However, the dietary supplements industry is largely unregulated in the U. That means there are no standards for what's inside your multivitamin. Fortunately, many brands seek voluntary approval through third-party agencies like USP and NSF International. Nutrient deficiencies can be tough to spot.

But these are some under-the-radar clues that may suggest you need a multivitamin. The National Institutes of Health explains that iron is essential for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body for energy. Falling short of iron can lead to several health issues, including a nail abnormality called koilonychia.

Signs of koilonychia are thin, brittle, spoon-shaped nails. Night blindness and cloudy vision are potential signs of a vitamin A deficiency. Vitamin A plays a crucial role in your vision, allowing you to view the full spectrum of light, reports the American Academy of Opthalmology.

Without adequate vitamin A, your eyes cannot produce the pigments required for proper retinal function, leading to night blindness and impaired vision. Additionally, vitamin A is essential for helping your eyes produce enough moisture to keep them lubricated and healthy.

Vitamin A deficiency in the United States is rare; however, according to the NIH , children and adults with gastrointestinal disorders, such as irritable bowel disease, and those with cystic fibrosis or pancreatic insufficiency may be at risk for inadequacy.

Angular cheilitis, a condition characterized by painful cracks at the corners of the mouth, is associated with several nutrient deficiencies, according to information from StatPearls. These deficiencies include iron, zinc and B vitamins such as folate, riboflavin and B Luckily, proper oral or topical antibiotic treatment improves angular cheilitis within a few days, with full healing in two weeks.

Of course, you'll also need to correct any nutrient deficiencies at the root of the problem. Have you noticed you bruise easily and that the bruises take a long time to heal?

If so, you may lack vitamins C and K, says the NIH. Vitamin C deficiency can cause weak blood vessels due to insufficient collagen production, resulting in easy bruising, per StatPearls. Vitamin K is essential for blood coagulation and clotting after injury. According to the Merck Manual , inadequate vitamin K levels can lead to easy bruising.

While it's generally safe to take a daily multivitamin to ensure nutritional adequacy, most people who eat a healthy, balanced diet don't need them.

Before starting any new supplement, "always check with your doctor, especially if you have nutrient deficiencies or any medical conditions that may affect how you absorb and store nutrients," Kunik advises. If you're healthy and eating a nutritious, well-balanced diet , don't stress about taking a multivitamin.

If you don't have any nutrient deficiencies, then whether you take a multivitamin is a personal choice," says Lubeck.

Depending on your needs, you may need to take individual supplements instead of a multivitamin. This results in an insufficient amount of healthy red blood cells.

Some vitamin deficiencies cause more than one symptom, and some symptoms like sleepiness can occur as a result of a few different vitamin deficiencies. Because symptoms do not always clearly correlate with the specific vitamin deficiency, diagnostic testing is the only way to confirm a vitamin deficiency.

The diagnosis of vitamin deficiencies can take some time. That is because it is not routine to test for vitamin levels. Your healthcare provider may consider testing if you have symptoms or if your physical examination identifies issues like bruises, wounds, skin discoloration, and neuropathy.

Neuropathy is a condition in which nerve function is impaired. It is associated with a lack of vitamin B It can cause you to have decreased sensation, diminished reflexes, and muscle weakness.

Very early neuropathy might not cause these changes, but an electromyography EMG or nerve conduction study NCV can often detect early stages of neuropathy that have not yet caused signs or symptoms. Blood tests can show signs of vitamin deficiency and can be used to measure your vitamin levels.

A complete blood count is the most common screening test. A low red blood cell count or a pattern of enlarged red blood cells megaloblastic anemia is a common sign of vitamin B12 deficiency. In some instances, your vitamin levels may be measured with a blood test. Vitamins that can be measured with a blood test include folate vitamin B9 , vitamin D, and vitamin B If there is a concern that you could have a digestive problem causing vitamin malabsorption, your healthcare provider may order a test to examine the internal appearance of your stomach or intestines.

An endoscopy is used to examine the appearance of your stomach and the upper portion of your small intestine using a camera that is inserted down your throat.

A colonoscopy is used to examine the internal appearance of your large intestine using a camera that is inserted into the rectum. These tests can be uncomfortable, so they are done with an anesthetic medication.

Your healthcare provider can identify problems such as Crohn's disease and some types of malabsorptive syndromes with these interventional examinations.

Treatment for vitamin deficiency involves vitamin replacement. If a medical condition is the cause of your vitamin deficiency, then treatment of that condition is necessary as well. In many instances, even if a medical condition is contributing to your vitamin deficiency, long term dietary changes can help correct and prevent the deficiency from worsening.

You can learn which foods contain the vitamins you need so that you can pay attention to getting an adequate amount of these vitamins. You may benefit from meeting with a dietitian, who can help you identify which foods you could consider including in your diet. You may also need help with creating a healthy meal plan.

There are several ways to make sure that you get adequate vitamins. Vitamin supplements can be an option. You may be given a recommendation for an over-the-counter OTC or prescription supplement.

Sometimes when there is a problem with absorption, supplements such as vitamin B12 need to be injected instead of taken orally. Nutritional supplements aren't safe for everyone.

They may have side effects, negative effects on medical conditions, dangerous interactions with medications, or unwanted effects during pregnancy or breastfeeding. Always talk to your healthcare provider about a supplement before you start taking it.

If you have a medical condition such as irritable bowel syndrome or inflammatory bowel disease, you will benefit from getting treated for that condition.

There are a number of medical and surgical treatments for gastrointestinal conditions. Some illnesses, such as liver failure, may not be treatable at late stages. Long-term injected vitamin supplementation may be necessary.

A healthy and varied diet is an important part of good health. Generally speaking, supplements are no substitute for good nutrition. Be sure to discuss any supplement use with your healthcare provider—they can help counsel you on appropriate use and dosage.

National Institutes of Health, U. National Library of Medicine: MedlinePlus. Nowak A, Boesch L, Andres E, et al. Effect of vitamin D3 on self-perceived fatigue: A double-blind randomized placebo-controlled trial [published correction appears in Medicine Baltimore.

Medicine Baltimore. Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and minerals for energy, fatigue and cognition: A narrative review of the biochemical and clinical evidence.

Published Jan Folate-deficiency anemia. VanBuren CA, Everts HB. Vitamin A in skin and hair: An update. Published Jul Rembe JD, Fromm-Dornieden C, Stuermer EK. Effects of vitamin B complex and vitamin C on human skin cells: is the perceived effect measurable?

Adv Skin Wound Care. Pullar JM, Carr AC, Vissers MCM. The roles of vitamin C in skin health. Umar M, Sastry KS, Al Ali F, Al-Khulaifi M, Wang E, Chouchane A. Vitamin D and the pathophysiology of inflammatory skin diseases. Skin Pharmacol Physiol. Oregon State University, Linus Pauling Institute: Micronutrient Information Center.

Vitamin A and skin health. Mikkelsen K, Stojanovska L, Apostolopoulos V. The effects of vitamin B in depression. Curr Med Chem. Pullar JM, Carr AC, Bozonet SM, Vissers MCM. High vitamin C status is associated with elevated mood in male tertiary students.

Antioxidants Basel. Xie F, Huang T, Lou D, et al. Effect of vitamin D supplementation on the incidence and prognosis of depression: An updated meta-analysis based on randomized controlled trials.

Front Public Health. Published Aug 1. Galimberti F, Mesinkovska NA. Skin findings associated with nutritional deficiencies. Cleve Clin J Med. Wolpert K, Szadkowski M, Miescier M, Hewes HA. The presentation of a fussy infant with bruising: Late-onset vitamin K deficiency bleeding.

Pediatr Emerg Care. Harvard University Medical School, Harvard T. Chan School of Public Health. Vitamin K. Barchitta M, Maugeri A, Favara G, et al. Nutrition and wound healing: An overview focusing on the beneficial effects of curcumin.

However, the latest report from the US Preventive Services Task Force finds that, after a thorough review of scientific research, there is insufficient evidence that routine daily multivitamin supplements or individual vitamin and mineral supplementation can reduce incidence of cancer or prevent cardiovascular disease 1 Reference Vitamins may be Fat soluble vitamins A, D, E, and K Water soluble B vitamins and vitamin C The B vitamins include biotin, folate, niacin, pantothenic acid, riboflavin B2 , thiamin B read more in community-dwelling, nonpregnant adults.

US Preventive Services Task Force, Mangione CM, Barry MJ, et al : Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: US Preventive Services Task Force Recommendation Statement. JAMA 23 , Learn more about the MSD Manuals and our commitment to Global Medical Knowledge.

Disclaimer Privacy Terms of use Contact Us Veterinary Manual. IN THIS TOPIC. OTHER TOPICS IN THIS CHAPTER. Overview of Vitamins By Larry E. View PATIENT EDUCATION. Vitamins may be. Fat soluble vitamins A, D, E, and K. All rights reserved. Was This Page Helpful?

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Another risk is faulty manufacturing processes, which may cause multivitamins to harbor much larger amounts of nutrients than intended Supplementing with large doses of certain nutrients can have harmful effects.

This is more likely to occur if you take a high-potency multivitamin on top of a nutrient-dense diet. Some individuals, including older adults, vegetarians, and vegans, may need higher amounts of certain vitamins or minerals. Multivitamins are not a ticket to optimal health.

In fact, evidence that they improve health for most people is inconsistent. In some cases, they may even cause harm. Multivitamins pack many nutrients, most of which you may not need. It may be best to speak with your healthcare provider to decide your best course of action.

Eating a balanced diet of fresh, whole foods is much more likely to ensure good health over the long term. I started taking a daily multivitamin a year after I moved to Washington State. My doctor also recommended I get more vitamin C and Iron, so it was nice to get all three in a single pill.

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

VIEW ALL HISTORY. This article is based on scientific evidence, written by experts and fact checked by experts. Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses 1, 2, 3 are clickable links to peer-reviewed scientific papers. Whole foods are the best sources of nutrients. Here are 8 healthy foods that contain higher amounts of certain nutrients than multivitamins.

Gummy vitamins are increasingly popular. This article tells you whether they are good or bad for your health. It doesn't hurt to take a daily vitamin, but do you actually know what goes into it — and does it have vitamin D?

If you had to check, you may want to…. Vitamins and other nutrients from whole foods have many health benefits. The same may not apply to synthetic nutrients from supplements. Vitamin B12 is an essential nutrient that plays many critical roles in the body.

Learn about its many health benefits, symptoms of a deficiency, and…. MindBodyGreen provides third-party-tested supplements made with high quality ingredients.

Our testers and dietitians discuss whether MindBodyGreen…. Vitamins are for athletes to stay healthy. You may get all you need from the food you eat. Some athletes may benefits from vitamin supplements. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep?

Health Conditions Discover Plan Connect. Nutrition Evidence Based Do Multivitamins Work? The Surprising Truth. Medically reviewed by Alan Carter, Pharm. What they are Ingredients Heart disease Cancer Other benefits Downsides Recommendation Bottom line Comments. How we vet brands and products Healthline only shows you brands and products that we stand behind.

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Read more about our vetting process. Was this helpful? What are multivitamins? What do multivitamins contain? Multivitamins and heart disease. Multivitamins and cancer. Do multivitamins have any other health benefits? Multivitamins may be harmful in some cases. Should you take multivitamins?

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Jan 28, Medically Reviewed By Alan Carter, PharmD. Malabsorption conditions. Any condition that interferes with normal digestion can increase the risk of poor absorption of one or several nutrients.

Examples: Diseases like celiac, ulcerative colitis, or cystic fibrosis. Surgeries that remove parts of digestive organs such as having a gastric bypass for weight loss or a Whipple procedure that involves many digestive organs.

Illnesses that cause excess vomiting or diarrhea can prevent nutrients from being absorbed. Alcoholism can prevent nutrients, including several B vitamins and vitamin C , from being absorbed.

Certain medications. Proton pump inhibitors prescribed for acid reflux and heartburn can prevent the absorption of vitamin B12 and possibly calcium and magnesium. A note on vitamin D For most people, the best way to get enough vitamin D is taking a supplement because it is hard to get enough through food.

Although some foods are fortified with vitamin D, few foods contain it naturally. Vitamin D production in the skin is the primary natural source of vitamin D, but many people have insufficient levels because they live in places where sunlight is limited in winter, or because they have limited sun exposure.

Also, people with darker skin tend to have lower blood levels of vitamin D because the pigment melanin acts like a shade, reducing production of vitamin D.

Cancer A randomized double-blind placebo-controlled trial provided a multivitamin or placebo to more than 14, male physicians, some with a history of cancer. Mortality Some research has suggested that the rates of death appear higher in people using multivitamins. It showed that women over the age of 55 who took multivitamins were at higher risk for dying than those who did not.

As a result, it is unknown whether the women were already taking vitamins when they became ill, or if they became ill and then started taking vitamins.

In women who were already sick, taking vitamins was unlikely to lower their risk of dying. The benefit appeared strongest for participants with a history of cardiovascular disease CVD ; this result may have been due to lower baseline blood levels of certain vitamins and minerals or susceptibility to drug interactions causing lower nutrient levels in patients with CVD, as the authors confirmed had been shown in prior observational studies.

The COSMOS-Web trial followed 3, older adults, examining their memory and executive functioning specific to the hippocampus region of the brain by using neuropsychological tests. References Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS, Thomas PR, Betz JM, Sempos CT, Picciano MF.

Dietary supplement use in the United States, — The Journal of nutrition. Fulgoni III VL, Keast DR, Bailey RL, Dwyer J.

Foods, fortificants, and supplements: where do Americans get their nutrients?. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, Rautiainen S, Manson JE, Lichtenstein AH, Sesso HD.

Dietary supplements and disease prevention—a global overview. Nature Reviews Endocrinology. Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the US Preventive Services Task Force.

Annals of internal medicine. Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE. Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE, Gaziano JM. Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR.

Archives of internal medicine. Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G, Copeland T, Clar A, Mora S, Moorthy MV, Sarkissian A. Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study COSMOS randomized clinical trial.

The American Journal of Clinical Nutrition. Baker LD, Manson JE, Rapp SR, Sesso HD, Gaussoin SA, Shumaker SA, Espeland MA. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial.

Manson and Sesso received support for the COcoa Supplement and Multivitamin Outcomes Study COSMOS through an investigator-initiated grant from Mars Edge, a segment of Mars, Inc.

dedicated to nutrition research, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare now Haleon provided support through the partial provision of study pills and packaging.

Neither the National Institutes on Health, Mars, nor Pfizer contributed to any aspect of the trial including design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

The authors have no competing interests to report. Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, Sloan RP, Sesso HD, Manson JE, Brickman AM.

Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. The American journal of clinical nutrition. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

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Trace minerals microminerals , although equally important to bodily functions are required in smaller amounts. Examples include iron, zinc, copper, manganese, and iodine selenium. Calcium is vital to keep our bones strong and healthy.

Calcium helps:. At different life stages, our calcium needs vary. It is better to get calcium from foods than from calcium supplements. Good sources of calcium include dairy foods like milk, yoghurt and cheese and some plant-based foods with added calcium for example, soymilk, tofu and breakfast cereals.

Iodine is essential to make thyroid hormones. These hormones control your metabolic rate the rate your body uses energy when it is resting. They also help your brain and body grow and develop. We only need a very small amount of iodine in our diet. Iodine is found naturally in foods such as:.

Iodine can also be found in iodised salt. All bought breads except organic in Australia are fortified with iodised salt. You are likely to be getting enough iodine through your diet.

However, if you are deficient and need to take a supplement, be guided by your doctor. Too much iodine can be harmful, especially if you have an underlying thyroid disorder.

Iron is an important mineral that is involved in various bodily functions, including the transport of oxygen in the blood the provision of energy to cells.

It also vital to help our immune system function effectively to fight infection. Iron deficiency is common and can affect adults and children. Around one in 8 people do not consume enough iron to meet their needs. Some factors such as certain foods and drinks can affect how much iron your body absorbs.

Also, some groups are more at risk of iron deficiency, such as babies and young children, teenage girls, women with heavy periods , vegans and vegetarians and people with chronic conditions.

Zinc is an important mineral involved in various bodily functions — growth and development as well as immune function. Zinc is highest in protein-rich foods but may also be found in some plant foods.

Dietary sources include:. Magnesium is important due to its many functions in the body — including maintaining bone health and using glucose for energy. Potassium is important for the nerves, muscles and heart to work properly.

It also helps lower blood pressure. Our bodies are designed for a high-potassium diet, not a high-salt diet. Food processing tends to lower the potassium levels in many foods while increasing the sodium content. It is much better to eat unprocessed foods — such as fruit, vegetables and lean meats, eggs, fish and other healthy, everyday foods.

Be guided by your doctor, some people with kidney disease , or who are taking some medications, need to be careful not to get too much potassium in their diet.

A small amount of sodium is important for good health as it helps to maintain the correct volume of circulating blood and tissue fluids in the body. Most of us are consuming far more sodium than we need. In fact, many Australians are consuming almost double the amount required.

Too much sodium can lead to high blood pressure hypertension and other health conditions. Salt is the main source of sodium in our diet. It is a chemical compound electrolyte made up of sodium and chloride. Many foods — wholegrains, meat and dairy products — naturally contain small amounts of sodium, while highly processed foods usually contain large amounts.

The fat-soluble vitamins A, D, E and K can be locked away in the liver and body fat, and stored for a long time. The water-soluble vitamins, including B-complex and vitamin C, are mostly only stored for a shorter period.

A vitamin deficiency takes weeks or months before it will affect your health. For instance, it would take months of no vitamin C before you developed scurvy. Vitamin and mineral supplements may be recommended in certain circumstances to correct vitamin and mineral deficiencies — such as folate for women who are pregnant or planning a pregnancy.

Others who may be at risk of a vitamin or mineral deficiency include:. Remember, supplements are a short-term measure and should only be taken on advice from your doctor or a dietitian.

An occasional lapse in good eating will not harm you, if your usual diet consists of a wide variety of fresh foods. This page has been produced in consultation with and approved by:. Learn all about alcohol - includes standard drink size, health risks and effects, how to keep track of your drinking, binge drinking, how long it takes to leave the body, tips to lower intake.

The Alexander technique stresses that movement should be economical and needs only the minimum amount of energy and effort. A common misconception is that anorexia nervosa only affects young women, but it affects all genders of all ages. Antioxidants scavenge free radicals from the body's cells, and prevent or reduce the damage caused by oxidation.

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Healthy eating. Home Healthy eating. Vitamins and minerals. Most have not found an effect of MVM use on any of the health outcomes measured. One of the largest prospective studies of MVM use was the Women's Health Initiative, which evaluated the health of , postmenopausal women age 50—79 years and their risk factors for cancer, heart disease, and osteoporosis.

A total of When the investigators compared the outcomes of supplement users and nonusers, they found no association between use of these products for a median of 8 years and an increased risk of any common cancer or total cancers, CVD, or total mortality [ 35 ].

Investigators who followed a multiethnic cohort of , men and women age 45—75 years living in Hawaii and California for an average 11 years found similar results [ 36 ]. Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the National Health Interview Survey.

This analysis included 4, adults who reported taking an MV or MVM during the previous 12 months and 16, nonusers [ 37 ]. The supplement users reported better overall health than the nonusers, but the results showed no differences in various psychological, physical, or functional health outcomes [ 37 ].

Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. In , researchers reviewed 63 published RCTs between and early that evaluated the potential impacts of MVs and MVMs and individual nutrient supplements on health and on the risk of certain medical conditions cancer; age-related sensory loss; and cardiovascular, endocrine, neurologic, musculoskeletal, gastroenterologic, renal, and pulmonary diseases [ 7 ].

An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [ 1 ].

The Physicians Health Study II was the longest clinical trial to investigate whether MVMs might help prevent chronic disease. The study randomly assigned 14, male physicians in the United States age 50 and older to take a daily MVM Centrum Silver or placebo for a median of Participants who took the MVM did not have fewer major cardiovascular events, myocardial infarctions, strokes, or cardiovascular-related deaths than nonusers [ 38 ].

The supplement also had no effect on cognitive decline with age [ 40 ]. The COcoa Supplement and Multivitamin Outcomes Study COSMOS was a subsequent clinical trial to investigate whether MVMs might help prevent cancer and CVD in both men and women [ 42 ]. This study randomly assigned 8, men age 60 years and older and 12, women age 65 years and older to take a daily MVM Centrum Silver, with small differences in ingredients and amounts than the supplement used in the Physicians Health Study II , a cocoa extract containing mg of cocoa flavanols, both Centrum Silver and the cocoa extract, or both placebos for a median of 3.

An ancillary study to COSMOS, known as COSMOS-Mind, enrolled 2, of the older COSMOS participants mean age 73 years to investigate whether the cocoa extract, MVM, or both supplements might improve cognition compared with placebo over 3 years of daily use [ 43 ]. Participants completed standardized cognitive tests administered over the telephone at baseline and annually for 3 years.

MVM supplementation, with or without the cocoa extract, improved global cognition, a benefit most pronounced in participants with a history of CVD. The MVM also improved memory and executive function. Similar findings were reported from COSMOS-Web, another ancillary study to COSMOS that included 3, participants mean age 71 years [ 44 ].

In this study, participants who took the MVM had significantly better memory at both 1 year and across 3 years of follow-up, on average, compared with those who took placebo.

These findings suggest that MVM supplementation can help maintain or enhance cognitive function in older adults. Other RCTs have evaluated the effects of MVMs on outcomes in individuals with a range of chronic diseases. One RCT conducted in Linxian, China, randomized 3, persons age 40—69 years who had precancerous lesions in the esophagus a relatively common condition in this population, which had a low dietary intake of several nutrients to receive a daily MVM containing 14 vitamins and 12 minerals in doses two to three times recommended amounts or a placebo for 6 years [ 45 ].

The supplement did not reduce incidence or mortality rates for esophageal cancer or the rate of mortality from any cause. After the investigators followed participants for up to 20 additional years, when participants were no longer taking the study supplement, the use of the MVMs during the RCT did not result in lower rates of total mortality or mortality from any cause of death examined, including cancer, heart disease, and stroke [ 46 ].

One meta-analysis of 21 RCTs investigated whether daily use of MVs and MVMs products containing three or more nutrients for at least 1 year affected mortality risk [ 47 ]. The studies included a total of 91, healthy adults average age 62 years taking the MVs or MVMs for an average of 43 months, and the investigators reported 8, deaths.

The products provided an average of 14 nutrients, although the products with three nutrients in five trials did not contain a mineral. The use of MVs or MVMs had no effect on all-cause mortality or on mortality due to CVD or cancer.

However, the quality of the studies was generally poor, most had small samples as few as 20 participants , and they used different MVs and MVMs and outcome measures.

One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. In the French Supplémentation en Vitamines et Minéraux Antioxydants SU. MAX study, investigators randomly assigned 13, adults age 35—60 years to receive a placebo or a daily supplement containing moderate amounts of vitamin C mg , vitamin E 30 mg , beta-carotene 6 mg , selenium mcg , and zinc 20 mg [ 49 ].

After 7. The supplements provided no protection from CVD. Overall, MVMs do not appear to reliably reduce the risk of chronic diseases when people choose to take these products for up to a decade or more or when studies randomize people to take them as part of a clinical trial.

An evidence review commissioned by the U. Preventive Services Task Force USPSTF included 78 RCTs with , participants and six cohort studies with , participants [ 50 ].

It concluded that vitamin and mineral supplements had little or no benefit in preventing cancer, CVD, and death, except that MVMs may provide a small benefit against cancer.

Based on this review, the USPSTF concluded there was insufficient evidence to determine the balance of benefits and harms in taking MVMs to prevent CVD or cancer [ 51 ]. The American Institute for Cancer Research recommends against taking dietary supplements for cancer prevention because supplements do not provide the same benefits as eating whole foods [ 52 ].

Similarly, the American Heart Association advises against the use of MVMs to prevent CVD because scientific studies have found them to be of no value for this purpose [ 53 ].

Although MVM use might not reduce overall chronic disease risk, several nutrients in MVMs might benefit certain groups of people. Examples of these populations are described below. Obtaining sufficient amounts of folic acid in the periconceptual period reduces the risk of neural tube defects in newborns.

The Dietary Guidelines for Americans — DGA notes that the critical period for folic acid supplementation to prevent neural tube defects starts at least 1 month before conception and continues through the first 2 to 3 months of pregnancy [ 55 ].

The American College of Obstetricians and Gynecologists recommends that pregnant people take a daily prenatal vitamin [ 57 ]. Acknowledging that most health care providers recommend that pregnant people take a daily prenatal MVM, the DGA states that this practice may be necessary to meet the needs for folate or folic acid, iron, iodine, and vitamin D during pregnancy [ 55 ].

The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them.

The report recommends that people following a vegetarian or vegan diet consult their health care provider about whether they need supplementation with iron, vitamin B12, and other nutrients e. The World Health Organization recommends iron and folic acid supplementation throughout pregnancy [ 58 ].

The academy also recommends that non-breastfed infants and older children who consume less than 1 liter of vitamin D-fortified formula or milk receive IU 10 mcg supplemental vitamin D daily. The DGA, noting the difficulty of obtaining sufficient vitamin D from foods, advises that young children might need to continue taking a vitamin D supplement after age 12 months [ 55 ].

The DGA adds that infants fed human milk might also require a vitamin B12 supplement if the mother's vitamin B12 status is inadequate, which might occur, for example, if she follows a vegan diet [ 55 ].

The FNB advises people older than 50 years to obtain recommended amounts of vitamin B12, mainly from fortified foods or dietary supplements. Adults in this age group might not be able to absorb enough of the protein-bound, naturally occurring vitamin B12 in food because gastric acidity tends to decline and atrophic gastritis tends to become more common with age [ 6 ].

The DGA also recommends obtaining recommended amounts of vitamin B12 primarily from fortified foods or dietary supplements, but only for people age 60 and older. The DGA adds that the use of some medications such as proton pump inhibitors can decrease absorption of vitamin B12 in foods [ 55 ].

Individuals who have poor nutrient intakes from diet alone, consume low-calorie diets, or avoid certain foods such as strict vegetarians and vegans might benefit from taking an MVM [ 61 ].

Health care providers sometimes prescribe MVMs for people who have medical conditions and diseases that impair digestion, absorption, or use of nutrients.

government health agency, private health group, or health professional organization promotes regular use of MVMs. In general, MVMs might help people who do not eat a nutritious variety of foods to obtain adequate amounts of essential nutrients.

However, MVMs cannot take the place of the variety of foods that are important to a healthy diet, because foods provide other nutrients and components that have benefits for health. Taking a basic MVM that provides nutrients in amounts that are approximately the same as recommended intakes should be safe for healthy people.

Studies of MVM users reveal no adverse effects, except that both treatment and placebo groups in some studies experienced some minor gastrointestinal issues [ 62 ]. Adults need 2. Most of us know that calcium keeps bones strong; it also helps control muscle and nerve function and regulate our heartbeat.

As estrogen drops, our ability to absorb calcium diminishes, and those on vegan diets can compound the risk by avoiding dairy products. Calcium-rich foods include cow's milk, fortified soy or almond milks, yogurt, cheese, fortified cereals, and dark green vegetables like kale and broccoli.

Most adults need 1, mg each day, but women over 50 need 1, mg. Don't count on symptoms — or their absence — to clue you in to a possible nutritional deficit.

Most deficiencies are subtle, with few glaring signs, Blake says. And it's not something you can diagnose on your own. That requires medical testing. Additionally, our bodies store small amounts of extra vitamins and minerals that would tide us over several weeks of poor eating, meaning our levels would have to be extremely low before a problem even shows up.

A vitamin D deficiency, for instance, might only announce itself in a broken bone. Calcium levels can't be accurately gauged from a blood test, Fung says. Typically, however, blood tests can reveal whether you're lacking in key nutrients, including vitamin D, iron, or B While there's "no need to test for every deficiency under the sun," Fung advises asking your doctor if she feels your risk factors warrant a closer look.

More than 24 million Americans cope with autoimmune disorders such as rheumatoid arthritis, psoriasis, or thyroid disease.

But so far, scientists haven't identified potential ways to prevent these burdensome conditions, which disproportionately affect women. Now, however, a Harvard study suggests that vitamin D and fish oil supplements may offer adults over 50 protection against developing autoimmune disorders.

All these conditions — which number more than 80 — occur when the immune system mistakenly attacks healthy cells, tissues, or organs.

Their symptoms vary, but may include pain, fatigue, skin problems, and other chronic problems. JoAnn Manson, chief of the Division of Preventive Medicine at Harvard-affiliated Brigham and Women's Hospital, who led the main Vitamin D and Omega-3 Trial VITAL and co-authored the new report, published Jan.

The randomized controlled trial — considered the gold standard of research — included 25, racially diverse older adults over age 50, who were split into four groups. People in one group took 2, IU of vitamin D 3 each day; those in another took 1, milligrams of fish oil containing marine-based omega-3 fatty acids ; those in a third group took both; and the rest took two placebos.

None knew which group they were in. The vitamin D dose used in the trial is more than twice the recommended daily intake of IU or IU for people 71 and older.

During a five-year follow-up period, participants told researchers whether they'd been diagnosed with any autoimmune diseases, and diagnoses were confirmed through medical records.