Vitamins & Supplements · Multivitamin formula
Multivitamins for Adults Over 50
Multivitamin-mineral supplements for older adults · also called 50 plus multivitamin, senior multivitamin, multivitamínico para mayores de 50 años
A multivitamin for adults over 50 is a mixed vitamin and mineral product sold for older age. Large trials found small gains in memory test scores in older adults, but no protection against heart disease or early death, and mixed results for cancer. No trial was found showing that a '50 plus' formula works better than an ordinary multivitamin. The main checks are vitamin A, iron, folic acid, B6, vitamin K and your medicines.
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 for Adults Over 50
A multivitamin for adults over 50 is a mix of vitamins and minerals sold for older age. Large trials show small memory-score gains but no protection against heart disease or early death. Check vitamin A, iron, folic acid, B6, vitamin K and your medicines, and add up every product you take.
What this kind of product is
A multivitamin-mineral is a pill, capsule or similar product with many vitamins and minerals in it. NCCIH and the US health surveys count a product with 10 or more vitamins and minerals as a multivitamin. A 'for adults over 50' product is one the maker sells for older age.
No source we read defines what a '50 plus' formula must contain, or shows how it differs from an ordinary adult multivitamin. Contents vary by maker, so read the label.
What is usually inside
Products differ, and we do not name brands. Nutrients named in the sources we read for this topic include vitamin B12, folic acid, vitamin B6, vitamin A, vitamin K, vitamin D, calcium, iron, iodine and selenium. The NHS says many multivitamins contain vitamin A. A US lab study found iodine, selenium, folic acid and calcium in adult multivitamin-minerals, often above the amount on the label. One trial used a product with vitamin K1.
Each of these has its own page here; see the related links. Amounts per tablet were not read for this page.
How to read the label
In the US, the nutrition panel on a supplement is called Supplement Facts. It must list the serving size and the amount of each dietary ingredient. A serving is the largest amount the label recommends per eating occasion, or one unit (a tablet or capsule) if none is given. The percent Daily Value (%DV) compares one serving with a single FDA reference number; 5% or less is low and 20% or more is high.
A 'proprietary blend' must be named, with its total weight, and its ingredients listed in order of weight. The Daily Value is a label reference, not a personal target. For example, the FDA lists 18 mg for iron, while the NHS gives 8.7 mg a day for women over 50, because different bodies use different systems. Whether gummies, capsules and tablets differ was not researched.
Who uses them
In 2011 to 2012, 31% of US adults took a multivitamin or multimineral, down from 37% in 1999 to 2000. NCCIH says women are more likely than men to take supplements. The most common reasons given are overall health and filling nutrient gaps in the diet (US Preventive Services Task Force).
Which nutrients change after 50
Vitamin B12: older adults absorb it from food less well. In a study of 3,299 adults aged 60 and over, B12 deficiency was found in 38% of those with a stomach-lining condition (atrophic gastritis), versus 15% of others. MedlinePlus lists age over 50 as a main risk group.
Iron: the NHS gives 8.7 mg a day for women aged 50 and over, down from 14.8 mg for women 19 to 49. Women still having periods after 50 may need the higher figure.
Vitamin A: the NHS says long-term intake above 1.5 mg a day may raise fracture risk, and postmenopausal women and older men are the group named. Folic acid above 1 mg a day can hide B12 deficiency, a concern for older people.
Food versus pills
The NHS says most people should be able to get what they need from a varied diet. It names meat, fish, milk, cheese and eggs for B12; liver, red meat, beans, nuts and fortified cereals for iron; and cheese, eggs, oily fish and milk for vitamin A.
Trials here tested pills, not food. No trial comparing a multivitamin with the same nutrients in food was read, and amounts per portion were not read, so none are stated.
What the research shows
For memory, three analyses from the COSMOS trial found small gains in test scores in older adults, but an earlier trial in 5,947 men found none. The gains were on tests, not dementia. For cancer, one trial in men found a small reduction and the larger, newer one found none overall. For heart disease and early death, trials show no effect. The US Preventive Services Task Force calls the evidence for heart disease and cancer prevention insufficient.
No trial tested a '50 plus' formula against an ordinary multivitamin.
At a glance
Traditional uses history, not proof
- Multivitamins are a modern product and have no traditional use
- Sold to fill possible nutrient gaps in older age
Studied for research
- Memory and thinking test scores, low certainty
- Filling nutrient gaps such as B12, insufficient trial evidence
- Cancer, mixed evidence
- Heart disease and living longer, no benefit found in trials
- Infections in older people, insufficient evidence
- Hip fracture, very low certainty (observational only)
Main compounds
- Vitamin B12
- Folic acid
- Vitamin B6
- Vitamin A
- Vitamin D and calcium
- Iron
- Vitamin K
Common forms
- Tablets and capsules (the forms named in NCCIH)
- Gummies and other forms were not researched
Research links: 2023 trial: multivitamin and memory in older adults (COSMOS-Web) · 2024 pooled analysis: multivitamin and cognition (COSMOS) · 2022 trial: multivitamin and cancer (COSMOS) · 2012 trial: multivitamin and cancer in men · 2022 US Preventive Services Task Force statement · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Multivitamin-mineral supplements for adults over 50 (sometimes sold as '50 plus' or senior formulas)
- Common names
- Multivitamin for adults over 50 (English); 50 plus multivitamin (English); Multivitamínico para mayores de 50 años (Spanish)
- Family or group
- Mixed vitamin and mineral supplement. NCCIH and the NHANES surveys count a product with 10 or more vitamins and/or minerals as a multivitamin/multimineral.
- Harvest and processing
- Made by blending vitamins and minerals into a tablet, capsule or other form. Lab work found that makers often add ingredients above the declared label amount, and these overages are not standardised between makers. No source read defines a '50 plus' formula.
- Look-alikes and adulterants
- Name: Ordinary adult multivitamin; Note: Has its own page; no source read defines how a '50 plus' formula differs.; Name: Prenatal and postnatal vitamins; Note: A different product made for pregnancy; has its own page.; Name: Greens powders; Note: Food-based powders; have their own page.; Name: Single-nutrient products (vitamin D, B12, calcium, iron); Note: One ingredient at a time; each has its own page.
- 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 |
|---|---|---|---|---|
| Vitamin B12 | vitamin | Not read from a source for multivitamins. | MedlinePlus says B12 helps form red blood cells and maintain the nervous system; deficiency is most common in people over 50. 27 17 | Human data |
| Folic acid (folate) | vitamin | Not read from a source for multivitamins; lab work found folic acid above the label amount in most adult products. | The NHS says folic acid above 1 mg a day can mask B12 deficiency. 34 1 | Human data |
| Vitamin B6 | vitamin | Not read from a source for multivitamins. | The NHS says B6 helps use energy from food and form haemoglobin; high doses can damage nerves. 34 | Human data |
| Vitamin A | vitamin | The NHS says many multivitamins contain vitamin A; amounts were not read. | The NHS says vitamin A supports the immune system and vision in dim light; long-term high intake may weaken bones. 33 7 | Human data |
| Vitamin D and calcium | vitamin and mineral | Lab work found calcium above the label amount in most multivitamin-minerals; vitamin D amounts were not read for adult products. | The NHS sets limits above which each could be harmful; calcium alone was linked with more heart attacks in a pooled analysis. 35 29 5 1 | Human data |
| Iron | mineral | Not read from a source for multivitamins. | The NHS says iron is needed for red blood cells; the reference amount falls for women after 50. 31 8 | Human data |
| Vitamin K1 | vitamin | One trial used a product with 25 micrograms per tablet (studied in the trial). | Helps blood clot; opposes warfarin. 13 36 | Human data |
| Iodine and selenium | minerals | Measured amounts exceeded label amounts by more than 20% in 50% to 99% of adult products tested. | Named in a US lab analysis as ingredients with common overages. 1 | Laboratory |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Vitamin B12 absorption with age | Not specified in the sources read | Atrophic gastritis and higher-dose acid-reducing medicine lower stomach acid and went with lower B12 status in older adults. The B12 form used to fortify foods does not need stomach acid for absorption. 17 | Human data |
| Folate and B12 together | Not specified in the sources read | In older adults with low B12, high blood folate went with more anaemia and cognitive impairment; with normal B12, high folate went with less cognitive impairment. 15 | Human data |
| Vitamin K and blood clotting | Not specified in the sources read | A multivitamin with vitamin K1 lowered warfarin effect in people with low vitamin K status. 13 | Human data |
| How a multivitamin might help thinking | Not specified in the sources read | No measured mechanism. The memory trial authors suggest nutrient shortfalls may matter, but this was not tested in the abstracts read. 23 | Hypothesis |
Absorption, metabolism and elimination
- Absorption
- B12 is freed from food by stomach acid; crystalline B12 (fortified foods) is not. Absorption of other nutrients in multivitamins was not read.
- Distribution
- Not found.
- Metabolism
- Not found.
- Elimination
- MedlinePlus says water-soluble vitamins such as B12 leave the body in urine once the body has what it needs, and the liver stores a few years of B12.
- Bioavailability
- Not compared across products in the sources read.
Isolated compounds versus whole extracts
The NHS says most people should be able to get the vitamins and minerals they need from a varied, balanced diet, and names food sources for each nutrient. Trials on this page tested pills, not food. No trial comparing a multivitamin with eating the same nutrients in food was read.
Nutritional composition
Food sources named by the NHS: iron (liver, red meat, beans, nuts, dried fruit, fortified cereals); vitamin A (cheese, eggs, oily fish, milk and yoghurt, liver; plus beta carotene from yellow, red and green vegetables and fruit); vitamin B12 (meat, fish, milk, cheese, eggs, some fortified cereals); vitamin B6 (pork, poultry, some fish, peanuts, soya beans, oats, bananas, milk). Amounts per portion were not read because USDA and NIH ODS pages could not be used, so none are stated.
1 mixed findings1 low certainty1 very low certainty2 not enough evidence2 evidence against
What was looked at
The 7 benefits and uses checked for Multivitamins for Adults Over 50, each with how strong the evidence is. Tap one to open it.
- Memory and thinking test scoresLow certainty
- Filling nutrient gaps after 50 (B12 as the main example)Not enough evidence
- CancerMixed findings
- Heart disease and strokeEvidence against
- Living longerEvidence against
- Infections in older peopleNot enough evidence
- Hip fractureVery low certainty
Lab markers tracked in the studies
Episodic memory test scoreVitamin B12 status (blood markers)
What is Multivitamins for Adults Over 50 good for?
The main studied uses and how strong the human evidence is for each. Most trials tested one commercial product in older adults, and their results do not automatically carry over to another product.
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.
Memory and thinking test scores
Low certaintyThree analyses from one large trial programme (COSMOS) found small gains in memory and overall thinking-test scores in older adults taking a daily multivitamin-mineral for 2 to 3 years. A separate large trial in older men found no difference. The gains are small, were measured with tests (not dementia), and come mostly from one research group.
4 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
COSMOS-Web (3,562 older adults, online tests) found better immediate-recall scores at 1 year and across 3 years. COSMOS-Mind (2,262 people, telephone tests) found a small gain in global cognition, memory and executive function. The in-person clinic group (573 people) had better episodic memory but a global score that was not significant. Pooling the three COSMOS cognition studies (5,203 people) gave small gains in global cognition and memory. The earlier Physicians' Health Study II cognition trial (5,947 men aged 65 or older, up to 12 years) found no difference.
Results
Mixed to positive on test scores. Small gains in COSMOS, null in an earlier trial in men. No trial showed fewer cases of dementia.
Effect sizes as reported
COSMOS-Web memory score P = 0.025 at 1 year; COSMOS-Mind global z = 0.07 (95% CI 0.02 to 0.12); pooled global 0.07 (0.03 to 0.11) and memory 0.06 (0.03 to 0.10); Physicians' Health Study II global change -0.01 (-0.04 to 0.02).
Why this rating
Low because the gains are small test-score changes, three of four analyses come from one trial programme, one product was tested, and the other large trial found nothing.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Mostly older US adults; COSMOS-Mind was mostly White participants; the other trial was male physicians.
Limits
One product tested. Test scores are not the same as day-to-day memory or dementia. The three COSMOS analyses are not independent of each other. The cognition trial in men was partly industry-funded (BASF, Pfizer, DSM).
Why researchers looked
Memory tends to slip with age, and researchers asked whether low or marginal nutrient levels play a part.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Hypothesis
Not established. The authors of the COSMOS studies propose that a multivitamin may correct small nutrient shortfalls, but the abstracts do not show a measured mechanism.
A proposed mechanism does not show that the effect happens in people.
No safety signal was reported in the abstracts. See the Safety tab for what to check on a label.
Filling nutrient gaps after 50 (B12 as the main example)
Not enough evidenceVitamin B12 is harder to absorb from food as stomach acid falls with age. A large Irish and UK study found B12 deficiency in 38% of older adults with a stomach-lining condition. This shows why B12 is on the label of 50-plus products. No trial in the sources read measured whether a multivitamin corrects B12 or other deficiencies.
2 studiesThe form studied was crystalline B12 in fortified foods, not a multiv…
Studies, doses and limits
What the trials found
In 3,299 adults aged 60 and over who did not take B12 supplements, atrophic gastritis was found in 15% and went with B12 deficiency in 38%, versus 21% in regular acid-reducing medicine users and 15% in others. Regular fortified-food eating went with better B12 markers but did not restore normal levels in people with atrophic gastritis. This is a survey, not a multivitamin trial.
Results
Insufficient. The link between age, low stomach acid and low B12 is documented. Whether a multivitamin fixes it is untested in the sources read.
Effect sizes as reported
Deficiency 38% (atrophic gastritis) vs 21% (medicine users) vs 15% (controls).
Why this rating
No trial of a multivitamin on B12 or other nutrient levels was read. Survey data show who is at risk, not what a pill does.
Form and dose studied
The form studied was crystalline B12 in fortified foods, not a multivitamin. Amounts are not stated here.
Who was studied
Adults aged 60 and over in Ireland and the UK, not taking B12 supplements.
Limits
Cross-sectional. Does not test a multivitamin. A blood test and a doctor decide whether B12 is low.
Why researchers looked
B12 is needed for red blood cells and nerves, and MedlinePlus lists age over 50 as a main risk group for B12 deficiency.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Established physiology
B12 in food is released by stomach acid; the crystalline B12 used to fortify foods does not need acid to be absorbed. This is from the Porter study abstract and describes foods, not multivitamins.
A proposed mechanism does not show that the effect happens in people.
Low B12 and high folic acid can interact; see the Safety tab.
Cancer
Mixed findingsTwo large trials gave different answers. In male physicians, a daily multivitamin lowered total cancer by about 8%, just at the edge of statistical significance. In the later COSMOS trial of older women and men, total cancer did not differ; only lung cancer, a secondary result, was lower. The US Preventive Services Task Force says evidence is insufficient.
3 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
Physicians' Health Study II (14,641 men, median 11.2 years): total cancer HR 0.92 (0.86 to 0.998), no effect on prostate (HR 0.98) or colorectal cancer (HR 0.89), cancer deaths HR 0.88 (0.77 to 1.01). COSMOS (21,442 women and men, median 3.6 years): total cancer HR 0.97 (0.86 to 1.09); lung cancer HR 0.62 (0.42 to 0.92) as a secondary result. The 2022 US Preventive Services Task Force statement calls the evidence for multivitamins and cancer prevention insufficient.
Results
Mixed. One trial found a small reduction, the other none.
Effect sizes as reported
Total cancer: HR 0.92 (men) vs 0.97 (older women and men).
Why this rating
Two large trials point in different directions. The first result is borderline, the second is null, and the lung result is one of several secondary comparisons.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Male US physicians aged 50+; US women 65+ and men 60+.
Limits
Different products and populations. COSMOS follow-up (3.6 years) is short for cancer. Not a test of any single nutrient.
Why researchers looked
Observational studies were inconsistent, so researchers ran long trials of a daily multivitamin.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Hypothesis
Not established. Authors have suggested correcting small nutrient shortfalls, but this was not measured in the abstracts.
A proposed mechanism does not show that the effect happens in people.
COSMOS reported no safety concerns. The Physicians' Health Study II abstract does not discuss safety.
Heart disease and stroke
Evidence againstTwo large trials and a pooled review found no protection against heart attack, stroke or death from heart disease. The US Preventive Services Task Force calls the evidence insufficient.
4 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
Physicians' Health Study II (14,641 men, median 11.2 years): major cardiovascular events HR 1.01 (0.91 to 1.10); heart attack HR 0.93; stroke HR 1.06; total deaths HR 0.94 (0.88 to 1.02). COSMOS (21,442 people): cardiovascular events HR 0.98 (0.86 to 1.12); all-cause death HR 0.93 (0.81 to 1.08). A 2018 review of 18 studies found no link with cardiovascular death or stroke, and the lower coronary-disease risk seen overall disappeared when only trials were counted (RR 0.97, 0.80 to 1.19).
Results
Null. No benefit shown in trials.
Effect sizes as reported
Major events HR 1.01 and 0.98 in the two trials.
Why this rating
Both large trials and the pooled review show no protection.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Older US adults; men in the first trial.
Limits
Different products and short follow-up in COSMOS.
Why researchers looked
People hoped that covering nutrient gaps would protect the heart.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Not established
Not established. No mechanism was shown to work in these trials.
A proposed mechanism does not show that the effect happens in people.
No cardiovascular harm was reported in these trials.
Living longer
Evidence againstA review of 21 randomised trials (91,074 people, about 8,800 deaths) found no change in the chance of dying. A 2026 review of reviews also found no benefit for deaths. One large cohort study found slightly higher death rates in multivitamin users; see the Safety tab.
3 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
Macpherson 2013: all-cause death RR 0.98 (0.94 to 1.02), vascular death RR 1.01, cancer death RR 0.96. NCCIH says most research shows no effect on living longer, cognitive decline or risk of cancer, heart disease and diabetes (page last updated January 2019).
Results
No effect found in trials.
Effect sizes as reported
All-cause death RR 0.98 (95% CI 0.94 to 1.02).
Why this rating
A large pooled review of trials and a 2026 review of reviews both found no benefit.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Independently living adults, average age 62.
Limits
Trials used different products. Average duration 43 months.
Why researchers looked
Multivitamins are often taken for general health, so researchers asked whether they change survival.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Not established
Not established. Survival is an outcome count, and no mechanism was tested in these trials.
A proposed mechanism does not show that the effect happens in people.
Pooled trials showed no extra deaths.
Infections in older people
Not enough evidenceA 2005 review of 8 small trials found fewer days with infection in 3 studies, but no clear change in how many people got an infection. The authors called the evidence weak and conflicting.
1 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
Days with infection fell by 17.5 a year (95% CI 11 to 24) in 3 studies, but the chance of at least one infection was not different (OR 1.10, 0.81 to 1.50) and the infection rate ratio was 0.89 (0.78 to 1.03, not significant).
Results
Mixed and weak.
Effect sizes as reported
17.5 fewer days with infection a year in 3 studies; other measures not significant.
Why this rating
Small old trials, different outcomes, and adverse events were poorly reported.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Older adults in 8 small randomised trials.
Limits
Old review (2005). Only part of the trials could be pooled for each outcome.
Why researchers looked
Poor nutrition can weaken the immune system, and older people get more infections.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
Adverse events were poorly reported.
Hip fracture
Very low certaintyA 2021 review of 8 observational studies found about half the odds of hip fracture in multivitamin users. No trials were found, so cause and effect is not shown; users may differ in diet and health.
2 studiesTrials tested a single commercial multivitamin-mineral. A result for …
Studies, doses and limits
What the trials found
OR 0.49 (0.32 to 0.77) in 8 observational studies of 80,148 people. The reviewers found no randomised trials. A 2026 review of reviews also reported an association in observational studies only.
Results
Association only; not tested in trials.
Effect sizes as reported
OR 0.49 (95% CI 0.32 to 0.77).
Why this rating
Observational studies only. People who take multivitamins often differ in other healthy habits.
Form and dose studied
Trials tested a single commercial multivitamin-mineral. A result for one product does not carry over to another. Amounts studied are in the studies table.
Who was studied
Adults with osteoporotic hip fracture; average age 69.
Limits
No trials. Possible confounding.
Why researchers looked
Bone strength depends on vitamin D, calcium and other nutrients found in many multivitamins.
Traditional use
Multivitamins are a modern product. They were not part of traditional medicine.
Proposed mechanism Not established
Not established.
A proposed mechanism does not show that the effect happens in people.
Too much vitamin A may raise fracture risk; see the Safety tab.
Connections to the rest of health
How Multivitamins for Adults Over 50 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 |
|---|---|---|---|---|
| Memory Support | Low certainty | Memory and thinking test scores: Three analyses from one large trial programme (COSMOS) found small gains in memory and overall thinking-test scores in older adults taking a daily multivitamin-mineral for 2 to 3 years. A separate large trial in older men found no difference. The gains are small, were measured with tests (not dementia), and come mostly from one research group. | 23 2 21 10 | |
| Cognitive Performance | Low certainty | Memory and thinking test scores: Three analyses from one large trial programme (COSMOS) found small gains in memory and overall thinking-test scores in older adults taking a daily multivitamin-mineral for 2 to 3 years. A separate large trial in older men found no difference. The gains are small, were measured with tests (not dementia), and come mostly from one research group. | 23 2 21 10 | |
| Energy Support | Not enough evidence | Filling nutrient gaps after 50 (B12 as the main example): Vitamin B12 is harder to absorb from food as stomach acid falls with age. A large Irish and UK study found B12 deficiency in 38% of older adults with a stomach-lining condition. This shows why B12 is on the label of 50-plus products. No trial in the sources read measured whether a multivitamin corrects B12 or other deficiencies. | 17 27 | |
| Healthy Aging | Not enough evidence | Filling nutrient gaps after 50 (B12 as the main example): Vitamin B12 is harder to absorb from food as stomach acid falls with age. A large Irish and UK study found B12 deficiency in 38% of older adults with a stomach-lining condition. This shows why B12 is on the label of 50-plus products. No trial in the sources read measured whether a multivitamin corrects B12 or other deficiencies. | 17 27 | |
| Healthy Aging | Mixed findings | Cancer: Two large trials gave different answers. In male physicians, a daily multivitamin lowered total cancer by about 8%, just at the edge of statistical significance. In the later COSMOS trial of older women and men, total cancer did not differ; only lung cancer, a secondary result, was lower. The US Preventive Services Task Force says evidence is insufficient. | 9 19 20 | |
| Heart Health | Evidence against | Heart disease and stroke: Two large trials and a pooled review found no protection against heart attack, stroke or death from heart disease. The US Preventive Services Task Force calls the evidence insufficient. | 18 19 12 20 | |
| Healthy Aging | Evidence against | Living longer: A review of 21 randomised trials (91,074 people, about 8,800 deaths) found no change in the chance of dying. A 2026 review of reviews also found no benefit for deaths. One large cohort study found slightly higher death rates in multivitamin users; see the Safety tab. | 14 22 28 | |
| Immune Support | Not enough evidence | Infections in older people: A 2005 review of 8 small trials found fewer days with infection in 3 studies, but no clear change in how many people got an infection. The authors called the evidence weak and conflicting. | 6 | |
| Bone Health | Very low certainty | Hip fracture: A 2021 review of 8 observational studies found about half the odds of hip fracture in multivitamin users. No trials were found, so cause and effect is not shown; users may differ in diet and health. | 3 22 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Nervous System | Biological association | Low certainty | Studied for: Memory and thinking test scores Studied for: Filling nutrient gaps after 50 (B12 as the main example) | 23 2 21 10 17 27 |
| Brain Focus | Biological association | Low certainty | Studied for: Memory and thinking test scores | 23 2 21 10 |
| Blood | Biological association | Not enough evidence | Studied for: Filling nutrient gaps after 50 (B12 as the main example) | 17 27 |
| Immune System | Biological association | Mixed findings | Studied for: Cancer Studied for: Infections in older people | 9 19 20 6 |
| Circulatory System | Biological association | Evidence against | Studied for: Heart disease and stroke Studied for: Living longer | 18 19 12 20 14 22 28 |
| Bones Joints Muscles | Biological association | Very low certainty | Studied for: Hip fracture | 3 22 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Episodic memory test score | Biological association | Low certainty | Measured in trials: slightly better in COSMOS; no difference in Physicians' Health Study II. A lab change is not the same as a health benefit. | 23 21 10 |
| Vitamin B12 status (blood markers) | Biological association | Low certainty | Measured in trials: lower in atrophic gastritis and with higher-dose acid-reducing medicine. A lab change is not the same as a health benefit. | 17 |
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Vitamin B12 | Preliminary mechanism | Human | Absorption falls with low stomach acid; main reason B12 appears in 50-plus products. | 17 27 |
| Folate | Preliminary mechanism | Human | Folic acid can hide B12 deficiency. | 34 15 |
| Vitamin A | Preliminary mechanism | Human | Long-term high intake may weaken bones. | 33 7 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Vitamin B12 | Biological association | Human | MedlinePlus says B12 helps form red blood cells and maintain the nervous system; deficiency is most common in people over 50. | 27 17 |
| Folic acid (folate) | Biological association | Human | The NHS says folic acid above 1 mg a day can mask B12 deficiency. | 34 1 |
| Vitamin B6 | Biological association | Human | The NHS says B6 helps use energy from food and form haemoglobin; high doses can damage nerves. | 34 |
| Vitamin A | Biological association | Human | The NHS says vitamin A supports the immune system and vision in dim light; long-term high intake may weaken bones. | 33 7 |
| Vitamin D and calcium | Biological association | Human | The NHS sets limits above which each could be harmful; calcium alone was linked with more heart attacks in a pooled analysis. | 35 29 5 1 |
| Iron | Biological association | Human | The NHS says iron is needed for red blood cells; the reference amount falls for women after 50. | 31 8 |
| Vitamin K1 | Biological association | Human | Helps blood clot; opposes warfarin. | 13 36 |
| Iodine and selenium | Biological association | Laboratory | Named in a US lab analysis as ingredients with common overages. | 1 |
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 7 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 for Adults Over 50. 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 started from our existing page on this topic, then re-read PubMed abstracts for every trial, review and lab study cited, and read the NHS, NCCIH, FDA and MedlinePlus pages named. Only abstracts were read. The NIH Office of Dietary Supplements fact sheet could not be read and is marked unverified.
Study library: every study we checked 36
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| 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 |
Laboratory analysis |
Multivitamin-mineral products reported in NHANES, tested by chemical analysis | Adult and children's multivitamin-mineral products Oral · vs Label claims |
Many ingredients are added above the declared label amount, and overages are not standardised. For several nutrients, measured amounts were more than 20% above label in 50% to 99% of adult multivitamin-minerals (iodine and selenium), and more than 10% above for folic acid in most products. Iodine and selenium >20% over label in 50-99% of adult products; folic acid >10% over in most; calcium 10-20% over in most (Not applicable) Methods, limits and fundingOutcomes: Measured amount versus label amount Limitations: Describes the typical US market, not any one product. Some products also had below-label content. Funding and conflicts: Database run by US government agencies; 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 2,262 older women and men (mean age 73; 60% women; 89% non-Hispanic White), tested by telephone for 3 years |
A commercial multivitamin-mineral (given in a two-by-two design with cocoa extract) Oral Amounts not in the abstract 3 years · vs Placebo |
The multivitamin group had a small but statistically significant better global cognition score. Memory and executive function were also better. The authors say the gain was largest in people with a history of heart disease. Global cognition mean z = 0.07 (P = 0.007) (95% CI 0.02 to 0.12) Methods, limits and fundingOutcomes: Global cognition composite (secondary endpoint for the multivitamin); memory; executive function Limitations: The multivitamin result was a pre-specified secondary endpoint, not the main one. Mostly White participants. Telephone tests. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT03035201 Read: abstract |
| Beeram 2021 Multivitamins and risk of fragility hip fracture: a systematic review and meta-analysis. Arch Osteoporos · PMID 33575883 · DOI |
Systematic review meta analysis observational |
80148 8 observational studies of adults with osteoporotic hip fractures (average age 69; 21% men; 4,237 fractures) |
Combined multivitamin use Oral At least 1 year of follow-up · vs Non-users |
Multivitamin use was linked with about half the odds of a hip fracture. No randomised trials were available, so cause and effect is not shown. OR 0.49 (0.32 to 0.77) Methods, limits and fundingOutcomes: Fragility hip fracture Limitations: Observational only: people who take multivitamins may differ in many other ways. No trials. Funding and conflicts: No funding or conflict statement in the abstract. 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 randomised trials; 26 in healthy people; average age 63 |
Antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, selenium), alone or with other vitamins Oral Varied 28 days to 12 years · vs Placebo or none |
Overall no clear effect on deaths. In the 56 lower-bias trials, antioxidants raised deaths slightly. Beta-carotene and vitamin E raised deaths; vitamin A, vitamin C and selenium did not significantly. Higher vitamin A doses were linked with more deaths. All trials RR 1.02; low-bias trials RR 1.04; beta-carotene RR 1.05; vitamin E RR 1.03; vitamin A RR 1.07 (not significant) (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; vitamin A 0.97 to 1.18) Methods, limits and fundingOutcomes: Death from any cause Limitations: These are single antioxidants or antioxidant combinations, not multivitamins. They show why some ingredients in a multivitamin deserve a closer look. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Bolland 2010 Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ · PMID 20671013 · DOI |
Systematic review meta analysis |
20072 15 randomised placebo-controlled trials in adults over 40 (5 with patient-level data, 8,151 people) |
Calcium supplements alone (without vitamin D) Oral At least 500 mg a day (tested alone) More than 1 year (median 3.6 years in the patient-level trials) · vs Placebo |
More heart attacks with calcium supplements. Stroke and death rose slightly but not significantly. Heart attack HR 1.31 (patient-level); RR 1.27 (trial-level) (1.02 to 1.67; 1.01 to 1.59) Methods, limits and fundingOutcomes: Heart attack, stroke, death Limitations: Trials of calcium alone, not multivitamins. Whether the smaller amounts in a multivitamin matter was not tested here. This finding is debated; the Iowa cohort found the opposite for calcium. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| El-Kadiki 2005 Role of multivitamins and mineral supplements in preventing infections in elderly people: systematic review and meta-analysis of randomised controlled trials. BMJ · PMID 15805125 · DOI |
Systematic review meta analysis |
8 randomised trials in older people (only some could be pooled for each outcome) | Multivitamins and mineral supplements Oral Varied Varied · vs Placebo or none |
Fewer days with infection in 3 studies, but no clear change in the chance of any infection or in the infection rate. The authors call the evidence weak and conflicting. 17.5 fewer days a year (3 studies); odds of any infection OR 1.10 (P = 0.53); infection rate ratio 0.89 (P = 0.11) (Days 11 to 24 fewer; OR 0.81 to 1.50; rate ratio 0.78 to 1.03) Methods, limits and fundingOutcomes: Days with infection; chance of at least one infection; infection rate Limitations: Old review (2005); different outcomes reported across trials; adverse events poorly reported. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Feskanich 2002 Vitamin A intake and hip fractures among postmenopausal women. JAMA · PMID 11754708 · DOI |
Prospective cohort |
72337 Postmenopausal women in the Nurses' Health Study (603 hip fractures over 18 years) |
Vitamin A from food and supplements, including multivitamins Oral Intake groups from diet questionnaires 18 years · vs Lowest intake group |
The highest total vitamin A group had a higher risk of hip fracture, mainly from retinol. Beta carotene did not add risk significantly. Women taking a vitamin A supplement had a 40% higher risk that was not statistically significant. Highest vs lowest total vitamin A RR 1.48; retinol RR 1.89; supplement RR 1.40 (Total 1.05 to 2.07; retinol 1.33 to 2.68; supplement 0.99 to 1.99) Methods, limits and fundingOutcomes: Hip fracture Limitations: Observational; intakes were self-reported. Women only. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Fleming 1998 Dietary determinants of iron stores in a free-living elderly population: The Framingham Heart Study. Am J Clin Nutr · PMID 9537620 · DOI |
Cross sectional |
634 Free-living adults aged 67 to 93 in the Framingham Heart Study |
Diet and supplement iron (food questionnaire) Oral Self-reported Previous year |
Heme iron, supplemental iron, dietary vitamin C and alcohol were linked with higher iron stores; coffee with lower. Age was not related to iron stores in this elderly group. Not given in the abstract (Not given in the abstract) Methods, limits and fundingOutcomes: Serum ferritin (a measure of body iron stores) Limitations: Cross-sectional. It shows a link, not harm. Older diet data. Funding and conflicts: No funding or conflict statement in the abstract. 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 (mean age 64.3), including 1,312 with a history of cancer |
A common daily multivitamin Oral Amounts not in the abstract Median 11.2 years · vs Placebo |
Fewer total cancers with the multivitamin, a small gain at the edge of statistical significance. No effect on prostate or colorectal cancer. Cancer deaths were lower but not significantly. Total cancer HR 0.92 (P = 0.04); prostate HR 0.98; colorectal HR 0.89; cancer death HR 0.88 (P = 0.07) (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 (main); prostate, colorectal and other site-specific cancers; cancer deaths Limitations: Men, nearly all physicians. P value was only just below 0.05. One product. Not a test of any single nutrient. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT00270647 Read: abstract |
| Grodstein 2013 Long-term multivitamin supplementation and cognitive function in men: a randomized trial. Ann Intern Med · PMID 24490265 · DOI |
Randomised controlled trial |
5947 Male US physicians aged 65 or older; up to 4 telephone cognitive tests over 12 years |
A common daily multivitamin Oral Amounts not in the abstract Up to 12 years · vs Placebo |
No difference in cognitive change or level between the multivitamin and placebo groups at any of the four test points. Global composite difference in change -0.01 SU; verbal memory -0.005 SU (Global -0.04 to 0.02; memory -0.04 to 0.03) Methods, limits and fundingOutcomes: Global cognition composite; verbal memory Limitations: Men only, mostly well-nourished physicians (authors say doses may be too low or the group too well nourished to benefit). Different product from COSMOS. Funding and conflicts: National Institutes of Health, BASF, Pfizer and DSM Nutritional Products are named as funders in the abstract (industry support). Registration: NCT00270647 Read: abstract |
| Kantor 2016 Trends in Dietary Supplement Use Among US Adults From 1999-2012. JAMA · PMID 27727382 · DOI |
Cross sectional survey |
37958 US adults in NHANES 1999-2012 |
Dietary supplement use Oral |
52% of adults used any supplement in 2011-2012. Multivitamin/multimineral use fell from 37% to 31%. Vitamin D from products other than multivitamins rose from 5.1% to 19%. MVMM use 31% in 2011-2012 (Not applicable) Methods, limits and fundingOutcomes: Use of any supplement; multivitamin/multimineral (a product with 10 or more vitamins and/or minerals) Limitations: Survey of self-reported use; ages 50+ not given in the abstract. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Kim 2018 Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes · PMID 29991644 · DOI |
Systematic review meta analysis |
2019862 18 studies (trials and cohort studies) with about 2 million people in the general population |
Multivitamin-mineral use (only 5 studies named the type or dose) Oral Varied; not specified in most studies Varied · vs Non-use or placebo |
No link with cardiovascular death, coronary death, stroke death or stroke. Coronary heart disease cases were lower overall but not in the trials alone. Cardiovascular death RR 1.00; coronary heart disease RR 0.88 overall, 0.97 in trials (CVD death 0.97 to 1.04; CHD overall 0.79 to 0.97; CHD trials 0.80 to 1.19) Methods, limits and fundingOutcomes: Cardiovascular and coronary deaths; stroke; coronary heart disease Limitations: Mixes trials and observational studies; most did not describe the product. Funding and conflicts: No funding or conflict statement in the abstract. 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 people taking warfarin: 9 with low and 7 with normal vitamin K1 status (from 102 screened) |
A multivitamin tablet containing vitamin K1 Oral One tablet a day (25 micrograms of vitamin K1 per tablet in this trial) 4 weeks, then 4 weeks of a vitamin K-free multivitamin in some · vs Vitamin K-free multivitamin (period 2) |
In people with low vitamin K status, every one (9 of 9) had a too-low INR on the vitamin K-containing multivitamin, versus 1 of 7 with normal status. Warfarin dose had to rise. INR fell by a median of 0.51; warfarin dose rose 5.3% (Not given in the abstract) Methods, limits and fundingOutcomes: Blood-clotting measure (INR) and warfarin dose Limitations: Very small trial. One brand and one vitamin K amount. 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 randomised articles in independently living adults (average age 62; about 8,794 deaths) |
Daily multivitamin-multimineral for at least 1 year Oral Varied Average 43 months · vs Placebo or no supplement |
No effect on deaths from any cause, vascular causes or cancer. A trend towards fewer deaths in prevention trials was not significant. All-cause RR 0.98; vascular 1.01; cancer 0.96 (All-cause 0.94 to 1.02; vascular 0.93 to 1.09; cancer 0.88 to 1.04) Methods, limits and fundingOutcomes: All-cause death; vascular death; cancer death Limitations: Trials used different products. Younger average age than this page's group. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Morris 2007 Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clin Nutr · PMID 17209196 · DOI |
Cross sectional |
1459 US adults aged 60 and over in NHANES 1999-2002 |
Blood folate level (not a supplement trial) Oral Single time point · vs Normal folate |
In people with low vitamin B12 status, high blood folate went with more anemia and more cognitive impairment. In people with normal B12 status, high folate went with less cognitive impairment. Low B12 and high folate: anemia OR 3.1; cognitive impairment OR 2.6. Normal B12: cognitive impairment OR 0.4 (Anemia 1.5 to 6.6; impairment 1.1 to 6.1; normal B12 0.2 to 0.9) Methods, limits and fundingOutcomes: Anemia, large red blood cells, low Digit Symbol-Coding score Limitations: Cross-sectional: it cannot show that folate caused the problems. Blood levels, not supplement use. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Omenn 1996 Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med · PMID 8602180 · DOI |
Randomised controlled trial |
18314 Smokers, former smokers and workers exposed to asbestos |
Beta carotene plus vitamin A (retinyl palmitate) together Oral 30 mg beta carotene plus 25,000 IU retinol a day (studied in the trial) Average 4 years (stopped 21 months early) · vs Placebo |
More lung cancer and more deaths with the combination. The trial was stopped early. Lung cancer RR 1.28; death from any cause RR 1.17; lung cancer death RR 1.46 (Lung cancer 1.04 to 1.57; any death 1.03 to 1.33; lung cancer death 1.07 to 2.00) Methods, limits and fundingOutcomes: Lung cancer (main); deaths Limitations: High-risk group (smokers, asbestos exposure). Two ingredients only, not a multivitamin. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| Porter 2021 Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr · PMID 34134144 · DOI |
Cross sectional |
3299 Adults aged 60 or older not taking B12 supplements (Trinity-Ulster-Department of Agriculture cohort) |
Not a supplement trial: stomach condition, acid-reducing medicine use and fortified-food intake versus blood B12 markers Oral Single time point · vs People without atrophic gastritis who did not use proton pump inhibitors |
Atrophic gastritis (15% of people) went with the most B12 deficiency (38%) versus 21% in acid-reducing medicine users and 15% in controls. Medicine users had lower holoTC only at higher doses. Eating fortified foods often went with better B12 markers but not enough to restore normal status in people with atrophic gastritis. The B12 form in fortified foods does not need stomach acid to be absorbed. Deficiency: 38% (atrophic gastritis), 21% (medicine users), 15% (controls) (Not given in the abstract) Methods, limits and fundingOutcomes: Four B12 blood markers; B12 deficiency Limitations: Cross-sectional; people taking B12 supplements were excluded, so it does not test a multivitamin. Funding and conflicts: No funding or conflict statement in the abstract. 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 (mean age 64.3), including 754 with a history of cardiovascular disease |
A common daily multivitamin Oral Amounts not in the abstract Median 11.2 years · vs Placebo |
No effect on major cardiovascular events, heart attack, stroke, cardiovascular death or total deaths. Major events HR 1.01 (P = 0.91); heart attack HR 0.93; stroke HR 1.06; death HR 0.94 (Major events 0.91 to 1.10; deaths 0.88 to 1.02) Methods, limits and fundingOutcomes: Major cardiovascular events (heart attack, stroke, cardiovascular death); each separately; total deaths Limitations: Men, nearly all physicians. One product. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT00270647 Read: abstract |
| Sesso 2022 Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Am J Clin Nutr · PMID 35294969 · DOI |
Randomised controlled trial |
21442 12,666 US women aged 65 or older and 8,776 men aged 60 or older, free of major cardiovascular disease and recent cancer |
A daily multivitamin-mineral Oral Amounts not in the abstract Median 3.6 years · vs Placebo |
No significant effect on total invasive cancer, breast or colorectal cancer, cardiovascular disease or all-cause death. Lung cancer was lower (a secondary result). The abstract reports no safety concerns. Total cancer HR 0.97 (P = 0.57); lung cancer HR 0.62; cardiovascular HR 0.98; death HR 0.93 (Total cancer 0.86 to 1.09; lung 0.42 to 0.92; cardiovascular 0.86 to 1.12; death 0.81 to 1.08) Methods, limits and fundingOutcomes: Total invasive cancer (main); site-specific cancers; cardiovascular disease; all-cause death Limitations: Follow-up (3.6 years) is short for cancer. The lung result is one of several secondary comparisons. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT02422745 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 adults | Multivitamins, single and paired nutrients Oral Varied Varied |
The Task Force says evidence is insufficient to judge benefits and harms of multivitamins for preventing heart disease or cancer (I statement). It recommends against beta carotene or vitamin E for this purpose (D recommendation). Not applicable (Not applicable) Methods, limits and fundingOutcomes: Prevention of cardiovascular disease and cancer Limitations: A statement for healthy adults, not a test of any product. It does not cover memory or deficiency. Funding and conflicts: Government-appointed expert panel; no industry funding stated 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 and pooled analysis |
5203 Clinic subcohort: 573 adults tested in person for 2 years. Pooled analysis: 5,203 non-overlapping adults from three COSMOS cognition studies (573 + 2,158 + 2,472) |
A daily multivitamin-mineral supplement Oral Amounts not in the abstract 2 years (clinic subcohort) · vs Placebo |
In the in-person clinic group the global score gain was small and not statistically significant, but episodic memory was better. Pooling the three COSMOS cognition studies showed small gains in global cognition and episodic memory. Executive function and attention did not differ in the clinic group. Clinic: global 0.06 SD units, memory 0.12. Pooled: global 0.07 (P = 0.0009), memory 0.06 (P = 0.0007). Authors say the global effect is like 2 years less cognitive ageing. (Clinic global -0.003 to 0.13; clinic memory 0.002 to 0.23; pooled global 0.03 to 0.11; pooled memory 0.03 to 0.10) Methods, limits and fundingOutcomes: Global cognition, episodic memory, executive function and attention Limitations: The pooled analysis combines three studies from one trial, so it is not independent confirmation. Small effects on test scores. Clinic global result was not significant. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT02422745, NCT03035201, NCT04582617 Read: abstract |
| Wang 2026 Multivitamin and mineral use: A rapid review of meta-analyses on health outcomes. Ageing Res Rev · PMID 41308839 · DOI |
Umbrella review |
19 meta-analyses (2000 to 2025) covering many groups, including pregnancy and children | Multivitamin and mineral supplements Oral Varied Varied · vs Varied |
Trials: better global cognition, episodic memory and immediate recall in older or cognitively intact adults; no benefit for deaths, COVID-19 outcomes, vision or several other cognitive areas; one review found higher risk of macular degeneration progression. Observational studies: links with lower colorectal cancer, coronary disease, cataract and hip fracture, but not breast cancer, prostate cancer, stroke or total deaths. The authors note there is no consistent definition of a multivitamin. Not given in the abstract (Not given in the abstract) Methods, limits and fundingOutcomes: Cognition, mortality, eye, cancer, heart, bone and other outcomes Limitations: A review of reviews; abstract only. Definitions of 'multivitamin' differ between studies. Funding and conflicts: No funding or 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, online memory testing once a year for 3 years |
A commercial multivitamin-mineral made for older adults (brand named in the abstract, not here) Oral Amounts not in the abstract 3 years · vs Placebo |
Memory score was better with the multivitamin at 1 year (the main outcome) and on average over 3 years. The other tests did not differ. 1 year: t = 2.25, P = 0.025; 3-year average: t = 2.54, P = 0.011. Authors estimate a gain equal to about 3.1 years of age-related memory change. (Not given in the abstract) Methods, limits and fundingOutcomes: Episodic memory (immediate recall on the ModRey test) at 1 year; memory over 3 years; object recognition; executive function Limitations: Test scores only, taken at home online. One product. Not a trial of dementia. Same trial programme as the other COSMOS studies, so the results are not independent. Funding and conflicts: No funding or conflict statement in the abstract. Registration: NCT04582617 Read: abstract |
| Zinn 2016 Evaluation of Dietary Supplement Contamination by Xenobiotic and Essential Elements Using Microwave-Enhanced Sample Digestion and Inductively Coupled Plasma-Mass Spectrometry. J Diet Suppl · PMID 25730528 · DOI |
Laboratory analysis |
6 Six widely used products from four companies (type of supplement not stated in the abstract) |
Dietary supplement products Oral |
Contamination by toxic or essential elements was found in all samples, and essential elements were often not listed on the label. The abstract does not give amounts. Not given in the abstract (Not given in the abstract) Methods, limits and fundingOutcomes: Cadmium, mercury, aluminum, lead, arsenic, antimony and several essential elements Limitations: Only six products; amounts not in the abstract; the abstract does not say how they compare with safety limits. Not specific to multivitamins. Funding and conflicts: No funding or conflict statement in the abstract. Read: abstract |
| s-fda-dv FDA: Daily Value on the Nutrition and Supplement Facts Labels · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-fda-labelguide FDA: Dietary Supplement Labeling Guide, Chapter IV (Nutrition Labeling) · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-medlineplus-b12 MedlinePlus: Vitamin B12 · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nccih-wisely NCCIH: Using Dietary Supplements Wisely · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-calcium NHS: Calcium · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-doxycycline NHS: Doxycycline · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-iron NHS: Iron · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-levothyroxine NHS: Levothyroxine · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-vitamin-a NHS: Vitamin A · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-vitamin-b NHS: B vitamins and folic acid · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-vitamin-d NHS: Vitamin D · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text | ||
| s-nhs-warfarin NHS: Warfarin · Source |
Regulator page n/a |
Methods, limits and fundingRead: page text |
What we do not know yet
- No trial tested a '50 plus' formula against an ordinary multivitamin.
- No trial in the sources read measured whether a multivitamin corrects B12, iron or vitamin D levels in older adults.
- Three of the four cognition analyses come from one trial programme.
- No randomised trial of fractures was found.
- The NIH ODS multivitamin fact sheet could not be read (HTTP 403).
- Typical label amounts, gummies versus capsules, and heavy-metal surveys of the whole market were not researched.
- NHS pages read were last reviewed in 2020; later review dates have passed.
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 2
Episodic memory test score
Slightly better in COSMOS; no difference in Physicians' Health Study II in trials
A test where people recall words or objects soon after seeing them.
Low certaintyResults and what it means
Why it was measured
To see whether a multivitamin changes memory performance in older adults.
Statistical vs. clinical meaning
The gain is small and not shown to mean fewer memory problems in daily life.
Safety implication
No harm signal in the abstracts.
| Study | Result | People | Product |
|---|---|---|---|
| 23 | Better immediate recall at 1 year (P = 0.025) and over 3 years (P = 0.011) | 3,562 older adults | Daily commercial multivitamin-mineral for 3 years |
| 21 | Pooled episodic memory 0.06 SD units better (95% CI 0.03 to 0.10) | 5,203 adults in three COSMOS cognition studies | Daily multivitamin-mineral |
| 10 | Verbal memory change -0.005 SU (95% CI -0.04 to 0.03), no difference | 5,947 men aged 65 or older | Daily multivitamin for up to 12 years |
Vitamin B12 status (blood markers)
Lower in atrophic gastritis and with higher-dose acid-reducing medicine in trials
Blood tests such as total B12 and holotranscobalamin that show whether the body has enough B12.
Low certaintyResults and what it means
Why it was measured
To find older adults at risk of B12 deficiency.
Statistical vs. clinical meaning
Shows who is at risk, not what a multivitamin does.
Safety implication
Low B12 can harm nerves and blood; see a doctor for testing.
| Study | Result | People | Product |
|---|---|---|---|
| 17 | B12 deficiency in 38% with atrophic gastritis, 21% in acid-reducer users, 15% in controls | 3,299 adults aged 60 and over | Not a supplement trial |
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 5
- The same nutrient can add up across several products and foods. Many people take a multivitamin and also a vitamin D, calcium, iron or B-complex product, and eat fortified foods. Lab work on US multivitamin-minerals found that many ingredients are added above the label amount (for example iodine and selenium in most adult products, and folic acid in most). The NHS names its own limits for several nutrients (vitamin A, iron, B6, folic acid, vitamin D and calcium); they are listed under Regulators below. Add up every source and read every label. Laboratory analysis and authoritative guidance 1 33 31 34 35 29
- Vitamin A and bones after menopause. The NHS says an average above 1.5 mg of vitamin A a day over many years may make bones more likely to fracture, and that postmenopausal women and older men should stay within that from food and supplements combined. Many multivitamins contain vitamin A (NHS). In the Nurses' Health Study, women with the highest vitamin A intake (mostly retinol) had more hip fractures. That study was observational. Authoritative guidance and cohort study 33 7
- Folic acid can hide a B12 shortage. The NHS says folic acid above 1 mg a day can mask B12 deficiency, which can eventually damage nerves, and that this matters most for older people. In a US survey of adults aged 60 and over with low B12, high blood folate went with more anaemia and more cognitive impairment. That survey cannot prove folate caused it. Authoritative guidance and cross sectional study 34 15
- Check for beta carotene and high-dose vitamin E on the label. The US Preventive Services Task Force recommends against beta carotene or vitamin E supplements for preventing heart disease or cancer. A trial of beta carotene plus vitamin A in smokers, former smokers and asbestos-exposed workers was stopped early because of more lung cancer and deaths. A Cochrane review found beta carotene and vitamin E slightly raised deaths in lower-bias trials. These trials tested single ingredients or pairs, not multivitamins. Guideline, randomised trial and meta analysis 20 16 4
- Vitamin K in a multivitamin can change warfarin control. In a small controlled trial, a multivitamin tablet with vitamin K1 lowered blood-thinning control in people on warfarin who had low vitamin K status. The NHS warfarin page says not to take vitamin K supplements with warfarin. Tell the clinic about any multivitamin. Controlled trial and authoritative guidance 13 36
Side effects 6
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Constipation, nausea, vomiting and stomach pain from iron The NHS lists these effects for iron taken above 20 mg a day. | Not given | Usually mild Not stated | Authoritative guidance 31 |
| Stomach pain and diarrhoea from high calcium The NHS links these to more than 1,500 mg of calcium a day. | Not given | Mild Not stated | Authoritative guidance 29 |
| Nerve damage (numb arms and legs) from high-dose vitamin B6 The NHS ties this to 200 mg or more a day; effects between 10 and 200 mg are unclear. | Not given | Usually improves after stopping; permanent in a few cases The NHS says it usually improves after stopping, but in a few cases it can be permanent | Authoritative guidance 34 |
| Skin flushing from high-dose nicotinic acid (a form of niacin) The NHS says long-term high doses of nicotinic acid could lead to liver damage. | Not given | Mild Not stated | Authoritative guidance 34 |
| Swallowing problems from large vitamin pills in older adults The figure is for all dietary supplements, not multivitamins alone. | Part of an estimated 23,000 US emergency room visits a year linked to dietary supplements (2015 study, as reported by NCCIH) | Not stated Not stated | Authoritative guidance 28 |
| No safety concerns reported in the COSMOS trial NCCIH (January 2019) says taking a multivitamin is unlikely to pose any health risks. Both statements cover typical products and typical use, not stacked or very high-dose products. | Not different from placebo as reported in the abstract | Not applicable Not applicable | Randomised trial 19 |
Liver
No liver injury from multivitamins as a product type was found in the sources read. The NHS says long-term high doses of nicotinic acid (niacin) could lead to liver damage. A liver-safety reference (LiverTox) was not opened for this page. 34
How often. No frequency was found.
Monitoring. No agency monitoring advice was found.
This is a safety connection. It is not evidence that Multivitamins for Adults Over 50 supports liver health.
Medicines and supplements 6
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Warfarin (blood thinner) prescription | Vitamin K helps blood clot, so it works against warfarin. | A multivitamin with vitamin K1 lowered clot-test (INR) control in warfarin users with low vitamin K status in a 16-person trial. The NHS says not to take vitamin K supplements with warfarin. | Controlled trial and authoritative guidance Low certainty 13 36 | Tell your warfarin clinic about any multivitamin before starting it. |
| Levothyroxine (thyroid medicine) prescription | The NHS lists calcium and iron supplements among things that may not mix well with levothyroxine. Many multivitamin-minerals contain calcium or iron. | Authoritative guidance Low certainty 32 | Ask a pharmacist how to space a multivitamin-mineral from thyroid medicine. | |
| Doxycycline (antibiotic) prescription | The NHS lists medicines or supplements that contain iron or zinc among things that may not mix well with doxycycline. | Authoritative guidance Low certainty 30 | Ask a pharmacist before taking a multivitamin-mineral with this antibiotic. | |
| Acid-reducing medicines (proton pump inhibitors) prescription | Less stomach acid means less B12 is freed from food. | Higher-dose proton pump inhibitor use (30 mg a day or more) went with lower holotranscobalamin, a B12 marker, in a survey of 3,299 older adults. This is a link, not a trial. | Cross sectional study Low certainty 17 | If you take an acid reducer long-term, ask a doctor whether B12 should be checked. |
| Surgery and anaesthesia procedure | NCCIH says some dietary supplements may increase bleeding risk or affect the response to anaesthesia. It does not single out multivitamins. | Authoritative guidance Low certainty 28 | Tell the surgical team about every supplement, as early as possible. | |
| Other supplements (vitamin D, calcium, iron, B-complex, fish oil) supplement | The same nutrient may be in several products, so totals add up. | The NHS vitamin A page notes that fish liver oil is also high in vitamin A and that many multivitamins contain it. Combined totals were not studied. | Authoritative guidance Low certainty 33 1 | Add up each nutrient across every product and the foods that are fortified. Ask a pharmacist. |
Who should check first 6
| Situation | Advice | Evidence |
|---|---|---|
| Current or former smoker, or past asbestos exposure | Ask a doctor before using any product with beta carotene or high-dose vitamin A. A trial in these groups found more lung cancer and deaths with beta carotene plus vitamin A. | Randomised trial 16 20 |
| Taking warfarin, thyroid medicine or tetracycline-type antibiotics | Ask a pharmacist. See the interaction entries above. | Controlled trial and authoritative guidance 13 32 30 36 |
| Known or suspected B12 deficiency, stomach-lining disease or long-term acid-reducer use | Ask a doctor about a B12 blood test. Folic acid in a multivitamin may hide B12 deficiency. | Authoritative guidance and cross sectional study 34 17 15 |
| Pregnancy and breastfeeding | A formula made for adults over 50 is not designed for pregnancy. NCCIH says many dietary supplements have not been tested in pregnant or nursing women. Ask a doctor or midwife. | Authoritative guidance 28 |
| Children | Keep iron-containing supplements out of children's reach. The NHS says very high iron doses can be fatal, especially for children. | Authoritative guidance 31 |
| Kidney or liver disease, or a history of heart attack | No multivitamin-specific kidney or liver advice was read for this page. Ask a doctor. | Absence of evidence |
Overdose, product quality and regulators
Summary. For a multivitamin used as the label says, the sources read describe little risk. Harm is mostly about specific nutrients in high or stacked amounts, in some medicines, or in some groups of people.
Animal. Not reviewed.
High dose or long term signals. NHS: very high iron doses can be fatal, especially for children; too much vitamin D over a long time can raise blood calcium and harm bones, kidneys and heart; vitamin B6 at 200 mg or more can damage nerves; long-term vitamin A above 1.5 mg a day may affect bones. These come from single-nutrient limits, not from a multivitamin trial.
Overdose response. If a child or anyone has swallowed a lot of an iron-containing product, call poison control or emergency services.
Genotoxicity. Not researched.
Amounts on the label are not always the amounts in the product, and trace contamination has been found in a small lab test of supplements.
Ingredient amounts above the label. Chemical analysis of US multivitamin-minerals found overages of more than 20% over label in 50% to 99% of adult products for iodine and selenium, and more than 10% for folic acid in the vast majority. Overages are not standardised between makers. Some products also had below-label content. 1
Toxic and unlisted elements. In one lab test of six widely used supplement products from four companies, every sample showed contamination by toxic elements or by essential elements. The elements tested for included cadmium, mercury, aluminum, lead, arsenic and antimony, and essential elements were often not on the label. The abstract gives no amounts and does not say whether any product exceeded a safety limit. 24
What is on the label vs what is inside. NCCIH says what is on the label may not be what is in the product, and that 'standardized', 'verified' or 'certified' does not guarantee quality. Its examples of hidden drugs are products sold for weight loss, sexual enhancement and bodybuilding, not multivitamins. No survey of undeclared ingredients in multivitamins was found. 28
| Body | Action | Date |
|---|---|---|
| NHS (UK) (United Kingdom) | Iron: 8.7 mg a day for women aged 50 and over (14.8 mg for women 19 to 49; women still having periods after 50 may need the higher figure). Side effects above 20 mg a day: constipation, nausea, vomiting, stomach pain. 17 mg or less a day of iron supplements is unlikely to cause harm. source | 2020-08-03 |
| NHS (UK) (United Kingdom) | Vitamin A: an average above 1.5 mg (1,500 micrograms) a day over many years may make fractures more likely; postmenopausal women and older men should avoid more than 1.5 mg a day from food and supplements combined. Many multivitamins contain vitamin A. source | 2020-08-03 |
| NHS (UK) (United Kingdom) | Folic acid above 1 mg a day can mask B12 deficiency (a concern for older people). Vitamin B6: 200 mg or more a day can cause nerve damage; the NHS advises no more than 10 mg a day in supplements unless a doctor advises it. Vitamin B12: 2 mg or less a day in supplements is unlikely to cause harm; there is not enough evidence on higher amounts. source | 2020-08-03 |
| NHS (UK) (United Kingdom) | Vitamin D: the NHS says not to take more than 100 micrograms (4,000 IU) a day as it could be harmful; long-term excess can raise blood calcium and weaken bones and harm kidneys and heart. Calcium: more than 1,500 mg a day could cause stomach pain and diarrhoea; 1,500 mg or less is unlikely to cause harm. source | 2020-08-03 |
| US Preventive Services Task Force (United States) | Evidence is insufficient to judge the balance of benefits and harms of multivitamins for preventing heart disease or cancer (I statement). It recommends against beta carotene or vitamin E supplements for that purpose (D recommendation). source | 2022-06-21 |
| NCCIH (US National Center for Complementary and Integrative Health) (United States) | Most research shows multivitamins do not result in living longer, slowing cognitive decline, or lowering the chance of cancer, heart disease or diabetes. Taking a multivitamin is unlikely to pose any health risks. Supplements may interact with medicines and may affect bleeding or anaesthesia; labels may not match contents. source | 2019-01 |
| US Food and Drug Administration (United States) | Sets the Daily Values used for % Daily Value on Supplement Facts labels. These are label reference numbers, not personal targets or limits. Examples: iron 18 mg, vitamin A 900 micrograms RAE, vitamin D 20 micrograms, vitamin B12 2.4 micrograms, folate 400 micrograms DFE, vitamin B6 1.7 mg, vitamin K 120 micrograms, calcium 1,300 mg. Different bodies use different reference numbers. source | |
| MedlinePlus (US National Library of Medicine) (United States) | Vitamin B12: the body stores it in the liver; deficiency is most common in people over 50, vegetarians and vegans, people with stomach or intestinal surgery or digestive disease, and people with pernicious anaemia. Low B12 can cause anaemia, loss of balance, numbness or tingling, weakness. source | 2025-01-21 |
When to get medical help
- Swelling of the face, lips or tongue, hives, wheezing or trouble breathing after a supplement: call emergency services.
- A child, or anyone, has swallowed a lot of an iron-containing product: call poison control or emergency services right away.
- Trouble swallowing, choking or a pill stuck in the throat: get medical help.
- Numbness or tingling in the arms and legs, loss of balance or new confusion: see a doctor (B12 shortage and high-dose B6 can both affect nerves).
- Unusual bruising or bleeding in someone on warfarin who has started a multivitamin: contact the warfarin clinic.
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
Is a multivitamin for adults over 50 different from a regular one?
Does a multivitamin help memory in older adults?
Does a multivitamin prevent cancer?
Does a multivitamin protect the heart or help you live longer?
Why is vitamin B12 so often in products for older adults?
Why does iron matter after 50?
The NHS reference iron amount falls to 8.7 mg a day for women over 50. The NHS also says very high iron doses can be fatal, especially for children. Check the label for iron.
Can vitamin A in a multivitamin harm bones?
Can folic acid hide a B12 problem?
Which medicines mix badly with a multivitamin?
Is what is on the label really in the pill?
Is a multivitamin safe to take with other supplements?
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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 started from our existing page on this topic, then re-read PubMed abstracts for every trial, review and lab study cited, and read the NHS, NCCIH, FDA and MedlinePlus pages named. Only abstracts were read. The NIH Office of Dietary Supplements fact sheet could not be read 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 had industry support; this is flagged where the abstracts show it.
Sources 36
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Andrews KW, Gusev PA, McNeal M, Savarala S, Dang PTV, Oh L 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, Sesso HD, Gaussoin SA, Shumaker SA 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)
- Beeram I, Mortensen SJ, Yeritsyan D, Momenzadeh K, von Keudell A, Nazarian A. Multivitamins and risk of fragility hip fracture: a systematic review and meta-analysis.. Arch Osteoporos. 2021. PMID 33575883. DOI 10.1007/s11657-021-00893-x. (abstract)
- Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. 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)
- Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD et al.. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis.. BMJ. 2010. PMID 20671013. DOI 10.1136/bmj.c3691. (abstract)
- El-Kadiki A, Sutton AJ. Role of multivitamins and mineral supplements in preventing infections in elderly people: systematic review and meta-analysis of randomised controlled trials.. BMJ. 2005. PMID 15805125. DOI 10.1136/bmj.38399.495648.8F. (abstract)
- Feskanich D, Singh V, Willett WC, Colditz GA. Vitamin A intake and hip fractures among postmenopausal women.. JAMA. 2002. PMID 11754708. DOI 10.1001/jama.287.1.47. (abstract)
- Fleming DJ, Jacques PF, Dallal GE, Tucker KL, Wilson PW, Wood RJ. Dietary determinants of iron stores in a free-living elderly population: The Framingham Heart Study.. Am J Clin Nutr. 1998. PMID 9537620. DOI 10.1093/ajcn/67.4.722. (abstract)
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- Grodstein F, O'Brien J, Kang JH, Dushkes R, Cook NR, Okereke O et al.. Long-term multivitamin supplementation and cognitive function in men: a randomized trial.. Ann Intern Med. 2013. PMID 24490265. DOI 10.7326/0003-4819-159-12-201312170-00006. (abstract)
- Kantor ED, Rehm CD, Du M, White E, Giovannucci EL. Trends in Dietary Supplement Use Among US Adults From 1999-2012.. JAMA. 2016. PMID 27727382. DOI 10.1001/jama.2016.14403. (abstract)
- Kim J, Choi J, Kwon SY, McEvoy JW, Blaha MJ, Blumenthal RS et al.. Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis.. Circ Cardiovasc Qual Outcomes. 2018. PMID 29991644. DOI 10.1161/CIRCOUTCOMES.117.004224. (abstract)
- Kurnik D, Loebstein R, Rabinovitz H, Austerweil N, Halkin H, Almog S 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)
- 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)
- Morris MS, Jacques PF, Rosenberg IH, Selhub J. Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification.. Am J Clin Nutr. 2007. PMID 17209196. DOI 10.1093/ajcn/85.1.193. (abstract)
- Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A et al.. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease.. N Engl J Med. 1996. PMID 8602180. DOI 10.1056/NEJM199605023341802. (abstract)
- Porter KM, Hoey L, Hughes CF, Ward M, Clements M, Strain J et al.. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults.. Am J Clin Nutr. 2021. PMID 34134144. DOI 10.1093/ajcn/nqab193. (abstract)
- Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M 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)
- Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G et al.. Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial.. Am J Clin Nutr. 2022. PMID 35294969. DOI 10.1093/ajcn/nqac056. (abstract)
- US Preventive Services Task Force, Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D 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, Cook NR, Rist PM, Weinberg A 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)
- Wang W, Wazny VK, Mahadzir MDA, Maier AB. Multivitamin and mineral use: A rapid review of meta-analyses on health outcomes.. Ageing Res Rev. 2026. PMID 41308839. DOI 10.1016/j.arr.2025.102965. (abstract)
- Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C 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)
- Zinn GM, Rahman GM, Faber S, Wolle MM, Pamuku M, Kingston HM et al.. Evaluation of Dietary Supplement Contamination by Xenobiotic and Essential Elements Using Microwave-Enhanced Sample Digestion and Inductively Coupled Plasma-Mass Spectrometry.. J Diet Suppl. 2016. PMID 25730528. DOI 10.3109/19390211.2015.1008610. (abstract)
- . FDA: Daily Value on the Nutrition and Supplement Facts Labels. . . (page text)
- . FDA: Dietary Supplement Labeling Guide, Chapter IV (Nutrition Labeling). . . (page text)
- . MedlinePlus: Vitamin B12. . . (page text)
- . NCCIH: Using Dietary Supplements Wisely. . . (page text)
- . NHS: Calcium. . . (page text)
- . NHS: Doxycycline. . . (page text)
- . NHS: Iron. . . (page text)
- . NHS: Levothyroxine. . . (page text)
- . NHS: Vitamin A. . . (page text)
- . NHS: B vitamins and folic acid. . . (page text)
- . NHS: Vitamin D. . . (page text)
- . NHS: Warfarin. . . (page text)
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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