Should I Take a Multivitamin?

“I was gardening for hours, cleaning out closets, energy, energy, energy!”

The 49-year-old woman from the Midwest gushed on amazon.com about the multivitamin she had been taking for all of one week. “I thought about it and realized it was the vitamins. I feel so much better overall than I’ve felt in several years. I will always take these.”

You may be asking, “Should I take a multivitamin, too?” You’re certainly not alone. One in three Americans say they take multivitamins and minerals regularly, downing 1 to 14 pills a day at a cost that can hit $75 a month.

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Do multivitamins provide any tangible benefits? Can you get too much of any nutrients from a multi? And, if you’re in the market for one, what should you be looking for?

Should I take a multivitamin for my health?

Study after study finds little or no long-lasting benefit from taking a daily multivitamin-and-mineral:

  • Among more than 182,000 middle-aged and older men and women living in California and Hawaii, those who took multivitamins lived no longer and were no less likely to be diagnosed with cardiovascular disease or cancer than those who didn’t take a multi.
  • The 41 percent of the more than 161,000 postmenopausal women in the Women’s Health Initiative Cohorts who were taking a multivitamin were just as likely to be diagnosed with breast, ovarian, colorectal, or another cancer as those who didn’t take a multivitamin.
  • One-quarter of the more than 83,000 men aged 40 to 84 in the Physicians’ Health Study were taking multivitamins. They were just as likely to die from coronary heart disease or stroke as the men who didn’t take a multivitamin.

Even when researchers look for more modest benefits, proof is elusive.

For example, healthy older adults who were given multivitamins in the United States, Canada, Scotland, France, and the Netherlands for up to 1 1⁄2 years were just as likely to get colds or other infections, stay sick just as long, or miss out on planned activities as similar people who were given a placebo.

And performances on memory and cognitive tests were no higher in healthy German women aged 60 to 91 who took a multivitamin for six months, or in healthy Scottish men and women 65 and older who took a multivitamin for 12 months, than in those who were given a placebo.

Should I take a multivitamin as dietary insurance?

Even if multivitamins won’t prolong your life or keep you from getting sick, “they can still fill in the gaps if you get too little of some vitamins and minerals from your food,” says Susan Roberts, a professor of nutrition and of psychiatry at Tufts University in Boston and author of “The ‘I’ Diet.”

The U.S. Dietary Guidelines Advisory Committee in 2010 singled out seven nutrients that many Americans consume too little of. Two of them—fiber and potassium—aren’t available in significant amounts from multivitamins, but the other five are:

  • Vitamin D. A majority of adults don’t get enough from their food (though our skin makes vitamin D when it’s exposed to the UV rays in sunlight).
  • Folic acid. It helps protect against spina bifida and other neural tube birth defects that can occur before a woman knows that she is pregnant. About one in five women who are capable of becoming pregnant don’t get enough folic acid.
  • Vitamin B-12. Adults over 50 should get some of their B-12 from fortified foods or supplements, since they may have too little stomach acid to absorb naturally occurring B-12 in foods.
  • Iron. About 15 percent of women 50 and younger are iron deficient.
  • Calcium. A majority of adults don’t get enough calcium from their food. Multivitamins—which typically have 100 to 200 milligrams—can help, though adults need 1,000 to 1,200 mg a day.

Are you still asking, “Should I take a multivitamin?” There’s not much evidence that people who take them are any healthier. Then again, a little insurance against something that may be missing from your diet couldn’t hurt.

Our advice: don’t waste your money on a multivitamin that has more than you may need…or should get.

Sources: Am. J. Epidemiol. 173: 906, 2011. Arch. Intern. Med. 169: 294, 2009.  Arch. Intern. Med. 162: 1472, 2002. J. Am. Geriatr. Soc. 55: 35, 2007. BMJ 331: 324, 2005. Ann. Intern. Med. 138: 365, 2003.  JAMA 288: 715, 2002. Int. J. Vitamin Nutr. Res. 63: 11, 1993. Prev. Med. 41: 253, 2005. Nutr. J. 6: 10, 2007.

10 Replies to “Should I Take a Multivitamin?”

  1. Thank you for this information. Do you have information on Fish Oil and Probiotics?
    I take both, and wonder if the cost of the Probiotics, especially, is worth it.

  2. Your advice is good. However the big problem with many of the studies which this article quotes is that there exists a vast difference in potency and solubility among different multivitamins. The studies generally confirm that a poor multivitamin won’t do you any good. However, there are non-biased sources by which to find nutritional supplements. One is the Nutrisearch Comparative Guide to Nutritional Supplements by Lyle McWilliams and another is the website: ConsumerLab.com where one can find more indepth information on specific products. I might add that current research by people like Dr. Bruce Ames and others seems to increasingly show the importance of supplementation to our North American diet in order to maintain health and longevity.

    1. [Disclosure: richardg65 sells dietary supplements manufactured by USANA, a multi-level marketing company.]

      Companies that manufacture expensive dietary supplements like to warn consumers that cheaper supplements are inferior and won’t do you any good. Consumerlab.com, however, has found that most multivitamins are well manufactured. In their latest survey, only 2 of 42 brands it tested failed a solubility test.

      The Nutrisearch Comparative Guide to Nutritional Supplements by Lyle McWilliams is hardly non-biased. McWilliams, who gives USANA products its top ranking, served in the past on USANA’s medical advisory board.

      Bruce Ames’ hypotheses about supplementation are interesting, but they’re based primarily on animal and test tube studies. He has not published trials showing in people the value of the supplementation he recommends.

  3. I am so startled and disappointed at your conclusion “…a little insurance against something that may be missing from your diet couldn’t hurt.” After all that data you present demonstrating that vitamin suppliments do not prolong life, decrease cardiovascular disease, or decrease acute illnesses, making this statement is not logical or evidence based. Moreover, it is misleading and implies that, perhaps, a multivitamin could “…fill in the gaps”. This reflects and fuels a cultural attitude that good nutrition is categorical and not wholistic. Nutritional suppliments can never compensate, as your quoted data indicate, a crappy diet. Further, your conclusions beg the question “what is a good diet?” For instance, what are good sources of fiber and potassium? You know the answer, and it is promoted in other literature you have printed–vegetables and fruit! This is a missed opportunity to teach and promote a diet that does effect changes in cardiovascular disease occurance and progression as well as certain cancers–plant based diet. You could have paralleled the data you quoted with studies by Ornish and Esselstyn and others that demonstrate these conclusions. Come on NutritionAction, be bold enough to present the whole, and whole foods, picture.

    1. As regular readers of the Nutrition Action Healthletter know, we’ve always stressed real food for the prevention of chronic diseases, we’re skeptical of the value of most dietary supplements, and we’ve never said that supplements can compensate for a poor diet.

      However, there are several individual nutrients that some people may have trouble getting enough of, such as vitamin B-12, folic acid, and vitamin D. For instance, the Institute of Medicine recommends that older adults, generally considered those 50 and older, get at least 2.4 micrograms of synthetic vitamin B-12 daily. That’s available only from dietary supplements or fortified foods. Women who could become pregnant need to make sure they’re getting enough folic acid.

      In these and other cases, it may be prudent to spend 10 cents a day on a good multivitamin.

  4. Unless one is found to lack a certain vitamin or has a malabsorption issue, most people in a developed country are wasting their money on vitamins and supplements. The vitamin and supplements makers will try to sell you the opposite idea to maintain a multi-billion dollar industry (scam).
    There are exceptions:
    1. Vitamin D (the sunshine vitamin) that should probably be supplemented by most people who live north of the Atlanta latitude (or the elderly and the obese)
    2. Folic acid for women planning or not preventing pregnancy.
    The other problem with vitamins and supplements is the lack of FDA control. According to Consumer Reports most vitamin D supplements had 15% to 150% of the dose on the label and that is probably true for others.
    So buyer beware.

    1. From Nutrition Action Healthletter: Only 2 of 21 popular brands of vitamin D did not have the labeled amount of the vitamin, according to the most recent analysis by consumerlab.com. Consumerlab.com is the leading authority on the quality of dietary supplements.

      Here’s what Consumer Reports said in May 2013:
      “Our latest tests yield some good news for the many people who take a daily vitamin D pill, or one that combines calcium and vitamin D: All of the 32 products met or exceeded their claimed levels of the vitamin, disintegrated or dissolved properly where applicable, and were well below the safe upper limit set by the Institute of Medicine.”

  5. If one needs supplemental vitamins, they should be taken as individual vitamin supplements, not with additional unnecessary others that may be in excessive amounts that may cause some harm. Vitamin B12 is not readily absorbed in the digestive tract needs to be taken as a soluble tablet under the tongue. Vitamin D is an oil soluble vitamin and usually absorbed in the intestine if the are available bile salts there. It may not be readily absorbed if the is not enough flow of bile from the liver. Folic acid supplements are only necessary for pregnant women, so why pay extra for it? for over 40 years, I have never found a case of scurvy (Vitamin C deficiency) in my practice nor have any of my associates. And excess Vitamin C wil flow out in the urine so it will add to reclaimed water pollution. And why add minerals to Multivitamins when an excess of some will be hazardous to your health? . There is not enough Iron in a multi to satisfy an iron deficiency need. Feosol or similar iron product should be taken. There is not enough calcium in a multi to satisfy a calcium deficiency. Please take only the individual vitamins and minerals you need

  6. No matter how good your diet is, there’s no way that you can get all of the RDA for all the vitamins and minerals. So what is it? Either RDA is wrong or Nutrition Action is wrong..

    1. From Nutrition Action Heathletter: We have never said that everyone needs to take a multivitamin or, on the other hand, that multivitamins are worthless. What we have said is that it may make sense for some people to take one regularly to make certain they get certain nutrients that they need, such as vitamin B-12, folic acid, and vitamin D, that may be hard for them to get enough from their diets. The amount of nutrients in common multivitamins like Centrum or One-A-Day are around the RDAs and are not harmful. For about 10 cents a day and one swallow, you can get the recommended amounts of most vitamins and essential minerals, so for some people this may be prudent and not worthless.

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