Which Vitamins Should You Take? Is a Multivitamin Enough?

If you shoved your multivitamins into a dark corner after the recent scare headlines (one actually said "Your Multivitamin May Be Killing You"), go dig 'em out. The research that sparked them is a great reason to get smarter about which vitamins you take (and what you eat). But it does not mean you should give all your vitamins the heave-ho.

We're talking about the new 19-year study of 38,000 Iowa women -- the one that found a 6% to 45% higher death risk among those who took supplements. Impressive, right? It makes vitamins sound like "the menace in your medicine cabinet." But we YOU Docs haven't stopped taking our multivitamins. Here's why.

For starters, this is the kind of study that's a first step. It's a population study, which means it unveils patterns that need further investigation, and sounds warning bells that may or may not be false alarms. Also, it relies on people remembering what they ate and took -- in this case, not over the course of days or weeks, but during 7 to 9 years. (How's your memory of the last 7 years?)

And that 6% to 45% risk applies only to comparisons of people actually in the study. When it's translated into your risk of dying from taking supplements for 19 years (what's called absolute risk), the range shrinks dramatically: 1% (for multivitamins) to 7% (for copper, the most worrisome finding). The 1% for a multi is so small it could be an error.

Furthermore, there are lots of unanswered questions. For instance, did the women need to take supplements, especially iron? What formulations did they take? (There's evidence that different formulas have different effects.) Also, the women reportedly ate twice as many fruits and vegetables as the average American. Really? They eat twice as healthfully in Iowa -- home of fried butter at the state fair -- than anyplace else in America?

Here's another reason we're still supplement fans: The study didn't monitor some proven benefits, such as reduced risk for bone fractures if you take calcium, or healthier heart, brain, and eyes if you take DHA omega-3 fatty acids.

Our bottom line? The right supplements are still a great insurance policy if you don't eat perfectly (who does?). That said, it's a good study -- but it's a beginning, not the end. Remember, it almost always takes at least three studies to settle anything. So here's our what-to-take advice.

• A multivitamin without copper and -- if you're a guy or a post-menopausal woman -- without iron. Buy one with just the recommended intake for most nutrients, but no copper (easy to find online). Copper was linked with the biggest death risk in the study. If you aren't menstruating, choose a multi without iron, too (this isn't new), unless your doc prescribes it. Iron overloads can damage your heart and liver. Take half your multi in the morning and half in the early evening to spread out the coverage. (Note: 98% of the women in the study were post-menopausal, so few should have been taking iron.)
• Vitamin D. It slightly decreased death risk in the study, and vitamin D has many other benefits, including improved bone and brain health. We recommend 1,000 IU a day (1,200 IU if you’re older than 60). Make sure it's vitamin D3, the most active form.
• Calcium and magnesium. While calcium lowered death risk in the study and magnesium slightly raised it, both effects are too small and too unusual to act on. We're sticking with our current advice: Get 600 mg of calcium from a daily supplement, and the other 600 mg of calcium from food. Add 200 mg of magnesium to counter the constipation/bloating that calcium can cause.
• Add our favorite "extras." Take 200 mg to 900 mg of the DHA form of omega-3s, the potent fatty acid that protects against memory loss, heart attacks, stroke, impotence, even wrinkles. Get some lutein, too. It guards your vision with only 20 mg a day.

Ignore Internet hype and don't take megadoses of anything, especially huge amounts of vitamin D.

Finally, EAT HEALTHFULLY! This includes consuming lots of fruits, veggies, beans, and 100% whole grains, as well as fish. (Some poultry is OK but eat very little red meat.) Resist inhaling junk food just because you took your vitamins today (some vitamin-takers do that!). Smart people like you know pills support -- not replace -- a healthful diet.

Learn how taking your multi can help you lose weight.

Find out which vegetables and fruits are the most nutritious -- and most popular.