg. In view of its importance to developing fetuses during the first few weeks after conception, it is recommended that all women capable of becoming pregnant consume 400 mcg from supplements or fortified foods in addition to intake of food folic acid from a varied diet.The UL for folic acid applies only to that consumed from supplements and fortified foods and is 300 mcg for children 1 to 3, 400 mcg for those 4 to 8, 600 mcg for those 9 to 13, and 800 mcg for those 14 to 18. For individuals 19 years and older the UL is 1,000 mcg. Intake of high doses of folic acid can make it difficult to detect severe vitamin B-12 deficiency; severe B-12 deficiency is a relatively rare condition, but missing the diagnosis can be catastrophic, and that possibility is the main reason for concern about excessive folic acid intake.
- B-12 deficiency can cause anemia, and, if the deficiency is severe enough, irreversible nerve damage may occur. B-12 is also required, along with folate and B-6, to maintain low homocysteine levels. However, true deficiency of this vitamin is rare. Vitamin B-12 is found in abundant quantity in meat, dairy products and eggs, and the body can store enough B-12 to last for years. Note, though, that B-12 is not found at useful levels in any purely plant-based substance. For this reason, total vegetarians (vegans) need to take a B-12 supplement. Deficiency might also occur in people with low stomach acidity, such as seniors or those taking drugs that reduce stomach acid (such as Prilosec or Zantac). The reason is that stomach acid is required to separate B-12 from the proteins in which it is naturally found. People with low stomach acid can still absorb the purified B-12 found in supplements. The RDA is 0.9 mcg for children 1 to 3, 1.2 mcg for those 4 to 8, and 1.8 mcg for those 9 to 13. For individuals 14 years and older the RDA is 2.4 mcg. However, the RDA for pregnant women is 2.6 mcg and for lactating women it is 2.8 mcg. ULs have not been established for vitamin B-12.
- Vitamin C (ascorbic acid) is required for healthy blood vessel walls, gums, and bones. It is also a strong antioxidant. Vitamin C is found in many vegetables, such as broccoli and Brussels sprouts, as well citrus and other fruits, so that a healthful diet should allow one to meet the RDA. The RDA is 15 mg for children 1 to 3, 25 mg for those 4 to 8, and 45 mg for those 9 to 13. For males 14 to 18 the RDA is 75 mg, and it is 90 mg for those ages 19 and higher. For females 14 to 18 the RDA is 65 mg, and it is 75 mg for those ages 19 and higher. However, the RDA for pregnant women 18 years and younger is 80 mg and 85 mg if 19 or older, and the RDA for lactating women 18 years and younger is 115 mg and 120 mg if 19 or older. Too much vitamin C can cause diarrhea and other gastric disturbances. The UL for vitamin C is 400 mg for children 1 to 3, 650 mg for those 4 to 8, 1,200 mg for those 9 to 13, 1,800 mg for those 14 to 18, and 2,000 mg for individuals 19 years and older. Dosages of vitamin C far above nutritional needs have been recommended for a great many illnesses, including the common cold. See ConsumerLab.com’s Vitamin C Product Review for more information.
- Vitamin D (cholecalciferol) helps the body absorb calcium to promote strong bones and teeth. It can be obtained in sufficient amounts from fortified milks and foods and from exposure to sunlight. However, people who live in northern climates may easily become vitamin D deficient during the winter, especially if they are dark-skinned. Also, increased concern about skin cancer has caused people to avoid the sun, and this creates a potential risk of reduced vitamin D. There is some evidence that inadequate vitamin D intake can lead to an increased risk of various forms of cancer, including breast cancer. Vitamin D is measured as micrograms of cholecalciferol or in International Units (IUs) of vitamin D activity. One microgram equals 40 IUs. An AI (Adequate Intake) has been established but is only relevant if an individual is not getting adequate exposure to sunlight. The AI is 5 micrograms (200 IU) for individuals ages 1 to 50, 10 micrograms (400 IU) for those 51 to 70, and 15 micrograms (600 IU) for those 71 years and older. Excessive intake of vitamin D as a supplement can potentially result in hypercalcemia (too much calcium in the blood) with symptoms including constipation, confusion, weakness, loss of appetite and painful calcium deposit. Taking too much during pregnancy can cause abnormalities in the fetus. The UL for individuals 1 year old and above is 50 micrograms (2,000 IU).
- Vitamin E (tocopherol) is an antioxidant. Most diets provide enough vitamin E to meet RDAs as it is easily obtained from food sources such as nuts, seeds, whole grains, vegetable oils, and the fatty part of meats. For a time, megadoses of this nutrient (much higher than could be reasonably obtained through diet) were widely recommended in the belief that it would help prevent cancer and cardiovascular disease. Unfortunately, accumulating evidence has largely dashed this hope, at least regarding the most common form of vitamin E supplements (alpha tocopherol, whether synthetic or natural). There is still some possibility that high dosages of vitamin E may reduce risk of prostate cancer, and that other forms of vitamin E, such as gamma tocopherol, might offer the benefits hoped for with standard vitamin E supplements. High dose vitamin E has also shown promise for slowing the progression of Alzheimer’s disease and enhancing the immune response to vaccinations in seniors. There are literally hundreds of other proposed uses of high dose vitamin E, but they generally lack strong scientific support. Vitamin E is measured as IUs of vitamin E activity or, more recently, in milligrams of active alpha-tocopherol. Most supplements are still labeled using IUs. Complicating matters a bit, the conversion factor between IUs and milligrams differs for natural vitamin E versus synthetic vitamin E. Most multis contain synthetic vitamin E, for which the conversion rate is 1 IU for each 0.45 mg of active alpha-tocopherol. The conversion rate for natural vitamin E is 1 IU for each 0.67 mg of active alpha-tocopherol.The RDA for vitamin E as active alpha tocopherol for children 1 to 3 is 6 mg (13 IU synthetic or 9 IU natural), for those 4 to 8 it is 7 mg (16 IU synthetic or 10 IU natural), and for those 9 to 13 it is 11 mg (24 IU synthetic or 16 IU natural). The RDA for individuals ages 14 and older is 15 mg (33 IU synthetic or 22 IU natural). However, the RDA for lactating women is 19 mg (42 IU synthetic or 28 IU natural). There are some concerns that high doses of vitamin E may impair platelet activity and lead to increased risk of bleeding. This risk would be expected to increase if high doses of vitamin E were combined with drugs that impair clotting. The ULs for vitamin E apply only to that consumed from supplements and fortified foods and are as follows: for children 1 to 3 it is 200 mg, for children 4 to 8 its is 300 mg, for those 9 to 13 it is 600 mg, and for those 14 to 18 it is 800 mg. The UL for individuals 19 and older is 1,000 mg. One must also be aware that the 1,000 mg per day adult UL translates into about 1,500 IU’s of natural vitamin E, but only 1,100 IU’s of synthetic vitamin E because both the active and inactive forms of alpha-tocopherol found in synthetic vitamin E may contribute to this effect on blood clotting. The ULs therefore translate approximately into the following IU amounts: for children 1 to 3 the UL is 220 IU synthetic or 300 IU natural, for those 4 to 8 it is 330 IU synthetic or 450 IU natural, for those 9 to 13 it is 660 IU synthetic or 900 IU natural, and for those 14 to 18 it is 880 IU synthetic or 1,200 IU natural.
(See ConsumerLab.com’s Vitamin E Product Review for more information).
- Vitamin K plays a central role in blood clotting as well as bone formation. Foods, such as green leafy vegetables, can provide sufficient amounts, and intestinal bacteria also produce vitamin K. True deficiency is rare; however, there is some evidence that vitamin K supplements at doses higher than nutritional needs may help fight osteoporosis. The AI (Adequate Intake) of vitamin K is measured in micrograms (shown as mcg). The AI is 30 mcg for children ages 1 to 3, 55 mcg for children 4 to 8, 60 mcg for those ages 9 to 13, and 75 mcg for those ages 14 to 18. For males 19 years and older, it is 120 mcg. For females 19 years and older, it is 90 mcg. There is no UL established for vitamin K.
- Calcium — While critical for strong bones and teeth, calcium is a very bulky material and most multis therefore do not contain the total recommended daily intake amount in a tablet, as it might make the tablet too large. Consequently, people should consider getting their calcium from a separate calcium supplement or fortified food or beverage. The AI for calcium is 500 mg for children 1 to 3, 800 mg for children 4 to 8, and 1,300 mg for children 9 to 18. For adults aged 19 to 50, it is 1,000 mg. For those 51 years and older it is 1,200 mg per day. The UL for calcium is 2,500 mg and applies to all individuals 1 year and older. Excessive use of calcium supplements might raise risk of kidney and bladder stones. (See ConsumerLab.com’s Calcium Product Review for more information.)
- Chromium plays a role in the body’s regulation of blood sugar. Chromium is found in liver and whole-wheat products. It is unclear whether marginal chromium deficiency occurs commonly or rarely. Chromium supplementation (especially in doses considerably above nutritional needs) has shown some promise for helping to regulate blood sugar levels in people with type 2 diabetes. Chromium is also sold as a weight-loss aid, but there is little evidence that it really works. AI’s for chromium are measured in micrograms (shown as mcg) and are: 11 mcg for children ages 1 to 3, and 15 mcg for children ages 4 to 8. For boys ages 9 to 13, it is 25 mcg, while for girls it is 21 mcg. For males ages 14 to 50 it is 35 mcg. For females ages 14 to 18 it is 24 mcg, rising to 25 mcg for those ages 19 to 50. For men 51 years and older it is 30 mcg, and for women aged 51 and older it is 20 mcg. Women who are pregnant need more � 29 mcg if 18 or younger and 30 mcg if 19 and older, while lactating women need even more � 44 mcg if 18 or younger and 45 mcg if 19 or older. There is no UL established for chromium, but there are concerns that excessive intake could cause kidney and other organ damage in certain susceptible people. (See ConsumerLab.com’s Weight Loss/Diabetes Management Product Review for more information.)
- Copper is necessary for proper development of connective tissue, nerve coverings, and skin pigment. Copper is found in foods such as organ meats, oysters, nuts, and seeds and can be obtained in sufficient quantity from a good diet. People who take zinc supplements may need to take extra copper. Copper in supplements may be shown in milligrams (mg) or micrograms (shown as mcg). One milligram is equal to 1,000 micrograms. The RDAs are: 340 mcg for children ages 1 to 3, 440 mcg for children ages 4 to 8, 700 mcg for those ages 9 to 13, 890 mcg for those 14 to 18. For people over 19 years of age, the RDA is 900 mcg. For women who are pregnant the RDA is 1,000 mcg, while for lactating women it is 1,300 mcg. Excessive consumption of copper may cause nausea and liver damage. The daily upper limits for copper are 1,000 mcg for children ages 1 to 3, 3,000 mcg for those 4 to 8, 5,000 mcg for those 9 to 13, 8,000 mcg for those 14 to 18, and 10,000 mcg for people 19 years and older.Animal studies have shown that one form of copper called copper (or cupric) oxide may not be well absorbed. Other forms, such as copper sulfate, cupric acetate, and alkaline copper carbonate, may, therefore, be preferable. Unfortunately, copper oxide is common in supplements (including some that have “passed” CL’s testing) because it is less bulky and allows for smaller pills.
- Iodine is needed for making thyroid hormones, and iodine deficiency causes hypothyroidism (low thyroid). However, iodine deficiency is uncommon in the developed world, and too much iodine can also cause hypothyroidism! Seafood and seaweeds provide iodine. In addition most table salt is now iodized and represents a good dietary source of iodine. The RDAs are given in micrograms (shown as mcg) and are: 90 mcg for children ages 1 to 8, and 120 mcg for children ages 9 to 13. For both males and females ages 14 and older, the RDA is 150 mcg. However, for pregnant women it is 220 mcg, and for lactating women it is 290 mcg. Too much iodine taken during pregnancy can cause problems in infants. ULs for iodine are: 200 mcg for children ages 1 to 3, 300 mcg for those 4 to 8, 600 mcg for those 9 to 13, 900 mcg for those 14 to 18, and 1,100 mcg for all people 19 years and older.
- Iron deficiency is the leading cause of anemia. Deficiency is most common in menstruating woman and is also seen in some children and pregnant women. Adult men are seldom deficient in iron, and many multivitamins for adult men specifically leave out iron, because there are concerns that excess iron intake might increase risk of heart disease. Meat, poultry and fish are rich in iron. Dried fruits, grains and green leafy vegetables are also good sources, although iron from plant sources is absorbed only half as well as that from animal sources. The RDA is 7 mg for children 1 to 3 years and 10 mg for those 4 to 8. It then falls to 8 mg for those 9 to 13. For males 14 to 18 it is 11 mg, and for those 19 years and older the RDA again falls to 8 mg. For females 14 to 18 it is 15 mg, and for those 19 to 50 it is 18 mg, falling to 8 mg for women ages 51 and higher. However, because of the needs of the fetus, the RDA for pregnant women is increased to 27 mg. For lactating women 18 years old and younger, the RDA is 10 mg, or 9 mg for lactating women 19 and older. Also, post-menopausal women taking hormone replacement therapy may need more iron if the therapy causes periodic uterine bleeding. Oral contraceptives may reduce menstrual blood losses, so women taking them may need less daily iron. High daily amounts of iron can cause gastrointestinal distress, especially when consuming iron supplements on an empty stomach. The UL is 40 mg for children 13 years and younger, and 45 mg for all other people. However, these limits may be too high for people with hereditary hemochomatosis, who are at risk for accumulating harmful levels of iron. See ConsumerLab.com’s Iron Product Review for more information.)
- Magnesium assists metabolism and the nervous system. There is some controversy regarding whether marginal magnesium deficiency is a rare or a common occurrence. Whole grains, nuts and beans are good sources of magnesium. The RDA is 80 mg for children 1 to 3, 130 mg for those 4 to 8, and 240 mg for those 9 to 13. For males 14 to 18 it is 410 mg, for those 19 to 30 it falls to 400 mg, and for those 31 years and older it is 420 mg. For females 14 to 18 it is 360 mg, for those 19 to 30 it falls to 310 mg, and for those 31 years and older it is 320 mg. However, for pregnant women it is 400 mg if they are 18 years or younger, 350 mg if 19 to 30, and 360 mg if 31 or older. For lactating women it is 360 mg if they are 18 years or younger, 310 mg if they are 19 to 30, and 320 mg if 31 or older. People with diabetes are thought to have an increase need for magnesium. Magnesium supplements around or above the levels of the ULs have shown some promise for the treatment of migraine headaches and high blood pressure, as well for preventing kidney stones. Excessive magnesium intake can cause nausea and vomiting, low blood pressure, and muscle weakness. The UL for magnesium applies only to that consumed from supplements or other medication and is 65 mg for children 1 to 3 and 110 mg for those 4 to 8. For individuals 9 years and older the UL is 350 mg. (See ConsumerLab.com’s Magnesium Product Review for more information.)
- Manganese is involved in bone formation and metabolism. Nuts, legumes, tea, and whole grains are rich sources of manganese and can provide adequate amounts. The daily AI for manganese is 1.2 mg for children 1 to 3 years, and 1.5 mg for those 4 to 8. It is 1.9 mg for males 9 to 13, 2.2 mg for those 14 to 18, and 2.3 mg for those 19 years and older. For females 9 to 18, the level is 1.6 mg, increasing to 1.8 mg for those 19 years and older. Pregnant women need 2.0 mg per day and lactating women need 2.6 mg per day. Too much manganese may cause neurological side effects. The UL for manganese is 2 mg for children 1 to 3, 3 mg for children 4 to 8, 6 mg for children 9 to 13, and 9 mg for children 14 to 18. The UL for adults 19 years and older is 11 mg.
- Molybdenum is a constituent of various enzymes in the body and can be obtained from legumes, grain products, and nuts in the diet. Deficiency is rare in the U.S. RDAs for molybdenum are given in micrograms (shown as mcg) and are: 17 mcg for children 1 to 3 years, 22 mcg for those 4 to 8, 34 mcg for those 9 to 13, and 43 mcg for those 14 to 18. Individuals 19 years and older need 45 mcg per day, except woman who are pregnant or nursing should get 50 mcg per day. Massive amounts of molybdenum can cause gout-like symptoms. The UL for molybdenum is 300 mcg for children 1 to 3, 600 mcg for those 4 to 8, 1,100 mcg for those 9 to 13, 1,700 mcg for those 14 to 18, and 2,000 mcg for people 19 years and older.
- Selenium is used by the body in it its antioxidant system. There is some preliminary evidence that selenium supplements may help prevent certain forms of cancer, but this benefit appears to be limited to those who are deficient in the mineral, and deficiency is thought to be relatively uncommon in the developed world. Foods containing selenium include nuts, wheat germ, whole wheat, and orange juice. The RDA is 20 mcg for children 1 to 3, 30 mcg for those 4 to 8, and 40 mcg for those 9 to 13. For individuals 14 and older the RDA is 55 mcg. However, the RDA for pregnant woman is 60 mcg and for nursing women it is 70 mcg per day. At very high doses selenium can cause hair loss and tissue damage. The UL for selenium is 90 mcg for children 1 to 3, 150 mcg for those 4 to 8, and 280 mcg for those 9 to 13. The UL for individuals 19 years and older is 400 mcg.
- Zinc plays a role in brain function, wound healing, and sperm production. Many breakfast cereals are fortified with zinc and it is naturally abundant in red meats, certain seafood, and whole grains. However, mild zinc deficiency is thought to be fairly common. Zinc supplements at nutritional doses may enhance immunity in people who are significantly deficient in the mineral, such as seniors in nursing homes and people who live in developing countries. The RDA of zinc is 3 mg for children ages 1 to 3, 5 mg for those 4 to 8, and 8 mg for those 9 to 13. For males 14 and older the RDA is 11 mg. For females 14 to 18 it is 9 mg, while for those 19 years and older it is 8 mg per day. The RDA for pregnant women who are 18 years or younger is 13 mg, while it is 11 mg for pregnant women 19 years and older. For lactating women the RDAs are 14 mg if 18 years and younger or 12 mg if 19 years or older. High doses of zinc have shown promise for treatment of acne, macular degeneration and sickle cell disease. However, too much zinc can be toxic, and people have caused harm to themselves using zinc for these conditions. Excessive zinc impairs the absorption of copper and can cause immune deficiency, heart problems and anemia. Weak evidence associates long-term zinc supplementation at high doses (over 100 mg per day) with an increased risk of prostate cancer.ULs for zinc are: 7 mg for children ages 1 to 3, 12 mg for those 4 to 8, 23 mg for those 9 to 13, 34 mg for those 14 to 18, and 40 mg for individuals 19 years and older. NOTE: Zinc is widely used in an entirely different manner for treatment of colds: in the form of a lozenge or nasal spray to kill viruses. This use has no relationship to the effects of zinc taken as an oral supplement. (See ConsumerLab.com’s Zinc Product Review for more information.)
� 2005 ConsumerLab.com, LLC. Reproduced without permission.
update 7-25-05: My Puritan’s Pride order arrived a week after ordering it. They look like vitamins, and taste like vitamins… they were inexpensive and Oxford Healthcare recommended them… so maybe I’ll live forever after all.