Vitamins and Supplements: Are They Necessary?
An integrative health specialist shares who may benefit from dietary supplements, and how to know which are the most effective kinds.
It’s easy to think you could benefit from vitamins, minerals, and herbal supplements. Walk down a pharmacy aisle and you’ll see bottles touting an array of benefits: from boosting memory to smoothing skin. But are they necessary to support your overall health?
In the broad category of dietary supplements, it’s usually “vitamins, minerals, and herbs,” says Dr. Chiti Parikh, an integrative medicine practitioner, and the Executive Director of Integrative Health and Wellbeing at NewYork-Presbyterian and Weill Cornell Medicine. “We all want to optimize our well-being and our organs, but if a diet is healthy and wholesome, you don’t need to supplement it.”
However, there are certain instances in which taking a supplement might prove helpful, like during pregnancy, for example, or to support an individual deficiency. And in those such cases, finding the right one isn’t as simple as shopping off the nearest shelf.
“If you look at the ingredient lists of different multivitamins, for example, there is significant variation in what they actually contain,” Dr. Parikh says.
To better understand the different types of vitamins and supplements and their potential benefits, Health Matters spoke with Dr. Parikh. She offers advice on how to learn if you need to supplement your diet, and how to spot the safest and best varieties if you do.
Dr. Chiti Parikh
How do you know if you need to take a supplement?
Dr. Parikh: As the name implies, a supplement is meant to add whatever you’re not getting enough of through your diet. It’s very important that we think about supplements as an addition to what we’re supposed to get from food.
Even though I do recommend supplements to my patients, I always tell them it is a bridge; supplementation is to fix a deficiency until you get your diet up to a level where it is enough. So I always tell people: Before you think about whether you’re missing out on a nutrient or not, ask yourself if you’re eating an ideal diet. Think about adopting more of a Mediterranean diet and plant-based diet, and steer away from more processed food and fast foods.
And this is true also for children: We should take the opportunity to train our kids in eating a healthy, well-balanced diet. It’s not about eating candy and then eating a multivitamin gummy.
Should we talk with our doctor before taking vitamins or supplements?
There’s no downside in getting a baseline blood test. These can be done as part of your routine annual physical. I treat supplements the same as I do any medication: If I’m prescribing a medication, I’ll first give a blood test. For instance, if I’m prescribing a medication for diabetes, I first check the person’s blood to make sure they have diabetes; then I check how serious it is and see what the right dose of medication will be. Then I’ll repeat the blood test to make sure the medication is working and if I need to adjust the dose.
I do the same when considering supplements. Often when I see my patients for the first time, I will get a baseline set of blood tests to check their vitamin and mineral levels to see if they’re deficient in any of them. Vitamins such as iron, B12, folate, and D can be easily checked through a blood test. A complete metabolic panel will often check for things like sodium, potassium, and calcium. From there I may suggest a multivitamin if someone is low in more than two or three different vitamins.
What should a person look for if they’re shopping for a supplement or multivitamin?
Check the label for daily value percentages. For instance, if it says vitamin C, 200%, that basically tells you that you are getting about 200% of your daily recommended value of vitamin C. I tell my patients that you want to be somewhere between 50% to 200%.
If you’re shopping for a multivitamin, make sure the ingredient list lists all the vitamins with their daily value percentages.
Another thing to be mindful of is that vitamins can be categorized into water soluble and fat soluble. Some vitamins like A, D, E and K are fat soluble, and it’s possible to overdose or get too much of them. That’s one reason a blood test is really necessary; you want to understand whether or not you need a certain vitamin, what dose is appropriate, and whether or not you’re absorbing the right amount.
Your body can eliminate excess doses of water-soluble vitamins. Examples of water-soluble vitamins are vitamin C, and the B vitamins like folate and b12. But if you’re taking fat-soluble vitamins, then you wouldn’t necessarily want to exceed the daily recommended values.
Are there certain populations or age groups for which supplements are highly recommended?
Absolutely. Pregnant women require supplementation because of their dietary and nutritional needs. And it’s important they get their blood test done as part of their routine checkups to make sure they’re taking the right doses.
If someone has IBS issues or an autoimmune disease of the gut that impairs their ability to absorb vitamins and nutrition from food, they would benefit from supplementation.
The elderly population might also need supplementation, if an individual’s diet isn’t varied enough.
"Even though I do recommend supplements to my patients, I always tell them it is a bridge; supplementation is to fix a deficiency until you get your diet up to a level where it is enough."— Dr. Chiti Parikh
What are common vitamins and supplements you end up telling patients to take?
An iron supplement might be beneficial for patients who experience heavy periods with heavy bleeding. It’s common when young girls start menstruating and losing blood to also lose more iron, and they might not be getting enough from their diet. In my estimation, about 20% of the women I see in my practice tend to be iron deficient. And often that’s something that can be overlooked.
People may also be deficient in vitamin D, folate and B12. Folate, which is one of the B vitamins, and B12 are very involved with brain health and our cognition. And studies have shown that folate levels correlate with mood. Many people with depression often have low levels of folate in their blood and in the fluid around their brain. Folate is found in fresh vegetables, fruits, and whole grains; if you’re eating mostly processed foods, you’re often not getting enough folic acid. And since vitamin B12 is in eggs, meat products and some dairy products, you might consider supplementing if you’re vegan.
What are your feelings about supplemental probiotics?
One question I often get about gut health is, “Which probiotic should I take?” A lot of research has gone into understanding our gut microbiome – the trillions of bacteria and microorganisms that live in the gut. We’re learning more about how they impact basically everything in the body, from our mood to our immune system.
I always say that bacteria are living, breathing things; they’re not just a chemical compound. We have to make sure our diet is optimal to support these good bacteria so they can live longer and continue to give us all the good benefits. A healthy diet, with a lot of fruits, vegetables, legumes, and whole grains is vital to support the bacteria in the gut.
Overall, when it comes to supplements, I encourage my patients to talk to their doctor and have an honest conversation. Express curiosity in checking if you’re deficient in any vitamins. If you learn that you do need to supplement, you can do it with more information at hand.