Multivitamins a waste of money?

[Greg Bernhardt]

Are multivitamins a waste of money? Editorial in medical journal says yes
http://www.cnn.com/2013/12/16/health/multivitamins-studies/index.html

More than half of all adults in the United States take some sort of multivitamin; many do so in hopes of preventing heart disease and cancer or even to aid with memory.
But an editorial published in this week's Annals of Internal Medicine says that using supplements and multivitamins to prevent chronic conditions is a waste of money.

I've taken vitamins and supplements during some periods and I admit, I can't tell the difference.

 

[Jimmy]

I'm guilty of taking a multivitamin once a day just to be 'safe'.

Sometimes there's a need to use supplements if there's a deficiency in your diet. But they are often marketed as a cure-all.

Here's a related article:
http://www.sciencebasedmedicine.org/do-vitamins-prevent-cancer-and-heart-disease/

 

[Astronuc]

I've taken vitamins and supplements during some periods and I admit, I can't tell the difference.

They do make a difference if one is deficient, however, most in the west are not deficient.

Possibly they are a waste if in excess, because the excess is simply excreted.

 

[phinds]

I've been asking doctors about them for decades and have gotten answers all over the map, although none of the answers have been on the order of "everyone should be taking them" whereas on the other had there have been answers on the order of "waste of time ... if your diet is that bad, you are in serious trouble anyway". No one has ever told me they are bad for you though, so I've been taking them all along. I have no idea whether or not they actually do any good.

 

[jackmell]

Exactly how hard is it to get everything you need just with food? I mean even those trace elements like molybdenum and those others? It's not easy I think and how would you even know if you're getting everything you need without going through a lot of work researching everything and likely becoming consumed with the ordeal of checking your food so thoroughly. Don't have time for that anyway.

For the record, I do not feel taking just a multivitamin is a waste of time. I take one 3 or 4 times a week and I try to eat a balanced diet too. For me, that is the best recipe. :)

 

[Chronos]

I think it's just a marketing scam, like enzyte. They thrill you with tales of vitamin deficiencies that have not existed in the west since the 19th century.

 

[Johninch]

Since my company sold its vitamin division, I haven’t kept up to date with the marketing claims. But we used to recommend vitamin supplements for drinkers, smokers, dieters, athletes, sick people, old people, etc. It’s quite a big market.

There were several claims and rumours about the benefits of Vitamin C as an antioxidant and you were especially recommended to take a heavy dose for colds and flu. Several studies proved this to be invalid.

Personally I take a half day’s dose of 21 vitamins and minerals every day, just in case it does some good. Apart from that I don’t pay any attention to my diet.

.

 

[bohm2]

Are multivitamins a waste of money? Editorial in medical journal says yes
http://www.cnn.com/2013/12/16/health/multivitamins-studies/index.html

I do medication reviews and recommendations for people on multiple prescription drugs and I rarely (if ever) recommend them, unless blood tests show low levels (e.g. Vitamin B12, Vitamin D, etc.). There is little evidence for benefit for most people and some of the anti-oxidants like Vitamin E, beta-carotene, etc. likely pose more harm than benefit:

The myth of Antioxidants
http://www.ucl.ac.uk/~ucbtdag/Wenner_2013.pdf

Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements
http://annals.org/article.aspx?articleid=1789253

 

[Evo]

I do medication reviews and recommendations for people on multiple prescription drugs and I rarely (if ever) recommend them, unless blood tests show low levels (e.g. Vitamin B12, Vitamin D, etc.). There is little evidence for benefit for most people and some of the anti-oxidants like Vitamin E, beta-carotene, etc. likely pose more harm than benefit:

The myth of Antioxidants
http://www.ucl.ac.uk/~ucbtdag/Wenner_2013.pdf

Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements
http://annals.org/article.aspx?articleid=1789253

Very good articles bohm, thank you!

 

[Pythagorean]

I do medication reviews and recommendations for people on multiple prescription drugs and I rarely (if ever) recommend them, unless blood tests show low levels (e.g. Vitamin B12, Vitamin D, etc.). There is little evidence for benefit for most people and some of the anti-oxidants like Vitamin E, beta-carotene, etc. likely pose more harm than benefit:

The myth of Antioxidants
http://www.ucl.ac.uk/~ucbtdag/Wenner_2013.pdf

Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements
http://annals.org/article.aspx?articleid=1789253

What do you think about the suggestion that people at northern latitude should take vitamin D supplement to make up for lack of sunlight?

http://www.hsph.harvard.edu/nutritionsource/vitamin-d/

 

[Evo]

What do you think about the suggestion that people at northern latitude should take vitamin D supplement to make up for lack of sunlight?

http://www.hsph.harvard.edu/nutritionsource/vitamin-d/

There was just a thread about vitamin D supplements. https://www.physicsforums.com/showthread.php?p=4610231#post4610231

The harvard link has a lot of old papers referenced, I haven't had a chance to look into the most current, although I do know the maximum dosage has been increased, people should not assume they need supplements, they should be tested by a doctor that also takes into consideration their current health and any issues.

 

[Greg Bernhardt]

I know my sister gives her 6 week old vitamin D supplement.

 

[Pythagorean]

We did too; my impression is that it's normal for doctors to prescribe it to newborns up north.

 

[Evo]

I know my sister gives her 6 week old vitamin D supplement.

I think it's recommended for infants, especially breast fed infants not drinking fortified formulas. Where you run into problems is people that start self-medicating without knowing if they have a deficiency or if they have a condition that makes taking a supplement potentially dangerous.

 

[bohm2]

What do you think about the suggestion that people at northern latitude should take vitamin D supplement to make up for lack of sunlight?

http://www.hsph.harvard.edu/nutritionsource/vitamin-d/

We recommend them for people with osteoporosis and on bisphosphonates (e.g. Alendronate, Risedronate), people on corticosteroids and elderly women who rarely go outside and/or consume few dairy foods or if blood tests reveal low levels. But the evidence of benefit (e.g. decreased fracture risk) even for many of these individuals is surprisingly not very strong as noted in this review:

Calcium and cardiovascular risks
http://www.australianprescriber.com/magazine/36/1/article/1375.pdf

And we always suggest that people get the vitamins/minerals from dietary sources instead of supplements, because supplements do not seem to show the same benefits seen with dietary sources. Consider, the more recent negative findings of omega-3 (no CVD benefit) and calcium supplements (possible harm), for example.

 

[Johninch]

I would only take high dosages of something if the doctor orders it. There are many substances which we ingest every day which are toxic in high doses. I am therefore careful about my alcohol consumption.

It is typical of animal toxicity studies to give high doses for a long time, in order to indicate the probably toxicity effects of low doses. Unsurprisingly, at high doses the rat develops problems and dies.

There are statistics on the popularity of vitamin and other dietary supplements including vitamins, but how high are typical effective dosages which people take?

One suspects that a lot of people are looking for a magic formula or quick fix and do likely overdose. Nobody is recommending that.

At my company, we never said that vitamin supplements increase life span. We only said that recommended regular doses of multivitamins and minerals could have health benefits. Higher doses have to be recommended by a physician. We marketed multivitamin preparations for unspecified health reasons and not only for anti-oxidative effects.

This thread is about multivitamins, but it is correct to comment on individual vitamin effects. We should be careful about a one-sided diet too.

On the other side, people like myself who take small doses of multivitamin and minerals tend to remain unimpressed by studies which we think do not apply to us. This is partly due to our unjustified beliefs which get hard wired. We also like to think that what we do in moderation may not be completely rubbish.

.

 

[bohm2]

It is typical of animal toxicity studies to give high doses for a long time, in order to indicate the probably toxicity effects of low doses. Unsurprisingly, at high doses the rat develops problems and dies.

This isn't just about toxicity issues but about possibly wasting money for zero benefits (for most people in Industrialized countries, who are pretty well all the buyers). Many human studies have been done looking at the effects of taking a daily multivitamin and benefits have not been seen. Some studies even suggest possible harm:

In contrast, we found that several commonly used dietary vitamin and mineral supplements, including multivitamins, vitamins B6, and folic acid, as well as minerals iron, magnesium, zinc, and copper, were associated with a higher risk of total mortality...Although we cannot rule out benefits of supplements, such as improved quality of life, our study raises a concern regarding their long-term safety...We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished population.

Dietary Supplements and Mortality Rate in Older Women
http://junksciencecom.files.wordpress.com/2011/10/aim-multivitamin-older-women-mortality.pdf
http://www.medscape.com/viewarticle/751263

 

[Q_Goest]

From Science Daily: Most Clinical Studies On Vitamins Flawed by Poor Methodology

They quote what appears to be an interview with Balz Frei, professor and director of the Linus Pauling Institute at Oregon State University who recently published this article in a journal called "Nutrients".

"One of the obvious problems is that most large, clinical studies of vitamins have been done with groups such as doctors and nurses who are educated, informed, able to afford healthy food and routinely have better dietary standards than the public as a whole," said Frei, an international expert on vitamin C and antioxidants.

...

"More than 90 percent of U.S. adults don't get the required amounts of vitamins D and E for basic health," Frei said. "More than 40 percent don't get enough vitamin C, and half aren't getting enough vitamin A, calcium and magnesium. Smokers, the elderly, people who are obese, ill or injured often have elevated needs for vitamins and minerals.

"It's fine to tell people to eat better, but it's foolish to suggest that a multivitamin which costs a nickel a day is a bad idea."

 

[AlephZero]

They quote what appears to be an interview with Balz Frei, professor and director of the Linus Pauling Institute at Oregon State University

Hmm... didn't Linus Pauling have some rather crackpot ideas about vitamins - in particular vitamin C ? http://www.quackwatch.com/01QuackeryRelatedTopics/pauling.html

And isn't the main natural source of vitamin D exposure to sunlight, not from food? The half-life of vitamin D in the body is 1 to 2 months, so you hardly need a "daily dose" to keep it topped up.

 

[Pythagorean]

I don't know anything about Linus, but your scond from last sentence is what makes me wonder if there's some validity to D supplements for populations far from the equator. Our pediatrician made it sound like there was some science behind it and that D deficiency was typical in the extreme latitudes.

edit: here's the research:

http://www.ncbi.nlm.nih.gov/pubmed/18767337

They seem to find deficiencies in the winter months in people around the world in northern latitudes. 1/3 of young adults in Finland. In northern Europe, it was prominent in young adolescent girls with measurable effects on bone health. It cites several papers showing deficiencies in the elderly at northern latitudes.

 

[Q_Goest]

Hi bohm2,

Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements
http://annals.org/article.aspx?articleid=1789253

Regarding this editorial (note that it's an editorial, not a research paper), I thought the responces under the Comments tab were interesting. Three of them are from medical doctors, the fourth from an RN. One of the MD's is Balz Frei who provides a number of references as does one of the other MD's. All of the responces are arguing against the authors of the editorial.

I have heard of this complaint however and suspect it's legit:

And we always suggest that people get the vitamins/minerals from dietary sources instead of supplements, because supplements do not seem to show the same benefits seen with dietary sources.

 

[Q_Goest]

Hi AlephZero,

Hmm... didn't Linus Pauling have some rather crackpot ideas about vitamins - in particular vitamin C ? http://www.quackwatch.com/01QuackeryRelatedTopics/pauling.html

I'm not familiar enough with this stuff but thought that was an interesting article. I'm sure there are plenty of quacky ideas out there. What I liked about Frei's interview was the suggestion that taking a $.05 vitamin isn't bad advice. If it works, great. If not, no harm done. You'll spend more than ten times that much on coffee every day. My only concern would be to find that vitamins might be detrimental to my health for some reason.

Perhaps the saying "everything in moderation" is applicable here.

 

[Q_Goest]

Hi Pythagorean,

I don't know anything about Linus, but your scond from last sentence is what makes me wonder if there's some validity to D supplements for populations far from the equator. Our pediatrician made it sound like there was some science behind it and that D deficiency was typical in the extreme latitudes.

edit: here's the research:

http://www.ncbi.nlm.nih.gov/pubmed/18767337

They seem to find deficiencies in the winter months in people around the world in northern latitudes. 1/3 of young adults in Finland. In northern Europe, it was prominent in young adolescent girls with measurable effects on bone health. It cites several papers showing deficiencies in the elderly at northern latitudes.

What strikes me is that people wear cloths and spend most of their time indoors, so unless we lay out to get a tan, wouldn't the amount of D our bodies can manufacture be relatively small? Does that get addressed in the paper? I can't seem to find a way to open the paper...

 

[Pythagorean]

There's a free version (direct pdf download:)

https://www.google.ca/url?sa=t&rct=...=BJcrbjSnEoPgzzcg_15s3Q&bvm=bv.58187178,d.aWc

Clothing tends to be less of a sunblock than most people assume (depending on what you're wearing). In particular, bleached cotton doesn't do much (which is probably the most common tshirt fabric). People at higher lattitudes are more likely to have more layers consisting of polyesters, increasing effective spf.
http://en.wikipedia.org/wiki/Sun_protective_clothing

It's conceivable that the lower latitudes still get enough sunlight throughout the year, especially since you can store D long term, so you'd only need a good dose of sun every week or two or small consistent doses daily (achievable if you're not a shut-in) whereas you can go months without clear skies in the north, and the sun is generally only up for a couple hours while you're at work in the thick of winter and it's often too cold to go out for most people. Of course, that's Way North, where I'm from (6 months of "darkness"); this paper sets the latitude line as low as the continental US. There are even psychological disorders associated with the lack of sunlight in home back North (Seasonal Affective Disorder).

 

[Ivan Seeking]

One thing that I'm finding is that it is hard to get a full dose of iron each day, especially heme iron. You can get 100% of the RDA of non-heme iron from iron-fortified cereal but I can't eat cereals. Nor can I eat legumes. I try to get everything from vegetables, peanut butter, milk, meat, cheese and other low-carb foods. I do eat a lot of spinach but I was checking and it is doubtful I can get enough iron from regular foods... without significantly increasing my consumption of meat.

 

[Monstrous Math]

All this talk of vitamin D reminds me of this interesting photo from national geographic that was on their "Photo of the Day" a while back: http://photography.nationalgeographic.com/photography/photo-of-the-day/ultraviolet-bath-mcnally-pod/

I guess in the far North of Russia where it's night 9 months of the year, that's how they give their kids vitamin D.

Also, interestingly, the only thing we know of that significantly increases lifespan (at least in lower organisms) that has been well-studied (though mostly in roundworms and fruitflies because of their convenient life spans) is starvation (usually reducing caloric intake by about 30-40% over the lifespan of the organism). We've only done two studies on monkeys (each one took around thirty years), and I'd say they were fairly inconclusive. One group was supposedly given healthier, more vitamin-rich food (and showed no difference), while the other was not (and the calorie restricted monkeys in this study lived longer). You can read about both studies here: http://www.nature.com/news/calorie-restriction-falters-in-the-long-run-1.11297

I take multivitamins. The risk seems low. The benefits high. *shrugs*

 

[Evo]

I take multivitamins. The risk seems low. The benefits high. *shrugs*

Post the studies that say taking vitamin supplements is of "High" benefit. I haven't seen any.

 

[Evo]

One thing that I'm finding is that it is hard to get a full dose of iron each day, especially heme iron. You can get 100% of the RDA of non-heme iron from iron-fortified cereal but I can't eat cereals. Nor can I eat legumes. I try to get everything from vegetables, peanut butter, milk, meat, cheese and other low-carb foods. I do eat a lot of spinach but I was checking and it is doubtful I can get enough iron from regular foods... without significantly increasing my consumption of meat.

Why do you think you need additional iron? Did your doctor do a blood test and find that you have an iron deficiency? It's not a common deficiency in men. I actually suffer from too much iron and it's killing me. Literally killing me, I have to give blood to try to reduce the iron in my body. Too much iron destroys the organs in the body, resulting in death. My doctor says it probably killed my father and other relatives because it wasn't diagnosed. I can't undo the damage the iron has already done, I can only try to rid myself of iron for the rest of my life to try to prevent further damage.

 

[DrDu]

Hmm... didn't Linus Pauling have some rather crackpot ideas about vitamins - in particular vitamin C ? http://www.quackwatch.com/01QuackeryRelatedTopics/pauling.html

As this quasi religious belief in mega doses of vitamins seems to be rather an US peculiarity, I also tend to believe that it may be due to Linus Paulings influence.

 

[DrDu]

And isn't the main natural source of vitamin D exposure to sunlight, not from food? The half-life of vitamin D in the body is 1 to 2 months, so you hardly need a "daily dose" to keep it topped up.

Vitamin D is quite another story. You can obtain all vitamin D from food. That's why in former times cod liver oil was given to children. Anyhow it is preferable to take up vitamin D with food than to expose your skin to sunlight, as the UV B needed to synthesize vitamin D is also the one which is most carcinogenic.
However, unlike water soluble vitamins, you have to be careful with dosage, as overdosages can result in toxic effects.

 

[Pythagorean]

So I guess cod liver oil supplements wouldn't be lumped in with the derogatory term "vitamins" since it's technically a whole food in pill form?

 

[Johninch]

Post the studies that say taking vitamin supplements is of "High" benefit. I haven't seen any.

I have spent some time searching the internet without success and come to the conclusion that there are NO serious studies on multivitamins taken at the recommended daily allowance. What you find everywhere are studies on individual vitamins, usually at higher dosages than the RDA. But we are discussing the probability of correcting a small dietary deficiency in one or more of about 20 vitamins and minerals. If you have a serious deficiency, this will not be corrected with multivits and it is not meant to. Multivits could even cover up a major dietary deficiency by undertreating it.

I have also searched for data on the number of healthy people who consume an RDA of multivitamin preparations. No luck. There are industry estimates. The Lewin Group for example does surveys of health issues by picking data out of selected studies, for industry clients, which the industry then uses for marketing purposes. Lewin evaluates the data and comes up with billions of potential health care savings from administering high doses of certain supplements in specific cases, such as the elderly with serious health problems or pregnant women. But the supplements are very specific and are not the OTC multivits we are talking about here.

In my case, I have no health issues and I take a half daily allowance of 21 vitamins and minerals every day. Nobody can tell me what is the likelihood of my being otherwise deficient in one of those ingredients. But if I were, then the multivits could be a high benefit. That’s why I do it. I don't detect a benefit of course, because I remain apparently healthy.

.

 

[Monstrous Math]

I have spent some time searching the internet without success and come to the conclusion that there are NO serious studies on multivitamins taken at the recommended daily allowance.

Multivitamin Use and Mortality in a Large Prospective Study:

http://aje.oxfordjournals.org/content/152/2/149.short (American Journal of Epidemiology - Johns Hopkins University)

Multivitamin Use and Risk of Prostate Cancer in the National Institutes of Health:

http://jnci.oxfordjournals.org/content/99/10/754.short (JNCI - National Cancer Institute)

Multivitamin Use, Folate, and Colon Cancer in Women in the Nurses' Health Study (Annals of Internal Medicine - American College of Physicians)

http://annals.org/article.aspx?articleid=711703

Periconceptional Use of Multivitamins and the Occurrence of Neural Tube Defects (Journal of the American Medical Association):

http://jama.jamanetwork.com/article.aspx?articleid=375357

 

[Office_Shredder]

Let's see what the results of those studies are.

http://aje.oxfordjournals.org/content/152/2/149.short (American Journal of Epidemiology - Johns Hopkins University)

However, adjustment of the relative risk estimates for potential risk factors besides age consistently narrowed the difference between people who did and those who did not use vitamin supplements, suggesting that vitamin use itself accounts for, at most, only part of the survival benefit associated with these products

There was no consistent gradient of decreasing risk with more prolonged (table 3) or more frequent (data not shown) use of supplements for either ischemic heart disease or stroke

Sounds like a ringing endorsement for vitamins.

http://jnci.oxfordjournals.org/content/99/10/754.short (JNCI - National Cancer Institute)

No association was observed between multivitamin use and risk of localized prostate cancer. However, we found an increased risk of advanced and fatal prostate cancers (RR = 1.32, 95% CI = 1.04 to 1.67 and RR = 1.98, 95% CI = 1.07 to 3.66, respectively) among men reporting excessive use of multivitamins (more than seven times per week) when compared with never users

Taking multivitamins won't help, but it might kill you (oops).

http://annals.org/article.aspx?articleid=711703

This is the only one that appears to support vitamin use

http://jama.jamanetwork.com/article.aspx?articleid=375357

At this time, it is not possible to determine whether this apparently lower risk is the direct result of multivitamin use or the result of other characteristics of women who use multivitamins.

All of the studies observe that people taking vitamins are generally healthier and take better care of themselves, so if a study is unable to rule out those effects it doesn't have a whole lot of sway.

At the end of the day one study says vitamins are good, and one study says they're bad out of the ones you posted.

 

[Ivan Seeking]

Why do you think you need additional iron? Did your doctor do a blood test and find that you have an iron deficiency? It's not a common deficiency in men. I actually suffer from too much iron and it's killing me. Literally killing me, I have to give blood to try to reduce the iron in my body. Too much iron destroys the organs in the body, resulting in death. My doctor says it probably killed my father and other relatives because it wasn't diagnosed. I can't undo the damage the iron has already done, I can only try to rid myself of iron for the rest of my life to try to prevent further damage.

I am looking at the RDA for iron and the amount in the foods I eat. Most people apparently get their iron from breakfast cereal, which I don't eat. Beyond that red meat is the best source. But I try to limit my intake of red meat.

Anyone who eats common breakfast cereal is effectively taking an iron supplement.