Office of Dietary Supplements. Nutrition Business Journal. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. J Acad Nutr Diet 2018;118:2162-73. Hypersegmented Neutrophils. This study prospectively followed 18,530 male physicians aged 40 years and older, of whom 20% reported taking an MV or MVM for an average of 12.2 years [24]. For a reader-friendly overview of Multivitamin/mineral Supplements, see our consumer fact sheet on Multivitamin/mineral Supplements. Alzheimer's & Dementia 2022;1-12. Multiple-micronutrient supplementation in pregnant adolescnts in low- and middle-income countries: A systematic review and meta-analysis of individual participant data. What is the prenatal vitamins mechanism of action? Common side effects may include: upset stomach; Studies of the association between MVM use and CVD outcomes have focused on several outcomes, including cardiovascular events and mortality. Taking a daily dose of a basic MVM is unlikely to pose a health risk for most people. The trials included a total of 15,283 pregnant adolescents and young adults from low- or middle-income countries in Africa and Asia. U.S. Preventive Services Task Force. These stacks can either be a mix within the same type of nootropics, such as a mixture of racetams or between different types, such as mixing choline with ampakines. Taking excess vitamin A (as retinol or other preformed forms of vitamin A but not beta-carotene) during pregnancy can increase the risk of birth defects in infants. Here are some of the key benefits of consuming red cabbage: Rich in nutrients: Red cabbage is a good source of vitamins and minerals, including vitamin C, vitamin K, vitamin A, potassium, calcium, and iron. Next: . Mechanism. Even in the United States, the amount of folic acid in prenatal MVM supplements is typically 800 or 1,000 mcg, which is much higher than the recommended amount (400 mcg) to reduce the risk of neural tube defects in babies [19]. What Is Complementary, Alternative, or Integrative Health? [, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, et al. Small Business Research Grant Program (SBIR), About Research Training and Career Development, Training Grant Application, Review, and Award Process, Integrative Medicine Research Lecture Series, Division of Extramural Research Sponsored by NCCIH, Division of Intramural Research Conducted at NCCIH, Dietary Guidelines for Americans 20152020, How To Find Information About Complementary Health Approaches on PubMed, Most individuals can get all of the necessary vitamins and minerals through a healthy eating pattern of nutrient-dense foods. MVM use is also more common among the children of women who take supplements; older adults; individuals with more education, a higher income, a healthier lifestyle and diet, and lower body-mass index (BMI); and residents of the western United States [1,2]. [. Men. Foods provide more than vitamins and minerals. Abdominal pain. Each of the product's ingredients works to enhance your health and well-being. Mechanism of Action Exerts oncotic pressure, which expands volume of circulating blood and maintains cardiac output. M. charantia maintains hypoglycemic effects through antioxidant effects promoting -cell protection and the decrease in glucose absorption from the intestines and glucose production from the liver by increasing hepatic glycogen and decreasing . Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. The supplement did not reduce incidence or mortality rates for esophageal cancer or the rate of mortality from any cause. Nutrients 2018, 10, 248. Minerals (especially taken in large doses) can cause side effects such as tooth staining . J Nutr 2016;146:1235-40. * This fact sheet focuses primarily on these basic, broad-spectrum MVMs. In the French Supplmentation en Vitamines et Minraux Antioxydants (SU.VI.MAX) study, investigators randomly assigned 13,017 adults aged 3560 years to receive a placebo or a daily supplement containing moderate amounts of vitamin C (120 mg), vitamin E (30 mg), beta-carotene (6 mg), selenium (100 mcg), and zinc (20 mg) [48]. Minerals, vitamins, and an immunity booster derived from various plant extracts are included. This raises questions regarding the safety of . Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. Another large prospective study investigated the association between use of MVs and MVMs (mostly MVMs described as "therapeutic or theragran," "one-a-day," or "stress-tab") and risk of cancer by following 489,640 men and women aged 5071 years for 16 years [8]. 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. . The prenatal supplement with BOTH DHA & EPA to help in baby's brain development. MVMs and MVs accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019 [4]. For example, 27.7% had inadequate intakes of vitamin A from foods alone, but this rate dropped to 15.5% when supplements were included. : CD004905. 1. [. It is not intended to substitute for the medical expertise and advice of your health care provider(s). For example, several B vitamins are necessary for basic survival function, such as converting glucose from food into cellular energy (adenosine triphosphate . One RCT conducted in Linxian, China, randomized 3,318 persons ages 4069 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 2 to 3 times recommended amounts or a placebo for 6 years [44]. Target Actions . When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too. 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]. . Vitamins and minerals are essential substances that our bodies need to develop and function normally. Follow all directions on the product package, or take as directed by your doctor. USES: This medication is a multivitamin product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. Take this medication by mouth, usually once daily or as directed. Studies that have examined associations of MVMs with CVD risk include the Physicians Health Study I. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed. The supplements did not prevent AMD onset or affect cataract risk. [, Johnstone JM, Hughes A, Goldenberg JZ, Romijn AR, Rucklidge JJ. Vomiting. 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. J Am Coll Cardiol 2021;77:423-36. Multivitamins with iron are used to provide vitamins and iron that are not taken in through the diet. Multivitamin use and the risk of mortality and cancer incidence: the Multiethnic Cohort Study. [, Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. Several epidemiological studies and small RCTs have suggested associations between higher intakes of antioxidants or zinc and reduced risk of AMD, although not consistently [30]. As with some observational studies, some RCTs have suggested that MVM use has potential health benefits, but others have found no such benefits. Observational studies Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Dietary vitamins and minerals play ubiquitous roles throughout the human body by serving as veritable "helping hands" (e.g. Absorption of vitamins in the intestine is critical in avoiding deficiency states, and impairment of . One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. Honey has a low glycemic index, loaded with polyphenols, enzymes, minerals, and vitamins. The USPSTF also noted that beta-carotene supplementation may increase the risk of mortality from CVD. Participants completed standardized cognitive tests administered over the telephone at baseline and annually for 3 years. Join the ODS Email List. U.S. Department of Agriculture and U.S. Department of Health and Human Services. RCTs The study measured rates of major CVD events, including MI, stroke, and CVD death [27]. What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? Some studies have suggested potential health benefits or harms from the use of MVMs, but others have found none. Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. Chemical name: pantothenic acid. The World Health Organization recommends iron and folic acid supplementation throughout pregnancy [57]. In the presence of insulin, the micronutrient combination tested further enhanced this effect up to 1445% over controls. Topically applied minoxidil is generally well tolerated, but common side effects include itching of the eye, itching, irritation at the treated area, and unwanted hair growth elsewhere on the body. Obimin Plus is a pre- and postnatal supplement to help provide adequate supply of vitamins, minerals and DHA and EPA, during pregnancy and lactation. NCCIH has provided this material for your information. [, O'Connor EA, Evans CV, Ivlev I, Rushkin MC, Thomas RG, Martin A, Lin JS. Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. Some experts have hypothesized that MVM use might reduce cancer risk or improve cancer outcomes, possibly because certain nutrients in MVMs might inhibit carcinogenesis or tumor progression. Oral high-dose multivitamins and minerals after myocardial infarction. Vitamins are organic and can be broken down by heat, air, or acid. [, Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study Group. Most studies of the potential value of MVMs to enhance health and prevent disease have been observational and compared individuals who chose to take MVM supplements with others who did not take supplements. J Nutr 2021;151:1976-82. It is also indicated to meet the increased demands for vitamins & minerals. 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. At baseline, 37.8% reported taking an MVM (typically containing 2030 vitamins and minerals). 8. Function: It is necessary for producing energy and hormones. Whether you are stacking different types of natural nootropics, synthetic . A randomized trial. Simply stated, dietary supplements arent required to be standardized in the United States. Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the 2012 National Health Interview Survey. Approximately 48% of the men and 52% of the women in this study reported taking an MV or MVM. Folic acid supplementation for the prevention of neural tube defects. Infants and children Molecules, 24 (2019), p. 2362, 10.3390/molecules24132362. People who take certain blood thinners, such as warfarin (Coumadin, Jantoven), should talk with their health care providers before taking any MVM or dietary supplement containing vitamin K [67,68]. MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. They are also used to treat iron or vitamin deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions. Except in cases of iron deficiency or inadequacy, or unless a physician recommends otherwise, adult males and postmenopausal women should avoid using iron supplements or MVMs containing more than their recommended daily allowance for iron (8 mg/day). [, Chan ALF, Leung HWC, Wang S-F. Multivitamin supplement use and risk of breast cancer: A meta-analysis. Although they are all considered micronutrients, vitamins and minerals differ in basic ways. Nutrition intervention trials in Linxian, China: Multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. 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]. [, Christen WG, Glynn RJ, Manson JE, MacFadyen J, Bubes V, Schwartz M, et al. Vitamins A, C, D and E were used alone, in combination or with other nutritional and non . We encourage you to discuss any decisions about treatment or care with your health care provider. When your child needs vitamin D, iron, and zinc. Women who took more than one MV or MVM daily had a 53% higher risk of oropharyngeal cancer but a 35% lower risk of leukemia. Health care providers determine the dose of this medication for a given patient in part by assessing the amount of vitamin K that the patient routinely consumes. Absorption of Vitamins. Cardiovascular disease (CVD) 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]. Inflammation comes from the Latin word inflammare, which means "to set on fire.". This is the essential step leading to carboxylation and activation of the blood-clotting proteins. Pregnant and breastfeeding people, adult women, non-Hispanic Blacks, people of low socioeconomic status, and individuals who are underweight or overweight are among the groups with the greatest risk of deficient intakes of one or more nutrients [9]. [, Rautiainen S, Rist PM, Glynn RJ, Buring JE, Gaziano JM,Sesso HD. Vitamins are not sources of energy as are carbohydrates, fats, and proteins. Adults in their 50s and older NIH State-of-the-Science Panel. 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]. Upper Limit. which is why it's a critical component in prenatal vitamins mechanism of action. Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. 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 [51]. 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. Health care providers sometimes prescribe MVMs for people who have medical conditions and diseases that impair digestion, absorption, or use of nutrients. Excess nutrient intakes are even more likely among MVM users who also take single vitamin and mineral supplements [15]. 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. However, they are required to bear a Supplement Facts label and ingredient list describing whats in theproduct. U.S. Preventive Services Task Force recommendation statement. 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. 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. [, Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. Website: https://pubmed.ncbi.nlm.nih.gov/. Nutrition Reviews 2021; published online ahead of print. Based on these two trials, the USPSTF warned that beta-carotene supplementation may increase the risk of lung cancer in people who smoke, have smoked, or have occupational exposure to asbestos [50]. Iron supplements may be recommended for women of childbearing age, pregnant women, preterm infants, older infants, and teenage girls because they are at greater risk of developing deficiency. Vitamin A is effective for the treatment of Vitamin A deficiency. The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. Multivitamins, vision are an over-the-counter (OTC) product used to reduce the risk of vision loss among moderate to advanced age-related macular degeneration (AMD) patients and as an ocular (eye) vitamin supplement. Check Price on Amazon. Because of limited information on product characteristics, our ability to directly compare results across studies, estimate changes in usage patterns or intakes over time, and generalize . . Systematic information on the bioavailability and bioequivalence of vitamins and minerals in marketed products and on potential drug interactions is scarce. [, Prentice RL. The FNB does not address whether or to what extent nutrient supplements can compensate for dietary inadequacies. Ann Intern Med 2013;159:806-14. For example, a 2018 meta-analysis of 16 prospective cohort studies (including the study described above and the 2 below) and 2 RCTs evaluated the association between use of MVMs (defined as containing more than three vitamins and minerals) and risk of various CVD outcomes, including coronary heart disease and stroke [25]. The FNB notes that RDAs and AIs for nutrients are levels of intake to ingest, on average, each day from the diet [6]. Am J Clin Nutr 2015;101:144-52. Be sure to check the percent daily value (% DV) to see what proportion of your daily allotment youregetting. Vitamin K is involved in blood clotting and decreases the effectiveness of warfarin and similar drugs. Taking an MVM increases nutrient intakes and helps people obtain recommended amounts of vitamins and minerals when they do not meet these needs from food alone [9,12]. However, MVM use is common in the general population. MVMs were taken in the past 30 days by 24.0% of men and women aged 2039 years, 29.8% of those aged 4059 years, and 39.4% of those aged 60 and over [10]. It is found in various plants, including grapes, berries, peanuts, and red wine. Vitamin K. Accessed January 12, 2011. Among the more common ingredients are amino acids, protein, creatine, and caffeine. JAMA 2022;327:2334-47. Some experts have hypothesized that MVM use might reduce the incidence of CVD or rates of deaths from this disease, possibly because certain nutrients in these products might reduce blood pressure or affect vascular function. Vitamin B12 (Cobalamin) Mechanism and Deficiency. In another RCT of 18,314, smokers, former smokers, and asbestos-exposed persons, participants who took a combination of 30 mg/day of beta-carotene plus 25,000 IU/day of vitamin A (as retinol) had a 28% higher lung cancer risk than those taking a placebo after an average 4-year follow-up period [65]. [, Cowan AE, Jun S, Gahche JJ, Tooze JA, Dwyer JT, Eicher-Miller HA, et al. The supplement also had no effect on cognitive decline with age [40]. An earlier analysis of 20112014 NHANES data found that 31.2% of the U.S. adult population aged 19 years and older reported taking an MVM in the past 30 days [2]. Mechanism of action. NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. By age 71 or older, 48% of women and 43% of men were taking supplements. Smokers and, possibly, former smokers should avoid MVM products providing large amounts of beta-carotene or vitamin A because two studies have linked these nutrients to an increased risk of lung cancer in smokers [63]. Arch Intern Med 2009;169:294-304. A similar meta-analysis of 13 RCTs investigated whether use by pregnant adolescents and young adults aged 10-19 years of an MVM (containing multiple nutrients) led to better birth outcomes than supplementation with only iron and folic acid [34]. 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. No U.S. government health agency, private health group, or health professional organization promotes regular use of MVMs. Estimation of total usual dietary intakes of pregnant women in the United States. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information. Nausea. Nutri-Vet has provided us with their Multi-Vite Paw-Gel for cats that is the best overall supplement available. Most have not found an effect of MVM use on any of the health outcomes measured. Vitamin C is responsible for synthesizing collagen and is necessary for proper wound healing.6 Vitamin C is also secreted in breast milk thus, a higher dietary intake is recommended for lactating women to make up for this loss. The supplements provided no protection from CVD. MVMssuch as those for energy, enhanced athletic performance, weight control, improved immune function, or eye healthoften combine several vitamins and minerals with botanical and specialty ingredients, such as coenzyme Q10, probiotics, or glucosamine. They belong to the micro nutrients and are required for normal metabolism in layer poultry. Check with your physician for additional information about side effects. MVM supplementation did not have a beneficial or harmful effect on risk of stillbirths or of perinatal and neonatal mortality in comparison with iron and folic acid supplementation.

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