Vitamins & Supplements · Formula
Multivitamins
Multivitamin-mineral products · also called Multivitamin-mineral, MVM, multivitaminas, multivitamínico
A multivitamin is a single product that holds several vitamins and often minerals. The largest long trial found no effect on heart disease, and cancer results are small and uncertain. Small memory gains appeared in older adults. Labels can be off, and adult products with iron are dangerous to children.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Multivitamins
A multivitamin is a mix of vitamins and minerals in one product. Large trials found no effect on heart disease or death, mixed results for cancer, and small memory gains in older adults. Iron, stacking and label accuracy are the main cautions.
What multivitamins are
A multivitamin, or multivitamin-mineral, is one product that combines many vitamins and usually minerals. It is sold as tablets, capsules, gummies, powders and liquids, and in versions for women, men, older adults, children and pregnancy.
Every product is a different mix, so the studies tell us about the products tested, not about all multivitamins.
What is usually inside
Sources read name iron, zinc, calcium, vitamins A, D, E and K, folic acid, iodine, selenium, chromium, potassium and manganese among the ingredients. Some also add herbs, probiotics, omega-3 fats or a stool softener (in some prescription prenatal products). Each nutrient has its own page on this site; the related list links the main ones.
Typical amounts per tablet were not read from a source, so none are stated. Amounts used in trials appear only in the studies table.
Who takes them
About 31% of US adults used a multivitamin-mineral product, most often for general health or to fill gaps. In 2017 to 2018, 23.8% of US children and teens did. Use has fallen slightly in adults since 1999 while single vitamins, minerals and botanicals have risen.
Reading the label
A Supplement Facts panel lists a serving size, which is the maximum amount the label says to take at one time (or one unit if it says nothing). Percent Daily Value shows how much of a Daily Value one serving gives. For food labels the FDA says 5% or less is low and 20% or more is high.
A proprietary blend must show its total weight, with its ingredients listed by weight from most to least. That means you may not know how much of each ingredient is inside. Gummies, capsules and powders follow the same labeling rules but the studies read did not compare their benefits.
What the research shows
No trial tested multivitamins in people with proven nutrient gaps. The largest trial, in 14,641 male doctors, found no effect on heart disease and a borderline drop in cancer. Pooled trials found no effect on death. COSMOS studies found small memory gains in older adults.
Special eye-disease vitamin formulas slowed late macular degeneration in people who already had it, and multiple-nutrient products in pregnancy gave fewer low-birthweight babies in low-income countries. These are not results for an ordinary adult multivitamin. The Task Force calls the evidence on multivitamins for heart disease and cancer insufficient.
At a glance
Traditional uses history, not proof
- Taken daily as a general-health product
- Sold to fill gaps in the diet
Studied for research
- Heart disease: no effect found, low certainty
- Cancer: mixed
- Death from any cause: no effect, low certainty
- Memory in older adults: small gains, low certainty
- Cataract: low certainty
- Macular degeneration (special eye formulas): moderate
- Pregnancy outcomes (iron and folic acid comparison): moderate
- Stress and mood: low certainty
Main compounds
- Vitamins and minerals
- Iron
- Vitamin K1
- Beta-carotene
Common forms
- Tablets and capsules
- Gummies
- Powders and liquids
- Prenatal and children's versions
Research links: 2012 trial: multivitamins and heart disease in men · 2012 trial: multivitamins and cancer in men · 2022 Task Force recommendation · 2023 COSMOS-Mind: memory trial · 2026 lab test: manganese in children's products · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Multivitamins and multiminerals (multivitamin-mineral products)
- Common names
- Multivitamin (English); Multivitamin-mineral (MVM) (English); Multivitamin-multimineral (MVMM) (English); Multivitaminas (Spanish); Multivitamínico (Spanish)
- Family or group
- Formula supplement: a mix of several vitamins and often minerals in one tablet, capsule, gummy, powder or liquid.
- Harvest and processing
- Made by blending vitamin and mineral ingredients into a dosage form. The US government database says many ingredients are added above the label amount during manufacturing.
- Look-alikes and adulterants
- Name: Prenatal vitamins; Note: Multivitamin-mineral products made for pregnancy. A 2017 survey found prescription and non-prescription versions differ in what they list.; Name: Children's multivitamins; Note: 23.8% of US children and teens used a multivitamin-mineral product in 2017 to 2018.; Name: Single-nutrient and B-complex products; Note: Different products, covered on their own pages.; Name: Eye-disease (AREDS-type) formulas; Note: Specific vitamin and mineral formulas studied for macular degeneration, not general multivitamins.
- Sustainability and conservation
- Not assessed.
What is inside, and how it may work
What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Iron | mineral | Whole product Not read from a source. | Often present in adult and prenatal products; the poisoning risk for children comes from iron. 27 18 | Human data |
| Vitamin D, iodine, selenium, chromium, potassium, calcium, folic acid | vitamins and minerals | Whole product Not read from a source. | Named by a US government database as often above label amount in multivitamin-mineral products. 2 | Laboratory |
| Vitamin K1 | vitamin | Whole product 25 micrograms per tablet in the warfarin trial (studied). | Can offset warfarin. 11 | Human data |
| Beta-carotene and vitamin A, vitamin E | antioxidant vitamins | Whole product Not read from a source. | Studied as single supplements; beta-carotene raised lung cancer risk in people at high risk. 16 4 | Human data |
| Zinc, copper, manganese, magnesium and the B vitamins | minerals and vitamins | Whole product Not read from a source. | Manganese was measured in children's products. Others are commonly listed but their typical amounts were not read. 8 18 | Laboratory |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Replacing missing vitamins and minerals | Not specified in the sources read | The logic is that a product fills gaps in the diet. The trials read did not select people with proven gaps. The Task Force notes the common reasons given for use are overall health and filling gaps. 21 | Hypothesis |
Absorption, metabolism and elimination
- Absorption
- Not found for multivitamin products as a whole.
- Distribution
- Not found.
- Metabolism
- Not found.
- Elimination
- Not found.
- Bioavailability
- Not compared across products in the sources read.
Isolated compounds versus whole extracts
The trials read tested supplements, not foods. In a US cohort, lower death risk linked with adequate intake of vitamin A, vitamin K, magnesium, zinc and copper came from food and not from supplements.
Nutritional composition
No USDA or NIH food-amount tables were read for this formula page, so none are stated. Food sources of each nutrient are on that nutrient's page.
2 moderate certainty1 mixed findings5 low certainty1 not enough evidence
What was looked at
The 9 benefits and uses checked for Multivitamins, each with how strong the evidence is. Tap one to open it.
- Heart attacks, strokes and heart-related deathLow certainty
- Cancer riskMixed findings
- Living longer (death from any cause)Low certainty
- Memory and thinking in older adultsLow certainty
- CataractLow certainty
- Age-related macular degeneration (special eye formulas, not ordinary multivitamins)Moderate certainty
- Pregnancy outcomes (multiple-micronutrient supplements)Moderate certainty
- Stress and moodLow certainty
- Filling gaps in the dietNot enough evidence
Lab markers tracked in the studies
Major cardiovascular eventsGlobal cognition scoreLow birthweightPerceived stress
What is Multivitamins good for?
The main studied uses and how strong the human evidence is for each. Most large trials tested one product in older adults who were not short of nutrients, so results may not apply to you.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Heart attacks, strokes and heart-related death
Low certaintyThe largest long trial of a daily multivitamin (14,641 male US doctors, about 11 years) found no drop in heart attacks, strokes or heart-related deaths. The US Preventive Services Task Force calls the evidence on multivitamins for preventing heart disease insufficient.
4 studiesOne common daily multivitamin tablet. Amounts per tablet are not give…
Studies, doses and limits
What the trials found
The Physicians' Health Study II (14,641 men) found no effect on major cardiovascular events (HR 1.01) or on heart attack, stroke or cardiovascular death. A follow-up found no sign that diet quality changed this. The 2022 evidence review and Task Force statement found the evidence for multivitamins insufficient.
Results
No benefit for heart disease was shown for one multivitamin in men.
Effect sizes as reported
Major cardiovascular events HR 1.01 (95% CI 0.91 to 1.10); heart attack HR 0.93; stroke HR 1.06; cardiovascular death HR 0.95.
Why this rating
Low: one large trial of one product, in men only; the review panel calls the overall evidence insufficient.
Form and dose studied
One common daily multivitamin tablet. Amounts per tablet are not given in the abstract.
Who was studied
Male US doctors aged 50 and over.
Limits
Men only, mostly well-nourished; results may differ in women, younger people or people short of nutrients.
Why researchers looked
Many people take a multivitamin hoping to protect the heart. Researchers wanted a long, placebo-controlled test of that idea.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established. No single mechanism is claimed for a mixed product.
A proposed mechanism does not show that the effect happens in people.
No safety signal in this trial.
Cancer risk
Mixed findingsIn the same doctors' trial there were slightly fewer cancers overall with a daily multivitamin (about 8% fewer, a result that sat right at the edge of chance), but no clear effect on prostate or colorectal cancer or on cancer death. The Task Force still calls the evidence insufficient.
3 studiesOne common daily multivitamin; pooled trials used different products.
Studies, doses and limits
What the trials found
The Physicians' Health Study II found total cancer HR 0.92 (95% CI 0.86 to 0.998). The 2022 evidence review pooled 4 trials (48,859 people) and found slightly lower odds of any cancer (OR 0.93), but said the evidence had important limits. Beta-carotene supplements raised lung cancer risk in people at high risk of it, which is why the Task Force advises against them.
Results
A small possible drop in total cancer; no effect on cancer death.
Effect sizes as reported
Total cancer HR 0.92; prostate HR 0.98; colorectal HR 0.89; cancer death HR 0.88 (CI 0.77 to 1.01). Pooled any cancer OR 0.93 (0.87 to 0.99).
Why this rating
Mixed: a small positive result with limits, no effect on cancer death, and the Task Force finds the balance of benefit and harm unclear.
Form and dose studied
One common daily multivitamin; pooled trials used different products.
Who was studied
Mostly older men; 1,312 men had a history of cancer.
Limits
The main result is borderline; men only; only a few trials in the pooled review.
Why researchers looked
Vitamins and minerals take part in cell repair, so researchers asked whether a multivitamin lowers cancer risk.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
No extra harm reported in the abstracts for multivitamins. Beta-carotene is a separate concern (see Safety).
Living longer (death from any cause)
Low certaintyPooled trials of daily multivitamin-multimineral products (21 articles, 91,074 people) found no effect on death from any cause, vascular death or cancer death.
3 studiesMany different daily multivitamin-multimineral products.
Studies, doses and limits
What the trials found
The 2013 meta-analysis found all-cause death RR 0.98 (95% CI 0.94 to 1.02). There was a trend toward fewer deaths in primary-prevention trials (RR 0.94, 0.89 to 1.00). The doctors' trial reported total death HR 0.94 (0.88 to 1.02). A Cochrane review of single antioxidant supplements found slightly higher death in low-bias trials for beta-carotene and vitamin E; that is about single nutrients, not multivitamins.
Results
No clear effect on lifespan.
Effect sizes as reported
All-cause death RR 0.98 (0.94 to 1.02); vascular RR 1.01; cancer RR 0.96.
Why this rating
Low: trials differ in product and length; no clear benefit and no clear harm.
Form and dose studied
Many different daily multivitamin-multimineral products.
Who was studied
Adults living independently, average age 62.
Limits
Products pooled together; results may not apply to people with real deficiencies.
Why researchers looked
If a multivitamin protected against many diseases, fewer people would die. This outcome tests that directly.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
No increase in death from multivitamin-multimineral products in this review.
Memory and thinking in older adults
Low certaintyThree studies inside the COSMOS trial found small gains in memory or overall thinking scores with a daily multivitamin-mineral in older adults over 2 to 3 years. The gains were small and the three studies are not independent of each other.
3 studiesOne commercial multivitamin-mineral tablet, daily.
Studies, doses and limits
What the trials found
COSMOS-Mind (2,262 adults, average age 73, 3 years) found a small better global cognition score (mean z 0.07, 95% CI 0.02 to 0.12), with memory and executive function also better. COSMOS-Web (3,562) found better immediate recall at 1 year and across 3 years but no effect on its other tests. COSMOS-Clinic (in-person, 573 people) found better episodic memory and a global result that touched zero; pooling the three gave global cognition 0.07 and memory 0.06 (the authors say about 2 years of cognitive ageing).
Results
Small better scores on memory tests; not shown to prevent dementia.
Effect sizes as reported
Global cognition z 0.07 (0.02 to 0.12) in COSMOS-Mind; pooled 0.07 (0.03 to 0.11); episodic memory pooled 0.06 (0.03 to 0.10).
Why this rating
Low: one trial programme with small effects, three overlapping sub-studies, testing mostly by phone or online, and mostly White participants.
Form and dose studied
One commercial multivitamin-mineral tablet, daily.
Who was studied
Adults aged 60 and over, mostly White.
Limits
Not independent studies. Small effects. Dementia itself was not shown to be prevented in these abstracts.
Why researchers looked
Some vitamins and minerals are needed by the brain, and older adults can run low, so researchers tested a multivitamin against cognitive decline.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established. The authors say more work is needed to understand how it could work.
A proposed mechanism does not show that the effect happens in people.
No safety problem reported in the abstracts.
Cataract
Low certaintyIn the doctors' trial, a daily multivitamin was linked with slightly fewer new cataracts (about 9% fewer) over 11 years. No effect was seen on visually significant macular degeneration.
1 studiesOne common daily multivitamin.
Studies, doses and limits
What the trials found
In 14,641 male US doctors, cataract occurred 872 times with the multivitamin and 945 times with placebo (HR 0.91, 95% CI 0.83 to 0.99). Visually significant AMD: 152 vs 129 cases (HR 1.19, 0.94 to 1.50, not significant).
Results
A modest drop in cataract in one trial.
Effect sizes as reported
Cataract HR 0.91 (0.83 to 0.99); AMD HR 1.19 (0.94 to 1.50).
Why this rating
Low: one trial, men only, result near the edge of chance.
Form and dose studied
One common daily multivitamin.
Who was studied
Male US doctors aged 50 and over.
Limits
Men only; no second trial read.
Why researchers looked
Eye lenses are exposed to oxidative stress, so researchers asked whether vitamins and minerals protect them.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
No safety signal in the abstract.
Age-related macular degeneration (special eye formulas, not ordinary multivitamins)
Moderate certaintyA Cochrane review found that the AREDS-type vitamin and mineral formula probably slows progression to late macular degeneration in people who already have it. That formula is a specific eye product, not a general multivitamin, and it was not shown to prevent the disease.
2 studiesSpecific eye formulas (vitamins C and E, zinc and, originally, beta-c…
Studies, doses and limits
What the trials found
The 2023 Cochrane review (26 studies, 11,952 people with AMD) found OR 0.72 for progression to late AMD (moderate certainty). The AREDS2 trial found that adding lutein + zeaxanthin and/or omega-3 fats did not significantly reduce progression further in its main analyses, and found more lung cancers with beta-carotene, mostly in former smokers.
Results
Slower progression to late AMD with the AREDS-type formula in people who already have it.
Effect sizes as reported
Progression to late AMD OR 0.72 (95% CI 0.58 to 0.90).
Why this rating
Moderate for the defined formulas in people with AMD; it does not carry over to ordinary multivitamins or to healthy eyes.
Form and dose studied
Specific eye formulas (vitamins C and E, zinc and, originally, beta-carotene).
Who was studied
People aged 50 to 85 with early, intermediate or advanced AMD.
Limits
The formula is not the same as a typical multivitamin; beta-carotene is a concern in smokers and former smokers.
Why researchers looked
Macular degeneration damages the centre of vision, and diet studies pointed to antioxidants.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
Beta-carotene raised lung cancer in former smokers; GI upset was the main reported side effect; zinc was linked to more urinary problems in men in AREDS.
Pregnancy outcomes (multiple-micronutrient supplements)
Moderate certaintyA Cochrane review of 20 trials (141,849 women, nearly all in low- and middle-income countries) found that multiple-micronutrient supplements with iron and folic acid gave fewer low-birthweight babies than iron with or without folic acid alone. This is about specially made pregnancy products, not about an ordinary adult multivitamin.
1 studiesPrenatal micronutrient products with iron and folic acid.
Studies, doses and limits
What the trials found
Compared with iron with or without folic acid: low birthweight RR 0.88 (0.85 to 0.91, high certainty); small-for-gestational-age RR 0.92 (0.88 to 0.97); very preterm birth RR 0.81 (0.71 to 0.93); preterm birth RR 0.95 (0.90 to 1.01, borderline). No clear change in stillbirth or newborn death. One UK trial against placebo found less maternal anaemia in late pregnancy.
Results
Fewer low-birthweight babies in mostly low-income settings.
Effect sizes as reported
Low birthweight RR 0.88; small for gestational age RR 0.92; very preterm RR 0.81.
Why this rating
Moderate to high for the listed outcomes, but in settings where diets are poor and compared with iron-folic acid, not with no supplement.
Form and dose studied
Prenatal micronutrient products with iron and folic acid.
Who was studied
Pregnant women, mostly in low- and middle-income countries.
Limits
Does not show that an ordinary adult multivitamin helps in a well-fed population. Possible publication bias for some outcomes.
Why researchers looked
Pregnancy raises the need for many nutrients, so researchers compared mixed-nutrient products with iron and folic acid.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
See Safety for pregnancy cautions such as vitamin A and iron amounts.
Stress and mood
Low certaintyA review of 8 small placebo-controlled studies found that multivitamin/mineral supplements lowered perceived stress, anxiety, tiredness and mild psychiatric symptoms in people without a diagnosed illness, but not depression. The studies were few and small.
1 studiesMultivitamin/mineral products, some high in B vitamins.
Studies, doses and limits
What the trials found
The 2013 meta-analysis found lower perceived stress (SMD 0.35), mild psychiatric symptoms (0.30), anxiety (0.32), fatigue (0.27) and confusion (0.225). Depression did not change significantly. The authors said products with high amounts of B vitamins may work better.
Results
Small improvements in self-rated stress and mood.
Effect sizes as reported
Stress SMD 0.35 (0.22 to 0.47); anxiety 0.32 (0.16 to 0.48); depression 0.20 (not significant).
Why this rating
Low: only 8 studies, self-rated scores, different products, and an older review.
Form and dose studied
Multivitamin/mineral products, some high in B vitamins.
Who was studied
Adults without a diagnosed illness.
Limits
Small studies; not treatment for anxiety or depression.
Why researchers looked
B vitamins and minerals take part in brain chemistry, so researchers asked whether a multivitamin lifts everyday mood.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Preliminary mechanism
Not established. The authors suggest small gaps in nutrients might add up to small effects on brain chemistry.
A proposed mechanism does not show that the effect happens in people.
No safety signal in the abstract.
Filling gaps in the diet
Not enough evidenceMultivitamins are mostly taken to fill nutrient gaps. A large US study found that the lower death risk linked with enough of several nutrients came only from food, not from supplements. We found no trial that tested multivitamins specifically in people with proven gaps.
3 studiesNo product was tested for this purpose.
Studies, doses and limits
What the trials found
The USPSTF recommendation says 31% of US adults used a multivitamin-mineral product, mostly for general health and to fill gaps. In the NHANES cohort (30,899 adults), adequate intake of vitamin A, vitamin K, magnesium, zinc and copper was linked with lower death, but only when from food. Supplement use overall was not linked with lower death.
Results
Not shown as a health benefit in the sources read.
Why this rating
Insufficient: no trial of multivitamins in people with proven gaps was read, and observational data point to food, not pills.
Form and dose studied
No product was tested for this purpose.
Who was studied
US adults.
Limits
Observational data cannot show cause.
Why researchers looked
Most users say they take a multivitamin for general health or to fill gaps in the diet.
Traditional use
A multivitamin is a mixed product, not one ingredient. Its makers sell it as a daily 'insurance' against gaps in food; that is a marketing idea, not a traditional use.
Proposed mechanism Not established
Not applicable.
A proposed mechanism does not show that the effect happens in people.
See Safety for overlap and excess.
Connections to the rest of health
How Multivitamins connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Heart Health | Low certainty | Heart attacks, strokes and heart-related death: The largest long trial of a daily multivitamin (14,641 male US doctors, about 11 years) found no drop in heart attacks, strokes or heart-related deaths. The US Preventive Services Task Force calls the evidence on multivitamins for preventing heart disease insufficient. | 19 17 16 21 | |
| Preventive Wellness | Mixed findings | Cancer risk: In the same doctors' trial there were slightly fewer cancers overall with a daily multivitamin (about 8% fewer, a result that sat right at the edge of chance), but no clear effect on prostate or colorectal cancer or on cancer death. The Task Force still calls the evidence insufficient. | 9 16 21 | |
| Healthy Aging | Low certainty | Living longer (death from any cause): Pooled trials of daily multivitamin-multimineral products (21 articles, 91,074 people) found no effect on death from any cause, vascular death or cancer death. Cataract: In the doctors' trial, a daily multivitamin was linked with slightly fewer new cataracts (about 9% fewer) over 11 years. No effect was seen on visually significant macular degeneration. | 14 19 4 6 7 1 | |
| Memory Support | Low certainty | Memory and thinking in older adults: Three studies inside the COSMOS trial found small gains in memory or overall thinking scores with a daily multivitamin-mineral in older adults over 2 to 3 years. The gains were small and the three studies are not independent of each other. | 3 24 22 | |
| Womens Wellness | Moderate certainty | Pregnancy outcomes (multiple-micronutrient supplements): A Cochrane review of 20 trials (141,849 women, nearly all in low- and middle-income countries) found that multiple-micronutrient supplements with iron and folic acid gave fewer low-birthweight babies than iron with or without folic acid alone. This is about specially made pregnancy products, not about an ordinary adult multivitamin. | 10 | |
| Stress Relaxation | Low certainty | Stress and mood: A review of 8 small placebo-controlled studies found that multivitamin/mineral supplements lowered perceived stress, anxiety, tiredness and mild psychiatric symptoms in people without a diagnosed illness, but not depression. The studies were few and small. | 13 | |
| Balanced Nutrition | Not enough evidence | Filling gaps in the diet: Multivitamins are mostly taken to fill nutrient gaps. A large US study found that the lower death risk linked with enough of several nutrients came only from food, not from supplements. We found no trial that tested multivitamins specifically in people with proven gaps. | 5 21 12 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Heart Circulation | Biological association | Low certainty | Studied for: Heart attacks, strokes and heart-related death | 19 17 16 21 |
| Immune System | Biological association | Mixed findings | Studied for: Cancer risk | 9 16 21 |
| Whole Body | Biological association | Low certainty | Studied for: Living longer (death from any cause) Studied for: Filling gaps in the diet | 14 19 4 5 21 12 |
| Nervous System | Biological association | Low certainty | Studied for: Memory and thinking in older adults Studied for: Cataract | 3 24 22 6 7 1 13 |
| Reproductive System | Biological association | Moderate certainty | Studied for: Pregnancy outcomes (multiple-micronutrient supplements) | 10 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Age-related macular degeneration | Clinical | AREDS-type vitamin and mineral formulas probably slow progression to late disease in people who already have it. Preparation or compound: AREDS-type formula |
7 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Major cardiovascular events | Biological association | Low certainty | Measured in trials: no change. A lab change is not the same as a health benefit. | 19 |
| Global cognition score | Biological association | Low certainty | Measured in trials: slightly better. A lab change is not the same as a health benefit. | 3 22 |
| Low birthweight | Biological association | Moderate certainty | Measured in trials: fewer low-birthweight babies. A lab change is not the same as a health benefit. | 10 |
| Perceived stress | Biological association | Low certainty | Measured in trials: lower. A lab change is not the same as a health benefit. | 13 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Iron | Biological association | Human | Often present in adult and prenatal products; the poisoning risk for children comes from iron. Preparation or compound: Whole product |
27 18 |
| Vitamin D, iodine, selenium, chromium, potassium, calcium, folic acid | Biological association | Laboratory | Named by a US government database as often above label amount in multivitamin-mineral products. Preparation or compound: Whole product |
2 |
| Vitamin K1 | Biological association | Human | Can offset warfarin. Preparation or compound: Whole product |
11 |
| Beta-carotene and vitamin A, vitamin E | Biological association | Human | Studied as single supplements; beta-carotene raised lung cancer risk in people at high risk. Preparation or compound: Whole product |
16 4 |
| Zinc, copper, manganese, magnesium and the B vitamins | Biological association | Laboratory | Manganese was measured in children's products. Others are commonly listed but their typical amounts were not read. Preparation or compound: Whole product |
8 18 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 26, 2026).
Evidence at a glance: what the research found for 9 outcomes
Each outcome below is one thing researchers measured. Certainty is how far the evidence can be trusted, not how well it works. The full studies are on the next tab.
The evidence
The research centre for Multivitamins. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We re-read PubMed abstracts for every trial, review, lab survey and cohort cited, and read the FDA labeling guide, the FDA Daily Value page and MedlinePlus iron-poisoning page in full. The NIH Office of Dietary Supplements fact sheet was blocked and is marked unverified.
Study library: every study we checked 29
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Age-Related Eye Disease Study 2 Research Group 2013 Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial JAMA · PMID 23644932 · DOI |
Randomised controlled trial |
4203 People aged 50 to 85 at risk of advanced AMD |
The AREDS formula with or without added lutein + zeaxanthin and/or omega-3 fats; variations without beta-carotene or with less zinc Oral Lutein 10 mg + zeaxanthin 2 mg; DHA 350 mg + EPA 650 mg (as studied in the trial) Median 5 years · vs Placebo |
Adding lutein + zeaxanthin and/or omega-3 fats to the AREDS formula did not significantly reduce progression to advanced AMD in the main analyses. Removing beta-carotene or lowering zinc made no clear difference. More lung cancers occurred with beta-carotene, mostly in former smokers. Lutein + zeaxanthin HR 0.90; omega-3 HR 0.97; both HR 0.89 (98.7% CI: 0.76 to 1.07; 0.82 to 1.16; 0.75 to 1.06) Methods, limits and fundingOutcomes: Development of advanced AMD Limitations: Studies a special eye formula in people at risk of advanced AMD, not an ordinary multivitamin. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Andrews 2018 Dietary Supplement Ingredient Database (DSID) and the Application of Analytically Based Estimates of Ingredient Amount to Intake Calculations J Nutr · PMID 31505677 · DOI |
Database description n/a |
US national database of analysed dietary supplement content (NIH ODS and USDA), linked to NHANES products | Multivitamin-mineral products Oral · vs Label amounts |
Many ingredients are added above the label amount (overages). Amounts over 20% above label are predicted in half to nearly all multivitamin-mineral products for iodine and selenium in adult products, for iodine and vitamins D and E in children's products, and for iodine, chromium and potassium in non-prescription prenatal products. Overages over 20% in 50 to 99% of the products named (Not applicable) Methods, limits and fundingOutcomes: Analysed amount compared with label amount Limitations: Estimates, not a count of every product on the shelf. Funding and conflicts: Government-authored; no conflict statement in the abstract. Read: abstract |
| Baker 2023 Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial Alzheimers Dement · PMID 36102337 · DOI |
Randomised controlled trial |
2262 Older US adults, average age 73, 60% women; 89% non-Hispanic White |
A commercial multivitamin-mineral (also cocoa extract in a two-by-two design) Oral Daily; amount per tablet not given in the abstract 3 years · vs Placebo |
The multivitamin-mineral gave a small better global cognition score than placebo; benefits were also seen for memory and executive function. Cocoa extract showed no effect. Global cognition mean z = 0.07 (P = .007); no cardiovascular history 0.06; history 0.14 (Global 0.02 to 0.12; no history 0.01 to 0.11; history -0.02 to 0.31) Methods, limits and fundingOutcomes: Global cognition score (telephone tests), memory, executive function Limitations: Mostly White, older adults; tests done by telephone; small effect size; the larger effect in people with heart disease was not a main test. Funding and conflicts: The authors state no competing interests and that NIH, Mars and Pfizer had no role in design, analysis or writing. Read: abstract |
| Bjelakovic 2012 Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases Cochrane Database Syst Rev · PMID 22419320 · DOI |
Systematic review meta analysis |
296707 78 trials, healthy people and people with stable disease; average age 63 |
Antioxidant supplements (beta-carotene, vitamin A, C, E, selenium), alone or with other vitamins and minerals Oral Varied by trial 28 days to 12 years (mean 3 years) · vs Placebo or no treatment |
No significant effect on death in the main model. In the 56 low-risk-of-bias trials, antioxidant supplements raised the risk of death slightly. Beta-carotene and vitamin E, but not vitamin C or selenium, raised death risk in low-bias trials. Vitamin A dose was linked with higher death risk. All trials RR 1.02; low-bias trials RR 1.04; beta-carotene RR 1.05; vitamin E RR 1.03 (All trials 0.98 to 1.05; low-bias 1.01 to 1.07; beta-carotene 1.01 to 1.09; vitamin E 1.00 to 1.05) Methods, limits and fundingOutcomes: Death from any cause Limitations: Single antioxidants, not multivitamins as such; included to show why high single-nutrient doses are a separate question. Funding and conflicts: Funding sources had no role in the work, per the abstract. Read: abstract |
| Chen 2019 Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study Ann Intern Med · PMID 30959527 · DOI |
Cohort study |
30899 US adults 20 and older in NHANES 1999 to 2010, followed a median 6.1 years |
Dietary supplement use and nutrient intake from food and supplements Oral Median 6.1 years · vs People not using supplements or with lower intake |
Using supplements was not linked with lower death. Adequate intake of several nutrients was linked with lower death, but only when the nutrient came from food. Calcium above the Tolerable Upper Intake Level was linked with more cancer deaths, and the link seemed to come from supplements. Calcium above upper limit vs at or below: cancer death rate ratio 1.62; supplement calcium 1,000 mg or more a day vs none: 1.53 (1.07 to 2.45; 1.04 to 2.25) Methods, limits and fundingOutcomes: Death from all causes, cardiovascular disease and cancer Limitations: Observational, so it cannot show cause; people report their own supplement use. Funding and conflicts: Funded by the US National Institutes of Health; authors report no conflicts. Read: abstract |
| Christen 2014 Effects of multivitamin supplement on cataract and age-related macular degeneration in a randomized trial of male physicians Ophthalmology · PMID 24268861 · DOI |
Randomised controlled trial |
14641 Male US physicians aged 50 or older |
A common daily multivitamin (one product) Oral Daily Average 11.2 years · vs Placebo |
Fewer cataracts with the multivitamin (872 vs 945 cases). No significant effect on visually significant AMD (152 vs 129 cases). Cataract HR 0.91 (P = 0.04); AMD HR 1.19 (P = 0.15) (Cataract 0.83 to 0.99; AMD 0.94 to 1.50) Methods, limits and fundingOutcomes: New cataract; visually significant age-related macular degeneration (AMD) Limitations: Men only; cataract result is close to chance; outcomes confirmed from self-report plus medical records. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Evans 2023 Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration Cochrane Database Syst Rev · PMID 37702300 · DOI |
Systematic review meta analysis |
11952 26 studies in people aged 65 to 75 with age-related macular degeneration (AMD); most evidence from the AREDS trial |
Antioxidant vitamin and mineral supplements, mostly the AREDS formula (vitamins C and E, beta-carotene, zinc) Oral Formulas varied by trial 6 months to 5 years · vs Placebo or no treatment |
The AREDS-type vitamin and mineral formula probably slows progression to late AMD in people who already have it (moderate certainty). Lutein and zeaxanthin alone had similar or slightly lower risk with low certainty. Beta-carotene raised lung cancer risk, mostly in former smokers. Progression to late AMD OR 0.72 (3 studies, 2,445 people) (0.58 to 0.90) Methods, limits and fundingOutcomes: Progression to late AMD, vision loss, side effects, death Limitations: These are special eye formulas in people who already have AMD, not ordinary multivitamins taken by healthy people. Funding and conflicts: Cochrane review; authors report no known conflicts. Read: abstract |
| Frisbie 2026 Excessive manganese content in children's multivitamin supplements: Potential for neurodevelopmental harm and other adverse health outcomes PLoS One · PMID 41849337 · DOI |
Laboratory survey n/a |
52 52 children's multivitamin and mineral products (tablets, capsules, gummies, powders, liquids) |
Children's multivitamin-mineral products Oral · vs Institute of Medicine tolerable upper intake levels (ULs) for manganese |
Of 26 products listing manganese, 23 had more than the label said and 3 had less. Five would exceed the UL based on measured amounts, and nine would if used on top of an ordinary diet. Half of 26 products with no manganese on the label still contained some. Average 42.5% difference between labelled and measured manganese (Not applicable) Methods, limits and fundingOutcomes: Measured manganese compared with the label and with the UL Limitations: Only 52 products; the authors compare with limits set for general nutrition; the abstract does not say which brands. Funding and conflicts: The authors state no competing interests. Read: abstract |
| Gaziano 2012 Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial JAMA · PMID 23162860 · DOI |
Randomised controlled trial |
14641 Male US physicians aged 50 or older (average 64); 1,312 had a history of cancer |
A common daily multivitamin (one product) Oral Daily; amount per tablet not given in the abstract Median 11.2 years · vs Placebo |
Slightly fewer cancers overall with the multivitamin. No clear effect on prostate cancer, colorectal cancer, other site-specific cancers or cancer death. Total cancer HR 0.92 (P = .04); prostate HR 0.98; colorectal HR 0.89; cancer death HR 0.88 (P = .07) (Total cancer 0.86 to 0.998; prostate 0.88 to 1.09; colorectal 0.68 to 1.17; cancer death 0.77 to 1.01) Methods, limits and fundingOutcomes: Total cancer (not counting non-melanoma skin cancer); prostate, colorectal and other cancers; cancer death Limitations: Men only; the total-cancer result sits right at the edge of chance (upper limit 0.998). The abstract carries an erratum notice. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Keats 2019 Multiple-micronutrient supplementation for women during pregnancy Cochrane Database Syst Rev · PMID 30873598 · DOI |
Systematic review meta analysis |
141849 20 trials of pregnant women; 19 in low- and middle-income countries |
Multiple-micronutrient supplements with iron and folic acid Oral Varied by trial Through pregnancy · vs Iron with or without folic acid (19 trials); placebo (1 UK trial) |
Compared with iron with or without folic acid, multiple-micronutrient supplements gave fewer low-birthweight babies (high-certainty) and probably fewer small-for-gestational-age babies and very preterm births. Preterm birth fell slightly but the range touched no effect. No clear change in stillbirth or deaths. In the one UK trial against placebo, maternal anaemia in the third trimester was lower. Low birthweight RR 0.88; small for gestational age RR 0.92; very preterm RR 0.81; preterm RR 0.95 (Low birthweight 0.85 to 0.91; small for gestational age 0.88 to 0.97; very preterm 0.71 to 0.93; preterm 0.90 to 1.01) Methods, limits and fundingOutcomes: Preterm birth, small-for-gestational-age babies, low birthweight, stillbirth, newborn deaths, maternal outcomes Limitations: Most trials were in low- and middle-income countries where diets differ; the comparison was iron-folic acid, not no supplement; possible publication bias for preterm and small-for-gestational-age results. Funding and conflicts: Authors: none, except one who led a trial included in the review but did not take part in screening or extraction. Read: abstract |
| Kurnik 2004 Over-the-counter vitamin K1-containing multivitamin supplements disrupt warfarin anticoagulation in vitamin K1-depleted patients. A prospective, controlled trial Thromb Haemost · PMID 15543329 · DOI |
Controlled trial |
16 16 adults on warfarin: 9 with low and 7 with normal vitamin K1 status |
A multivitamin tablet containing 25 micrograms of vitamin K1 (as studied in the trial) Oral One tablet daily 4 weeks, then 4 weeks vitamin-K-free for some · vs Vitamin K-free multivitamin (second period) |
In people with low vitamin K status, the vitamin K multivitamin pushed INR down in all 9 (too little blood thinning) and warfarin doses had to rise. In people with normal vitamin K status there was no important change. Subtherapeutic INR in 9 of 9 vs 1 of 7 (p < 0.001) (Not given in the abstract) Methods, limits and fundingOutcomes: INR (blood-clotting test), warfarin dose Limitations: Very small trial; not randomised in the usual sense (groups were chosen by vitamin K level). Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Lam 2026 Emerging Patterns in Dietary Supplement Use Among US Adults, 1999-2023 JAMA Netw Open · PMID 42295756 · DOI |
Cross sectional survey |
63442 US adults 20 and older, NHANES 1999 to 2023 |
Dietary supplements overall and multivitamin-multimineral products Oral |
Overall supplement use rose from 51% to 60%. Multivitamin-multimineral use fell from 35% to 31%, while single vitamins, single minerals and botanicals rose. Use was highest in adults 65 and older. Multivitamin-multimineral use 35% to 31% (35% (33 to 37) to 31% (29 to 34)) Methods, limits and fundingOutcomes: Prevalence of supplement use over time Limitations: Self-reported use in the United States only. Funding and conflicts: Some authors report grants and company ties outside the work; not about multivitamins. Read: abstract |
| Long 2013 Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis Psychosom Med · PMID 23362497 · DOI |
Systematic review meta analysis |
8 randomised, placebo-controlled studies in people without a diagnosed illness, with multivitamin/mineral supplements for at least 28 days | Multivitamin/mineral supplements Oral Varied by trial At least 28 days · vs Placebo |
Lower perceived stress, mild psychiatric symptoms, anxiety, fatigue and confusion. No significant effect on depression. The authors say products with high amounts of B vitamins may work better. Stress SMD 0.35; mild symptoms 0.30; anxiety 0.32; depression 0.20 (not significant, p = .089); fatigue 0.27 (Stress 0.22 to 0.47; symptoms 0.18 to 0.43; anxiety 0.16 to 0.48; fatigue 0.15 to 0.40; the depression range crossed no effect) Methods, limits and fundingOutcomes: Perceived stress, mild psychiatric symptoms, anxiety, depression, fatigue, confusion Limitations: Only 8 small studies of different products; short; mood was self-rated; the abstract does not give the number of people. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Macpherson 2013 Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials Am J Clin Nutr · PMID 23255568 · DOI |
Systematic review meta analysis |
91074 21 articles of daily multivitamin-multimineral trials of one year or longer in adults living independently; average age 62; 8,794 deaths |
Daily multivitamin-multimineral products (various) Oral Varied by trial Average 43 months · vs Placebo or control |
No effect on death from any cause. A trend toward fewer deaths in primary-prevention trials just touched the line of no effect. No effect on vascular or cancer death. All-cause death RR 0.98; primary prevention RR 0.94; vascular RR 1.01; cancer RR 0.96 (All-cause 0.94 to 1.02; primary prevention 0.89 to 1.00; vascular 0.93 to 1.09; cancer 0.88 to 1.04) Methods, limits and fundingOutcomes: Death from any cause, vascular death, cancer death Limitations: Different products pooled together; older trials. Funding and conflicts: No conflict statement in the abstract. Read: abstract |
| Mindak 2008 Lead in women's and children's vitamins J Agric Food Chem · PMID 18646762 · DOI |
Laboratory survey n/a |
324 324 multivitamin-mineral products labelled for women and children (US, tested by the US Food and Drug Administration) |
Multivitamin-mineral products including gummies Oral · vs Provisional tolerable lead intake levels |
Estimated median lead intake from these products was low and below the provisional tolerable levels for every group. Five products would have given more than 4 micrograms a day. Median 0.123 micrograms a day (young children), 0.845 (pregnant or lactating women); maximum 8.97 micrograms a day (pregnant or lactating women) (Not applicable) Methods, limits and fundingOutcomes: Lead content and estimated daily lead intake Limitations: Products bought before 2008; levels may have changed. Funding and conflicts: Government laboratory study; no conflict statement in the abstract. Read: abstract |
| O'Connor 2022 Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force JAMA · PMID 35727272 · DOI |
Systematic review meta analysis |
739803 84 studies in healthy adults without known deficiencies (evidence review for the US Preventive Services Task Force) |
Vitamin and mineral supplements, including multivitamins Oral Varied by trial Varied · vs Placebo or no supplement |
For multivitamins, pooled trials linked use to slightly lower odds of any cancer and of lung cancer, but the abstract says the evidence had important limitations. Overall, vitamin and mineral supplements gave little or no benefit for cancer, heart disease and death. Any cancer OR 0.93 (4 trials, 48,859 people); lung cancer OR 0.75 (2 trials, 36,052 people) (Any cancer 0.87 to 0.99; lung cancer 0.58 to 0.95) Methods, limits and fundingOutcomes: Death, cardiovascular disease, cancer, serious harms Limitations: Mixes many products and single nutrients; the multivitamin result rests on few trials. Funding and conflicts: No conflict of interest reported. Read: abstract |
| Rautiainen 2017 Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk: A Secondary Analysis of the Physicians' Health Study II Randomized Clinical Trial JAMA Cardiol · PMID 28384735 · DOI |
Randomised controlled trial |
13316 Male US physicians from the Physicians' Health Study II who completed a food questionnaire |
A common daily multivitamin (one product) Oral Daily Mean 11.4 years · vs Placebo |
No consistent sign that diet quality, food intake or earlier supplement use changed the lack of effect on cardiovascular events. A few interactions appeared but were inconsistent and likely due to multiple testing. Not summarised in one number (Not given in the abstract) Methods, limits and fundingOutcomes: Whether baseline diet and supplement use changed the multivitamin effect on cardiovascular events Limitations: Secondary analysis; men only; many comparisons. Funding and conflicts: Some authors reported research grants from Pfizer and from the Council for Responsible Nutrition Foundation, outside the submitted work. Read: abstract |
| Saldanha 2017 Is Nutrient Content and Other Label Information for Prescription Prenatal Supplements Different from Nonprescription Products? J Acad Nutr Diet · PMID 28571654 · DOI |
Label survey n/a |
214 82 prescription and 132 non-prescription prenatal supplements in two US databases |
Prenatal multivitamin-mineral products Oral · vs Prescription vs non-prescription products |
Prescription and non-prescription prenatal products differ in what they list. Nearly all contained at least one nutrient above the Recommended Dietary Allowance for pregnant or breastfeeding women. Labels were similarly sparse about how to use them. Prescription products listed fewer vitamins (9 vs 11) and minerals (4 vs 8) (Not applicable) Methods, limits and fundingOutcomes: Declared nutrients and safety information on labels Limitations: Label information only, not laboratory testing. Funding and conflicts: One co-author holds stock in pharmaceutical companies, some of which make supplements; the abstract says all authors are employed by the US federal government. Read: abstract |
| Sesso 2012 Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial JAMA · PMID 23117775 · DOI |
Randomised controlled trial |
14641 Male US physicians aged 50 or older (average 64); 754 had earlier cardiovascular disease |
A common daily multivitamin (one product) Oral Daily; amount per tablet not given in the abstract Median 11.2 years · vs Placebo |
No effect on major cardiovascular events, heart attack, stroke, cardiovascular death or total death. Major cardiovascular events HR 1.01; heart attack HR 0.93; stroke HR 1.06; cardiovascular death HR 0.95; total death HR 0.94 (P = .13) (Major events 0.91 to 1.10; heart attack 0.80 to 1.09; stroke 0.91 to 1.23; cardiovascular death 0.83 to 1.09; total death 0.88 to 1.02) Methods, limits and fundingOutcomes: Major cardiovascular events (non-fatal heart attack, non-fatal stroke, cardiovascular death); heart attack, stroke, total death Limitations: Men only, all physicians; one product; results may not apply to women, younger people or people who are short of nutrients. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Stierman 2020 Dietary Supplement Use in Children and Adolescents Aged ≤19 Years - United States, 2017-2018 MMWR Morb Mortal Wkly Rep · PMID 33119556 · DOI |
Cross sectional survey |
US children and adolescents aged 19 and under, NHANES 2017 to 2018 | Dietary supplements, including multivitamin-mineral products Oral |
In 2017 to 2018, 34.0% of US children and adolescents used a dietary supplement in the past 30 days, and 23.8% used a multivitamin-mineral product, the most common type. 34.0% any supplement; 23.8% multivitamin-mineral (Not given in the abstract) Methods, limits and fundingOutcomes: Prevalence of supplement use Limitations: Self-reported use in the United States only. Funding and conflicts: No conflicts disclosed. Read: abstract |
| US Preventive Services Task Force 2022 Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement JAMA · PMID 35727271 · DOI |
Guideline |
Community-dwelling, non-pregnant US adults | Multivitamins and single or paired nutrient supplements Oral |
The Task Force found the evidence insufficient to judge the balance of benefits and harms of multivitamins for preventing cardiovascular disease or cancer (I statement). It recommends against beta carotene and vitamin E for this purpose (D). Not applicable (Not applicable) Methods, limits and fundingOutcomes: Task Force recommendation on supplements to prevent cardiovascular disease and cancer Limitations: Covers prevention of heart disease and cancer in adults only. It is not advice about deficiency, pregnancy or other uses. Funding and conflicts: Public guideline body; no conflict statement in the abstract. Read: abstract |
| Vyas 2024 Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS Am J Clin Nutr · PMID 38244989 · DOI |
Randomised controlled trial |
5203 Older US adults: 573 in an in-person clinic group, plus a pooled analysis of three COSMOS cognition studies |
Daily multivitamin-mineral (also cocoa extract in a two-by-two design) Oral Daily About 2 years in the clinic group; up to 3 years in the others · vs Placebo |
In the in-person clinic group, global cognition moved in the same direction but the range reached zero, and episodic memory improved. Pooled across the three COSMOS cognition studies, global cognition and episodic memory were better with the multivitamin-mineral. Clinic: global 0.06 SD units; memory 0.12. Pooled: global 0.07 (P = 0.0009); memory 0.06 (P = 0.0007) (Clinic: global -0.003 to 0.13; memory 0.002 to 0.23. Pooled: global 0.03 to 0.11; memory 0.03 to 0.10) Methods, limits and fundingOutcomes: Global cognition and episodic memory (in-person tests); pooled analysis of three sub-studies Limitations: The pooled people are from the same trial, so it is not an independent confirmation. n is the sum of the three groups named in the abstract (573 + 2,158 + 2,472). Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| White 2022 Lead in Mineral or Multivitamin-Multimineral Products Ann Pharmacother · PMID 34096339 · DOI |
Narrative review n/a |
Studies of lead in mineral and multivitamin-multimineral products, 1980 to May 2021 | Mineral and multivitamin-multimineral products Oral · vs FDA interim reference level for lead |
Lead risk in these products has fallen a lot since 2000, and products tested since 2007 had low average lead. But the gap between products is large, with some products having worrying amounts. Without third-party testing it is hard to know which. Children could still get more lead than the FDA interim level, even from seal-bearing products. Not given in the abstract (Not applicable) Methods, limits and fundingOutcomes: Lead content of products Limitations: Narrative review, not a systematic count. Funding and conflicts: No conflict statement in the abstract. Read: abstract |
| Yeung 2023 Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial Am J Clin Nutr · PMID 37244291 · DOI |
Randomised controlled trial |
3562 Older US adults in the COSMOS-Web online study |
A daily multivitamin-mineral (one product) Oral Daily 3 years · vs Placebo |
Better immediate recall than placebo at 1 year (the main goal) and across 3 years. No significant effect on secondary outcomes (object recognition, executive function). The authors estimated the gain as like 3.1 years of age-related memory change. Recall at 1 year t = 2.25, P = 0.025; over 3 years t = 2.54, P = 0.011 (Not given in the abstract) Methods, limits and fundingOutcomes: Episodic memory (immediate recall on an online test) at 1 year; other online tests over 3 years Limitations: Online testing; one product; older adults who could use the internet. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| s-fda-dv US FDA: How to understand and use the Nutrition Facts label (last updated 2024-03-05) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-fda-labeling-guide US FDA Dietary Supplement Labeling Guide, Chapter IV: Nutrition Labeling (guide dated April 2005) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-medlineplus-iron MedlinePlus Medical Encyclopedia: Iron poisoning (review date 2025-10-14) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-medlineplus-vitamins MedlinePlus Medical Encyclopedia: Vitamins (review date 2025-01-21, editorial update 2025-08-12) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-ods-mvm NIH Office of Dietary Supplements: Multivitamin/mineral supplements fact sheet · Source |
Reference database n/a |
Methods, limits and fundingRead: not-read |
What we do not know yet
- No trial tested multivitamins in people with proven nutrient gaps.
- Most large trials tested one product in older, mostly well-nourished adults.
- NIH ODS multivitamin/mineral fact sheet could not be read, so no official upper limits are listed.
- No trial compared gummies, powders and capsules.
- No lab survey of undeclared drugs in multivitamins was read.
- Typical amounts of each nutrient per tablet were not read.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue before the page changes.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Other 4
Major cardiovascular events
No change in trials
A combined count of non-fatal heart attack, non-fatal stroke and death from heart or blood vessel disease.
Low certaintyResults and what it means
Why it was measured
To see whether a multivitamin changes real heart outcomes.
Statistical vs. clinical meaning
This is a real clinical outcome, not a lab marker.
Safety implication
No safety signal reported.
| Study | Result | People | Product |
|---|---|---|---|
| 19 | HR 1.01 (95% CI 0.91 to 1.10) versus placebo | 14,641 male US doctors, median 11.2 years | Daily multivitamin |
Global cognition score
Slightly better in trials
A combined score from several memory and thinking tests, shown as a z-score (how many standard deviations from the starting average).
Low certaintyResults and what it means
Why it was measured
To see whether a multivitamin slows decline in thinking.
Statistical vs. clinical meaning
A very small shift on a research score; the authors compare it to about 2 years of cognitive ageing.
Safety implication
No safety problem noted.
Low birthweight
Fewer low-birthweight babies in trials
A baby born weighing less than 2,500 grams (the usual cut-off).
Moderate certaintyResults and what it means
Why it was measured
Low birthweight raises risks for newborns.
Statistical vs. clinical meaning
A real clinical outcome but in settings with poorer diets.
Safety implication
See Safety for pregnancy.
| Study | Result | People | Product |
|---|---|---|---|
| 10 | RR 0.88 (0.85 to 0.91) versus iron with or without folic acid | 68,801 participants in 18 trials | Multiple-micronutrient supplements with iron and folic acid |
Perceived stress
Lower in trials
A self-rated score of how stressed a person feels.
Low certaintyResults and what it means
Why it was measured
To see whether a multivitamin changes everyday stress.
Statistical vs. clinical meaning
Self-rated, small studies.
Safety implication
No safety signal.
| Study | Result | People | Product |
|---|---|---|---|
| 13 | SMD 0.35 (0.22 to 0.47) lower stress versus placebo | 8 studies of adults without a diagnosed illness | Multivitamin/mineral supplements |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 4
- Iron in adult multivitamins can poison a child. MedlinePlus says a severe iron overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. Children's multivitamins usually cause only minor effects. Symptoms can include stomach pain, vomiting (sometimes bloody), black stools, drowsiness and shock, and they may ease for a few hours and then return. In the US the Poison Help number is 1-800-222-1222. Authoritative guidance 27
- The same nutrient in several products can add up. Many people take a multivitamin and other pills too. In a US cohort of 30,899 adults, calcium above the Tolerable Upper Intake Level was linked with more cancer deaths, and the link seemed to come from supplement calcium (1,000 mg or more a day) rather than food. This is observational and cannot prove cause. Beta-carotene supplements raised lung cancer risk in people at high risk of it, and the Task Force recommends against beta-carotene and vitamin E for preventing heart disease or cancer. Cohort study and evidence review 5 16 21
- Labels are not always right. A US government database finds that many ingredients are added above the label amount. Overages above 20% were predicted for iodine and selenium in adult multivitamin-minerals, for iodine and vitamins D and E in children's products, and for iodine, chromium and potassium in non-prescription prenatal products. In a lab test of 52 children's products, 23 of 26 that listed manganese had more than the label said. Laboratory analysis and database 2 8
- Vitamin K in a multivitamin can weaken warfarin. In a small controlled trial of people on warfarin, a multivitamin with 25 micrograms of vitamin K1 lowered the blood-thinning effect in all 9 people with low vitamin K status, and warfarin doses had to be raised. People with normal vitamin K status were not affected. Anyone on warfarin should check with the prescriber before starting a multivitamin. Controlled trial 11
Side effects 4
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Lung cancer with beta-carotene supplements in people at high risk (for example smokers and former smokers) AREDS2 also found more lung cancers with beta-carotene, mostly in former smokers. Check whether a product lists beta-carotene. | OR 1.20 (95% CI 1.01 to 1.42) in 4 trials of 94,830 people | serious Not stated | Meta-analysis 16 1 |
| Possible higher risk of hip fracture (vitamin A), hemorrhagic stroke (vitamin E) and kidney stones (vitamin C, calcium) with single-nutrient supplements These are findings for single nutrients, not multivitamins as products. They show why stacking matters. | Limited evidence | serious Not stated | Systematic review 16 |
| Stomach and bowel upset and, for zinc in the eye-disease trial, urinary problems in men From the eye-disease vitamin and mineral formulas, not ordinary multivitamins. | Not given in the abstract | mild to moderate Not stated | Meta-analysis 7 |
| No harm signal for death from a daily multivitamin-multimineral Most trials were one to a few years and in adults who were not short of nutrients. | RR 0.98 for death from any cause | Not applicable Not applicable | Meta-analysis 14 19 |
Liver
No liver injury from multivitamins was reported in the abstracts read. MedlinePlus says high doses of certain vitamins can be toxic. 28
How often. No frequency was found.
Monitoring. No agency monitoring advice was found.
This is a safety connection. It is not evidence that Multivitamins supports liver health.
Medicines and supplements 3
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Warfarin (blood thinner) prescription | Vitamin K1 in the product can offset warfarin. | In a controlled trial, 9 of 9 people with low vitamin K status had too-low blood-thinning tests on a multivitamin with 25 micrograms of vitamin K1; people with normal vitamin K status did not. | Controlled trial Low certainty 11 | Ask the prescriber or a pharmacist before starting or stopping a multivitamin. |
| Other supplements with the same nutrients (calcium, vitamin A, vitamin E, beta-carotene, zinc and others) supplement | Amounts from several products add together. | Calcium above the upper level was linked with more cancer deaths in a cohort, mainly from supplements. Beta-carotene raised lung cancer in people at high risk. | Cohort study and evidence review Low certainty 5 16 | Add up the nutrients on every label and ask a pharmacist. |
| Prescription medicines (general) prescription | No mechanism found for multivitamins as a class. | Apart from warfarin, no interaction study of multivitamin products and a medicine was read. | Absence of evidence Not enough evidence | Absence of a study is not proof of safety. Tell a doctor or pharmacist about every supplement. |
Who should check first 4
| Situation | Advice | Evidence |
|---|---|---|
| Children (iron, manganese and lead) | Keep adult multivitamins out of children's reach. MedlinePlus says a severe iron overdose can follow a child eating adult multivitamins such as prenatal vitamins. A 2026 lab test found children's products with more manganese than the label said, some above the Institute of Medicine upper levels. Ask a paediatrician or pharmacist before giving any supplement. | Authoritative guidance and laboratory study 27 8 23 |
| Pregnancy and breastfeeding | Prenatal products differ a lot. A 2017 label survey found that nearly all contained at least one nutrient above the Recommended Dietary Allowance for pregnancy or breastfeeding, and labels were sparse on how to use them. Ask the midwife, doctor or pharmacist before choosing a product. | Label survey 18 |
| Smokers and former smokers (beta-carotene) | Beta-carotene supplements raised lung cancer risk in people at high risk of it. Check whether a product lists beta-carotene or a high vitamin A amount, and ask a pharmacist. | Meta analysis and randomised trial 16 1 |
| People on warfarin | Ask the prescriber before starting a multivitamin with vitamin K. | Controlled trial 11 |
Overdose, product quality and regulators
Summary. Official upper limits (Tolerable Upper Intake Levels) exist for many nutrients. The NIH Office of Dietary Supplements fact sheet could not be read, so no upper-limit numbers are listed here. See each nutrient's own page. Risk comes mainly from adding the same nutrient across products and from label amounts that differ from what is inside.
Animal. Not reviewed.
High dose or long term signals. Long daily use for 11 years in a trial of male doctors did not raise death or major heart events. Long-term safety in children and in pregnancy was not read.
Overdose response. For iron in a child, call the local emergency number or Poison Help (US 1-800-222-1222), per MedlinePlus.
Genotoxicity. Not researched.
Quality varies between products. Lead has fallen a lot since 2000 but some products still have worrying amounts, and children's manganese was above the label in most tested products listing it.
Lead. A 2008 US survey of 324 women's and children's multivitamin-mineral products found estimated lead intake below provisional tolerable levels for all groups, with five products over 4 micrograms a day. A 2022 review says lead has fallen since 2000 but large differences between products remain, and a seal does not guarantee children stay under the FDA interim level. 15 23
Manganese in children's products. 23 of 26 products that listed manganese had more than the label said (average difference 42.5%); 5 would exceed Institute of Medicine upper levels on measured amounts; half of the 26 products that listed none still contained some. 8
Label overages. Analysed content is often above the label for iodine, selenium, vitamins D and E, chromium, potassium, calcium and folic acid in many multivitamin-mineral products. 2
Undeclared drugs. No lab survey of hidden or undeclared drugs in multivitamin products was read.
| Body | Action | Date |
|---|---|---|
| US Preventive Services Task Force (United States) | 2022: evidence is insufficient to judge the balance of benefits and harms of multivitamins for preventing cardiovascular disease or cancer in healthy adults (I statement). It recommends against beta-carotene and vitamin E for that purpose (D). source | 2022-06-21 |
| US Food and Drug Administration (United States) | Labeling guide (dated April 2005): a proprietary blend must show its total weight, with ingredients listed by weight from most to least; serving size is the label's maximum amount per occasion; percent Daily Value shows how much of a Daily Value a serving gives. source | 2005-04-01 |
| MedlinePlus (US National Library of Medicine) (United States) | Iron poisoning: a severe overdose can follow a child eating adult multivitamins such as prenatal vitamins; children's multivitamins usually cause minor effects. US Poison Help 1-800-222-1222. source | 2025-10-14 |
When to get medical help
- A child has swallowed adult multivitamins, especially ones with iron: call the local emergency number or Poison Help (US 1-800-222-1222) at once, even if the child seems well, because symptoms can ease and then return.
- Vomiting blood, black or bloody stools, severe stomach pain, drowsiness, fast weak pulse or fainting after taking supplements.
- Swelling of the face, lips or tongue, hives or trouble breathing after a supplement.
- Unusual bleeding or bruising while on warfarin and starting a multivitamin.
Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is a multivitamin?
Who takes multivitamins?
In the US, 31% of adults used a multivitamin-mineral product, mostly for general health or to fill gaps in the diet. Among children and teens in 2017 to 2018, 23.8% did. Adult use of multivitamin-minerals has slipped from 35% to 31% over 25 years while single vitamins and botanicals have risen.
Do multivitamins prevent heart disease?
Do multivitamins prevent cancer?
Do multivitamins help memory?
Do multivitamins help you live longer?
Is a prenatal vitamin the same as a multivitamin?
Not exactly. A 2017 survey found prenatal products differ from each other and from adult products, and nearly all had at least one nutrient above the Recommended Dietary Allowance for pregnancy. A Cochrane review found multiple-micronutrient products with iron and folic acid gave fewer low-birthweight babies than iron and folic acid alone, mostly in low-income countries.
Are gummy multivitamins as good as tablets?
Is what is on the label what is in the bottle?
Can a multivitamin be dangerous?
For adults, large trials found no harm signal for death. The main dangers are children swallowing adult products with iron, stacking the same nutrient across products, beta-carotene in smokers, and vitamin K with warfarin. Call Poison Help (US 1-800-222-1222) or the local emergency number for a child who has swallowed pills.
What do 'proprietary blend' and '% Daily Value' mean?
The FDA says a proprietary blend must show its total weight, with ingredients listed by weight from most to least. Percent Daily Value shows how much of a Daily Value one serving gives; 5% or less is low and 20% or more is high. The serving size is the amount the label says to take at one time, or one unit if it says nothing.
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Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-26
- Last substantive update
- 2026-10-26
- How we research
- We re-read PubMed abstracts for every trial, review, lab survey and cohort cited, and read the FDA labeling guide, the FDA Daily Value page and MedlinePlus iron-poisoning page in full. The NIH Office of Dietary Supplements fact sheet was blocked and is marked unverified.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No brands are named and no affiliate links are shown. Some trials were run by teams with research grants from supplement makers or trade groups; this is flagged where the abstracts show it.
Sources 29
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013. PMID 23644932. DOI 10.1001/jama.2013.4997. (abstract)
- Andrews KW, Gusev PA, McNeal M, et al.. Dietary Supplement Ingredient Database (DSID) and the Application of Analytically Based Estimates of Ingredient Amount to Intake Calculations. J Nutr. 2018. PMID 31505677. DOI 10.1093/jn/nxy092. (abstract)
- Baker LD, Manson JE, Rapp SR, et al.. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimers Dement. 2023. PMID 36102337. DOI 10.1002/alz.12767. (abstract)
- Bjelakovic G, Nikolova D, Gluud LL, et al.. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2012. PMID 22419320. DOI 10.1002/14651858.CD007176.pub2. (abstract)
- Chen F, Du M, Blumberg JB, et al.. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med. 2019. PMID 30959527. DOI 10.7326/M18-2478. (abstract)
- Christen WG, Glynn RJ, Manson JE, et al.. Effects of multivitamin supplement on cataract and age-related macular degeneration in a randomized trial of male physicians. Ophthalmology. 2014. PMID 24268861. DOI 10.1016/j.ophtha.2013.09.038. (abstract)
- Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2023. PMID 37702300. DOI 10.1002/14651858.CD000254.pub5. (abstract)
- Frisbie SH, Mitchell EJ, Hoeltge A, et al.. Excessive manganese content in children's multivitamin supplements: Potential for neurodevelopmental harm and other adverse health outcomes. PLoS One. 2026. PMID 41849337. DOI 10.1371/journal.pone.0343600. (abstract)
- Gaziano JM, Sesso HD, Christen WG, et al.. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2012. PMID 23162860. DOI 10.1001/jama.2012.14641. (abstract)
- Keats EC, Haider BA, Tam E, et al.. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019. PMID 30873598. DOI 10.1002/14651858.CD004905.pub6. (abstract)
- Kurnik D, Loebstein R, Rabinovitz H, et al.. Over-the-counter vitamin K1-containing multivitamin supplements disrupt warfarin anticoagulation in vitamin K1-depleted patients. A prospective, controlled trial. Thromb Haemost. 2004. PMID 15543329. DOI 10.1160/TH04-06-0346. (abstract)
- Lam CS, O'Connell K, Monroy-Iglesias MJ, et al.. Emerging Patterns in Dietary Supplement Use Among US Adults, 1999-2023. JAMA Netw Open. 2026. PMID 42295756. DOI 10.1001/jamanetworkopen.2026.19291. (abstract)
- Long SJ, Benton D. Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Psychosom Med. 2013. PMID 23362497. DOI 10.1097/PSY.0b013e31827d5fbd. (abstract)
- Macpherson H, Pipingas A, Pase MP. Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2013. PMID 23255568. DOI 10.3945/ajcn.112.049304. (abstract)
- Mindak WR, Cheng J, Canas BJ, et al.. Lead in women's and children's vitamins. J Agric Food Chem. 2008. PMID 18646762. DOI 10.1021/jf801236w. (abstract)
- O'Connor EA, Evans CV, Ivlev I, et al.. Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2022. PMID 35727272. DOI 10.1001/jama.2021.15650. (abstract)
- Rautiainen S, Gaziano JM, Christen WG, et al.. Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk: A Secondary Analysis of the Physicians' Health Study II Randomized Clinical Trial. JAMA Cardiol. 2017. PMID 28384735. DOI 10.1001/jamacardio.2017.0176. (abstract)
- Saldanha LG, Dwyer JT, Andrews KW, et al.. Is Nutrient Content and Other Label Information for Prescription Prenatal Supplements Different from Nonprescription Products?. J Acad Nutr Diet. 2017. PMID 28571654. DOI 10.1016/j.jand.2017.04.002. (abstract)
- Sesso HD, Christen WG, Bubes V, et al.. Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2012. PMID 23117775. DOI 10.1001/jama.2012.14805. (abstract)
- Stierman B, Mishra S, Gahche JJ, et al.. Dietary Supplement Use in Children and Adolescents Aged ≤19 Years - United States, 2017-2018. MMWR Morb Mortal Wkly Rep. 2020. PMID 33119556. DOI 10.15585/mmwr.mm6943a1. (abstract)
- US Preventive Services Task Force, Mangione CM, Barry MJ, et al.. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2022. PMID 35727271. DOI 10.1001/jama.2022.8970. (abstract)
- Vyas CM, Manson JE, Sesso HD, et al.. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr. 2024. PMID 38244989. DOI 10.1016/j.ajcnut.2023.12.011. (abstract)
- White CM. Lead in Mineral or Multivitamin-Multimineral Products. Ann Pharmacother. 2022. PMID 34096339. DOI 10.1177/10600280211023328. (abstract)
- Yeung LK, Alschuler DM, Wall M, et al.. Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. Am J Clin Nutr. 2023. PMID 37244291. DOI 10.1016/j.ajcnut.2023.05.011. (abstract)
- . US FDA: How to understand and use the Nutrition Facts label (last updated 2024-03-05). . . (full-text)
- . US FDA Dietary Supplement Labeling Guide, Chapter IV: Nutrition Labeling (guide dated April 2005). . . (full-text)
- . MedlinePlus Medical Encyclopedia: Iron poisoning (review date 2025-10-14). . . (full-text)
- . MedlinePlus Medical Encyclopedia: Vitamins (review date 2025-01-21, editorial update 2025-08-12). . . (full-text)
- . NIH Office of Dietary Supplements: Multivitamin/mineral supplements fact sheet. . . (not-read)
Where to buy
Check the label first. Whatever you buy, look for these:
- The amount of the active ingredient per serving, not just the front-label claim
- A third-party testing mark (USP, NSF or ConsumerLab)
- Other ingredients and allergens
- Ask a pharmacist about interactions with your medicines
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
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