FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, October 12, 2011
What Kind of Medical Study Would Have Grandma Believe that Her Daily Multivitamin is Dangerous?
by Robert G. Smith, PhD
(OMNS, Oct 12, 2011)
A newly released study suggests that multivitamin and nutrient
supplements can increase the mortality rate in older women . However,
there are several concerns about the study's methods and significance.
- The study was observational, in
which participants filled out
a survey about their eating habits and their use of supplements. It
reports only a small increase in overall mortality (1%) from those
taking multivitamins. This is a small effect, not much larger than would
be expected by chance. Generalizing from such a small effect is not
- The study
actually reported that taking supplements of B-complex, vitamins C, D,
E, and calcium and magnesium were associated with a lower risk of mortality.
But this was not emphasized in the abstract, leading the non-specialist
to think that all supplements were associated with mortality. The
report did not determine the amounts of vitamin and nutrient supplements
taken, nor whether they were artificial or natural. Further, most of
the association with mortality came from the use of iron and copper
supplements, which are
known to be potentially inflammatory and toxic when taken by older
people, because they tend to accumulate in the
body [2,3,4]. The risk from taking iron supplements should not be
generalized to imply that all vitamin and nutrient supplements are
- The study lacks scientific
plausibility for several reasons. It tabulated results from surveys of
38,000 older women, based on their recall of what they ate over an
18-year period. But they were only surveyed 3 times during that period,
relying only on their memory of what foods and supplements they took.
This factor alone causes the study to be unreliable.
of these women smoked (~15%) or had previously (~35%), some drank
alcohol (~45%), some had high blood pressure (~40%), and many of them
developed heart disease and/or cancer. Some preexisting medical
conditions were taken into account by adjusting the risk factors, but
the study to contradict what we already know about efficacy of
supplements. For example, the study reports an increase in mortality
from taking vitamin D, when adjusted for several health-relevant
factors. However, vitamin D has recently been clearly shown to be
helpful in preventing heart disease  and many types of cancer ,
which are major causes of death. Furthermore, supplement users were
twice as likely to be on hormone replacement therapy, which is a more
plausible explanation for increased mortality than taking supplements.
- The effect of doctor recommendations was not taken into account. By their own repeated admissions, medical
doctors and hospital nutritionists are more likely to recommend a daily
multivitamin, and only a multivitamin, for their sicker patients.
The study did not take this into account. All it did was tabulate
deaths and attempt to correct the numbers for some prior health
conditions. The numbers reported do not reflect other factors such as
developing disease, side effects of pharmaceutical prescriptions, or
causes for the mortality. The study only reports statistical
correlations, and gives no plausible cause for a claimed increase in
mortality from multivitamin supplements.
effect of education was not taken into account. When a doctor gives
advice about illnesses, well-educated people will often respond by
trying to be proactive. Some will take drugs prescribed by the doctor,
and some will try to eat a better diet, including supplements of
vitamins and nutrients. This is suggested by the study itself: the
supplement users in the survey had more education than those who did not
take supplements. It seems likely, therefore, the participants who got
sick were more likely to have taken supplements. Because those who got
sick are also more likely to die, it stands to reason that
they would also be more likely to have taken supplements. This effect is
purely statistical; it does not represent an increase in risk that
taking supplements of vitamins
and essential nutrients will cause disease or death. This type of
statistical correlation is very common in observational health studies
and those who are health-conscious should not be confounded by it.
known safety of vitamin and nutrient supplements when taken at
appropriate doses was not taken into account. The participants most
likely took a simple multivitamin tablet, which contains low doses. Much
higher doses are also safe [4,7], implying that the low doses in common
multivitamin tablets are very safe. Further, because each individual
requires different amounts of vitamins and nutrients, some people must
take much higher doses for best health .
In an observational study of older women in good
health, it was said that those who died were more likely to have taken
multivitamin and nutrient supplements than those who did not. The effect
was small, and does not indicate any reason for
disease or death. Instead, the study's methods suggest that people who
have serious health conditions take vitamin and mineral supplements
because they know that supplements can help. Indeed, the study showed a
benefit from taking B-complex, C, D, and E vitamins, and calcium and
magnesium. Therefore, if those wanting better health would take
appropriate doses of supplements regularly, they would likely continue
to achieve better health and longer life.
(Robert G. Smith is Research Associate Professor, University of Pennsylvania
Department of Neuroscience. He is a member of the Institute for
Neurological Sciences and the author of several dozen scientific papers
 Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr (2011) Dietary supplements and mortality rate in older women. The Iowa Women's Health Study. Arch Intern Med. 171(18):1625-1633.
 Emery, T. F. Iron and your Health: Facts and Fallacies. Boca Raton, FL: CRC Press, 1991.
 Fairbanks, V. F. "Iron in Medicine and Nutrition." Chapter 10 in Modern Nutrition in Health and Disease, editors M. E. Shils, J. A. Olson, M. Shike, et al., 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
 Hoffer, A., A. W. Saul. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, CA: Basic Health Publications, 2008.
 Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB,
Clarke A, Franco OH. Levels of vitamin D and cardiometabolic disorders:
systematic review and meta-analysis. Maturitas. 2010 Mar;65(3):225-36.
 Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium
supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.
 Padayatty SJ,
Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous
use by complementary and alternative medicine practitioners and adverse
effects. PLoS One. 2010 Jul 7;5(7):e11414.
 Williams RJ, Deason G. (1967) Individuality in vitamin C needs. Proc Natl Acad SciUSA.57:16381641.
Also of Interest:
Orthomolecular Medicine News Service, April 29, 2010. Multivitamins Dangerous? Latest News from the World Headquarters Of Pharmaceutical Politicians, Educators and Reporters. http://orthomolecular.org/resources/omns/v06n15.shtml
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