I was pleased to see this today - as so many 'authorities' have repeatedly put down the use of multi vitamins as being a waste of money - here is a quite extensive study showing the opposite. I used to see a very highly acclaimed consultant who said exactly the same to me and would test me for deficiencies every three months - if he found I was low on B6 I would take it and then another test showed the B6 was adequate but it had now unbalanced something else - it was a roller coaster - I then realised despite what he said that surely it is better to have a 'trickle' dose of everything just in case - our diets today are - in my opinion very low in nutrition unlike yesteryear so I think they are essential in some cases. In saying this however some of the multis are far too high a dose to be a trickle dose. It did make me smile that the organisation who paid for this study were to do with Cocoa industry and it found that it didn't help at all !
COSMOS-Mind — Multivitamins Linked to Slower Cognitive Decline
The COSMOS-Mind study involved 2,262 participants with a mean age of 73 and looked at how taking cocoa extract or multivitamins and minerals (MVM) for three years affected brain function.3 Researchers called participants to test their thinking skills at the start of the study and then annually.
They measured overall brain function by looking at average scores from different tests, including memory and problem-solving activities. While the study found that cocoa extract didn't make a difference in overall brain function, significant benefits were found from the daily multivitamin, with three years of such supplementation translating to a 60% slowing of cognitive decline, which is equivalent to about 1.8 years.4
Improvements in global cognition, episodic memory and executive function were noted, with the effects most pronounced in people with cardiovascular disease. According to the study, which was published in the journal Alzheimer’s & Dementia:5
COSMOS-Mind provides the first evidence from a large-scale, long-term, pragmatic RCT [randomized controlled trial] to suggest that daily use of a safe, readily accessible, and relatively low-cost MVM supplement has the potential to improve or protect cognitive function for older women and men.
An additional trial is needed to confirm these findings in a more representative cohort and to explore potential mechanisms for cognitive benefit. This work may ultimately have important public health implications for standard of care to improve or protect cognitive function in older adults.”
COSMOS-Web — Multivitamins May Improve Memory in Those 60 and Over
The second study, COSMOS-Web, included men over the age of 60 and women over 65 who received either a multivitamin supplement or a placebo. The participants were evaluated at baseline and each year using neuropsychological tests over a period of three years.
Those taking the multivitamin supplement had better immediate recall at the first year point, which was maintained during follow-up. Effects were most pronounced in people with cardiovascular disease.
"When we start seeing that kind of consistency across well-designed studies, it certainly helps convince me — the ultimate skeptic — that we're on to something real," professor Adam Brickman of Columbia University, who worked on the first study, told Insider. "... I started taking multivitamins the day we ran the analyses and saw the results, and I take 'em every morning."
“There is evidence that people with cardiovascular disease may have lower micronutrient levels that multivitamins may correct, but we don’t really know right now why the effect is stronger in this group,” Brickman said.
The researchers estimated that taking a multivitamin improved performance by "the equivalent of 3.1 years of age-related memory change" compared to placebo8 and could not only help maintain cognitive functioning but potentially enhance it later in life. The team concluded:9
Vitamin supplementation is relatively inexpensive, accessible, and has a few adverse effects, and thus might be a potentially useful population health intervention ... Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age.”
COSMOS-Clinic — Multivitamins Improve Memory and Slow Cognitive Aging
The third study, COSMOS-Clinic, analyzed the effects of a daily multivitamin supplement on cognitive changes based on in-person visits involving 573 people.10 It, too, found multivitamins had a positive impact on overall brain function over two years when compared to a placebo. Specifically, they found a significant improvement in memory of past events, but not in the ability to plan or pay attention.11
The researchers, from Massachusetts General Hospital, Harvard Medical School and Brigham and Women’s Hospital in Boston, also conducted a meta-analysis involving all three COSMOS studies, without repeating participants and spanning two to three years of taking multivitamins.
The meta-analysis “showed strong evidence of benefits for both global cognition and episodic memory,” according to a press release. “The authors estimate that the daily multivitamin slowed global cognitive aging by the equivalent of two years compared to placebo.”12 Study author Chirag Vyas with Massachusetts General Hospital (MGH), said:13
“Cognitive decline is among the top health concerns for most older adults, and a daily supplement of multivitamins has the potential as an appealing and accessible approach to slow cognitive aging ... The meta-analysis of three separate cognition studies provides strong and consistent evidence that taking a daily multivitamin, containing more than 20 essential micronutrients, helps prevent memory loss and slow down cognitive aging.
These findings will garner attention among many older adults who are, understandably, very interested in ways to preserve brain health, as they provide evidence for the role of a daily multivitamin in supporting better cognitive aging.”
Since the three trials used varied methods to assess cognition — including telephone, online and in-person assessments — and involved a large number of participants, they provide convincing evidence for the positive role of multivitamins in healthy brain aging. Study author Howard Sesso, with Brigham and Women’s Hospital, added:14
“With these three studies using different approaches for assessing cognition in COSMOS, each providing support for a daily multivitamin, it is now critical to understand the mechanisms by which a daily multivitamin may protect against memory loss and cognitive decline with a focus on nutritional status and other aging-related factors.
For example, the modifying role of baseline nutritional status on protecting against cognitive decline has been shown for the COSMOS cocoa extract intervention. A typical multivitamin such as that tested in COSMOS contains many essential vitamins and minerals that could explain its potential benefits.”
Multivitamins Improve Biomarkers of Nutrition in Men Aged 68 and Over
It’s estimated that one-third of U.S. adults — and one-quarter of children and adolescents — use multivitamin and mineral supplements,15 making them one of the most common supplements in the U.S. But despite their popularity, many wonder whether taking multivitamins really makes a difference in health.
A team of researchers from Oregon State University (OSU), who conducted a study involving 35 men aged 68 years or older, concluded, “Our evidence indicates that many older men could benefit from a daily multivitamin.”16
The men took either a multivitamin/multimineral (MV/MM) supplement or a placebo for at least six months. The researchers were mainly looking to see if the supplements would change levels of certain nutrients in their blood, a sign of better vitamin and mineral status. They also wanted to see if these supplements would affect how cells use oxygen, which is important for energy and health.
Those who took the MV/MM supplements saw improvements in their blood levels of certain vitamins, such as B6, vitamin D, vitamin E and beta-carotene, showing that the supplements could indeed boost the amount of these nutrients in the body.
However, the supplements didn't make a significant difference in the levels of minerals like calcium and zinc. Interestingly, the supplements helped prevent a decrease in the rate at which certain immune cells used oxygen, which could be a good sign for overall health, particularly for metabolism and the immune system.
In contrast, the placebo group didn't see these benefits and even saw a drop in some vitamin levels, suggesting they were moving toward a less optimal vitamin status. While vitamin and mineral deficiencies weren’t widespread in the healthy subjects that took part in the study, the researchers still found multivitamins to be worthwhile, explaining:
“The use of MV/MM supplements can improve or prevent declines in the status of several vitamins and may prevent declines in cellular bioenergetic status. Although MV/MM supplementation is a ‘one-size-fits-all’ strategy and does not target specific micronutrient needs, it is a cost-effective approach to improve micronutrient status in older men and may have an as yet unappreciated impact on maintaining metabolic function in cells.”
Can You Get Enough Vitamins and Minerals From Food Alone?
Ideally, people of all ages should strive to get their nutrition from whole, nutrient-dense foods — and it’s certainly possible to get the vitamins and minerals your body requires via your diet. However, nutrient deficiencies are common, even among people who believe they’re eating a balanced diet. In the U.S., 31% of the U.S. population was found to be at risk of at least one vitamin deficiency or anemia.
Beyond cognitive function, your body depends on essential nutrients for growth, development and health maintenance, and deficiencies in certain vitamins can impact your immunity, vision, wound healing, bone health and much more.
This is why, if you think you may be missing out on important vitamins in your diet, the best way to boost your intake is via organic, whole foods. But if you’re not eating right, a high-quality multivitamin may help fill in any gaps and improve biomarkers of nutrition.
"We're not suggesting that people should get their vitamin and nutrient intake from supplements — the primary source of that should be from whole and healthy foods," Brickman told Insider. “... I think that multivitamins, along with a lot of other things that we could potentially do as we age, might have a modest but meaningful effect on how we age, cognitively.
He added in a news release, “Supplementation of any kind shouldn’t take the place of more holistic ways of getting the same micronutrients.” When choosing a multivitamin, be sure to look for a manufacturer that has checks and balances in place to ensure the quality of the product.
And remember, since multivitamins contain both water- and fat-soluble vitamins, it’s generally recommended to take half your daily dose in the morning, with breakfast, and the other half with your main meal.
Hope you find this interesting.
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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
I found it difficult to be absolutely sure which CentrumSilver product was used and found more complete details on Centrum’s own site - if I got the right one!
People tend to take multivitamins and think they are getting what they need. But there are problems with that naive approach. Like there is no iron content.
There are also ingredients many would wish to avoid - whether rationally, ethically, or even wrongly.
Colours:
Blue 2 Lake, Red 40 Lake, Yellow 6 Lake
Whitening agent:
Titanium Dioxide (now banned as a food ingredient in the EU though the decision has been controversial).
B6:
Pyridoxine Hydrochloride (Vit. B6) rather then P-5-P.
Ingredient of animal origin:
Gelatin (Not sure if any others are also of animal origin).
Talc (although legal, many try to avoid it in all forms due to suspicions of carcinogenicity though that appears top be largely source-dependent).
B12
Cyanocobalamin (Vit. B12) rather than, for example, methyl-cobalamin. (Important for a small number who cannot take cyanocobalamin though I'd hope those with Leber's already know the problems.)
And this is a major problem - it is towards hard work deciding whether a product is acceptable because there is so much information to work through. And the formulations change over time - it could well be that UK, EU and other formulations are actually not the same!
[ Edited slightly to clarify sources of information. ]
Many years ago I was lucky enough to have private medical insurance and was suffering badly with dislocations etc. (which actually was low thyroid hormone believe it or not !) and went to see people who would test vitamins and minerals - the products I was prescribed were 'professional ones' they were not open to being sold to anyone else - I am pleased to say that these companies are now selling to the general public - and their products do not contain all the rather extensive list of additives etc. you list here - if you want to PM me I can tell you who those companies are - the ones you mention are not ones I would use. The reason iron is missing is because there are companies who are leaving out iron for people like me who cannot tolerate it and also iodine - but they then provide those items in their other products - but as for talc being in the products you mention - that is such an old additive I am amazed it is still being used - I thought it was banned. Centrum Silver is a USA product I daresay - the other C product you mention I would not use anyway with all those additives and odd ingredients. The companies who sold to the professionals during those years do NOT put in such ingredients they are much purer hence why they were used by professional nutritionists Drs etc.
Centrum is the product used in the first COSMOS study, as I understand. I didn't just go to find any multivitamin!
Though I acknowledge it might be a different Centrum Silver product as the details are not super-clear but the ingredients and the COSMOS list seem to be very similar.
I am absolutely positive that distinguished scientists would use a different product to that which is just sold in Boots - but all I wanted to do was show people that there is hope for cognitive brain health - over and out not willing to discuss this any further if you don't mind !
all I wanted to do was show people that there is hope for cognitive brain health.
Perhaps....but we might also consider that an optimal level of T3 is required by the brain but this is generally sidelined
How many " professionals" are willing to test and prescribe T3.... and knowledgeable enough to correctly use it.
If " distinguished scientists" were researching this surely they would look at individual V&Ms rather than lumping them together as a multi
Similar to thyroid medication, vitamin and mineral supplementation is an individual requirement
If a nutrient level tests as low, then supplement that nutrient appropriately for the individual.
Randomly swallowing multis, just in case, is likely to provide too much or too little of whatever....it's a lottery
And it may just end up as expensive bodily excretions!
So what this review is basically saying is that we had better buy these products if we wish to avoid various ailments and dementia in our later years....cynical I may be but is this introducing a fear factor and are we seeing a move to mass treatment with V& Ms....for profit!
If " distinguished scientists" were researching this surely they would look at individual V&Ms rather than lumping them together as a multi. Sorry, I have to disagree with this. When you have a whole chain of reactions involving a number of V and Ms, if 2 or more are low, they will both limit the speed of the reaction. Adding in only one will not speed up the reaction, because the 2nd one is still low, and still limiting. You need to add both to increase the rate. So, yes, you could test for 'everything ' and see that you only need to supplement those 2 things, or, you could take the cheaper route (more appropriate if looking at a population wide approach) and supplement with a multi
surely it is better to have a 'trickle' dose of everything just in case
Well, yes and no. It does depend - as do most things! If your multi contains iron then you're not going to benefit from that trickle because the iron will block absorption of a lot of things. Iron should be taken at least two hours away from everything, except vit C.
Then there are the things that you probably don't need, like calcium. And things that you really shouldn't be taking, like iodine.
Then there's the specific hypo question of zinc and copper: normally they should be kept balanced. But, hypos usually have one high and therefore the other low (it's like a seesaw). So, taking more of the one that is high is not a good idea!
There are so many things to take into consideration that even apart from the money aspect, I consider multis to be best avoided.
That said, I would suggest a B complex is taking just one B vit here and there. But a B complex with just Bs in it, nothing else.
There are products that do not contain iron or iodine specifically for thyroid patients and choline too for those with choline issues as I did at the time - these companies took on board our needs. Without my multi vitamins or indeed supplements I hate to think where I would now !
First I've heard of it. You're not allowed to post links to suppliers of prescription only meds without a prescription. But a link to a multi-vit is fine.
Thanks for this. Really interesting. Many of us here know first-hand the importance of a B-complex, vit D etc. I suggested to a friend her issues might improve if she increased her vits and minerals. She replied, her friend, the GP, who has practised for decades and knows everything has told her there's no need, she can get all she needs from her food. (This from a lady with ibs probably due to low stomach acid...). I just smiled, and left her to it! Give it a couple of decades and the NHS might pick this up!
I was in a GP surgery when I was 19 (in 1967) and was reading a Woman's mag column by Clare Rayner who was talking about a book she had just read on vitamins and minerals deficiency in illness/disease - I bought the book and it changed my life for the better - I have used my knowledge to recognise what was going on - disease - = dis-ease of the body and to get through many years of high stress without drugs or anti depressants which I could not tolerate - using the vitamins and minerals that I suspected were being lost due to the stress etc. - it worked - that is why I was so pleased to at last see something positive about supplements as I am absolutely convinced the bad behaviour of humans including children today is as a result of dietary deficiencies see FAB (Food and Behaviour Institute) fabresearch.org/viewItem.php - it is so sad when I hear a medical professional say you get all your nutrition from your food - you might have done 60 years or so ago but not now and the population is showing this in their health problems including thyroid dysfunction. You would have to eat 3 times the amount of toms - vegetables etc. etc. to get the same amount of nutrition as when I was a child. FAB once did an experiment in a Young Offenders Prison and the young lads were queuing outside the Drs door the next morning for their supplements as they felt so much better - how very very sad that the medical profession will not take up anything other than drugs - but there again they might all be out of a job I suppose (in jest !) By the way - I found low stomach acid was due to low Vitamin C as C is involved in the process. I wince when I hear someone has been put on acid reduction drugs - we need stomach acid to break down our food - such ignorance out there from the medical profession.
Yes, its awful the ignorance out there still, after all these decades. It should be common sense. We know we need these micronutrients for hundreds of vital metabolic reactions, so it makes absolute sense that if you are low in one thing or another, the entire chain of reactions will be affected. Its basic chemistry! Limiting factors. With the intensive, fast growth farming methods, the methods used to extend shelf life, let alone the highly processed 'foods' for sale, its a miracle if there are any micronutrients in the food at all. It makes absolutely no sense that the NHS will readily prescribe all manner of drugs, but scoff when you mention vitamins. Yes, I also wince when I hear people prescribed antacids and proton pump inhibitors. Inside I'm screaming!
Although it is interesting to see that multivitamin supplementation does not seem to be a complete waste of time, I have quite a few issues with this study:
1.) The study uses a fairly small patient sample - 2,262 participants is really not a lot of people. Question is, how were these participants randomised? Did they account for underlying illnesses? What illnesses did they have? The meta-analysis also included smaller groups of over 500 and a group with just 35 people. These small sample sizes are too insignificant to draw conclusions on a wider population level.
2) Depending on the search parameter that were applied, the meta-analysis study may have only included findings that were positive and not studies that showed no effects of multivitamin supplementation. There could be a large sample bias that would therefore support the conclusions that multivitamins could be effective.
3) A research analysis conducted by Hopkins Medicine involving 450,000! people found that multivitamins did not reduce the risk for heart disease or cancer. A study that tracked the mental functioning and multivitamin use of 5,947 men for 12 years found that multivitamins did not reduce risk for mental declines such as memory loss or slowed-down thinking.
4) Like others have mentioned, why would you have the need to supplement with something that you don't need? Surely it is better to test what you will need, rather than do a 'one-size-fits-all' approach. In the ages of personalised medicine, should we not also do personalised supplementation?
5) Many of these multivitamins have cheap ingredients (Mg oxide, folic acid), which are not well absorbed. Most also have additives, colorants and fillers, which are not necessary and should be avoided. Yes, they are perhaps cheaper than the quality individual supplements, but cheap and quality do not usually go together and I believe that our health should be worth investing in.
It is of course everyone's personal choice, where they spend their money. However, if the overwhelming evidence is not stacking up, perhaps it is time to think about it and invest in something more effective.😉
I do not use cheap products I'm afraid but professional products that were used by the medical establishment only in those days - it is the short sighted approach you mention that is preventing the people of this country becoming well - even their mental health issues can be zinc or B deficiency related - as I said previously I was lucky enough to have extensive (5 pages long) vitamin and mineral tests undertaken every three months - I would be given the necessary supplements to take to ensure my deficiency was met and then low and behold another three months those particular deficiencies were now OK but others went out of balance - so more supplements - it was like the forth bridge. Sorry but I don't agree with you and I have proved it - however if you take cheap rubbishy products I could only agree with you - you may as well pour them down the loo as they are not good enough. I will be so pleased when zinc deficiency is tested for anorexia and for people with suicidal thoughts etc. etc. - everyone is different and their bodies metabolise their foods dependent on the lifestyle they have - alcohol consumption - stressful lives - lack of sleep etc. etc. - we are not all the same and nor are our dietary/nutritional needs which can even be genetic !
Surely it is better to test what you will need, rather than do a 'one-size-fits-all' approach. In the ages of personalised medicine, should we not also do personalised supplementation?Agree, but cost. Cheaper to supplement than to test everyone for everything. Bearing in mind that we are on this forum trying to find answers that we are not getting from our gp, and that due to various absorption issues we are often missing something vital, we are often prepared to bear the cost of testing regularly and supplementing selectively. On a population wide scale this is not realistic. I suspect the majority of the population don't have absorption issues but could benefit from some or other micronutrient. The question is, if a MVM (and obviously some are better than others) 'does no harm' is the cost of doling this out to the entire population going to bring both long term financial (and health) benefits.
Well, if a study of 450,000 people showed no benefits of multivitamins, and another study of over 5000 people showed no effects on cognitive function - why would you take them even if they are cheap? Sorry, but that makes no sense to me.
And you don't need to do excessive testing necessarily either.
For example, plenty of studies are showing that low Vitamin D3 levels are associated with cognitive decline in older adults. Many people in the UK are getting too little of this Vitamin and supplementation with Vitamin D3 (at least 2000 IUs) has been shown to improve cognitive function. So if I was worried about this, I'd rather invest in a quality supplement of Vitamin D3 (with K2); doses up to 3000IU should be fine even without testing.
However, if you are very low in your Vitamin D3, the low level of Vitamin D3 in the multivitamin supplements will not raise your level enough to have an effect and therefore plenty of large studies show that multivitamins do not improve cognitive function. And one of the reasons probably is that the Vitamin D3 is too low.
Do you know what - you have caused me so much stress today those who criticise me when I was only trying to bring some positive news for once - might I suggest you make your comments to the study organisers themselves as I am NOT replying any further on this issue - fed up with the negativity!
Why do you take it personally? I am only trying to point out some scientific facts to help people make their own decisions. You are free to do what you feel is right for yourself, I have no issues with that at all.
But seriously, since when are scientific facts negative?
Thank you for bringing attention to good quality multivitamins directed at thyroid patients and those with iron issues.
Once my nutritional deficencies had been optimised several years ago I started taking a multivitamin pill and only needed to add an additional VitD pill to maintain all levels of everything. The pill is expensive but cheaper than buying vast quantities of individuals, and only taking two pills a day is much preferable. If I go on holiday I don't even bother taking them now.
However, I think problems risk arising when people try to address dire deficiencies with a multivitamin that just doesn't contain enough, or use the cheaper brands that might incorporate less useful ingredients/fillers but this could equally apply to individual supplements also.
Hi there totally agree but if someone cannot get vitamin testing and I explained what happened to me - fix one and the other went out - I don't think there is any alternative - but actually there aren't that many items that can go out badly as you probably know - D Selenium Zinc B complete and C and Iron and Magnesium/Calcium. The rest can tick along quite efficiently from food unless you had a genetic problem.
I found low stomach acid was due to low Vitamin C as C is involved in the process.
Low stomach acid can also be due to low salt intake. And with the currant belief that salt is bad for you, I imagine a lot of people don't get enough salt. Also, stomach acid levels drop with age. But the main culprit, when you're hypo, is low T3.
Reading your replies to others I get the impression people are saying no supplements are necessary. And that's not the case. As hypos we recognise the need to keep our levels optimal. And just relying on food isn't going to cut it. It's just multi-vits that are being objected to.
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Some help with vitamins please
Maybe some hope at last
Vitamin D3 Deficiency - Looking for some advice please
at last I've been prescribed some HRT
Zinc and vitamin D - fantastic aid to decent sleep (at last)
