By David. H. Rahm
Q: I take a women’s multi-vitamin on a daily basis. My husband doesn’t take a vitamin but periodically takes my multi. Should a man take a woman’s vitamin or should he be taking a multi designed specifically for men?
A. It really depends on a number of factors including the product formulation and health concerns. I explain in greater detail below.
What Should a Multi Contain?
A good quality multivitamin, regardless if targeted to a woman or a man, should be formulated with a wide range of vitamins and minerals. Key nutrients to look for include the fat-soluble vitamins A, D, E and K along with the water-soluble vitamins C and B-complex. Key bulk minerals to look for include calcium and magnesium along with the trace minerals zinc, selenium, copper, manganese, chromium and molybdenum.
Should a Multi Exclude Certain Nutrients?
I would not look to a multivitamin to meet your daily requirements for potassium as it would be difficult to obtain the almost 5 grams recommended on a daily basis in a pill. Dark leafy greens are an excellent source of potassium, a mineral which plays a role in maintaining blood pressure (along with magnesium and sodium). Given that our diet often includes more phosphorus, chloride and sodium than necessary, you also don’t need to take a multivitamin that is formulated with these minerals.
Do Nutritional Requirements Differ?
Recommended intake levels for 14 vitamins and 15 minerals have been established by the Food and Nutrition Board of the Institute of Medicine (IOM) for men and women of all ages (infancy to over 70 years) and life stages (pregnancy, lactation).
In examining the recommendations, you’ll see that in many cases, intake levels are similar for adult men and adult women (excluding pregnant or lactating women). For example, adult men are advised to obtain 90 mg of vitamin C whereas adult women are advised to obtain 75 mg of this nutrient. Given that most adults take 300mg to 500mg of vitamin C daily, especially during the wintertime, this distinction is lost.
In fact, for more than half of the micronutrients, the recommendations are the same for adult men and adult women. Examples include vitamin E (15 IUs), B6 (1.3 mg), B12 (2.4 mcg), folate (400 mcg), calcium (1,000mg), potassium (4,700 mg) and sodium (1,500 mg).
Iron and zinc are the only two micronutrients that have somewhat different nutritional requirements. Adult men are advised to obtain a lower amount of iron than adult women (8 mg vs 18 mg). On the other hand, adult women are advised to obtain less zinc than adult men (8 mg vs 11 mg).
The net result? If you’re taking a multivitamin that meets 100% of the recommended intakes for most vitamins and minerals, the supplement is probably fine for both men and women. The key exception is iron, as I indicate below.
Why Women Supplement with a Multi
Multis targeted to women often provide higher levels of nutrients to address key women’s health concerns including osteoporosis, breast cancer and healthy hair, skin & nails.
To support bone health, it is common practice for extra calcium and magnesium to be formulated in a women’s multivitamin. While supplementing with a multivitamin can help meet the daily requirements for calcium, I recommend that 50 percent be obtained from foods like Greek yogurt and dark, leafy greens. This is important as studies have shown that in both men and women, higher intake of calcium (from supplements) is associated with increased cardiovascular risk.
Due to higher nutritional requirements, iron is often found in a woman’s multivitamin. Iron is not found in men’s multivitamins because studies in men have shown an association with higher iron intake and cardiovascular disease (for more information, refer to the NIH’s fact sheet under Current Issues and Controversies about Iron). However, more recent studies in women have also shown this association. For this reason, women should only supplement with iron if they are found to be anemic. To improve absorption, an iron supplement should be taken separately from a multi.
To support women’s health, some women’s multis are also formulated with herbs such as black cohosh, uva ursi and red clover. However, the level of these botanicals tends to be low given the limited number of nutrients that can fit into one tablet. If you’re interested in obtaining the benefits of these botanicals, I recommend taking these in a separate supplement.
Why Men Supplement with a Multi
Like women, men are concerned with a number of health issues including cardiovascular disease, prostate cancer and sexual function.
To support heart health, multis targeted toward men are often formulated with higher levels of B6, B12 and folate. While these three B-vitamins help to reduce homocysteine, an independent risk factor for cardiovascular disease, a more recent study did not demonstrate a lower risk of mortality or morbidity when taking the vitamins.
To support prostate health, lycopene and saw palmetto are often formulated in a men’s multivitamin. If you’re a man looking to obtain the benefits of these botanicals, I recommend taking them in a separate supplement.
Should a Multi Address Health Issues?
Most experts agree that taking a daily multi to cover gaps in the diet is prudent. However, the evidence is equivocal whether supplementing with a multi prevents against cardiovascular disease, prostate, breast or other cancers. Repeatedly, studies show that following a health promoting diet and lifestyle plays a dominant role in preventing chronic disease and cancer.
Can One Multi Meet the Needs of Men & Women?
Higher levels of certain nutrients have distinguished women’s multivitamins from men’s multivitamins. Increasingly, studies have demonstrated that higher levels of these nutrients are not warranted for either men or women.
For this reason, I would look for a multivitamin that is formulated with an optimal amount of vitamins & minerals. You don’t need a multivitamin that is formulated with botanicals. And, in particular, steer away from multis that are formulated with iron.
When I developed VitaMedica’s Multi-Vitamin & Mineral over 15 years ago, I formulated the supplement so that it could meet the needs of both my male and female patients.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition. Dr. Rahm’s most recent book, The Wellness Prescription, offers practical advice along with simple guidelines to help patients extend their health span.