What vitamins and minerals are typically found in ‘multis’?

‘Multis’ contain a long list of nutrients that help to support energy production, assist in healthy blood cell production, support healthy immune system function, and support a healthy stress response, as well as maintaining general health and wellbeing. These nutrients commonly include an extensive range of vitamins and minerals; select amino acids, such as taurine; and other important nutrients, often including alpha-lipoic acid, choline and inositol.

The number, dose and form of vitamins and minerals varies depending on brand and product. Some ‘multis’ even contain additional ingredients, such as Rosa canina (Rosehip) dry fruit powder,¹ bromelains² and/or citrus bioflavonoids³ for added antioxidant and anti-inflammatory support.

Why do some multivitamin and mineral supplements not contain iron?

Some multivitamins do not contain iron for several reasons including:

• Risk of Iron Overload: excess iron can accumulate in the body, leading to conditions like liver damage, heart problems and diabetes. This is particularly a concern for men who do not lose iron through menstruation.⁴
• Absorption Issues: iron can interfere or compete with the absorption of other minerals and vitamins in a ‘multi’, especially zinc. The inverse is true for calcium which can inhibit iron absorption. By excluding iron, manufacturers can enhance the overall effectiveness of the multivitamin. However, it should also be noted that some nutrients, such as ascorbic acid (vitamin C), enhance the absorption of non-haem iron.⁵
• Targeted Supplements: some individuals, like women during their reproductive years (menstruating), those with specific health conditions (e.g. iron deficiency anaemia)⁶ or those adhering to specific diets (e.g. plant-based vegetarian or vegan diets that provide less bioavailable iron),⁷ may require additional iron. In such cases, it’s often recommended to take iron supplements separately to better manage dosage and absorption. For reference, women of reproductive age have a recommended daily intake (RDI) of 18 mg/day for iron whereas men of the same age have an RDI of only 8 mg/day.⁸

* For more information on optimising iron status through supplementation, refer to the Eagle Who Should Take Iron With Cofactors? Article, available from practitioner.integria.com/articles/who-should-take-iron-with-cofactors

Can’t we get all the nutrients we need from food alone?

It can be difficult to obtain enough nutrients from dietary sources alone. This comes down to three main factors:

• Modern Agricultural Practices: limited available information suggests that most New Zealand soils contain relatively low concentrations of iodine and selenium. Some areas of Australia also have a history of iodine deficiency.⁹ Aside from soil depletion, the use of pesticides in conventional produce (as compared to organic produce) reduces the antioxidant content and nutritional value of food;¹⁰ and long cold storage times reduce the antioxidant activity of fruits and vegetables.¹¹
• Poor Dietary Choices: the Western diet is common these days, characterised by a high intake of processed foods, refined grains, unhealthy fats, and added sugars, often at the expense of nutrient-rich foods that supply essential vitamins, minerals, fibre, and antioxidants.¹² This correlates with the findings of one study finding that out of 31 eligible nutrients for consideration intake of 22 nutrients (71%) was inadequate across Australian and New Zealand populations.¹³
• Stress: the burden of stress can deplete micronutrients, such as magnesium and zinc.¹⁴

Who could benefit from multivitamin and mineral supplementation?

While most people within the general population could benefit from increasing their intake of vitamins and minerals to achieve nutritional adequacy,¹⁵ it is particularly important for the elderly and pregnant and breastfeeding women to do so.

Elderly individuals may require additional nutrients to help preserve and support their cognitive function;¹⁵ and help to address malnutrition, when diet alone is insufficient to meet the age-specific requirements of older adults.^16,17,18 Medications, hospitalisation and other social determinants increase the risk of malnutrition in the older population.^19,20 The presence of diseases, polypharmacy and a wider variation in nutritional status make it difficult to generalise the recommendation of ‘multis’ to those over 60 years of age.²¹ Healthcare professionals are encouraged to further investigate appropriate doses and nutrients for use in specific cases, and to be aware of any potential drug-nutrient interactions.

Pregnant and breastfeeding women are specifically advised to take a prenatal multivitamin and mineral supplement from preconception and throughout pregnancy. Key nutrients include:

• Folate is especially important to help prevent neural tube defects such as spina bifida.^21,22 The neural tube closes in the first month of pregnancy,²³ so folate supplementation prior to conception is important.
• Iodine,^21,24 choline^25,26 and iron²⁷ for healthy brain development.
• Omega-3 fatty acids for healthy brain and eye development.^21,28
• Calcium and vitamin D for bone development. Vitamin D also plays a key role in immune health.^21,29

Who should take activated B group vitamins?

Activated B vitamins can be particularly beneficial for individuals with the methylenetetrahydrofolate reductase (MTHFR) gene mutation. Those with this genetic mutation have difficulty converting regular folate into its active form. Activated B vitamins bypass this issue, ensuring proper absorption and utilisation. Given the importance of folate in a healthy pregnancy, activated folate may be indicated for those with the MTHFR genetic mutation to prevent neural tube defects, though clinical studies are still lacking.^30-32

When should ‘multis’ be taken?

One tablet daily with food is the typical recommendation.

Can multivitamin and mineral supplements interact with certain medications?

Some vitamins and minerals interact with prescription medication (e.g. blood thinners [anticoagulants], cancer [chemotherapy] drugs, certain antibiotics, etc.), altering drug efficacy and causing adverse effects.³³ If you are a healthcare professional and unsure about checking and advising on potential interactions, please contact Clinical Support at clinicalsupport@integria.com.

References

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