There are a lot of contentious issues in medicine but one that has been center stage for decades seems puzzling to us. It is the question: Should you take a multivitamin? For some doctors it is a given that a little vitamin insurance seems like a good thing. For others it is a travesty. The phrase we hear most often is “just eat a well-balanced diet.” The media loves to enter the fray, as it did several years ago.
In October 2011 an article in the journal Archives of Internal Medicine spurred the following headlines:
“More Evidence Against Vitamin Use” (New York Times)
“Multivitamins no fountain of youth for women” (Reuters)
“Is This the End of Popping Vitamins?” (Wall Street Journal)
“Women Who Take Vitamin Supplements May Have Increased Death Risk” (MSNBC)
“Are Supplements Killing You? The Problem With Vitamins, Minerals” (The Atlantic)
Based on such headlines you would probably conclude that vitamins are a waste of money and possibly dangerous. No doubt a lot of people gave up their daily multivitamin.
The Iowa Women’s Health Study:
All these headlines were based in part on the results from the Iowa Women’s Health Study. This observational study followed 38,000 women for nearly two decades. The women who reported taking multivitamins had better survival rates, but they also had healthier lifestyles overall.
After making statistical adjustments for their better diets and exercise habits, the researchers concluded that multivitamins didn’t prolong their lives and may actually have increased their risk of dying early by a small amount. That conclusion is what led to all those scary headlines.
The Naysayers Rejoice:
Vitamin nihilists were delighted to use this study to proclaim that people taking a multivitamin were wasting their money and risking their health. This is a popular theme, and showed up in the headline of Public Citizen’s Worst Pills, Best Pills newsletter (Oct. 2012): “Dietary Supplements Offer Little to No Benefit and May Be Harmful.”
A Different Perspective:
The problem is that observational studies provide the weakest kind of scientific evidence. People are unpredictable. They behave differently from one day to another, and their lives are complicated. It’s hard to tell by observing them whether you have come to the correct conclusion. Sadly, headlines don’t distinguish between this type of study and the highest quality research, known as a randomized controlled trial (RCT).
The best way to eliminate factors that can muddy the results is to conduct an actual experiment where one group of subjects is randomly assigned to receive a pill and another group gets a look-alike placebo. That type of RCT was published in the Journal of the American Medical Association (online, Oct. 17, 2012). It involved more than 14,000 male physicians who took either a Centrum Silver multivitamin or a placebo between 1997 and 2011.
The investigators found that the men taking the supplement were slightly less likely (8%) to be diagnosed with cancer during that time. This is among the biggest and best studies of vitamins that have been done. Though the benefit was modest, it was statistically significant. The conclusion is far stronger than that from the Iowa Women’s Health Study. Anything that reduces the risk of cancer is welcome. And unlike the women’s study, there were no significant problems associated with vitamins.
The multivitamin formula that was used in the study was Centrum Silver. According to ConsumerLab.com, similar but less expensive brands include Costco (Kirkland brand), Dollar General (DG Health brand), Sam’s Club (formerly Member’s Mark brand), and Walmart (Equate brand). All five passed ConsumerLab.com’s quality testing.
BOTTOM LINE:
We think a multivitamin makes sense on several levels. For one thing, it’s a little like insurance. Even though a vitamin pill is no substitute for a healthy diet, it helps to ensure that you are not lacking in one nutrient or another.
Millions of Americans swallow medications, ranging from over-the-counter acid-suppressing drugs like Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole) to prescription diabetes drugs like metformin or diuretics such as hydrochlorothiazide (HCTZ). Such medicines can deplete the body of critical vitamins and minerals.
You can learn more about the controversy over vitamin supplements by listening to our radio interview from October 13, 2012 with one of the authors of the Iowa Women’s Health Study and the director of the Alliance for Natural Health International as well as Tieraona Low Dog, MD. You will get a balanced perspective and be able to draw your own conclusions about the pros and cons of vitamins.
You can get a FREE copy of our Guide to Drug and Nutrient Interactions.
Perhaps the best reference on this entire topic is the most recent book by Dr. Low Dog. It is titled Fortify Your Life Your Guide to Vitamins, Minerals and More. We cannot recommend this book highly enough. Should you wish to listen to our one-hour interview with Dr. Low Dog on this topic, here is a link to radio show.
If you are taking diabetes medicine, medications for heartburn, or blood pressure pills with diuretics like hydrochlorothiazide, you will want to listen to the podcast and/or read the book! Then you can decide for yourself whether a multivitamin makes sense. Listen to our radio show (# 1050) on eye health with one of the country’s leading ophthalmologists. He will explain why eye doctors agree that nutritional supplements are good for the eyes.
Revised by Joe Graedon: 9/15/16
