Are vitamins a waste?

During the past several weeks, two studies were released showing that vitamins are less effective in helping prevent some specific conditions than hoped. This information produced some controversy over whether or not vitamins (and, to a degree, supplements) were relatively useless and a waste of money.

Considering that vitamins, minerals, supplements and similar products account for multibillions of dollars in yearly sales, that’s a lot of money to waste. Especially for a very limited return for that capital outlay.

But is it a waste of money? Let’s see what the studies say. But before we do, some information from the US Preventive Services Task Force, or USPSTF. The USPSTF is:

“. . . an independent panel of non-Federal experts in prevention and evidence-based medicine and is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists).

The USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services (such as screening, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. These recommendations are published in the form of “Recommendation Statements.”

The USPSTF came out with a statement last year saying that there is not enough evidence to date to recommend for or against using vitamin and mineral supplements for the primary prevention of cardiovascular diseases or cancer. In other words, from the USPSTF’s standpoint the jury is still out as to whether or not vitamins and minerals might help to prevent cancer or heart attacks. They may make a recommendation after they review additional, future studies.

Vitamins via Shutterstock

Vitamins via Shutterstock

The First Study: Post-heart attack

In the first study, about 1,700 patients in the US and Canada who had had a recent myocardial infarction (heart attack) were studied.

Some of the patients took a high-dose pill that contained a mix of 28 different vitamins and minerals. Others took a placebo (sugar pill). They followed these patients for several years. Basically, except perhaps, for a small subgroup of patients, there was essentially no difference in cardiovascular events between the placebo and multivitamin group. The conclusion drawn was that there was no benefit to supplementing the diet with most mineral or vitamin supplements for the prevention of chronic disease, in this case, cardiovascular disease in particular.

The Second Study: Cognitive function

The second study involved almost 6,000 male physicians, 65 years old or older.

About half took a multivitamin daily (Centrum Silver) the remainder took a placebo. This study looked at cognitive function (gaining knowledge and comprehension of ideas) in terms of cognitive decline. The question the study looked at might be asked this way: Will taking a daily multivitamins prevent or slow the loss of cognitive function? Will a multivitamin prevent memory loss?

The cognitive functions of all of the physicians were assessed through different tests including tests of verbal memory. These men were followed for several years and some were retested up to four times. The results showed a lack of benefit for those taking the multivitamin. They experienced as much cognitive decline as those in the control group. The researchers said, “These data do not provide support for use of multivitamin supplements in the prevention of cognitive decline,” However, they did note that a multivitamin given in the same study did show that there was a “modest protection against overall cancer risk.”

So, basically, these studies show that there isn’t a benefit in using multivitamins to prevent cardiovascular events or cognitive decline. However, a few additional points need to be made.

First off, both of these studies were done on groups of patients/volunteers who were well-nourished to begin with. Considering the propensity of Americans to be obese, to eat junk foods and rely on fast foods, perhaps a similar study needs to be run on people who aren’t well-nourished to see if there are any significant differences.

Secondly, the study on cognition involved (only) male physicians. Is there a possibility that the results might be different in females? Probably not, but that wasn’t addressed here though there is a similar study being done now in women.

Thirdly, this doesn’t mean that vitamins and minerals are valueless – they’re not. They are very useful in treating some diseases. This data just shows that, in these studies, the vitamins used did not PREVENT MIs or cognitive decline. In other words, don’t expect your multivitamin to keep you from losing your memory or preventing a heart attack.

Next, these studies only looked at the vitamins and minerals in Centrum Sliver in one study, and at the effects of a high-dose mixture of vitamins and minerals produced for members of the cardiovascular study. This does’t mean that there may not be compounds that aren’t in those two medicines that might prove efficacious in preventing MIs and mental decline.

However, it should be noted that, under certain circumstances, taking too much of a particular vitamin or mineral may be harmful. There are cases of hypervitaminosis. These are uncommon, but can be potentially dangerous. So if you do take vitamins and supplements, be aware that you can take too much and actually become ill. Don’t use the “If one is good, two must be better” rule.

So, for now, it seems that the USPSTF (non)recommendation makes the most sense.

Now, here’s some information on making some safer choices when buying over the counter medications.

Vitamins, minerals, herbals supplements and the like are not regulated by the Food and Drug Administration (FDA). So what you buy may not be pure, or have the stated amount of the vitamin/supplement, or may not even be the real supplement at all.

How can you be sure?

You may not be able to be absolutely sure. But here are a few ideas that can help when you purchase a vitamin, supplement or mineral (it may be more difficult to verify the purity of some herbals.)

1. You can see if it has been certified by the USP (United States Pharmacopoeia).

2. If not, a reputable supplier will often have had an analysis of the particular supplement done by a laboratory. It should show exactly what is in the sample – how pure it is, contaminants, etc. For example, some over the counter fish oil products may be made from fish that have a high mercury content. Getting fish oil that is USPS certified, or has a certificate of analysis offered by the seller, should help to protect you somewhat.

3. I’d suggest that you avoid buying online from “foreign pharmacies,” “discount pharmacies” or the like. You don’t want to buy a supplement that was manufactured in someone’s garage.

(I’m told that in order to better see my Facebook posts in your feed, you need to “follow” me.)

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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