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, magnesium^a

Age-related macular degeneration: specific formulation of antioxidant vitamins, zinc, copper

Medications (long-term use):

Proton pump inhibitors^a: vitamin B₁₂, calcium, magnesium

Metformin^a: vitamin B₁₂

Restricted or suboptimal eating patterns: multivitamins/multiminerals, vitamin B₁₂, calcium, vitamin D, magnesium

^a Inconsistent evidence.