In this column, I try to provide recently published work on topics of nutrition that apply to the practicing chiropractor. Multivitamins are commonly discussed, due to their popularity and the emerging data that supports their use. For example, a recently published article provided the following conclusion: "A convincing argument now develops that routine polyvitamin supplementation (folic acid, vitamin B12, vitamin B6, vitamin E, and beta-carotene) becomes increasingly important for women and men receiving antiepileptic drugs at all ages. The atheroprotective effect of multivitamins is through their antioxidant and anti-inflammatory effects together with their lipid and homocysteine lowering effects."1
If you have followed the nutrition supplement literature over the past twenty years, it becomes obvious that such a statement would not have been made in the 1980’s. We had little data on the use of multivitamins or other supplements at that time.
However, we now have studies that suggest the use of multivitamins will prevent heart attacks,2 cancer,3 and Bruce Ames suggests we should all take a multivitamin as part of a metabolic tune-up4 to promote health. With respect to pregnant mothers, researchers are now making the following statement: "At present we can recommend the daily use of multivitamin supplement including 400-800 mcg of folic acid with a healthy diet and lifestyle for women who want to do their best to have a baby without neural tube defects and some other congenital anomalies."5
As mentioned in a previous article in The American Chiropractor, researchers use "nature identical" supplements, and not "whole-food supplements." There is minimal to no data available on "whole-food" supplements, despite the very boisterous claims to the contrary.
Additionally, when researchers suggest that all women and men receiving antiepileptic drugs should be taking a multivitamin, they are referring to the "nature identical" variety. It turns out the antiepileptic meds deplete folic acid, which leads to elevated homocysteine levels, and this is thought to be a reason why epileptic patients have a higher expression of atherosclerosis.1
Several nutrients are depleted by antiepileptic medications. For example, folic acid is depleted by phenobarbital, phenytoin (dilantin), carbamazepine, and valproic acid (depakote). Vitamin B1 is depleted by dilantin. Vitamin D and calcium are depleted by phenobarbital and dilantin; and zinc and selenium are depleted by valproic acid. Vitamin B6 and B12, which are also involved in maintaining appropriate homocysteine levels, seem to be unaffected by antiepileptic meds.
The multivitamin and epilepsy article by Hamed and Nabeshima1 is quite detailed, so space does not permit a thorough discussion of their paper. If you like, go to pubmed.gov and you can download their paper for free. In short, please understand that the anti-inflammatory and antioxidant effects of multivitamins discussed in their paper apply to all of us, not just epileptics. I would suggest that we also take magnesium, perhaps calcium, fish oil, coenzyme Q10, and an anti-inflammatory botanical. Also, since most people don’t get adequate sun exposure, vitamin D supplementation is a smart choice.
Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. He is also a faculty member at Palmer College of Chiropractic Florida, where he teaches nutrition and subluxation theories. He can be reached by e-mail at