Ought to I Take a Multivitamin? 4 Issues to Think about First

A study published Wednesday in JAMA that included almost 400,000 people and followed those people for nearly 30 years found that the participants who took daily multivitamins were no less likely to have died in that time period than the people who did not take a daily multivitamin. Meaning: Multivitamins do not positively affect a person’s longevity (and in fact, the death rate was even slightly higher in the group of daily multivitamin-takers).

The median age of participants at the outset of the study was mid-60s, so it mostly tracked an older population as they aged. The study accounted for variables like demographic differences, pre-existing conditions, and lifestyle factors, making outside experts confident² in the study’s design and conclusions.

It’s just one study, sure. But if you’re like us, you’re probably wondering at this point: Should I take a multivitamin?

“I think there’s a general assumption that multivitamins are good, and if somebody wants to be health-conscious, it’s an easy kind of general blanket item to reach for that people think probably has some benefit [and] very little harm,” says Justin Mazur, MD, CFMP, a physician at the functional medicine practice Health Meets Wellness.

Given this assumption, the results of the study were somewhat surprising to him. However, “it’s a very large study and the timeframe is significant, so I don’t think the results can be discounted,” he says.

Tod Cooperman, MD, the president and founder of ConsumerLab.com, which tests and assesses supplements, points out that the study’s main limitation is that there’s no way to know whether the daily multivitamin-users kept taking the vitamins for the duration of the study, or if non-users started taking vitamins at some point (though there were follow-ups three to nine years after the initial surveys, and the study only considered people in the daily multivitamin-user cohort if they reaffirmed that they took multivitamins every day in the followup).

Overall, though, Dr. Cooperman says, the study provides more evidence for what several previous studies (including a 2022 meta-analysis conducted by the US Preventive Services Task Force³) have already shown (albeit with smaller subject pools and shorter follow-up times): Multivitamins don’t seem to have a positive effect on a person’s longevity.

“I am not surprised by the findings of this study,” says Sarah Pflugradt, PhD, RDN, CSCS, a doctor of health and human performance and registered dietitian. “There is no magic bullet for health and no one should expect immortality from a daily multivitamin.”

So if you have a multivitamin bottle on your shelf, is it time to simply… throw it in the trash? Here’s what you should consider if you’re wondering whether you should still take a multivitamin.

Question 1: Are you taking a multivitamin for longevity?

If generally living a longer life is the primary reason you’re taking a multivitamin, this recent study and other supporting studies show you’re probably not getting that benefit. But a multivitamin could have some upsides if you’re hoping to target things that affect your quality of life, as opposed to how long you actually live.

“It’s fair to say that people are looking to multivitamins to prevent deficiencies that might reduce their quality of life in a variety of ways as opposed to living longer,” Dr. Cooperman says. Multivitamins have been shown to have benefits in cognitive function⁴ and cataract reduction⁵ in older adults, for example. Pflugradt also points out that they can help with nutrient deficiencies, which can affect things like your energy level.

“For some nutrients, such as vitamin C and B vitamins, we have daily requirements,” Dr. Pflugradt says. “If the needs for these nutrients are not being met, a multivitamin is a good choice.”

So if you’re an older person interested in supporting eyesight and sharpness, or have a diet that you know doesn’t hit some nutrient marks, don’t throw out that bottle just yet. But for general good health and long life? Yeah, not so much.

Question 2: Are you taking a multivitamin every day, or situationally?

One of the study components that stood out to Elizabeth Sharp, MD, IFMCP, the founder and CEO of Health Meets Wellness (Dr. Mazur is a colleague), was that the subjects were ostensibly taking the supplements every day for 20-plus years. While taking a multivitamin is generally a low-risk proposition, she points out that the participants likely spent lots of money on vitamins over that time period. What’s more, supplements can have side effects. In fact, she’s treated patients who are suffering from getting too much of a nutrient.

“There isn’t any resounding data to support taking a multivitamin, however, there can be specific reasons or chunks of time for someone to take one,” Dr. Sharp says.

If you’re traveling, sick, in a period where you’re not cooking as much (which can often happen when you get older) and relying more packaged food, or are not eating as many fruits and vegetables, a multivitamin can give you some extra nutrient padding. There are also specific times in your life, like if you are pregnant, when doctors recommend you take a multivitamin (or in that case, a prenatal vitamin).

“Okay, if you’re breastfeeding or you’re pregnant or you’re trying to get pregnant, take a prenatal,” Dr. Sharp says. “There are reasons [to take one].” But taking a multi continuously for a 20-year period? “I would say no. Anybody can just walk into the store and grab one off the shelf, [but] that is not an effective method. Taking a multivitamin should be done with careful consideration.”

Question 3: Do you know what you’re trying to supplement?

Dr. Cooperman describes a multivitamin as a “shotgun approach” to supporting your nutrient levels, meaning you don’t actually know if you’re getting enough nutrients in your diet—and the shotgun approach can be problematic.

“It’s very rare that someone needs every single thing that’s in a multivitamin,” says Dr. Sharp. “I’m a big proponent of supplementation that’s specific to a patient or specific things.” Common supplements she recommends often depend on needs like increased vitamin B12 for vegetarians.

Meanwhile, why take vitamins if you don’t know you actually need them? Dr. Mazur recommends doing plasma and blood tests to see if you have any deficiencies in the first place.

“Some people who’ve done these who’ve had good diets, myself included, have had some surprising results,” Dr. Mazur says. “It’s better practice to do that kind of thing first before” turning to a multivitamin.

Of course, tests like these can run several hundred dollars, and they’re tests you’ll probably want to repeat every year or every few years to see where your body stands. At the same time, a month’s supply of multivitamins can cost anywhere from $10 to hundreds of dollars, depending on what’s in them and who’s selling them.

“I customize recommendations and give certain supplements, not multis,” says Gowri Reddy Rocco, MD, founder of Optimum Wellness & Longevity. She often recommends her patients take fish oils, vitamin D, and B vitamins, “but not one multivitamin that covers everything. I always prescribe nutrition first and change someone’s quality of life to improve how they process foods, their inflammation resistance, and their exercise and sleep.”

In fact, that’s what all the experts say is the best option of all: Focus on lifestyle factors including quality sleep, regular exercise, and nutrition in the form of eating lots of fruits and vegetables.

Because in the end? “You can’t supplement your way out of a poor diet or unhealthy lifestyle factors,” Pflugradt says.

What’s more, even with the ‘firehose’ multivitamin approach, you may still not be getting all the nutrients you need if you’re relying on a multivitamin. “Multivitamins only give a small portion of nutrients that may be missing from someone’s diet,” Pflugradt says. “Other nutrients to consider are the powerful phytonutrients found in fruits and vegetables, which have been shown to help reduce the risk of chronic conditions. Those can’t be bottled up and sold as a pill; their packaging comes in the form of apples, carrots, pomegranates, and the many other colorful fruits and vegetables available in a different section of the grocery store.”

Question 4: Are you confident in the quality of your multivitamin?

In ConsumerLab.com’s assessment of multivitamins, Dr. Cooperman and his organization found that 1 out of every 3 multivitamins they tested did not contain the nutrients or the amounts of nutrients as advertised on the label. Overall, quality control in supplements often falls woefully short because, while the FDA sets manufacturing guidelines, it does not mandate or enforce any kind of quality testing before supplement bottles hit store shelves.

“Most supplements are not proven to be what they claim,” Dr. Rocco says. “The FDA requires a statement on every vitamin saying that the FDA did not review this brand or bottle.” Quite simply: “We don’t know what’s really in them.”

Dr. Rocco prefers to prescribe nutraceuticals, which get third-party tested for safety and accuracy.

But even with this problem in the supplements industry as a whole, multivitamins are specifically susceptible to inaccuracy.

“A multivitamin is a very complicated supplement,” Dr. Cooperman says. “You’re trying to get in the right amounts of so many different ingredients. Some of them are microgram level, some are a thousand times more, at the milligram level, and it all has to be mixed properly so that each pill actually has the right amount. So it’s not so easy to make a product that always hits the mark. And so when we test multivitamins and look for these various ingredients, I think that explains why, among all the vitamin-mineral supplements, it’s the one that’s most likely to fall short on something on one of its ingredients.”

Maybe unsurprisingly, then, prenatal vitamins have the same issues: Recent analyses show that they often fall short on the amounts of nutrients recommended by the American Gynecological Association to support a healthy pregnancy.

That’s all the more reason to be discerning when it comes to the quality of the supplement you’re taking (pro tip: ask your doctor for their recommendation) and whether you choose to take it situationally or every day.

“I think this was a valuable study and the results, like those of many studies, lead us into a conversation about how to use dietary supplements, like multivitamins, to best support health,” Pflugradt says. “A daily multivitamin is not necessary for everyone, and its use should come with scrutiny, thought, and care, as with anything else you put in your body.”