An editorial published in the December 2013 issue of Annals of Internal Medicine says that using supplements and multivitamins to prevent chronic conditions is a waste of money. Are they right? Multiple studies over the years have provided conflicting results making the consumer quite confused.

Traditional multivitamins are falling out of favor among Americans, while supplements such as vitamin D, fish oil and probiotics are gaining ground.

No clear answers yet:
The U.S. Preventive Services Task Force is deliberating whether vitamin supplements make any difference in the average person's risk of heart disease or cancer. The government advisory group said in December 2013 that there's not enough evidence to tell for at this time.
   I agree: There is still not enough evidence to tell whether taking a multivitamin and multi-mineral pill pill each day reduces the risk of major diseases or helps people live longer. It is very difficult to do a long term study since after a few months or years many participants in the study will stop taking their pills altogether or forget to take them daily, or some may be taking other types of supplements or medications making interpretations of the studies quite challenging. Plus, there will be different results based on what is contained within the pills. Each product on the market has a different dosage for vitamin A, Bs, C, D, and E. How do we know whether it is better to take 50 mg of vitamin C a day or 500 mg? Each product also has a different dosage of minerals. How do we know what the right dosage is for ideal long term benefits? Furthermore, each person has a different need or benefit depending on their diet, their activity level, and the content of the soil from which their produce comes from. To add to the confusion, some products contain synthetic vitamin E whereas others have natural vitamin E. Could this also make a difference? This whole issue is extremely complicated and no clear answers are available at this time.
   Bottom line: I can't suggest with confidence whether someone should or should not take a daily multivitamin/mineral pill. However, if you feel better taking one, that is a different story and by all means continue.

Choosing the best multivitamin supplement
There are hundreds of multivitamin supplement products on the market, and choosing the best can be difficult. One option is to have a couple of different ones and to alternate their use. Buy a product that is balanced, not too high on some nutrients and low on others. It is impossible to tell which is best suited for you until you try them and see which one you like or which one makes you feel your best over the long run. Also, take a break from use at least 2 days a week. I do not see the need to take a pill each and every day.

MultiVit Rx - I have formulated a one source multivitamin supplement that has a good amount of antioxidants, and a reasonable and balanced level of B vitamins, not too high and not too low. Many people report better energy and better mood when taking these pills. Most people do fine taking one pill a few times a week, others prefer taking 2 pills.
High Quality Daily Vitamins and Minerals - Manufactured by a FDA-approved and GMP-certified facility.

Find out the benefits of MultiVit Rx multivitamin supplement.
 

Supplement Facts:
Vitamin A
     Beta Carotene
     Retinyl Palmitate
Vitamin C with Rose hips (ascorbic acid)
Vitamin D
Vitamin E (mixed tocopherols)
Vitamin B-1(thiamine hcl)
Vitamin B-2 (riboflavin)
Niacinamide
Vitamin B-6
Folic acid
Vitamin B12
Biotin information, Biotin vitamin is also sold as a separate supplement.
Pantothenic acid (d-calcium pantothenate)
Calcium (citrate)
Iodine (potassium iodine)
Magnesium (oxide)
Zinc mineral
Selenium (amino acid chelate) - Selenium is a mineral that people require in small amounts; food sources include grains, certain nuts and some meats and seafood, such as beef and tuna.
Copper (amino acid chelate)
Manganese (carbonate)
Chromium (amino acid chelate)
Molybdenum (amino acid chelate)
Potassium (carbonate). You can purchase a Potassium supplement at this internet vitamin company.
Green Tea (leaves)
Inulin (Jerusalem artichoke plant fiber extract-inuflora)
N-Aceytl-L-Cysteine
Inositol
PABA (para aminobenzoic acid)
Rutin
Citrus Bioflavonoid Complex
Choline (bitartrate)
Beta-Glucan 1/3-Beta, 1/6-Glucan (insoluble form from cell walls of Saccharomyces cerevisiae)
Lycopene (from tomato)
Lutein (from marigold extract)
Astaxanthin
Zeaxanthin helps with vision
Octacosanol

Curr Aging Sci. 2014. Vitamins in the prevention or delay of cognitive disability of aging. Preservation of brain integrity, which is partly influenced by nutrition, presumably is the main target in the attempt to delay the development of disability of aging. Optimal micronutrient status would moderate the deterioration in brain integrity. The human brain is probably the most vulnerable tissue affected by a long-term unbalanced nutrition and is particularly vulnerable to reactive oxygen species and to oxidative stress, because of its high oxygen requirement, its iron storage capacity and its elevated polyunsaturated fatty acid content, and because of its low synthesis capacity of endogenous antioxidants. Most of the tolerable upper intake levels for the micronutrients, published by authorized institutions, were set without considering the long-term effects of overdosing. Excessive intake of almost all the micromutrients, particularly for a long period of time, produces adverse effects. In most of the elderly people prevail an insufficient intake of one or more micronutruients. Therefore, until an efficient laboratory system for evaluating blood levels is established, a moderate 'multivitamin' supplementation at an amount of about half the American RDA for most of the micronutrients is suggested.

Q. I have a couple of questions that I would appreciate an answer to before I take a MultiVitamin. I have 73 years and presently I only take 1 medication, 5mg.Norvascdaily. Can I also take MultiVit Rx each day with the Norvasc? My sister is 86 years old and recently was prescribed to take Aricept (5mg),and Namenda 5mg. Can she also take and maybe benefit from a multivitamin pill daily while taking those medications?
   A. It is difficult to predict a response or reaction in any one individual, but, as a general rule, most people have no problems taking a mutivitamin-mineral pill 3 or 4 times a week. They are not needed to be taken daily.

Other Multi Vitamin products sold online
Controlled Labs, Orange Triad, Multi-Vitamin, Joint, Digestion & Immune Formula, 270 Tablets
Yum-V's, Multi Vitamin, for Adults,Raspberry Flavor, 60 Jelly Vitamins
Garden of Life, MyKind Organics, Prenatal Multi, Whole Food Multivitamin, 180 Vegan Tablets

Benefits and side effects
Does a multivitamin supplement for a man differ from a product for a woman?
   Not as much as one thinks. There may be differences in iron, calcium and a few other nutrients, but there are more in common than there are differences. Women's multivitamin need is therefore not too different from a man's except the dosages of the individual nutrients would be less. If it says to take 4 capsules on a bottle, then 3 would be fine for a woman.

What effects should I notice form a multivitamin with mineral pill?
   Unless you are very sensitive, you probably will not notice any major effects from most products on the market. Feedback from MultiVit Rx indicates people notice being mentally sharper, more alert, and with clearer vision, but most importantly having more all day energy.

How do I know which is the best multivitamin for me?
   It is impossible to know what vitamins your body is marginally lacking or which is the best multivitamin for you. Since it is nearly impossible to tell which is the best multivitamin for you to purchase, you may consider alternating 2 or 3 different ones.

Is there any such thing as an all inclusive multivitamin or supplement that will eliminate the need for, and inconvenience of a cabinet full of varied tablets? In short, a single daily dosage?
   There is no such pill. The human body is too complicated and so much depends on diet, the person's individual body chemistry, and many, many other factors.

What do you think of websites that do a best multivitamin review, comparison or rating?
   Since each person is unique in their requirement, it is difficult to know which multivitamin is ideal for each individual. Plus, the websites reviewing other products may have their own agenda.

Are liquid multivitamins better?
   Since most multivitamin capsules are well absorbed, I don't see the urgent need to take a liquid multivitamin supplement unless a person has serious issues with absorption. Furthermore, since many good multivitamin supplements have several times the RDA of nutrients, even if absorption is not perfect, one still would get enough of the important nutrients. Some multivitamin and multimineral supplements have too high doses anyway, so absorbing less is actually preferable. A liquid multivitamin supplement may be appropriate for those who have difficulty swallowing pills or those who prefer to pour some in their shake or other drinks. As far as health reasons, I don't see the advantage of a liquid multivitamin supplement over a capsule.

Do I need to take an antioxidant and multivitamin together or is the latter alone enough?
   Since there are countless multivitamin bottles out there, it depends which one you are taking. As a rule, though, it would probably be okay to take additional antioxidants if your multi is weak.

Cancer
Although studies have shown conflicting results, the latest on in JAMA, 2012, shows a slight reduction in cancer rates.

Duke Med Health News. 2013. Long-term multivitamin use may be cancer preventive in middle-aged and older men. Findings are part of first large-scale trial linking effects of common multivitamins with prevention of chronic diseases.

Fertility
Curr Opin Obstet Gynecol. 2013 June. The effect of micronutrient supplements on female fertility. Benefit of micronutrient supplementation on female fertility. Reports of randomized trials are rare. Most studies are focused on multivitamin supplementations. For some micronutrients, a positive impact on fertility could be shown. This article reviews the available clinical studies as well as the pathophysiological background of possible effects and summarizes the potential benefits of selected micronutrients on female fertility. Apart from lowering the malformation risk by periconceptional supplementation of folic acid, substitution with different micronutrients, particularly folic acid, vitamin B6, vitamin C, vitamin D, vitamin E, iodine, selenium, iron, and DHA might have a positive impact on infertility treatment. The multivitamin formulation should take the pathophysiology, clinical studies, and upper limits into account.

Multivitamins and longevity
Q. Does taking a multivitamin supplement daily increase longevity? What do studies say?
   A. I have not seen such a good study. When such studies are done, researchers have pooled information from users of various multivitamin products, not one standard multivitamin product. Each multivitamin product should be considered as a unique formula and not lumped together with other multivitamin products. Until a prospective study is done with a specific formula for at least a 10 to 15 year period, we will not know if taking a particular multivitamin formula influences longevity. Keep in mind that the majority of multivitamin products have synthetic vitamin E, and many may have B vitamins or other vitamins that are not provided proportionally.

Q. A well-respected medical newsletter [Harvard Men's Health Watch] carried an article in 2008 about daily multiple vitamins, concluding that people should no longer take them because recent studies indicate that the folate they contain raises the risk of colo-rectal cancer. They are proposing that the amount of folate in daily multiples and also added to cereals be reduced. Until then, stop taking daily multiples. Do you have any thoughts or opinion on this subject?
   A. In my opinion, more research needs to be published before we determine the role of folate from multivitamins and the influence on colon cancer.

The influence of folate and multivitamin use on the familial risk of colon cancer in women.
Cancer Epidemiol Biomarkers Prev. 2002.
Low intake of folate and methionine and heavy alcohol consumption have been associated with an increased overall risk of colon cancer, possibly related to their role in methylation pathways. We estimated the relative risk (RR) of colon cancer according to a history of colorectal cancer in a first-degree relative and categories of folate, methionine, and alcohol intake in a prospective cohort study of 88,758 women who completed family history and detailed food frequency questionnaires. During 16 years of follow-up, colon cancer was diagnosed in 535 women. The inverse association of folic acid with colon cancer risk was greater in women with a family history. Our results suggest that higher intake of folate and methionine, regular use of multivitamins containing folate, and avoidance of moderate to heavy alcohol consumption may diminish the excess risk of colon cancer associated with a family history of the disease.

Heart Failure
Micronutrient supplementation improves heart function and quality-of-life in elderly patients with chronic heart failure. Researchers investigated the effects of long-term multiple micronutrient supplementation in 32 patients older than age 70 years with stable heart failure. After an average of 295 days, the patients who had been assigned to get micronutrient supplements experienced significant improvements in cardiac pumping ability. Also, patients taking micronutrients had an increase in their quality-of-life score, whereas the participants who had been given placebo supplements had a decrease in their quality-of-life score. The differences in overall quality-of-life score were mainly due to improvements in scores for breathlessness on exertion, quality of sleep, and daytime concentration among the patients taking micronutrients. The multivitamin supplement included zinc, copper, and selenium, along with Co-Q10. European Heart Journal, November 2005.

The effects of a multivitamin/mineral supplement on micronutrient status, antioxidant capacity and cytokine production in healthy older adults consuming a fortified diet.
J Am Coll Nutr. 2000
Multivitamin treatment significantly increased, compared to placebo) plasma concentrations of vitamins D, E, pyridoxal phosphate, folate, B12, C, and improved the riboflavin activity coefficient, but not vitamins A and thiamin. The multivitamin reduced the prevalence of suboptimal plasma levels of vitamins E, B12, and C. Neither glutathione peroxidase activity nor antioxidant capacity (ORAC) were affected. No changes were observed in interleukin-2, -6 or -10 and prostaglandin E2, proxy measures of immune responses. Supplementation with a multivitamin formulated at about 100% Daily Value can decrease the prevalence of suboptimal vitamin status in older adults and improve their micronutrient status to levels associated with reduced risk for several chronic diseases.

HIV
Maternal multivitamin supplements containing vitamins B, C and E reduce the risks of motor developmental delays in infants born to HIV-positive mothers in developing countries.

Preeclampsia
Women who are considering becoming pregnant may significantly reduce their risk of developing preeclampsia by taking a multivitamin supplement regularly three months before conception and during the first trimester of pregnancy. Women who use them regularly have a reduction in preeclampsia risk, particularly for women who are not overweight prior to pregnancy. Because multivitamins contain many nutrients, it is difficult to know the exact mechanism by which the risk of preeclampsia is reduced.

Emails
There seems to be a differing of opinion between whole food and synthetic vitamin products on the market. Is there a difference between synthetic and whole food multi-vitamin products? Does the human body recognize synthetic vitamins the same as a whole food supplement? Does Multivit Rx contain all factors necessary for a positive nutritional effect on the body?
   When one evaluates a vitamin, such as vitamin C (ascorbic acid), the chemical structure is the same, whether it is extracted from a fruit or made synthetically in the lab. Other vitamins, such as vitamin E, come in several forms, and the synthetic version dl-alpha-tocopherol may not be as beneficial as the natural form, d-alpha-tocopherol, plus vitamin E comes in many other forms. Each vitamin and nutrient needs to be looked at individually. As a rule, if a chemical lab is able to make the pure chemical structure of the vitamin, then it should be as good as one extracted from nature.

I was searching the internet and came across a website that sells individual made supplements. This is what they say, "LifeScript is the premiere provider of Personalized Vitamins. We recommend the exact vitamins and nutritional supplements you need to achieve optimal health. When you complete our online health survey, we analyze specific data about your lifestyle, health concerns and daily diet to generate your unique Personalized Vitamin Profile. That information is then converted into a personalized vitamin program just for you." What is your opinion on this?
   In my opinion, it is impossible to determine through an online survey what a person's daily requirement would be of the countless nutrients and vitamins and minerals required by the body. There are innumerable variables that are involved, including physical activity, sleep patterns, diet, season and temperature, hormone levels, other supplements and herbs used, medicines used, mood, personality, smoking, alcohol use, and most important, genetics. And the requirements for nutrients by the body change with time. Even with a complete physical exam and blood studies it would still be extremely difficult if not impossible to determine optimal nutrient requirement, if any. Therefore, in my opinion, any website that promises that they can provide your optimal nutritional needs through pills by taking an online survey cannot be relied on.

My multivitamin already has a lot of pantothenic acid and B12 in it. Are the same vitamins being present in Mind Power RX going to create an overdose ?
   There is no concern with overdose of these two B vitamins, however it is a good idea to not take them together since each product is strong enough by itself. It is a good idea to alternate different supplements rather than using the same ones, such as the same multivitamin, all the time. You may wish to try Mind Power Rx by itself one day and see how it makes you feel before combining with your multivitamin if you wish. Each person has a different response, hence we can't give any precise answers.

Have recently heard fermented nutrients are much more utilizable and effective which New Chapter and Garden of Life Multi-vitamins contain. Is this true or do you have any information on this for of multivitamins?
   We have not seen any studies in humans with " fermented " multivitamins. At this point it appears to be a marketing gimmick.

I am a 53 year old male. I understand that taking a women's multivitamin is actually good for you. Is this true? Could you please tell me the pros and cons of taking a woman's multivitamin.
   There are hundreds or thousands of different multivitamin brands on the market, men's and women's multivitamins. Each is different than the other in terms of vitamin and mineral dosage, the inclusion of other nutrients or herbs. Therefore there is no way to say whether a woman's multivitamin is good for a man.

 I am taking Multivitamins Rx and I have to say they are excellent. However, while searching the net, I found the following product which seems even more interesting: Opti-men by Optimum Nutrition. I will be trying it as soon as I use up the 2 remaining bottles of Multivitamin Rx. It would be great, if you would consider developing a Multivitamin specifically for men in a similar fashion.
   There are thousands of multivitamin products on the market, and it is a good idea to try different ones to see which ones work best for your particular needs. We are not familiar with Opti-men by Optimum Nutrition.

I take your multivitamin product MultiVit Rx. Love your stuff. One capsule a day gives me wonderful sense of vitality.

Just need advice what supplement is best for a 2 year old boy.
   I prefer focusing on a healthy diet with lots of fresh vegetables, juices and fruits and a wide variety of whole foods and fish. As such no supplements would be necessary. Plus, research is not available to determine what supplements are helpful for children in the long run and whether imbalances could occur if certain vitamins and nutrients are given in a dosage that may not be acceptable to the body at that age. It is preferable to focus on organic and whole foods until the teenage years. However, if you really wish to give a multivitamin, occasional use of a children's multivitamin would be acceptable. Fish oils or cod liver oil would also be a good option if the child is not eating enough fish.

I am considering changing to your Multi-Vit. I currently take a multivitamin formulated for women. Why do you not have the multivitamins for men and women? I love your website.
   As far as multivitamins, there is not convincing evidence that the requirements for women and men are vastly different except in terms of iron and calcium. If some women need iron and calcium in higher amounts, they can take these supplements separately in the dosage they require. Otherwise, as far as the basic vitamins and minerals such as the B vitamins, A, C, E, magnesium, zinc, etc, there is no evidence that the dosage required in men or women is significantly different. Women would take a lesser dosage (fewer capsules) since their body weight is less that the body weight of men. The ideal dosage of vitamins and minerals has not yet been fully identified and it is difficult to determine ideal amounts as a group since each person has a uniquely different diet.

Are you the doctor who developed and provides Biovaxin. I am not sure of the spelling but am interested in this product if available.
   I have no affiliation with this product.

I would like your input of mass produced multivitamins, like One A Day for women 50+, I have osteoporosis and I'm questioning the quality of this product.
    I prefer not to comment on products that are not formulated by me, I have no way of knowing the quality of the  thousands of other multivitamin products on the market.

Do you have, or have you formulated a multivitamin that can be absorbed orally? My wife has no colon and only a few feet of her small intestine. My understanding is that vitamins are primarily absorbed via the intestinal track and not through the stomach lining.
    Sorry, at this time we do not have a sublingual formula.

We must move beyond the concept of preventing vitamin deficiencies and inadequacies to establishing health and, further, to creating optimal physiological functions. Each essential vitamin possesses different concentration thresholds for its variety of effects and the required balance necessary to achieving each has yet to be fully defined. Higher numbers of elderly lead to a dramatic shift in demographics, accompanied by an increase in non-communicable diseases such as cancer, cardiovascular disease and dementia. All these conditions are thought to be modifiable by diet to some degree and mounting evidence indicates that improved intakes of certain vitamins can slow their progress.