Mass General Hospital

Harvard Medical School

In Brief: Do You Need to Take Vitamin or Mineral Supplements?

According to a recent national survey, 52% of adults in the United States reported using at least one dietary supplement.  Among the most popular are vitamin and mineral supplements, which are taken by 48% and 39% of adults, respectively.  It will undoubtedly surprise many that, despite the prevalent use of these supplements, most people do not require these supplements.  Most clinical trials of vitamin and mineral supplements fail to demonstrate clear benefits for the prevention of chronic diseases (other than in the setting of nutritional deficiency).

This Viewpoint from the Journal of the American Medical Association (full text available) gives a nice review of what we know about vitamin and mineral supplements and when we should use them.  This table (copied form the article) is a concise summary of the article.

Ruta Nonacs, MD PhD

 

General Guidance for Supplementation in a Healthy Population by Life Stage

  • Pregnancy: folic acid, prenatal vitamins
  • Infants and children: for breastfed infants, vitamin D until weaning and iron from age 4-6 mo
  • Midlife and older adults: some may benefit from supplemental vitamin B12, vitamin D, and/or calcium

Guidance for Supplementation in High-Risk Subgroups

  • Medical conditions that interfere with nutrient absorption or metabolism:
    • Bariatric surgery: fat-soluble vitamins, B vitamins, iron, calcium, zinc, copper, multivitamins/multiminerals
    • Pernicious anemia: vitamin B12 (1-2 mg/d orally or 0.1-1 mg/mo intramuscularly)
    • Crohn disease, other inflammatory bowel disease, celiac disease: iron, B vitamins, vitamin D, zinc, magnesium
  • Osteoporosis or other bone health issues: vitamin D, calcium, magnesiuma
  • Age-related macular degeneration: specific formulation of antioxidant vitamins, zinc, copper
  • Medications (long-term use):
    • Proton pump inhibitorsa: vitamin B12, calcium, magnesium
    • Metformina: vitamin B12
  • Restricted or suboptimal eating patterns: multivitamins/multiminerals, vitamin B12, calcium, vitamin D, magnesium

a Inconsistent evidence.

Vitamin and Mineral Supplements: What Clinicians Need to Know.

Manson JE, Bassuk SS.  JAMA. 2018 Feb 5.

 

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