Multivitamins kill older women?

Will One A Day® make grandma have fewer days?

A new study in the Archives of Internal Medicine reports that dietary supplements — including multivitamins, folic acid, iron and copper, among others — “appears associated with an increased risk of death in older women.”

But before anyone throws away their vitamins consider the following.

All the study’s reported statistical associations of concern are weak, barely (suspiciously?) statistically significant and none are backed up by an medical investigation or biological plausibility. Food and vitamin intake was self-reported by the study subjects only three times by the women over the course of the 22-year long study — so “unreliable” would be a generous description of it.

Although a number of confounding risk factors for mortality were supposedly considered (at least statistically) by the researchers, multivariate analysis is simply not designed to handle such poor and inadequate data collection, and the complex interactions of potential confounding risk factors.

The bottom line is that the researchers have no idea how much vitamins and minerals, and in what combinations, these women actually consumed or why they died. To condemn multivitamins with such shoddy statistical inference is absurd.

This study proves nothing other than shocking and shockingly junky results can get published in otherwise reputable journal.

None of this is to say that some (many?) people aren’t wasting their money and obtaining false comfort overdosing on vitamin, mineral and other dietary supplements — but that’s a different question from safety that we’ll leave for another day.

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29 responses to “Multivitamins kill older women?

  1. Paul Rowlandson

    I would not be surprised if there isn’t some truth in it. As we age, our livers get less efficient. Many multivitamin formulas contain many times the Recommended Daily Allowances of various vitamins and minerals, all in the one tablet, some of them so large they look like horse tablets. We do not get this sort of concentration of different substances in nature, and the liver can have a hard time dealing with them in this concentrated form. The latest fashionable ‘over-dose’ substance is Resveratrol. Some Resveratrol formulas contain the equivalent Resveratrol of 600 glasses of red wine a day. This must tax the liver’s ability to process the stuff.

    • There has been a LOT of study & research on Resveratrol and it does indeed appear that 500 mg. daily is beneficial and worth the cost. I do not know how many glasses of wine 500mg represents but I am sure it is a lot more than you would want to drink.

  2. The study results are really bad news for us oldsters. We’ve all been taking many, many supplements for a lot of years. Now we know we’re liable to be goners at any time.

    • Also, the reverse causality effect isn’t accounted for. People in worse health take more medication, including vitamins. Those that are healthier live longer and take less medication. That alone could account for the entire discrepancy and more.

      • Bingo. This is like saying that the presence of insulin in your medicine cabinet “is associated with” an increased risk of diabetes in the family.

  3. There are seemingly at least one of these per day. It has long been recognized that people will react to reports that purport to be based on scientific studies over a period of years with very large populations involved. These are called observational studies and have been shown to produce very questionable and sometimes downright erroneous conclusions. Here’s one that will surely ruffle some feathers and cause some concern for people who are taking Statin drugs to lower their LDL Cholesterol levels. http://www.fathead-movie.com/index.php/2010/10/28/video-of-the-big-fat-fiasco-speech/

  4. This report is another example of shoddy meaningless science. There are chemically derived supplements and food based supplements. The manufactured chemical supplements are likely of little value and perhaps slightly harmful. The food based supplements (made from food) are much more likely to be beneficial. Supplements are no doubt greatly safer than pharmaceutical drugs that kill about 100,000 Americans every year even taken as directed. A medical journal reported no cases of deaths from supplements.

    • Unfortunately, Fred, the research paper does not tell us what these 38,000 older women were taking in terms of synthetic or natural supplements. Besides, I cannot tell the chemical difference between synthetic vitamin C and highly purified natural vitamin C. That holds true for most of the other vitamins, assuming that there was a chemical company that really wanted to and could afford to synthesize such a complex molecule as vitamin B12. However, I agree with your statement about the dangers of pharmaceutical medications..

  5. I was going to say what Ben of Houston said, but he already said it. “Why?” is the key question to ask here.

  6. To begin with, people today are living a lot longer than they did a few years back before everyone started a regular vitamin routine. Still a weak statistical link, but a lot stronger than this study.

    If you want to be a “hero” and get your name in the news, release a study finding some harmless and beneficial substance to be dangerous.

  7. The study mentioned iron. Most “for men” or “over 50″ have zero iron. After menopause women no longer have the monthly “period” blood loss so
    iron can build up.

  8. I wonder what the motivation would be, if any, for placing vitamin pills in such poor light.

  9. >>>I wonder what the motivation would be, if any, for placing vitamin pills in such poor light.<<<

    So they can sell more "Statin" and other risky preventive drugs? Or maybe because it makes an eye catching headline? :/ from Sue who is 67 and healthy and takes lots of vitamins! :)

  10. Fred, as a chemist, your “Chemical-based” versus “Food-based” diferrentiation irks me. Chemicals are chemicals, and while food-based might have a better taste due to additional impurities (make no mistake, the chemically derived products are much more pure, that’s why high-fructose corn syrup has a flat taste compared to sugar, it doesn’t have the complexity provided by all the junk in the plant), there is absolutely no difference in effect versus ferrous sulphate derived from food products or ferrous sulphate derived from iron ore because it is still FeSO4.

    • Ben, as a scientist I understand your point about chemicals and the purity of chemically derived supplements. Supplements that are food based have the extra stuff or “impurities” as you stated that may be very important. I can only hypothesize that the extra stuff is also important to health as well as the isolated chemicals. It may also be for example important for iron or calcium to be in a particular compound state to be most beneficial. The main point I meant to make was that by simply asking people 3 times during a many years’ study if they take supplements does not isolate many of the nuances of different vitamin types. For instance it is well known that older men should not load up on iron. A study in 2009 by the U S National Poison Center of 60 poison centers across the U S found not a single death occurred from supplements including vitamins, minerals, amino acids, and herbs. This is a truly amazing safety record for supplements versus pharmaceutical drugs that kill 10s of thousands of Americans each year even when taken as directed. Unfortunately even the TV networks are reporting this study this morning as “supplements may result in early death for older women”. This reporting only could benefit the pharmaceutical industry as I see it. Since a large percentage of network revenue comes from pharmaceutical ads, a story like this may get some play even though the associations, statistics, and methods may be suspect.

      • Fred, I’ll agree. However, I question your “tens of thousands” of deaths number from prescriptions. What is your source for that?

        Also, raw totals are deceptive. You cannot compare chemotherapy medication or IV-drip antibiotics with echinacea, much less Vitamin C. You have to compare Echinacea to Zyrtec, which I believe both have zero deaths.

        You have to compare apples to apples otherwise it’s pure-D junk science.

        • Ben, here is one 1998 source that estimates deaths from prescription drugs at 106,000 per year: JAMA. 2000;284(4):483-485. There are other articles that combine over-the-counter with prescription drugs.

      • Fred, I wasn’t able to get to the full original due to the paywall, but from the free extract I that could get to suggested 44,000 to 98,000 Americans die annually due to medical errors. However, this study is about medical mistakes, a far cry from evidence for your claim that people are dying due to properly administered prescriptions. You have many causes of deaths from medical mistakes: improper diagnosis, incomplete diagnosis, allergic reactions, cross-infections, surgery screw-ups (mostly resulting from the first two items), etc.

        Again, your initial claim that people are killed by pharmaceuticals but not vitamins, while technically true, is not a valid comparison, and it also omits the problems with people not seeking treatment. Herbal remedies don’t kill people, but relying on Beetroot, Lemon, and Garlic to cue AIDS will have you dead in short order.

  11. The FDA along with the WHO and their Codex Alimentarius committee well populated with Big Pharma KOLs are doing their best to have vitamins defined as prescription drugs. It is not for the health of the general population but for the benefit of Big Pharmas’ bottom line. They see the value of vitamins but can only make a killing if they are drugs!

  12. In a recent study conducted by “me” found that we are very likely to live until we die. It was also confirmed by the medical community (i.e. my dad’s doctor) who told my dad the same thing. My dad is 85 and believes that is correct.

    I wonder if I can get a government grant to gather proof. I only need a couple million to get me started.

  13. I was pretty upset that the journal would allow this report to be published. Why were they participants taking vitamins? Did they have a prior health concern and they were attempting to self-medicate? Did they die of that disease? The major flaw of this study is that the authors could not draw a causal relationship. All we know is that people who took the vitamins died. We cannot conclude that the use of vitamins killed them.

    The study goes on to say that the participants were more physically active. Being more physically active places one in a higher risk category for injury (more hours on the road, golf injuries leading to dr. visits, possible surgery and complications of the surgery).

    I read the article and I plan on continuing my vitamin protocols.

  14. To quote Marcello Truzzi, “extraordinary claims require extraordinary proof.”

    I won’t impugn the authors’ motives; any challenge is welcome so long as it is at least reasonably valid (think Warren and Marshall re: H Pylori). Also, the fact that one giant industry (pharma) may benefit at the cost of another giant industry (make no mistake, supplements rake in tens of billions yearly) does not invalidate the data.

    That said, I return to the original premise. In considering the study, the great number of possible confounders should reasonably outweigh the marginal results, and until either a clear and significant difference is found, or a preponderence of studies replicate these results, I’ll continue munching my Flinstones! (Feet first, or course).

  15. This does agree with another well known and statistically significant relationship study ( probably at great federal expense) that shows very clearly that longevity leads to an increase in death…..in other words life in excess leads to death.

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  18. Bix: You asked why the anti-vitamin bit? Reader’s digest shows why. About once or twice a year they publish a severe anti-vitamin article, but if you thumb through the magazine you will find every other page is a flashy centerfold advertising some pricey prescription drug, problem solved.

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  21. We all need to depend more on whole foods and less on supplements, because it’s not just a problem with multivitamins, other supplements have been found harmful too. Check out the NutritionFacts.org blog about it: http://nutritionfacts.org/?p=4597 (non-commercial, science-based site).

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