People wonder if MULTIvitamins are helpful
Are Multivitamins Necessary for Health?
As a nutrition support pharmacist, patients may inquire if multivitamins are beneficial, often prompted by reports suggesting limited benefits. Multivitamins do not reduce the risk of heart disease, cancer, or death in healthy adults, and excessive intake can be harmful. For instance, high-dose beta-carotene may increase lung cancer risk in smokers, and too much vitamin E may elevate the risk of hemorrhagic stroke, prostate cancer, and mortality.
NPS recommendations
Adults generally don't need a multivitamin if they are healthy and meet their nutritional needs through a balanced diet. However, consider multivitamins or targeted supplements for individuals with specific nutrient requirements.
Special recommendations for vitamin D and calcium
Children may require vitamin D if they are not getting sufficient amounts from formula or milk.
- Recommend 400 to 800 IU/day, with higher doses for children at higher risk for deficiency or living in areas with limited sunlight.
- See our note on "Vitamin D supplementation in infants and children." Similarly, adults with limited sun exposure or living in northern regions may benefit from 800 to 2000 IU/day of vitamin D.
- Refer to our notes on "Vitamin D deficiency in adults" and "Clinical points on vitamin D supplements."
Key nutrients for women of childbearing age and older adults
For women of childbearing age, folic acid (400 mcg/day) from fortified foods or supplements is essential to reduce the risk of neural tube defects during early pregnancy.
- See our notes on "Choosing the right prenatal vitamin" and "Nutrition during pregnancy." Older adults may need a total of 1200 mg/day of calcium from diet and supplements.
- See our note "Using calcium supplements safely."
Nutrient deficiencies linked to medications and health conditions
Certain medications and health conditions may contribute to nutrient deficiencies. For instance, long-term use of PPIs or metformin can lower vitamin B12 levels, and bariatric surgery can impair nutrient absorption. For more details, refer to our notes on "Treatment of METFORMIN-induced vitamin B12 deficiency."
References
- Moyer VA; U.S. Preventive Services Task Force. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive services Task Force recommendation statement. Ann Intern Med. 2014 Apr 15;160(8):558-64.
- Fortmann SP, Burda BU, Senger CA, et al. 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. 2013. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK169368.
- NHS Choices (2019). Do I need vitamin supplements? [online] NHS. Available at: https://www.nhs.uk/common-health-questions/food-and-diet/do-i-need-vitamin-supplements.
- Johns Hopkins Medicine Health Library. (2019). Is There Really Any Benefit to Multivitamins? [online] Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/is-there-really-any-benefit-to-multivitamins.