Supplements

Last update: 8 February 2020

This page is intended as a review of vitamin and mineral supplementation and all-cause mortality (the hardest of end-points). Very many people take supplements without even having any particular deficiency clinically evaluated. I have done so myself in the past, being ignorant. Currently, I don’t think you should be taking any supplements at all, unless you have a very clear, objectively assessed need for it – if you are dying from scurvy, or have a diagnosed clinical deficiency, or wish to go on a prolonged fasting regimen. In other cases, you should probably rethink your diet and eat more meat. On the margin, taking supplements in general seems to shorten your life slightly, but typically only costs you money. 

As always, I’m interested in seeing more data. Please find my contact details on the About Me page and bring any such to my attention. 

Nutrient Effect References
Beta-carotene No effect (small doses), increased mortality (large doses) 1, 2, 3, 11
Vitamin A No effect (small doses), increased mortality (large doses) 1, 2, 3, 11
Vitamin E No effect (inconsistent – possible harm) 1, 2, 3, 11
Vitamin C No effect 2, 11
Selenium No effect 2, 11
Vitamin D No effect (inconsistent – possible benefit) 4, 5, 9, 10, 11
Vitamins B6, B9 (folate) and B12 No effect 6
Vitamin B9 (folate) No effect 7, 11
Omega-3 fatty acids No effect 8, 11
Calcium No effect 11
Zinc No effect 11

Sources:

  1. Bjelakovic G, Nikolova D, Gluud C. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm?. PLoS One. 2013;8(9):e74558. Published 2013 Sep 6. doi:10.1371/journal.pone.0074558
  2. JAMA. 2007 Feb 28;297(8):842-57. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. Bjelakovic G1, Nikolova D, Gluud LL, Simonetti RG, Gluud C.
  3. Cochrane Database Syst Rev. 2012 Mar 14;(3):CD007176. doi: 10.1002/14651858.CD007176.pub2. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Bjelakovic G1, Nikolova D, Gluud LL, Simonetti RG, Gluud C.
  4. Zhang Y, Fang F, Tang J, et al. Association between vitamin D supplementation and mortality: systematic review and meta-analysis. BMJ. 2019;366:l4673. Published 2019 Aug 12. doi:10.1136/bmj.l4673
  5. Lancet Diabetes Endocrinol. 2017 Dec;5(12):986-1004. doi: 10.1016/S2213-8587(17)30357-1. Epub 2017 Nov 5. Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials. Autier P1, Mullie P2, Macacu A3, Dragomir M3, Boniol M3, Coppens K3, Pizot C3, Boniol M4.
  6. Clin Nutr. 2012 Aug;31(4):448-54. doi: 10.1016/j.clnu.2011.01.003. Epub 2012 May 29. Meta-analysis of B vitamin supplementation on plasma homocysteine, cardiovascular and all-cause mortality. Huang T1, Chen Y, Yang B, Yang J, Wahlqvist ML, Li D.
  7. JAMA. 2006 Dec 13;296(22):2720-6. Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomized controlled trials. Bazzano LA1, Reynolds K, Holder KN, He J.
  8. Aung T, Halsey J, Kromhout D, et al. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018;3(3):225–234. doi:10.1001/jamacardio.2017.5205
  9. JAMA Cardiol. 2019 Jun 19. doi: 10.1001/jamacardio.2019.1870. [Epub ahead of print] Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials: A Meta-analysis. Barbarawi M1, Kheiri B1, Zayed Y1, Barbarawi O2, Dhillon H1, Swaid B1, Yelangi A1, Sundus S1, Bachuwa G1, Alkotob ML3, Manson JE4.
  10. Evid Rep Technol Assess (Full Rep). 2014 Sep;(217):1-929. doi: 10.23970/AHRQEPCERTA217. Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update). Newberry SJ1, Chung M1, Shekelle PG1, Booth MS1, Liu JL1, Maher AR1, Motala A1, Cui M1, Perry T1, Shanman R1, Balk EM1.
  11. Schwingshackl L, Boeing H, Stelmach-Mardas M, et al. Dietary Supplements and Risk of Cause-Specific Death, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis of Primary Prevention Trials. Adv Nutr. 2017;8(1):27–39. Published 2017 Jan 17. doi:10.3945/an.116.013516