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== Manufacture ==

How are they made?
[[User:J1812|J1812]] ([[User talk:J1812|talk]]) 18:59, 6 January 2011 (UTC)

== This reads like medical literature - where is the history? ==

I believe this article should contain content on the ''history'' of multivitamins: invention, development, production, anthropological/sociological histories, etc.  I think this encyclopedia entry should include relationships to other topics, people, times.  --[[Special:Contributions/76.211.245.65|76.211.245.65]] ([[User talk:76.211.245.65|talk]]) 04:49, 4 May 2008 (UTC)

== No criticism ==

have there been no criticisms of multivitamins
i also agree with the preceding statement
:I heard that vitamin supplements are not very efficient, according to a med student here in Norway... can anyone come with a statement to the efficiency of most over the counter multivitamins, preferably comparing them to other vitamin supplements. [[User:CKaL|cKaL]] 18:14, 23 March 2007 (UTC)

i agree. some form of criticism is needed. there was a video on cnn recently showing that multivitamins are not useful for healthy individuals if not harmful.  <small>—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Zone|Zone]] ([[User talk:Zone|talk]] • [[Special:Contributions/Zone|contribs]]) 17:16, 6 April 2008 (UTC)</small><!-- Template:Unsigned --> <!--Autosigned by SineBot-->

== 'time release' niacin? ==

what is mean by "time release niacin, especially old versions over one hour" ? <small>—The preceding [[Wikipedia:Sign your posts on talk pages|unsigned]] comment was added by [[User:Substantiate|Substantiate]] ([[User talk:Substantiate|talk]] • [[Special:Contributions/Substantiate|contribs]]) 02:55, 20 March 2007 (UTC).</small><!-- HagermanBot Auto-Unsigned -->
:Niacin is typically marketed in several forms, from pure, "instant release" niacin ([http://www.pbm.va.gov/reviews/niacinreview.pdf]) to various degrees of time release. also see this discussion[http://en.wikipedia.org/wiki/User_talk:Midgley/DfL]  The old slow("sustained") time release tablets, over 1 hour, are the type most frequently associated with problems, especially with alcoholics and advanced liver disease. New, "extended" or "intermediate release" forms (e.g. Enduracin and Niaspan), under one hour have been offered in the US to optimize the flushing and slow release side effects to improve compliance for HDL and dyslipidemia improvements.--[[User:TheNautilus|TheNautilus]] 04:34, 2 April 2007 (UTC)


== Needs studies ==

This page should link to large, long-term, randomized, placebo-controlled, double-blind studies of the effect of specific commercially available multivitamin supplements on objective measures of intelligence, strength, endurance, disease, scholastic achievement, etc.

== Multivitamin (with iron) use & prostate cancer ==

The current article looks like someone has naively swallowed all the advertising hype. These articles http://news.bbc.co.uk/1/hi/health/6657795.stm
http://jnci.oxfordjournals.org/cgi/reprint/99/10/754
http://jnci.oxfordjournals.org/cgi/reprint/99/10/742 , on the other hand, show that using multivitamins increases the risk of death from cancer, because there is a narrow margin between a good dose or a harmful dose of vitamins. I used to think I was doing myself good from taking a multivitamin, but after carefully studying the second article I now no longer take any vitamin pills but just eat a varied diet. [[User:80.2.221.47|80.2.221.47]] 20:16, 1 August 2007 (UTC)

:Just to clarify..  the second article actually concludes that "These results suggest that regular multivitamin use is not associated with the risk of early or localized prostate cancer."  It says that overuse (more than 7 times a week) can lead to higher risk of fatal prostate cancer.  But many people use multiple supplements together, which could lead to a total of more than 7 supplements a week.  They also found that supplements could decrease the risk of prostate cancer, but speed its progression once you have it.  [[User:MangoJesusSuperstar|MangoJesusSuperstar]] 14:34, 15 September 2007 (UTC)

::I have previously discussed this some[http://en.wikipedia.org/enwiki/w/index.php?title=Talk:Orthomolecular_medicine&diff=133150876&oldid=133041675].  This test was largely conducted with the 80s-90s era formulas before ''Centrum Silver'' became a commonplace "mainstream" iron-free mulitvitamin/multimineral supplement with other mainstream brands following over the last dozen (or fewer) years.  Typical daily multivitamin formulas then had 16-30 mg iron, commonly 18 mg Fe, for a single daily dosage.  The "More than seven times a week" category might be loosely interpreted as usually twice a day.  As I showed previously[http://en.wikipedia.org/enwiki/w/index.php?title=Talk:Orthomolecular_medicine&diff=133150876&oldid=133041675], any (excess) iron was already considered a big no-no in prostate cancer. '''One''' tab with iron might be one too many for certain people. If you go to your drugstore and look at the current "50+ seniors'" and "male" multivitamin versions, they typically leave out the iron (0 mg) or cut it to about 4-9 mg Fe if they put any iron in at all.  The "(fertile) female" formulas will typically still have 16-18 mg.--[[User:TheNautilus|TheNautilus]] 11:05, 16 November 2007 (UTC)

::I am moving the NCI study edit [http://en.wikipedia.org/enwiki/w/index.php?title=Multivitamin&diff=142343929&oldid=142082156 here] as redundant (A&E) & narrow with undue weight on multivitamin formula issues that are also already dated, e.g. the Theragran-M formula[http://www.rmillion.com/Products/Vitalert_Page/compare2.html] listed in the study used 27 mg iron per tablet(!), implying 54 mg iron per day or more for prostate cancer victims(!!!), before Thergaran-M formula's market shift ~2002 to 18 mg with the "Advanced formula".--[[User:TheNautilus|TheNautilus]] ([[User talk:TheNautilus|talk]]) 10:21, 5 March 2008 (UTC)

:::Other criticism about the ''AJCN'' paper's flaws:[http://www.lef.org/featured-articles/consumer_alert_060707.html]--[[User:TheNautilus|TheNautilus]] ([[User talk:TheNautilus|talk]]) 13:32, 4 May 2008 (UTC)

==Proper usage & studies' scope==
Proper (multi)vitamin use is an individual affair for genetic, environmental, nutritional and health condition related reasons (there is a lot of overlap) as somewhat reflected in the differentiated product lines.  

There are a number of nutrients that have very narrow ranges or significant subpopulations of concern.  

'''I'''ron is another fairly common nutrient of morbid, even deadly, excess especially for HFE and other iron absorbing/conserving genes, non-anemic "mature"  (50+) persons, males especially prostatic males and cancer cases.

'''F'''luoride is one such mineral micronutrient.  Never minding the tooth issue, its practical biochemical deficiency seems to be uncommon.  Excess intake of F- beyond limits identified by EPA research, is not uncommon.

'''Marginal vitamin''' status or deficiencies may be further “'''crowded out'''” by other similar nutrients. In unbalanced usage, especially with larger quantities, '''[http://www.360healthcare.com/articles_detail.php?id=16 synthetic betacarotene]''' and '''[http://www.springerlink.com/content/pn0dgkw61h5vr5av/ ''all-racemic'' (synthetic) vitamin E]'''<sup>[http://www.ajcn.org/cgi/content/full/77/4/899?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT][http://www.ncbi.nlm.nih.gov/pubmed/11131364]</sup> have been shown to create measurable physicological differences or to displace other related natural isomers & analogs, e.g. the natural spectrum of carotenes and tocopherols that have also been shown to have biological significance in health as well as vitamin K.

Potentially inadequate '''vitamin K''' levels are associated with less familiar problems such as osteoporosis, arterial calcification, connective tissue disorders, cancer, as well as inadequate blood clotting[http://www.lef.org/magazine/mag2006/ss2006_report_vitamink_01.htm .]   Vitamin K deficiency can be associated with antibiotics (over)use, [[malabsorption]], and aggravated by aspirin, BHT,  excess sugar as well as larger doses of vitamins A, D and E.  Individual vitamin K supplement sizes range from ~100 mcg K<sub>1</sub> (very common)  and 50 mcg K<sub>2</sub> (as MK-7) to 15,000 mcg (K<sub>2</sub> as MK-4), sometimes in combinations[http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=114386].   Vitamin K status is seldom assessed, especially on a graded basis, despite impressive work associating corrrective levels of vitamin K with amelioration and effective treatement of [http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.nu.15.070195.000245?journalCode=nutr osteoporosis][http://www.ncbi.nlm.nih.gov/pubmed/16030366 ,] cancer, and liver disease as well as bleeding problems (clot formation).  
Vitamin K is typically not in vitamin formulas outside of minor use in some female (and mature??) oriented formulas partly because of concerns about interferences with [[coumadin]] or [[heparin]].  The key to vitamin K use with these latter medicines is *consistency and monitoring*.  I will note that in the orthomolecular & nutritionally oriented medical world that one might not use "high voltage" blood thinners until exhausting other modalities for various sources of bllod problems such as fibrin (niacin for fibrinogen formation; systemic serrapeptase, nattokinase or lumbrokinase use for fibrin clot degradation) and mixed tocopherols (including high gamma tocopherols, "natural vitamin E").

vitamin A     nutrient interactions    medical interactions<br>
vitamin D     nutrient interactions   [http://www.umm.edu/altmed/articles/vitamin-d-000995.htm  medical interactions]<br>
vitamin E     nutrient interactions    medical interactions<br>
vitamin K     nutrient interactions    medical interactions<br>

If a study with sweeping statements does not systematically address (exclude or treat) these long known variables and problems, it is an incomplete study that should be weighted accordingly and augmented by other, more informed sources.--[[User:TheNautilus|TheNautilus]] ([[User talk:TheNautilus|talk]]) 01:35, 1 May 2008 (UTC)
:With respect, that opinion is a POV and is based upon your selected evidence. If a study has been published in a peer-reviewed journal it qualifies under [[WP:SOURCES]]. That said, I concur that this has to be balanced with [[WP:DUE]].[[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 04:47, 1 May 2008 (UTC)

==[[Wikipedia:Requests for comment/TheNautilus]]==
Editors of this article would be welcome to participate in this RfC. [[User:TimVickers|Tim Vickers]] ([[User talk:TimVickers|talk]]) 18:48, 31 May 2008 (UTC)

==borates==
Various (Na, K, Mg) borates are commonly listed as a boron source for common US supplements(e.g. [http://www.drugs.com/pdr/centrum-performance-complete-multivitamin-tablets.html Centrum], [http://www.oneaday.com/maximum.html One-A-Day] and most major generics) and in the Canadian [http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen-prod/monograph/multi_vitmin_suppl-eng.php multivitamin monograph]. The Canadian monograph specifically mentions "borax", a  hydrated sodium borate, as a source.  A borax industry [http://www.borax.com/pioneer55.html view] on boron, bones and arthritis. Although human poisonings have been known to occur, it is "classified as relatively nontoxic," with an oral LD<sub>50</sub> > 4 gram/kg in rats, its indirect use and residue are regulated[http://www.jstor.org/pss/3431970].  "borate(s)" will be more accurate.

Similar to the continued use of nitrite and nitrate to control obligate anaerobes in processed meats, in the 19th century, meatpackers and others used the slime, mold and odor inhibiting properties of substantial quantities of borax both to prevent deterioration in then common conditions and to mask decayed products (ham, sausage). Borax was used as part of preservative solutions, a [http://books.google.com/books?id=jzfJ6tNmTvsC&pg=PA59&lpg=PA59&dq=solution&source=web&ots=3E0Y3Va8uW&sig=zfMsaMtGbhTDhtUTQfqzM_VTmVA&hl=en&sa=X&oi=book_result&resnum=1&ct=result 3500+ ppm] example, or even as a dry powder. Upton Sinclair's book, ''The Jungle'' (1906), in  chapter 14 [http://sunsite.berkeley.edu/Literature/Sinclair/TheJungle/14.html on meatpacking], exposed reprehensible meatpacking industry practices, mentioning the wholesale abuse of borax specifically, that led to the very creation of the US FDA and food laws[http://www.foodsafety.gov/~lrd/history1.html][http://www.americanheritage.com/articles/web/20060628-theodore-roosevelt-pure-food-and-drug-fda-toxins-regulatory-agency-harvey-wiley.shtml].  In part the objection to borax as an additive was to the inferior pretreatment products themselves and the handling conditions rather than just borax toxicity alone.   Such a large, uncontrolled dosing was a much different proposition than with a multi.--[[User:TheNautilus|TheNautilus]] ([[User talk:TheNautilus|talk]]) 18:22, 3 August 2008 (UTC)

== Product safety ==
It seems like everything from yoghurt to margarin has added vitamins in them these days. Even candy and mints. Has there been any studies about the subject and safety of these products? One would assume that eating 100 grams of yoghurt which has 30% of your daily dose of vitamin X in it and taking a multivitamin (or just eating healthy enough to actually get all the vitamins you need) would cause an overdose, and health problems in long term use. --[[Special:Contributions/88.115.50.38|88.115.50.38]] ([[User talk:88.115.50.38|talk]]) 06:48, 22 August 2009 (UTC)

== Are prescription vitamins considered drugs? ==

The [http://en.wikipedia.org/wiki/Multivitamin#United_States US Government Regulation section] indicates that prescription vitamins are drugs (references the Rx vitamins as drugs in the second sentence quoted below).  I do not believe this to be the case.

:However, some multivitamins contain very high doses of one or several vitamins or minerals, or are specifically intended to treat, cure, or prevent disease, and therefore require a prescription or medicinal license in the U.S. Since such drugs contain no new substances, they do not require the same testing as would be required by a New Drug Application, but were allowed on the market as drugs due to the Drug Efficacy Study Implementation program.[19] 

It also states that some vitamins require prescriptions as a result of DESI.  While this may be true for older preparations of vitamins (i.e. those on the market before 1962),  I do not believe DESI applies to the regulatory path for any vitamin coming to the market since then.  DESI was a 160-person body that evaluated products marketed prior to the Kefauver-Harris Amendment that required evidence of efficacy in addition to safety. I can believe that this legislation requires some vitamin formulations to bear a certain burden of evidence (for efficacy?) in order to obtain licensure, and this burden is greater than for a standard multivitamin but less than for a standard drug.  But that prescription vitamins are "allowed on the market as drugs due to the Drug Efficacy Study Implementation program" doesn't seem correct to me.  

I would appreciate it if someone familiar with the regulatory path for '''prescription''' vitamins would comment and/or correct the text.  Vitamins/supplements are not my area of expertise.  I would also appreciate a comment on the claims that prescription vitamins can make.  Can manufacturers of these products make claims greater than the structure/function claims available to dietary supplement manufacturers?  Many thanks!
[[User:Lhowson77|Lhowson77]] ([[User talk:Lhowson77|talk]]) 21:54, 27 May 2010 (UTC)

== Biotin ==

The section on biotin seems sketchy--biotin supplements aren't exceptionally expensive (drugstore.com has one offering a purported 1667% of the recommended daily value for $15.99 a bottle), and the reason biotin isn't included in many multivitamins is actually that intestinal bacteria produce ample biotin. [[Special:Contributions/24.61.46.155|24.61.46.155]] ([[User talk:24.61.46.155|talk]]) 18:42, 15 December 2010 (UTC)

In addition, there is no RDA for biotin.  There is an adequate intake, AI, currently set at 30mcg for adults (see http://lpi.oregonstate.edu/infocenter/vitamins/biotin/)   The Daily Value, DV, listed on supplements, which dates from the 1960s, if I recall correctly, is 300mcg.  I suggest that many supplements deliberately include only 10% (or so) of the DV because they are aiming to supply the more recent AI.  <span style="font-size: smaller;" class="autosigned">—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[Special:Contributions/174.25.163.11|174.25.163.11]] ([[User talk:174.25.163.11|talk]]) 04:29, 3 May 2011 (UTC)</span><!-- Template:UnsignedIP --> <!--Autosigned by SineBot-->

== Recent studies ==
See [http://archinte.ama-assn.org/cgi/content/abstract/171/18/1625]. I'm not sure that our article accurately reflects current medical knowledge. In particular, there seems to be a growing body of evidence suggesting that multivitamin supplementation is, at best, not beneficial and perhaps minimally but measurably harmful ([http://news.yahoo.com/vitamins-may-increase-womens-risk-dying-research-finds-212402256.html]). Thoughts? '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 23:58, 10 October 2011 (UTC)
:I've got a lot of opinions about the article and the study itself, but I'll leave those aside for the moment. Studies like this tend to come up every so often that I've noticed that are just bashing vitamins or minerals in some way. Typically, they try to show a drug benefit for a single nutrient (which the FDA wouldn't let them claim as they aren't drugs), but they don't point out the rest of the nutritional guidelines (if there are any) or other health allowances (exercise or other aspects of a healthy lifestyle). The most concerning point about this to me is that it doesn't address what other nutrition sources they are getting (eg. if the multivitamin is causing an overdose or excessive dose for any of the participants), if they are using other supplements/drugs, or anything else that a nutritional study would evaluate. I personally don't see studies like this as having much clout... especially when 2.4% more of the group (starting at age 62, which would make them around 87 today) passed away for various reasons; there's just too many factors that they don't address that would be important from a nutritional standpoint. [[User:Burleigh2|Burleigh2]] ([[User talk:Burleigh2|talk]]) 22:24, 13 October 2011 (UTC)
::You said you'd leave aside your personal opinions about the study, but your post consists of little else. There is a large and growing body of scientific evidence suggesting that both individual vitamin supplements and multivitamins are either non-beneficial or actively harmful (e.g. [http://well.blogs.nytimes.com/2011/10/11/more-evidence-against-vitamin-use/]. In particular, the ''[[Archives of Internal Medicine]]'' study ([http://archinte.ama-assn.org/cgi/content/short/171/18/1625]) addressed your criticism by testing not a single nutrient, but a range of individual vitamin and multivitamin supplements.<p>Regardless, I appreciate that you view these studies as worthless and designed solely to "bash" vitamin supplements. Nonetheless, we are probably obligated to move beyond your personal viewpoint and inform the reader of actual expert opinion in the field, which seems to be solidifying with accumulating evidence of multivitamins' ineffectiveness and possible harmfulness. '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 23:53, 13 October 2011 (UTC)
:::Regarding the Iowa Women’s Health Study you cited, let's not forget that it was simply an observational study. And not, let's be honest - given that the use of 15 supplements was assessed merely three times over a 19 year period (via ''self-reporting'' questionnaire surveys) - a particularly good one either. Moreover, the study reports only a small increase in overall mortality (1%) from those taking multivitamins. A small effect, in other words, and not much larger than would reasonably be expected by chance. Bear in mind too that 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, not a higher one. Oh yes, and some of the women either smoked (~15%) or had previously (~35%). As always, it speaks volumes, MastCell, that you consider this sort of study to be "scientific evidence." This is scientific reductionism, plain and simple, and a shameful example of the massaging of data to achieve a desired result.[[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 19:43, 14 October 2011 (UTC)
::::I get it - this study makes you angry and you don't like it. I disagree with most of your criticisms of the study, and in particular with your implication of scientific fraud, which I think is irresponsible, lazy, and probably a violation of [[WP:BLP]]. But we shouldn't even be discussing our personal opinions of the study (though you guys seem to be interested in little else). We should be discussing its reception by reliable sources. '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 02:07, 15 October 2011 (UTC)
:::::No, Mastcell, I am not generally prone to anger; I leave that to the likes of Orange and others. However, when it comes to personal opinions, I note that alt. med. WP talk pages are littered with those of yourself (plus Orange et. al.). As such, if you believe your criticism of my stating my opinions here is valid, the words "kettle", "pot" and "black" come readily to mind... [[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 11:06, 15 October 2011 (UTC)
::::::OK, you've been heard. Now do you think we can get back to pretending to respect the [[WP:TPG|talk page guidelines]], and discuss actual reliable sources and content issues? '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 19:15, 15 October 2011 (UTC)
:::::::Getting back to the discussion that you yourself started on this thread, there are many reliable studies reporting beneficial effects with multivitamins. As an example, let's start by considering recent research published by the German Cancer Research Centre which suggests that supplementation of antioxidant vitamins may reduce cancer and all-cause mortality. Particularly notably, the researchers specifically state that "''the significantly increased risks of cancer and all-cause mortality among baseline non-users who started taking supplements during follow-up may suggest a "sick-user effect," which researchers should be cautious of in future observational studies.''"[http://www.ncbi.nlm.nih.gov/pubmed/21779961] Whilst I fully recognize, based upon your previous comments on these pages, that you may prefer to pretend this study isn't relevant here, I strongly suggest that the expert nature of the body conducting this research clearly warrants including mention of this issue.[[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 20:40, 15 October 2011 (UTC)
::::::::OK, a source! You ripped the ''Archives'' study as worthless (or worse, fraudulent and conceived in bad faith) because it was observational, and because supplement use was assessed "merely three times" using "''self-reporting'' questionnaires". The German study is observational as well. And do you know how often supplement use was assessed in the German study, and by what means? Hell, I'll just tell you - they assessed at 3 time points, using self-administered questionnaires. So you don't seem to be truly concerned about study methodology, but rather with finding pretexts to dismiss findings that don't support your preconceived pro-vitamin viewpoint. Do you see how the difference in your approach to these two (methodologically very similar) studies makes it hard to take you seriously?<p>But anyway. There are a lot of primary studies about vitamin use. Rather than cherry-pick our favorites, we should be presenting them in the context of how they've been interpreted by expert bodies. This is basic stuff, outlined in [[WP:MEDRS|the relevant guideline]]. Literature reviews by experts consistently find no evidence of benefit for multivitamin supplementation (e.g. {{PMID|16880453}}, {{PMID|20697066}}, {{PMID|21273283}}, etc.) That should be clear to the reader, in the interest of basic honesty. We can cite individual studies to help illustrate the basis for expert opinion, but the tone on this talkpage is more like "let's pick a bunch of studies to illustrate how the experts are wrong". '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 21:36, 15 October 2011 (UTC)
:::::::::Good, MastCell, I'm pleased to see that you're paying attention and studying the sources here. I chose that study deliberately, of course. In light of your own fondness for, and defense of, observational studies of this type, it seemed quite appropriate to the discussion. My point being: You can't have it both ways.[[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 09:16, 16 October 2011 (UTC)
::::::::::I don't believe that you chose it deliberately or were aware of the overlap in methodology - I think that's just a convenient way to save face now that you've been called out. But I guess it doesn't matter. I haven't "defended" observational studies, either; like any kind of study, they have both strengths and limitations. I'm not trying to "have it both ways" - I'm trying to get this article to actually inform the reader about scholarly expert opinion on multivitamins and their purported health benefits. For some reason, that effort seems to consistently meet with entrenched opposition. '''[[User:MastCell|MastCell]]'''&nbsp;<sup>[[User Talk:MastCell|Talk]]</sup> 21:53, 16 October 2011 (UTC)
:::::::::::Similarly, I don't believe that you aren't trying to have it both ways, as the evidence on this page is strongly suggestive that you are. We do seemingly share one goal, however, which is to get this article to inform the reader about scholarly expert opinion on multivitamins and their purported health benefits. On the question of actual content, however, we would still appear to be poles apart. And my point remains: Given that you see the Iowa Women’s Health Study as valid for inclusion, the German Cancer Research Centre Study[http://www.ncbi.nlm.nih.gov/pubmed/21779961] ought to be included as well, for neutrality, balance and supporting information.[[User:Vitaminman|Vitaminman]] ([[User talk:Vitaminman|talk]]) 07:25, 17 October 2011 (UTC)
Not to interrupt your argument or anything, but about the only way that an absolute answer could be achieved (and not "cherry picking" that both sides tend to do) would be if some non-biased person or organization could raise the potentially few million dollars it would take to fund a solid, double-blind, placebo-controlled study using a good quality multivitamin in a controlled clinical setting over the course of several months to see what effect there would be. The problem is, about the only organizations that have that kind of money to spare would be the drug companies (which actually do fund most of the studies that "pro-vitamin people" find questionable, whether directly or through another company name... look it up). It's a nice ideal, but to find a completely unbiased person or organization willing to do that would be virtually impossible so a final answer that both sides would accept would never be found without that.
My only point in stating this (aside from hoping to end this seeming stale-mate argument that may be more appropriate via E-mail) is that both sides may not agree, but if you look at the basis behind any studies used, it may help to deem which ones are invalid or unacceptable by Wiki standards.[[User:Burleigh2|Burleigh2]] ([[User talk:Burleigh2|talk]]) 15:58, 17 October 2011 (UTC)

:I think this article needs a cleanup of small cohort studies and case-control studies, in order to put more emphasis on the 2011 studies that include hundreds of thousands of individuals. The older and smaller studies are included in the reviews if they are of enough scientific quality. [[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 12:17, 12 February 2012 (UTC)

::I moved some of the older and smaller studies to list below. It also appears that many of the studies haven't measured health effects directly (such as mortality), but rather surrogate parameters like homocysteine and C-reactive protein, whose effect on health, in turn, may not be entirely clear. Also, I don't find expert opinion as entirely true in these cases, as the opinions, in turn, may be based on older and smaller studies. It's possible that one or more of these entries should be reinserted in the article if we can form consensus for it. Also, I removed the classification of studies into positive, neutral and negative effects, because such a classifications inhibits the creation of an integrated overall picture of the health effects of vitamins, such as reviews finding both positive and negative effects. [[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 12:50, 12 February 2012 (UTC) 
*In 2002, a paper by Robert H. Fletcher and Kathleen M. Fairfield from the Harvard School of Medicine, in the Journal of the American Medical Association stated that "it appears prudent for all adults to take vitamin supplements." In this article, which examined the clinical applications of vitamins for the prevention of chronic diseases in adults examined English-language articles about vitamins in relation to chronic diseases published between 1966 and 2002, and concluded that inadequate intake of several vitamins has been linked to the development of diseases including coronary heart disease, cancer, and osteoporosis.<ref>{{cite journal |author=Fletcher RH, Fairfield KM |title=Vitamins for chronic disease prevention in adults: clinical applications |journal=JAMA |volume=287 |issue=23 |pages=3127–9 |year=2002 |month=June |pmid=12069676 |doi= 10.1001/jama.287.23.3127|url=}}</ref>
*Similarly, the April 9, 1998 issue of the New England Journal of Medicine featured an editorial entitled "Eat Right and Take a Multivitamin" that was based on studies that showed health benefits resulting from the consumption of supplemental folate to prevent birth defects and possibly decrease the incidence of cardiovascular disease.<ref>[http://content.nejm.org/cgi/content/short/338/15/1060 Eat Right and Take a Multivitamin] NEJM, Volume 338:1060-1061, April 9, 1998, Number 15. Published 9 April 1998. Accessed 27 Dec 2007.</ref>
*A 2007 UC Berkeley School of Public Health study in collaboration with Shaklee Corporation determined that long-term vitamin and mineral supplement users showed markedly better health than people who took no supplements. "After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood pressure and diabetes."<ref>{{cite journal |author=Block G, Jensen CD, Norkus EP, ''et al.'' |title=Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study |journal=Nutr J |volume=6 |issue= |pages=30 |year=2007 |pmid=17958896 |pmc=2164946 |doi=10.1186/1475-2891-6-30 |url=}}</ref>
*There is a new gravitation in the United States towards the [[Mediterranean diet]]. This diet is based on the [[Mediterranean Diet Pyramid]], created by [[Walter Willett]] in 1995.<ref>{{cite journal | author = Willet W. C., Sacks F., Trichopoulou A., Drescher G., Ferro-Luzzi A., Helsing E., Trichopoulos D. | year = 1995 | title = Mediterranean diet pyramid: A cultural model for healthy eating | url = | journal = The American Journal of Clinical Nutrition | volume = 61 | issue = 6| pages = 14025–14065 | pmid=7754995 }}</ref>  In 2008, the [[Harvard School of Public Health]] updated Willett’s pyramid in a Nutrition Source article called “Food Pyramids: What Should You Really Eat?”.  Included in this new pyramid, and the original pyramid, is a daily multivitamin.  The Harvard article states that “A daily multivitamin, multi-mineral supplement offers a kind of nutritional backup, especially when it includes some extra vitamin D. <strike>While a multivitamin can't in any way replace healthy eating, or make up for unhealthy eating, it can fill in the nutrient holes that may sometimes affect even the most careful eaters.”<ref>Harvard School of Public Health (2008). Food pyramids: What should you really eat?. Retrieved from http://www.hsph.harvard.edu/nutritionsource</ref></strike>
::I found the <strike>the crossed-out text</strike> to properly belong in the "Precautions"-section however, so I reinserted it there. [[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 12:27, 13 February 2012 (UTC)
*A 2009 study published in ''[[The American Journal of Clinical Nutrition]]'' reports that multivitamin use is associated with longer [[telomere]] length in women. Longer telomeres have recently been associated with longer life, and therefore multivitamins could have an anti-aging effect. However, this is the first study on this topic, so more studies must be done to confirm this effect.<ref>{{cite journal |author=Xu Q, Parks CG, DeRoo LA, Cawthon RM, Sandler DP, Chen H |title=Multivitamin use and telomere length in women |journal=Am. J. Clin. Nutr. |volume=89 |issue=6 |pages=1857–63 |year=2009 |month=June |pmid=19279081 |pmc=2714373 |doi=10.3945/ajcn.2008.26986 |url=}}</ref>
*In response to a 2009 study<ref>{{cite journal |author=Neuhouser ML, Wassertheil-Smoller S, Thomson C, ''et al.'' |title=Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts |journal=Arch. Intern. Med. |volume=169 |issue=3 |pages=294–304 |year=2009 |month=February |pmid=19204221 |doi=10.1001/archinternmed.2008.540 |url=}}</ref> stating the uselessness of multivitamins, the [[Linus Pauling Institute]] published an article refuting the study’s legitimacy and claims. According to the Linus Pauling Institute, the 2009 study was an observational study, not a randomized controlled trial. “Every epidemiologist will tell you that observational studies cannot establish cause-and-effect relationships; they only can observe associations.”  Additionally, 41.5 percent of the female participants took multivitamins and were overall healthier in all their habits . This makes it difficult to separate their healthy habits from their multivitamin use. Perhaps they used multivitamins because they already had healthy habits and were therefore healthier overall. The Linus Pauling article concludes with this statement: “Even Dr. JoAnn Manson, a principal investigator of the Women's Health Initiative and co-author of the study, acknowledges that ‘the research doesn't mean multivitamins are useless. Multivitamins may still be useful as a form of [health] insurance for people with poor eating habits.’ And let's not fool ourselves, that's the large majority of the people in this country!”.<ref>Linus Pauling Institute (2009). Are multivitamins useless? A response by the Linus Pauling Institute to an article published in the February 2009 issue of the Archives of Internal Medicine. Retrieved from http://lpi.oregonstate.edu</ref>
*[[Bruce Ames]], professor of [[Biochemistry]] and [[Molecular Biology]] at the [[University of California, Berkeley]], and a senior scientist at Children's Hospital Oakland Research Institute (CHORI), suggests that "to maximize human health and lifespan, scientists must abandon outdated models of micronutrients" and that "a metabolic tune-up through an improved supply of micronutrients is likely to have great health benefits."<ref>{{cite journal |author=Ames BN |title=Increasing longevity by tuning up metabolism. To maximize human health and lifespan, scientists must abandon outdated models of micronutrients |journal=EMBO Rep. |volume=6 Spec No |issue= |pages=S20–4 |year=2005 |month=July |pmid=15995656 |pmc=1369274 |doi=10.1038/sj.embor.7400426 |url=}}</ref>
*One study from 2008 found that multivitamin use had no effect on prevention of [[lung cancer]]. Participants in this observational study had been taking multivitamin supplements for an average of 10 years, and this use appeared to have no effect on the prevention of lung cancer.<ref>{{cite journal | author = Slatore C. G., Littman A. J., Au D. H., Satia J. A., White E. | year = 2008 | title = Long-term use of supplemental multivitamins, vitamin C, vitamin E, and folate does not decrease the risk of lung cancer | url = | journal = American Journal of Respiratory and Critical Care Medicine | volume = 177 | issue = 5| pages = 524–530 | pmid = 17989343 | doi = 10.1164/rccm.200709-1398OC | pmc = 2258445 }}</ref>
*A 2008 study found that multivitamin use increased the mean breast density in premenopausal women. Increased breast density is associated with a higher risk for breast cancer. The study surveyed premenopausal and postmenopausal women about their multivitamin use, and found that multivitamin use was associated with higher mean breast density in premenopausal women but not postmenopausal women. The length of time that the women had been taking multivitamins did not seem to affect their mean breast densities.<ref>{{cite journal |author=Bérubé S, Diorio C, Brisson J |title=Multivitamin-multimineral supplement use and mammographic breast density |journal=Am. J. Clin. Nutr. |volume=87 |issue=5 |pages=1400–4 |year=2008 |month=May |pmid=18469264 |doi= |url=}}</ref>
*In 2010, a Swedish study published in [[The American Journal of Clinical Nutrition]] found that multivitamin use may be associated with increased risk of [[breast cancer]] among women. The study followed 35,329 women between 1997 and 2009. At the end of the study, 974 women had been diagnosed with breast cancer, suggesting an increased risk of breast cancer relating to multivitamin use.<ref>{{cite journal |author=Larsson SC, Akesson A, Bergkvist L, Wolk A |title=Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women |journal=Am. J. Clin. Nutr. |volume=91 |issue=5 |pages=1268–72 |year=2010 |month=May |pmid=20335555 |doi=10.3945/ajcn.2009.28837 |url=}}</ref>

Also, I think the entry below doesn't add any new information, and is less specific, compared to the [[United States Department of Health and Human Services|HHS]]. [[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 12:17, 13 February 2012 (UTC)
*In 2006 the [[National Institutes of Health]] convened an expert panel to examine the available evidence on nutrient supplements.<ref name=NIHstmt2006/><ref name=Huang/> This review concluded that "Most of the studies we examined do not provide strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations of three or more." They noted that multivitamins could provide health benefits to some groups of people, such as [[menopause|postmenopausal]] women, but that there was "disturbing evidence of risk" in other groups, such as smokers. The panel's report concluded that the "present evidence is insufficient to recommend either for or against the use of Multivitamin/Mineral Supplements by the American public to prevent chronic disease."

===Reference list===
{{reflist}}

== Absorbtion Rate ==

I've seen rumors on the internet that multivitamins are only 20% absorbed by the body. Some say that liquid multis are better absorbed. However I can't track down a reputable source stating anything concrete on this subject.  <span style="font-size: smaller;" class="autosigned">— Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[Special:Contributions/71.194.190.179|71.194.190.179]] ([[User talk:71.194.190.179|talk]]) 19:14, 1 January 2012 (UTC)</span><!-- Template:Unsigned IP --> <!--Autosigned by SineBot-->

Yes bioavailability tends to be an issue that gets raised and probably warrants at least a paragraph. The form the compounds are in, compounds potentially blocking the absorption of some of the other compounds, etc. [[Anonymous]] 06:35, 3 August 2013 (UTC)

== The Physicians' Health Study II Randomized Controlled Trial ==

This section is about a one-off article that made some extraordinary claims, and which was subsequently questioned by later articles; and it takes quite a lot of text to do this.

Since the article itself is not [[WP:MEDRS]] compliant I think its inclusion (and the necessary inclusion of the counter material) is simply unnecessary - or at the very least too long, and the whole section should be ideally be removed.

Thought? [[User:Alexbrn|Alexbrn]] <sup>[[User talk:Alexbrn|talk]]|[[Special:Contributions/Alexbrn|contribs]]|[[User:Alexbrn#Conflict_of_interest_declaration|COI]]</sup> 14:16, 22 June 2013 (UTC)

{{done}} Hearing no opposition. [[User:Alexbrn|Alexbrn]] <sup>[[User talk:Alexbrn|talk]]|[[Special:Contributions/Alexbrn|contribs]]|[[User:Alexbrn#Conflict_of_interest_declaration|COI]]</sup> 06:48, 3 August 2013 (UTC)
:: I agree the section was too long, but I felt a discussion of PHS-II was warranted, so I merged it back in, in a much more concise form. I edited it significantly to make it more clear and remove excess verbiage.  The study (and questioning of it) is important to discuss considering the widspread media coverage about the positive result of the study. Additionally a recent meta analysis argues the positive result should not be overlooked [http://www.ncbi.nlm.nih.gov/pubmed/?term=25584933].  [[User:Danski14|Danski14]]<sup>[[User talk:Danski14|(talk)]]</sup> 04:04, 12 February 2015 (UTC)

==2013 Meta-analysis==
There's a 2013 meta-analysis "Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials" that should probably also be referenced. [[Anonymous]] 06:35, 3 August 2013 (UTC)

*{{cite journal |author=Macpherson H, Pipingas A, Pase MP |title=Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials |journal=Am. J. Clin. Nutr. |volume=97 |issue=2 |pages=437–44 |year=2013 |month=February |pmid=23255568 |doi=10.3945/ajcn.112.049304 |url=http://asn-cdn-remembers.s3.amazonaws.com/f9dfbd1514ffab3a318c58d69e92db68.pdf}}
*Editorial from same journal issue discussing the above meta-analysis.<br>{{cite journal |author=Chang SM |title=Should meta-analyses trump observational studies? |journal=Am. J. Clin. Nutr. |volume=97 |issue=2 |pages=237–8 |year=2013 |month=February |pmid=23255570 |doi=10.3945/ajcn.112.055111 |url=http://ajcn.nutrition.org/content/97/2/237.extract}}<br>--[[User:Anthonyhcole|Anthonyhcole]] ([[User talk:Anthonyhcole|talk]] · [[Special:Contributions/Anthonyhcole|contribs]] · [[Special:EmailUser/Anthonyhcole|email]])  07:08, 3 August 2013 (UTC)

== AIM editorial vs. HSPH opinion ==

I'd like to add something like this [https://en.wikipedia.org/enwiki/w/index.php?title=Multivitamin&diff=586900353&oldid=586600820] to balance out 'According to the Harvard School of Public Health: "Looking at all the evidence, the potential health benefits of taking a standard daily multivitamin seem to outweigh the potential risks for most people"', which looks to be becoming a minority view lately. However, my edit got reverted by [[User:Vitaminman]]. I'm not very familiar with [[WP:MEDRS]] yet, maybe removing the Harvard School of Public Health blurb instead of adding the AIM editorial would be the right thing to do to achieve NPOV without violating [[WP:MEDRS]]? [[User:Rolf h nelson|Rolf H Nelson]] ([[User talk:Rolf h nelson|talk]]) 02:58, 1 January 2014 (UTC)

== Prenatal vitamin recommendations ==

"Pregnant women should only take vitamin supplements on a health care provider’s recommendation." [http://americanpregnancy.org/pregnancyhealth/nutrientsvitaminspregnancy.html]

1. Does this pass [[WP:MEDRS]]?

2. What's the majority view? The Mayo Clinic seems more sanguine, and is specifically addressing mutivitamins.[http://www.mayoclinic.org/prenatal-vitamins/ART-20046945?p=1] The current text, "Generally, medical advice is to avoid multivitamins, particularly those containing vitamin A, during pregnancy unless they are recommended by a health care professional", seems too strong IMHO. I would argue for something like "Most multivitamins contain substances like vitamin A that may be harmful in the case of pregnancy. Therefore, organizations such as the Mayo Clinic strongly recommend against the consumption of general-purpose non-prenatal multivitamins by pregnant women, and by women attempting to become pregnant; appropriate [[prenatal vitamins]] should be consumed instead."  <small><span class="autosigned">—&nbsp;Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Rolf h nelson|Rolf h nelson]] ([[User talk:Rolf h nelson|talk]] • [[Special:Contributions/Rolf h nelson|contribs]]) 22:36, 19 January 2014 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot-->

== External links modified (February 2018) ==

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=="certain diseases"==
in the quote from the ''Guardian'' summary of the Cochrane review at the end of the article: "Current evidence does not support the use of antioxidant supplements in the general healthy population or in patients with certain diseases."  the phrase  ''in patients with certain diseases.''   is   confusing to the point of being meaningless. 
Does this mean
#Its use is not supported in some specific diseases (such as .... ) but it is supported in others, (such as ....)
#Its use is supported for most diseases, but not for certain particular ones (such as ....)
#Its use has been suggested for a number of specific diseases, but it is not supported for any of them  (That's what I think it means, in context, but "certain diseases, if in our text, would be tagged <nowiki>{{which}}</nowiki>

Additionally,  it's a quote discussing antioxidant supplements, not MVMs. MVMs contain antioxidants, but they contain other things also.  That could mean
#the use of  antioxidants is not supported, and therefore the use of MVMs is not supported because they contains antioxidants , or 
#the use of antioxidants alone is not supported, but the other substances in MVMs might be helpful
#the use of antioxidants in MVMs is not supported, but the value of the other   substances in MVMs  meeds to be considered separately.

'''[[User:DGG| DGG]]''' ([[User talk:DGG| talk ]]) 00:36, 27 November 2018 (UTC)

::not seeing any discussion, I removed it as not being about overall topic, but belonging elsewhere. multivitamins are not all antioxidants, and most antioxidants are not vitamins. '''[[User:DGG| DGG]]''' ([[User talk:DGG| talk ]]) 19:22, 13 March 2019 (UTC)
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