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The facts about multivitamins

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Almost 40 percent of adults 60 and older take multivitamin or mineral supplements, according to Centers for Disease Control and Prevention data from 2017 to 2018.

“A lot of my patients take multivitamins because they see them almost as an insurance policy to guarantee they get all the nutrients they need,” says Kenneth Koncilja, a geriatrician at the Cleveland Clinic.

But are they helpful? Here’s what we know — and what to consider.

What the research shows

A 2020 study published in the journal BMJ Open found that people who took these over-the-counter (OTC) product­s — which contain all or most recognized vitamins and minerals — reported better overall well-being. But most research doesn’t bear this out. The BMJ study found no measurable health benefits for users.

Papers published in 2013 in the Annals of Internal Medicine that looked at multivitamin use among tens of thousands of people found that they didn’t reduce the risk of heart disease, cancer, or cognitive decline. And a 2018 editorial in the journal JAMA that reviewed the research concluded that healthy adults 50 and older simply don’t need a multivitamin.

“When you put multivitamins to the test, research shows there’s no benefit, and there even might be some chance of harm,” says Edgar Miller III, a professor of medicine and epidemiology at Johns Hopkins University.

Can you trust label claims?

OTC supplements aren’t regulated by the Food and Drug Administration the way that prescription medications are. And 12 of the 27 multivitamin and mineral supplements analyzed last year by were found to have quality problems, such as having more or less of the vitamins and minerals than their labels claimed. Some may also contain contaminants.

Special situations

A multi may be helpful in a few cases — say, after gastric bypass surgery or for severe malnutrition due to cancer — but most of the time you’re best off getting nutrients from a balanced diet, Koncilja says. Still, evidence suggests that some older adults may benefit from certain single-ingredient supplements. If your doctor recommends one, check the product for certification or verification from a third-party group like the U.S. Pharmacopeia or NSF International. These include:

Vitamin B12. Adults older than 60 may have difficulty absorbing this vitamin (found in fish, meat, poultry, eggs and dairy), so they’re more likely to be deficient, says Nisha Rughwani, an associate professor of geriatrics and palliative care medicine at the Icahn School of Medicine at Mount Sinai in New York City. If tests show that your blood levels are under 300 picograms per milliliter, you’ll probably need a supplement, she says. Extremely low levels may call for temporary B12 injections.

Vitamin D. Fatty fish and fortified milk have vitamin D, and exposure to sunlight triggers your skin to produce it. But it’s hard to get the recommended daily amount for adults older than 70 (800 international units) this way, Koncilja says. If you take a vitamin D supplement, be aware that a significantly higher intake can hike kidney stone risk. If you use a combined vitamin D and calcium supplement, be aware that supplemental calcium has been linked to a higher risk of colon polyps, kidney stones and calcium buildup in the heart’s arteries, Miller says.

Iron. A bit more than 10 percent of people older than 65 have anemia. If you suspect you have it (signs are weakness, headache, fatigue, shortness of breath and rapid heartbeat during exercise, and brittle nails) ask your doctor about testing to determine whether you need an iron supplement. “You don’t just want to take it on your own, as iron tablets can cause constipation and stomach pain, nausea, and vomiting,” Rughwani says.

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