The Last Nail in the Coffin for Multivitamins
How much money would the US auto industry be making if every car they sold never started? How much could video game console makers charge if their products didn’t play any games? Well, in 2010 the US dietary supplement industry sold $28 billion dollars in vitamins, minerals and other supplements that, as far as we can tell, benefited virtually no one.
The current issue of Annals of Internal Medicine published three studies examining the effects of multivitamins. This is not the first investigation of a mysterious unexplored field. Lots of studies have already shown that in well-nourished people living in the Western Hemisphere, multivitamins are not helpful. Think of this more as sweeping away any traces of doubt.
“>Another study examined the effects of a multivitamin on cognitive decline. About 6,000 male physicians aged 65 and older were randomized to a multivitamin or placebo and given a battery of five tests of cognition and memory over 12 years of follow up. The two groups did the same.
“>An editorial in the same journal issue crystalized our current knowledge.
In conclusion, β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful. Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.
The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.
There are specific patient populations who are especially vulnerable to vitamin malabsorption, such as those who have had intestinal surgery and patients on long-term acid suppressing medications. They may be recommended specific vitamin supplements. Women in their child-bearing years should take folic acid. And it’s possible that vitamin D in the elderly prevents falls. But apart from those narrow groups, well-nourished people don’t benefit from supplements. (I don’t take any vitamins or minerals.)
Perhaps the latest studies and the barrage of resulting media coverage will make a difference. Then maybe we could save some of that $28 billion and spend it to buy some skepticism.
“>How do Americans waste $28 billion a year? On vitamins, doctors say (Los Angeles Times)
“>Oral High-Dose Multivitamins and Minerals After Myocardial Infarction: A Randomized Trial (Annals of Internal Medicine article. Abstract available without subscription)
“>Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force (Annals of Internal Medicine. Available without subscription.)
“>A Reminder to Dump Your Multivitamin (my post from 2011 reviewing the known effects of various vitamin supplements)
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Anything you read on the web should be used to supplement, not replace, your doctor’s advice. Anything that I write is no exception. I’m a doctor, but I’m not your doctor.