Nutritionists are probably pulling their hair out at this point over these new Multiple Vitamin aspects. "Not enough calcium or folic acid,..." "What is the deal with the family of vitamin E, other than alpha tocopherol, the others are not active..." Yes, there are conditions that go along with these recommendations that need explanations. But first is a most important point seldom mentioned concerning mulit-vitamin mineral use.
If a vitamin deficiency exists, 
taking a multi-vitamin supplement should have a beneficial impact on the functions of that vitamin. But if vitamin levels are already sufficient, it is a possibility that taking more could push levels of some vitamins and minerals up into the range for adverse effects. Thus, this is part of the rationale for the perceived lower dosages presented for some vitamins in this new vitamin criteria. A Precautionary approach is warranted until scientific research settles some controversial concerns mentioned below.
- Only natural sources for beta carotenes should be used. Synthetic beta carotene contains only one form, -trans, and is related to some negative findings. Natural form has at least 3 but also many other carotenoid family members.
- For the calcium story, you have to read this article. This article will explain the situation. There are many sides to the calcium story. Just increasing calcium or even calcium with vitamin D is not enough to completely protect bone, or even the most effective way to accomplish this protection.
- Folic acid (synthetic) is a dual sided sword, perhaps beneficial for young women of child bearing years but detrimental for older people, especially if cancer is present or they are low in vitamin B12.
- Vitamin B12 absorption amount of 1.6 mcg is maxed out at oral intake of cyanocobalamin of about 50 mcg. (5 mcg gives only slightly less since the percentage absorbed is greater = 60%.) Absorption at 500+ mcg is just 0.5 - 1 % absorbed. The Methylcobalamin form is absorbed at a slightly greater percentage. Testing levels will determine who needs to take therapeutic dosages of 1000+ mcg sublingual or injectable, under medical supervision. Limit vitamin B12 supplement amounts. ref
- Remember, these recommendations are added to the amounts from food each day. To get 100% from supplements of calcium and then add food amounts may be too much.
- The correct amount of calcium is under the influence of some other major minerals that supplements generally do not supply. Potassium, Phosphorus, and Sodium.
- Three times more potassium is needed than calcium. Since most people do not get this amount, calcium has to participate in one of potassium functions, buffering body acidity. Calcium could be pulled out of bones for this purpose.
- Phosphorus is needed to balance calcium since both combine together in bones.
- Too much sodium, common in today's diet, increases calcium loss in urine.
- Vitamin K, especially K2, is needed to activate vitamin D produced osteocalcin which then is able to bind calcium to bone. Plus, vitamin K activates an artery protein to prevent calcium from binding into artery cells, calcification.
- New anti-oxidant research dictates lower levels for selenium and some anti-oxidant vitamins. A balance point needs to be maintained for optimal health. Both too low and too high can exhibit adverse effects.
- The vitamin E story is becoming more complete. Some of the other family members are showing greater effects especially in areas where alpha tocopherol is not active. In fact by itself, high alpha tocopherol reduces the absorption of other vitamin E family members arriving from food. Alpha tocopherol, the only family member now allowed to be given vitamin E units, is effective against oxygen radicals but not against nitrogen radicals. Here, the gamma tocopherol form is needed.
- The Vitamin Workshop author coined a term "stimulus variation" to explain that one does not need to consume supplements every day, especially the fat soluble vitamins but also many water soluble ones as well. Skipping a day or two a week is OK and may even be preferred by many body functions. The body has adapted to save and store nutrients for rainy days. This gives the body time to catch up on nutrient processing and balance out any excesses too large for stored reserve capacity. The base of nutrients should be supplied by the diet and supplements should only provide a fraction of nutrient load. Fasting has shown to be good for the body. Systematically under-eating is the only method Scientists have found that extend lifespan.
- Last, but not least, it has to be pointed out that body digestion functions best at very low nutrient levels as found in foods. Supplements often concentrate the amount of vitamins in many servings of food and can overwhelm digestive and assimilation processes which interferes with lower dosage vitamins. Minerals like calcium in supplements have this same effect on other minerals. Supplements should be designed to work with the body and not against. Against is often the preferred method for drugs.
There appears to be major gaps in nutritional knowledge. Research has been revealing these gaps but scientists have been brushing them aside, even to the point of using unscientific protocols to explain research study results.
A Vitamin E Study Example ( study ref)
The Johns Hopkins Medical vitamin E meta analysis is a prime example. They attempted to interpret many different studies by comparing future death rates between the group taking vitamin E and the placebo control group. They found slightly more people died sooner in the vitamin E taking group. One major overlooked and necessary fact was absent. Were the deaths in any way plausibly connected to a function of vitamin E?
If the deaths were from hemorrhagic stokes, there may have been a vitamin E connection since vitamin E thins the blood, but if they were from the flu or a car accident, probably not. Without cause of deaths, the correct scientific protocol cannot be determined and the results could just be a chance association and not cause and effect. Since many of the study periods were short term, subjects were quite ill already, and it was not known if the subjects continued to take vitamin E or not, there are simply too many unknowns to attempt a scientific result.
One study out of the 19 studies analyzed, the CHAOS study, showed that the vitamin E group had 71% fewer second non-fatal heart attacks during the one year study. Out of 3000 possible vitamin E studies, only 19 were chosen since only these had follow up death rates. In one study, the WAVE, the authors mentioned that their result should not be used as a reference for other studies since the results were so different from the norm. Without this WAVE study, the Johns Hopkins meta-analysis would not have reached a significant margin for scientific protocols. Unseen by the public, there was a major uproar from the scientific community over this misuse of science. Almost every major newspaper in the world reported the results of the study as "Vitamin E will kill you" since it was quite sensational, but no mention of the many other scientists questioning the results or the use of faulty scientific methods. article
NOTE: Continued research on vitamin E offered other potential explanations and did not support the Johns Hopkins study. The majority of studies analyzed used higher dosages, synthetic forms, and did not consider the presence of the other vitamin E members. ref <This re-analyzed study added 10 extra studies as well as looked at the original 19 that now had an extended time period for mortality numbers.
This new vitamin criteria does not recommend such high levels, especially for the isolated alpha tocopherol form of vitamin E by itself. High levels of isolated alpha tocopherol limit absorption and assimilation of the other vitamin E members arriving in food at the same time. The Finnish study on vitamin E and lung cancer also comes up for vitamin E mortality. But, when smokers are the primary subjects, mortality is usually the reality. Plus, some thing in smoke turned the usually antioxidant vitamin E functions into a pro-oxidant behavior. ref
Nature probably has a reason for putting certain vitamin family members together in foods that compliments actions. Sometimes one form has the opposite function of the other and is used as a check and balance. Another way this balance system is used is when vitamin D starts to breakdown into another form, the new form is designed to have the complete opposite action which stops the activity that vitamin D set in motion. One such vitamin D action is to dissolve bone to release calcium into the blood for a vital calcium blood level. article Without this proper calcium blood level, nerves and muscles would misfire.