mechanism of action of multivitamins and minerals

MVMssuch as those for energy, enhanced athletic performance, weight control, improved immune function, or eye healthoften combine several vitamins and minerals with botanical and specialty ingredients, such as coenzyme Q10, probiotics, or glucosamine. . When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Telecommunications relay service (TRS): 7-1-1, Email: info@nccih.nih.gov (link sends email). Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. JAMA 2012;308:1871-80. An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in 2006 concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [1]. Because of limited information on product characteristics, our ability to directly compare results across studies, estimate changes in usage patterns or intakes over time, and generalize . Iron-deficiency can lead to decreased production of hemoglobin and a microcytic, hypochromic anemia. Smokers and, possibly, former smokers should avoid MVM products providing large amounts of beta-carotene or vitamin A because two studies have linked these nutrients to an increased risk of lung cancer in smokers [63]. The Physicians Health Study II was the longest clinical trial to investigate whether MVMs might help prevent chronic disease. 1 Supplement use is typically a safe and effective method of maintaining a healthy body . [, Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. Small Business Research Grant Program (SBIR), About Research Training and Career Development, Training Grant Application, Review, and Award Process, Integrative Medicine Research Lecture Series, Division of Extramural Research Sponsored by NCCIH, Division of Intramural Research Conducted at NCCIH, Dietary Guidelines for Americans 20152020, How To Find Information About Complementary Health Approaches on PubMed, Most individuals can get all of the necessary vitamins and minerals through a healthy eating pattern of nutrient-dense foods. Health care providers determine the dose of this medication for a given patient in part by assessing the amount of vitamin K that the patient routinely consumes. Know the Science: 9 Questions To Help You Make Sense of Health Research. Some published reports of studies of dietary supplements use the generic term "multivitamins" to include products with and without minerals. Because people with healthier diets and lifestyles are more likely to use dietary supplements, attributing health benefits that are distinct from the benefits of healthy behaviors to the use of supplements is difficult [13]. [, Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. Multivitamins are supplements that contain many different vitamins and minerals, sometimes alongside other ingredients ().Given that there's no standard for what constitutes a multivitamin . "Vitamin D and . Am J Clin Nutr 2007;85:277S-9S. Be sure to check the percent daily value (% DV) to see what proportion of your daily allotment youregetting. . Taking a basic MVM that provides nutrients in amounts that are approximately the same as recommended intakes should be safe for healthy people. The rate of death from breast cancer (6.7% of the cohort) was 30% lower among the MVM users than nonusers. Am J Clin Nutr 2010;91:1268-1272. A review of 16 RCTs of MVs and MVMs (containing more than four nutrients including, in most cases, at least one mineral) in 1,719 participants who had at least one of six types of psychiatric symptoms (depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, or autism) found that the supplements provided no clear reduction in symptoms [47]. This study included 4,203 participants aged 5085 years who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other eye. Vitamins and minerals serve crucial functions in almost all bodily processes and must be obtained from foods or supplements, as our bodies are unable to make them. Multivitamin-multimineral supplements: who uses them? Mutlvitamin-multimineral supplementation and mortality: A meta-analysis of randomized controlled trials. Depending on their formulations, MVMs can help individuals obtain adequate amounts of these nutrients, except for potassium (because MVMs contain only very small amounts of this mineral) and dietary fiber. NCCIH has provided this material for your information. Many types of MVMs, the focus of this fact sheet, are available in the marketplace. This document does not contain all possible side effects and others may occur. Revitalize Multi-vitamin and Mineral Complex: Iron (1.5 mg / cap) + Ascorbic acid . Art. An ancillary study to COSMOS, known as COSMOS-Mind, enrolled 2,262 of the older COSMOS participants (mean age 73 years) to investigate whether the cocoa extract, MVM, or both supplements might improve cognition as compared to placebo over 3 years of daily use [43]. Although MVM use might not reduce overall chronic disease risk, several nutrients in MVMs might benefit certain groups of people. Take this medication by mouth, usually once daily or as directed. Deficiency Signs and Symptoms. Vitamin A (preformed = retinol; beta-carotene can be converted to Vitamin A) 700 micrograms (2,333 IU) 900 micrograms (3,000 IU) Multivitamins with iron are used to provide vitamins and iron that are not taken in through the diet. The DGA does not mention MVMs, but it does recommend that Americans choose healthy, nutrient-dense food and beverages. MVMs taken once a day that contain all or most vitamins and minerals, most in amounts that do not exceed the Daily Values (DVs), Recommended Dietary Allowances (RDAs), or Adequate Intakes (AIs) for these nutrients. [, Kim J, Choi J, Kwon SY, McEvoy JW, Blaha MJ, Blumenthal RS, et al. On the whole, the . Studies of MVMs that have focused on cancer have been observational. Host factors include homeostatic mechanisms that regulate absorption or excretion depending on the nutrient status of the host . Multivitamin use and the risk of cardiovascular disease in men. Otten JJ, Hellwig JP, Meyers LD (editors). Rosenberg IH. What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? Read the label of any multivitamin product you take to make sure you are aware of what it contains. Huang H-Y, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer C, et al. After 7.5 years of use, the supplements lowered total cancer incidence by 31% and all-cause mortality rates by 37% in men but not women. It is not intended to substitute for the medical expertise and advice of your health care provider(s). Vitamins & Minerals; Supplier Directory; . MVMs providing nutrients at or up to 100% DV do not typically interact with medications. Pregnancy vitamin with Omega-3 for baby's brain development. Some electrolytes and water non-soluble vitamins require an active uptake mechanism. People in the United States have taken multi-vitamin/mineral (MVM) and multivitamin (MV) dietary supplements since the early 1940s, when the first such products became available [1]. Ask ODS Health care providers sometimes prescribe MVMs for people who have medical conditions and diseases that impair digestion, absorption, or use of nutrients. Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. However, MVMs cannot take the place of the variety of foods that are important to a healthy diet, because foods provide other nutrients and components that have benefits for health. The mechanisms of action of bitter melon in the reduction of blood glucose in relation to T2DM and AD. New technologies have allowed innovators to discover the mechanisms of action behind the efficacy of specific strains and bacteria-enhancing combinations, through advanced assay analysis, translational models, and even deep dives into public health data. The radioprotective effect ex vivo, in vitro and in vivo of vitamins was reviewed using PubMed and Embase and conducted according to the PRISMA statement. Most have not found an effect of MVM use on any of the health outcomes measured. This publication is not copyrighted and is in the public domain. MVMs can also increase the likelihood that users will have intakes of some nutrients that are higher than the ULs [14]. Taking an MVM increases nutrient intakes and helps people obtain recommended amounts of vitamins and minerals when they do not meet these needs from food alone [9,12]. Multivitamin use and colon cancer mortality in the Cancer Prevention Study II cohort (United States). Vitamins are important building blocks of . Each of the product's ingredients works to enhance your health and well-being. Overall, women are more likely (34.0%) to take an MVM than men (28.3%) [2]. [, Rock CL. Pregnant people Hypersegmented Neutrophils. A similar meta-analysis of 13 RCTs investigated whether use by pregnant adolescents and young adults aged 10-19 years of an MVM (containing multiple nutrients) led to better birth outcomes than supplementation with only iron and folic acid [34]. The greatest improvements in intake were for vitamins A and E and zinc. Examples of these populations are described below: People who could become pregnant These products go by various names, including "multis" and "multiples," and manufacturers determine the combinations and levels of vitamins, minerals, and other ingredients in them. Among the more common ingredients are amino acids, protein, creatine, and caffeine. US Pharm. Abdominal pain. However, no two RCTs have used MVMs with the same combinations and amounts of nutrients. No U.S. government health agency, private health group, or health professional organization promotes regular use of MVMs. Use of MVs and MVMs (products containing three or more vitamins and/or minerals in amounts below the ULs and no herbs) did not reduce the risk of any chronic disease. In Canada, almost all prenatal MVM supplements provide 1,000 mcg/day of folic acid. MVM use is less common among smokers and members of certain ethnic and racial groups, such as African Americans, Hispanics, and Native Americans, than among Whites. J Am Coll Cardiol 2021;77:423-36. ** These MVMs might also include other nutrients and botanical ingredients. Macrocytic Megaloblastic Anemia. Systematic information on the bioavailability and bioequivalence of vitamins and minerals in marketed products and on potential drug interactions is scarce. The compound is produced by plants as a defense mechanism against stress, injury, and infection. Overall, MVMs do not appear to reliably reduce the risk of chronic diseases when people choose to take these products for up to a decade (or more) or when studies randomize people to take them as part of a clinical trial. Nutrition intervention trials in Linxian, China: Multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. Ophthalmology 2014;121:525-34. Am J Clin Nutr 2007;85:257S-264S. J Nutr 2016;146:1235-40. There is no one single thing that makes it work. Observational studies If you have questions about affording vitamin supplements, contact CF Foundation Compass by calling 844-COMPASS, Monday through Friday, 9 a.m. until 7 p.m. which is why it's a critical component in prenatal vitamins mechanism of action. Vitamins and minerals are essential substances that our bodies need to develop and function normally. [, Park S-Y, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. Vitamin A is effective for the treatment of Vitamin A deficiency. For more information on safe upper levels of nutrients, visit the NIH Office of Dietary Supplements at: Smokers, and possibly former smokers, should avoid MVM products that provide more than 100% DV for vitamin A (either as preformed retinol or beta-carotene or some combination of the two) because two studies have linked high supplemental doses of these nutrients with an increased risk of lung cancer insmokers. Gestational folate and folic acid intake among women in Canada at higher risk of pre-eclampsia. . [, Murphy SP, White KK, Park S-Y, Sharma S. Multivitamin-multimineral supplements' effect on total nutrient intake. MVMs and MVs accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019 [4]. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers among male smokers. Mechanism of Action Exerts oncotic pressure, which expands volume of circulating blood and maintains cardiac output. Homeostatic regulation of Blood Pressure by a negative feedback system Positive Feedback Mechanisms In positive feedback mechanisms, the result or . [, Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G, et al. [, Bird JK, Murphy RA, Ciappio ED, McBurney MI. The World Health Organization recommends iron and folic acid supplementation throughout pregnancy [57]. In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy" [54]. Enzymes for detoxification of various mycotoxins: origins and mechanisms of catalytic action. Dietary supplement use differs by socioeconomic and health-related characteristics among U.S. adults, NHANES 2011-2014. Water and some water-soluble vitamins are absorbed by diffusion. Multivitamins in the prevention of cancer and cardiovascular disease: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Read the Supplement Facts label to identify MVMs in your supplement product. [, Rose EG, Murphy MSQ, Erwin E, Muldoon KA, Harvey ALJ, White RR, et al. . For example, a 2018 meta-analysis of 16 prospective cohort studies (including the study described above and the 2 below) and 2 RCTs evaluated the association between use of MVMs (defined as containing more than three vitamins and minerals) and risk of various CVD outcomes, including coronary heart disease and stroke [25]. : CD004905. In the Age-Related Eye Disease Study (AREDS), investigators randomized 4,757 individuals aged 5580 years who had varying degrees of AMD, cataract, or both conditions to receive a placebo or a daily supplement containing high doses of vitamin C (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) [30,31]. Therapeutic Vitamins/Minerals Capsule - Uses, Side Effects, and More Generic Name(S): multivitamin with min no.7-FA, multivitamin,tx-minerals View Free Coupon Vitamins and minerals can cause toxicity if consumed in large amounts. Multiple-micronutrient supplementation in pregnant adolescnts in low- and middle-income countries: A systematic review and meta-analysis of individual participant data. MVM and MV supplements have no standard or regulatory definition, such as what nutrients they must contain or in what amounts. [, Keats EC, Haider BA, Tam E, Bhutta ZA. Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States. Dietary supplement use in children and adolescents aged <19 yearsUnited States, 2017-2018. The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. NCCIH has provided this material for your information. Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. For example, 27.7% had inadequate intakes of vitamin A from foods alone, but this rate dropped to 15.5% when supplements were included. Multivitamin use and cardiovascular disease in a prospective study of women. A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 20012014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone [17]. Homocysteine to methionine. Women. NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Manufacturers choose which vitamins, minerals, and other ingredients, as well as their amounts, to include in their products. After adjustment for potentially confounding variables (e.g., age, race, BMI, serum lipids, and blood pressure), the use of MVMs for more than 3 years was associated with a substantial 44% reduction in CVD mortality rates among women, but not men. Methylmalonyl CoA to succinyl CoA. Am J Clin Nutr 2007:85:318S-22S. There are two different types of vitamin D, vitamin D3, which is the form . Previous. Am J Clin Nutr 2007;85:308S-13S. Nutrients 2017; 9: 655. Theres no convincing evidence that MVMs help prevent chronicdisease. Your child needs a variety of vitamins and minerals to grow healthy and strong. [, Rautiainen S, Rist PM, Glynn RJ, Buring JE, Gaziano JM,Sesso HD. Even in the United States, the amount of folic acid in prenatal MVM supplements is typically 800 or 1,000 mcg, which is much higher than the recommended amount (400 mcg) to reduce the risk of neural tube defects in babies [19]. Some studies have suggested potential health benefits or harms from the use of MVMs, but others have found none. Vitamins A, C, D and E were used alone, in combination or with other nutritional and non . The FNB and DGA agree that fully and partially breastfed infants should receive a supplement containing approximately 400 IU (10 mcg)/day vitamin D beginning in the first week of life [54,59]. Others MVM supplementation, with or without the cocoa extract, improved global cognition, a benefit most pronounced in participants with a history of CVD. The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. After the investigators followed participants for up to 20 additional years, when participants were no longer taking the study supplement, the use of the MVMs during the RCT did not result in lower rates of total mortality or mortality from any cause of death examined, including cancer, heart disease, and stroke [45]. Obimin Plus is a pre- and postnatal supplement to help provide adequate supply of vitamins, minerals and DHA and EPA, during pregnancy and lactation. Vitamin C is responsible for synthesizing collagen and is necessary for proper wound healing.6 Vitamin C is also secreted in breast milk thus, a higher dietary intake is recommended for lactating women to make up for this loss. In particular, in pregnant women, MVM together with iron and folic acid are recommended to improve birth outcome and reduce low birth weight and rates of miscarriage. Carbohydrates, such as cellulose, pass through the human intestinal tract undigested. JAMA 2022;327:2334-47. However, the quality of the studies was generally poor, most had small samples (as few as 20 participants), and they used different MVs and MVMs and outcome measures. Honey possesses antimicrobial, anti . The fat-soluble group includes the Vitamins A, D, E and K, while vitamins of the B complex (B1, B2, B6, B12, niacin, pantothenic . In one RCT of 29,133 male Finnish smokers, those who took supplemental beta-carotene (20 mg/day), with or without vitamin E (50 mg/day as dl-alpha tocopheryl acetate), had an 18% higher incidence of lung cancer during 58 years of follow-up than smokers who took a placebo or vitamin E [64]. A meta-analysis of 20 RCTs investigated whether supplementation with MVMs (whose composition varied by study but that contained multiple nutrients including iron and folic acid) by pregnant people led to better birth outcomes than use of supplements containing only iron with or without folic acid or, in one study, a placebo [33]. Recommended Daily Intake of Vitamins and Minerals for Adults. But taking an MVM can also raise the chances of getting too much of some nutrients, like iron, vitamin A, zinc, niacin, and folate/folic acid, especially when a person takes more than a basic, once-daily product that provides 100 percent of the daily value (DV) ofnutrients. Arch Ophthalmol 2001;119:1417-36. The USPSTF also noted that beta-carotene supplementation may increase the risk of mortality from CVD. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. Multivitamin and multimineral dietary supplements: definitions, characterization, bioavailability, and drug interactions. Breast Cancer Res Treat 2013;141:495-505. The evolving role of multivitamin/multimineral supplement use among adults in the age of personalized nutrition. Multivitamins are a combination of many different vitamins that are normally found in foods and other natural sources.. Multivitamins are used to provide vitamins that are not taken in through the diet. The academy also recommends that nonbreastfed infants and older children who consume less than 1 liter of vitamin D-fortified formula or milk receive 400 IU (10 mcg) supplemental vitamin D daily. Eye floaters are small, semi-transparent specks or cobweb-like substances that appear to float in the eye's vitreous humor, which is the clear, gel-like fluid that fills . The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed. One way to group them is as follows (Table 1): An additional complication for this product category is that many dietary supplements are not labeled as MVMs even though they contain a variety of vitamins and minerals [1]. MVMs providing nutrients in recommended amounts do not ordinarily interact with medications, with one important exception. A randomized trial. The American Academy of Pediatrics adds that all non-breastfed infants ingesting less than 1,000 mL/day of vitamin Dfortified formula or milk should receive a supplement containing 400 IU (10 mcg)/day vitamin D [58]. [, Rautiainen S, Lee I-M, Rist PM, Gaziano JM, Manson JE, Buring JE, Sesso HD. Iron is necessary for the production of hemoglobin. Target Actions . The mechanism of action of vitamin K is discussed in terms of a new carbanion model that mimics the proton abstraction from the gamma position of protein-bound glutamate. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, Multivitamin/mineral Supplements - Health Professional, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Funding of Grants & Administrative Supplements: FAQ, Administrative Supplements for Validation Studies of Analytical Methods, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee, consumer fact sheet on Multivitamin/mineral Supplements, Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, Multivitamin/Mineral Supplements and Prevention of Chronic Disease, Dietary supplement use among adults: United States, 2017-2018, How to prevent cancer: 10 recommendations, Multivitamins do not promote cardiovascular health, Dietary Guidelines for Americans, 2020-2025, WHO recommendations on antenatal care for a positive pregnancy experience, Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. The MVM also improved memory and executive function. People who take certain blood thinners, such as warfarin (Coumadin, Jantoven), should talk with their health care providers before taking any MVM or dietary supplement containing vitamin K [67,68]. The trial in the United Kingdom that compared an MVM to a placebo found no beneficial or harmful effect of the MVM on preterm births, birth at a smaller size than normal gestational age, or low birth weight. This section summarizes the evidence on the use of MVMs to increase nutrient intakes and to improve health or prevent chronic disease. JAMA. Adults in this age group might not be able to absorb enough of the protein-bound, naturally occurring vitamin B12 in food because gastric acidity tends to decline and atrophic gastritis tends to become more common with age [6]. Nutri-Vet Multi-Vite Paw-Gel Cat Vitamins - Best Overall. An analysis by the National Health and Nutrition Examination Survey (NHANES) of data collected from 2003 to 2006 found 33% of the U.S. population ages 1 year and older took an MVM supplement in a given month. According to results of the National Health and Nutrition Examination Survey, 52% of adults take dietary supplements. Nutrients 2018;10(8). The result is often a fresh perspective on . The Centers for Disease Control and Prevention (CDC) recommends that people capable of becoming pregnant consume 400 mcg/day of folic acid from fortified foods, dietary supplements, or both [6,53]. The known vitamins include A, C, D, E, and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. A 2021 meta-analysis of 9 RCTs (not including the study described above) evaluated the use of MVMs (defined as products that included most vitamins and minerals) by 22,773 individuals and a variety of CVD outcomesincluding total CVD incidence and mortality, MI incidence and mortality, and stroke incidence and mortalityand all-cause mortality [29]. [, Jenkins DJA, Spence JD, Giovannucci EL, Kim Y-I, Josse RG, Vieth R, et al. Vitamin D, iron, and zinc are three important ones. Even after using MVs and MVMs daily for at least 10 years, the women had the same risk of breast cancer as the nonusers. [, O'Connor EA, Evans CV, Ivlev I, Rushkin MC, Thomas RG, Martin A, Lin JS. Cobalamin. However, MVM use is common in the general population. National Institutes of Health. Vitamins and Minerals for Layer Poultry have been divided into two groups based on their solubility in lipids or in water. The NCCIH Clearinghouse provides information onNCCIHand complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. Manufacturers sometimes offer these MVMs in packs of two or more pills for users to take daily. In addition, the supplement reduced the risk of cataracts by 9% but did not help prevent AMD [41]. Check Price on Amazon. Pregnancy and birth outcomes Read the Nutrition Facts label on packaged foods or the Supplement Facts label of MVMs to see if the level far exceeds 100% DV. Impact of frequency of multi-vitamin/multi-mineral supplement intake on nutritional adequacy and nutrient deficiencies in U.S. adults. The FNB does not address whether or to what extent nutrient supplements can compensate for dietary inadequacies. Am J Clin Nutr 2013;97:437-44. Vitamin K is involved in blood clotting and decreases the effectiveness of warfarin and similar drugs. [, Bailey RL, Pac SG, Fulgoni III VL, Reidy KC, Catalano PM. Vitamin B5. The American College of Obstetricians and Gynecologists recommends that pregnant people take a daily "prenatal vitamin" [56]. Calciumade provides bone and joint care because it has high levels of elemental calcium carbonate that helps strengthen bones, Vitamin D 3 for better calcium absorption, and minerals (magnesium, zinc, and manganese) that help in making joints flexible. One meta-analysis of 21 RCTs investigated whether daily use of MVs and MVMs (products containing three or more nutrients) for at least 1 year affected mortality risk [46]. U.S. sales of all dietary supplements totaled an estimated $55.7 billion in 2020, including $21.2 billion for all supplements containing vitamins, minerals, or both, of which $8.0 billion was for MVMs and MVs [4]. Nevertheless, some users consider use of an MVM as a form of dietary or nutritional insurance, a concept first introduced by Miles Laboratories to market its One-A-Day line of nutrient supplements in the 1940s [13]. Chemical name: pantothenic acid. Topically applied minoxidil is generally well tolerated, but common side effects include itching of the eye, itching, irritation at the treated area, and unwanted hair growth elsewhere on the body. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. Stay Informed, Stay Healthy! Theoretical basis for harm.

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