2007;1:42-55. This is the essential step leading to carboxylation and activation of the blood-clotting proteins. RCTs
JAMA Network open 2019;2(6):e195967. Ask ODS
[, Blumberg JB, Frei BB, Fulgoni III VL, Weaver CM, Zeisel SH. The USPSTF advises people who are planning to become or capable of becoming pregnant to take a dietary supplement providing 400 to 800 mcg/day of folic acid daily [55]. Among women, taking a daily MV or MVM did not affect their overall risk of developing cancer except for oropharyngeal cancer, which increased by 46%. [, Larsson SC, kesson A, Bergkvist L, Wolk A. Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women. Vit. . Vitamins & Minerals; Supplier Directory; . Further metabolism of vitamin D to its major circulating form (25(OH)D) and hormonal form (1,25(OH)2D) takes place in the liver and kidney, respectively, but also in other tissues where the 1,25(OH)2D produced serves a paracrine/autocrine function . Am J Clin Nutr 2013;97:437-44. Boulder, CO: New Hope Network, 2021. Approximately 48% of the men and 52% of the women in this study reported taking an MV or MVM. Excess nutrient intakes are even more likely among MVM users who also take single vitamin and mineral supplements [15]. Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. In the Age-Related Eye Disease Study (AREDS), investigators randomized 4,757 individuals aged 5580 years who had varying degrees of AMD, cataract, or both conditions to receive a placebo or a daily supplement containing high doses of vitamin C (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) [30,31]. The studies (which were of low quality overall) included a total of 355,034 women ages 2079; those taking MVs and MVMs took them for at least 3 years. This publication is not copyrighted and is in the public domain. Theres no convincing evidence that MVMs help prevent chronicdisease. Product Presentation. In addition, the supplement reduced the risk of cataracts by 9% but did not help prevent AMD [41]. The American Academy of Pediatrics adds that all non-breastfed infants ingesting less than 1,000 mL/day of vitamin Dfortified formula or milk should receive a supplement containing 400 IU (10 mcg)/day vitamin D [58]. Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. What is the prenatal vitamins mechanism of action? Females (36%) were more likely to take one than males (31%). Many of these products contain numerous ingredients in varied combinations and amounts. [. Molecules, 24 (2019), p. 2362, 10.3390/molecules24132362. However, MVM use is common in the general population. After adjustment for potentially confounding variables (e.g., age, race, BMI, serum lipids, and blood pressure), the use of MVMs for more than 3 years was associated with a substantial 44% reduction in CVD mortality rates among women, but not men. B12 6mcg, biotin 30mcg, folic . The supplements did not prevent AMD onset or affect cataract risk. Whether you are stacking different types of natural nootropics, synthetic . Multivitamin-multimineral supplements: who uses them? However, supplement use increased the proportion of pregnant people with some intakes of iron (27.9%) and folic acid (33.4%) above the UL. Nutrition 2017;36:60-6. Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products. One way to group them is as follows (Table 1): An additional complication for this product category is that many dietary supplements are not labeled as MVMs even though they contain a variety of vitamins and minerals [1]. 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 [54]. Taking a daily dose of a basic MVM is unlikely to pose a health risk for most people. [, Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. For more information on safe upper levels of nutrients, visit the NIH Office of Dietary Supplements at: Smokers, and possibly former smokers, should avoid MVM products that provide more than 100% DV for vitamin A (either as preformed retinol or beta-carotene or some combination of the two) because two studies have linked high supplemental doses of these nutrients with an increased risk of lung cancer insmokers. Introduction. Taking excess amounts of vitamin A (preformed retinol form, not as beta-carotene) during pregnancy has been shown to increase the risk of birth defects. A review of 16 RCTs of MVs and MVMs (containing more than four nutrients including, in most cases, at least one mineral) in 1,719 participants who had at least one of six types of psychiatric symptoms (depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, or autism) found that the supplements provided no clear reduction in symptoms [47]. The study measured rates of major CVD events, including MI, stroke, and CVD death [27]. The Dietary Guidelines for Americans 2020-2025 (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 [54]. Basic MVMs contain both vitamins and minerals, most in amounts that do not exceed the DVs. Pharmacodynamics. JAMA Pediatr 2018;172:780-2. . The radioprotective effect ex vivo, in vitro and in vivo of vitamins was reviewed using PubMed and Embase and conducted according to the PRISMA statement. However, the supplement users had a 14% lower risk of undergoing cardiac revascularization (coronary angioplasty or coronary artery bypass grafting). Several studies have found that MVM users tend to have higher micronutrient intakes from their diet alone than nonusers [15]. Simply stated, dietary supplements arent required to be standardized in the United States. Am J Clin Nutr 2007;85:280S-4S. [, Mulholland CA, Benford DJ. [, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, et al. JAMA 2017;317:183-9. Am J Clin Nutr 2007;85:325S-7S. J Acad Nutr Diet 2018;118:2162-73. Adv Nutr 2020;11:753-9. Read the label of any multivitamin product you take to make sure you are aware of what it contains. Men and women who reported taking more than one MV or MVM daily at the beginning of the study had an 18% lower risk of developing colon cancer than nonusers. Multivitamins and minerals are also used to treat vitamin or mineral deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, certain medications, and many other conditions. Observational studies
The Dietary Guidelines for Americans 20152020 recommends that people should aim to meet their nutrient requirements through a healthy eating pattern that includes nutrient-dense forms of foods. Although they are all considered micronutrients, vitamins and minerals differ in basic ways. In the presence of insulin, the micronutrient combination tested further enhanced this effect up to 1445% over controls. For example, a manufacturer might label a product containing vitamins C and E, selenium, zinc, and beta-carotene as an antioxidant formula rather than an MVM. Vitamins are important building blocks of . Water and some water-soluble vitamins are absorbed by diffusion. [, Li J-Y, Taylor PR, Li B, Dawsey S, Wang G-Q, Ershow AG, et al. Vitamins are organic and can be broken down by heat, air, or acid. * This fact sheet focuses primarily on these basic, broad-spectrum MVMs. Enzymes for detoxification of various mycotoxins: origins and mechanisms of catalytic action. The DGA adds that the use of some medications (such as proton pump inhibitors) can decrease absorption of vitamin B12 in foods [54]. Multivitamins, vision are available under the following . The results showed no significant associations between MV or MVM use and risk of major CVD events, including myocardial infarction (MI), stroke, and CVD death. U.S. Preventive Services Task Force. The academy also recommends that nonbreastfed infants and older children who consume less than 1 liter of vitamin D-fortified formula or milk receive 400 IU (10 mcg) supplemental vitamin D daily. The DGA does not mention MVMs, but it does recommend that Americans choose healthy, nutrient-dense food and beverages. Long-term multivitamin supplementation and cognitive function in men: A randomized trial. Vitamin B12 (Cobalamin) Mechanism and Deficiency. Large reserve pool in the liver. Multivitamin use and the risk of mortality and cancer incidence: the Multiethnic Cohort Study. Nutrients 2017, 9, 849. [, Grodstein F, O'Brien J, Kang JH, Dushkes R, Cook NR, Okereke O, et al. A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 20012014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone [17]. Cancer Causes and Control 2001;12:927-34. Prenatal supplements generally provide no vitamin A in the form of retinol, and most childrens MVMs provide age-appropriate amounts of nutrients. Shelf Life/Expiry: 1.5 Years or 18 months from the date of manufacturing. MVMs providing nutrients in recommended amounts do not ordinarily interact with medications, with one important exception. The study's goal was to determine whether the supplement reduced the risk of additional cardiovascular events or death [28]. Join the ODS Email List. Use rates by sex and age are 19.5% for men and 26.1% for women ages 1930 years, 25.1% for men and 33.0% for women ages 3150 years, 34.5% for men and 36.2% for women ages 5170 years, and 40.9% for men and 44.0% for women ages 71 years and older. J Am Coll Cardiol 2021;77:423-36. Honey possesses antimicrobial, anti . Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the 2012 National Health Interview Survey. MVMs providing nutrients at or up to 100% DV do not typically interact with medications. This study randomly assigned 8,776 men aged 60 years and older and 12,666 women aged 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 500 mg of cocoa flavanols, both Centrum Silver and the cocoa extract, or both placebos for a median of 3.6 years. A meta-analysis of 20 RCTs investigated whether supplementation with MVMs (whose composition varied by study but that contained multiple nutrients including iron and folic acid) by pregnant people led to better birth outcomes than use of supplements containing only iron with or without folic acid or, in one study, a placebo [33]. Minerals (especially taken in large doses) can cause side effects such as tooth staining . Duplication is encouraged. Mishra S, Stierman B, Gahche JJ, Potischman N. Stierman B, Mishra S, Gahche JJ, Potischman N, Hales CM. The rate of death from breast cancer (6.7% of the cohort) was 30% lower among the MVM users than nonusers. But taking an MVM can also raise the chances of getting too much of some nutrients, like iron, vitamin A, zinc, niacin, and folate/folic acid, especially when a person takes more than a basic, once-daily product that provides 100 percent of the daily value (DV) ofnutrients. USES: This medication is a multivitamin product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. Art. When injected intravenously, it will increase circulating plasma volume by approximately 3 times the volume infused within 15 minutes if the client is well hydrated. Homocysteine to methionine. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. A total of 41.5% of the women took an MVM (containing 2030 vitamins and minerals in amounts not exceeding the RDAs), an MV (10 or more vitamins in amounts of 100% or more of the RDA), or a "stress multisupplement" (containing at least 10 nutrients, some in amounts more than twice the RDA) at least once a week. The investigators calculated nutrient intakes from participants' diets using a food frequency questionnaire and from MVMs (taken by 23%) using the nutrient composition of two commonly used MVMs. Vitamins are organic molecules necessary for normal metabolism in animals, but either are not synthesized in the body or are synthesized in inadequate quantities and must be obtained from the diet. 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]. Common side effects may include: upset stomach . Studies that have examined associations of MVMs with CVD risk include the Physicians Health Study I. [, Age-Related Eye Disease Study 2 Research Group. How to use Theragran-M oral. Marra MV, Bailey RL. These products go by various names, including "multis" and "multiples," and manufacturers determine the combinations and levels of vitamins, minerals, and other ingredients in them. After 7.5 years of use, the supplements lowered total cancer incidence by 31% and all-cause mortality rates by 37% in men but not women. 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 [50]. Women. [, Keats EC, Haider BA, Tam E, Bhutta ZA. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. The supplement also had no effect on cognitive decline with age [40]. Iron is necessary for the production of hemoglobin. Cochrane Database of Systematic Reviews 2019, Issue 3. Abdominal pain. Nevertheless, some users consider use of an MVM as a form of dietary or nutritional insurance, a concept first introduced by Miles Laboratories to market its One-A-Day line of nutrient supplements in the 1940s [13]. Brand Name: Generic Name: 32 Multivitamins & Multiminerals Dosage form: Tablet Indications: For the prevention and treatment of vitamins & mineral deficiencies as a complete daily nutritional supplement. Do not take more . Drug Class: Vitamins, Combos. The FNB does not address whether or to what extent nutrient supplements can compensate for dietary inadequacies. The FNB and DGA agree that fully and partially breastfed infants should receive a supplement containing approximately 400 IU (10 mcg)/day vitamin D beginning in the first week of life [54,59]. Cancer
Upper Limit. Huang H-Y, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer C, et al. Many types of MVMs, the focus of this fact sheet, are available in the marketplace. Iron is also a nutrient of public health concern for infants ages 611 months who are fed primarily human milk and do not consume enough iron from complementary foods, adolescent females, and people who are pregnant. We encourage you to discuss any decisions about treatment or care with your health care provider. Otten JJ, Hellwig JP, Meyers LD (editors). Am J Clin Nutr 2007;85:257S-264S. National Institutes of Health state-of-the-science conference statement: multivitamin/mineral supplements and chronic disease prevention.