Multivitamin dosage
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Multivitamin Dosage: Insights from Recent Research
Safety and Toxicity of Multivitamin Dosage
Acute and Long-term Toxicity in Animal Studies
A study assessing the safety of a new multivitamin formulation found that the lethal dose (LD50) in mice was greater than 2492 mg/kg body weight (BW), indicating a high margin of safety for acute toxicity. Long-term consumption at dosages up to 249.3 mg/kg BW/day did not result in chronic toxicity, suggesting that this multivitamin is safe for prolonged use at recommended dosages of 1.4 to 4.2 mg/kg BW/day 1.
Safety in HIV-infected Populations
In a randomized trial among HIV-infected pregnant women, multivitamin supplements at both single and multiple times the Recommended Dietary Allowance (RDA) were found to be similarly effective in reducing adverse pregnancy outcomes. This suggests that even standard RDA dosages are sufficient for beneficial effects without the need for higher doses 2. However, another study in HIV patients initiating highly active antiretroviral therapy (HAART) found that high-dose multivitamin supplementation did not reduce disease progression or mortality and was associated with increased levels of alanine transaminase (ALT), indicating potential liver toxicity 7.
Efficacy of Multivitamin Supplementation
Pregnancy Outcomes
Multivitamin supplementation at RDA levels was found to be as effective as higher doses in reducing the risk of low birth weight, preterm birth, and other adverse pregnancy outcomes among HIV-infected women, highlighting that standard dosages are adequate for these benefits 2.
Psychological Well-being
A study on healthy young male volunteers demonstrated that daily multivitamin supplementation significantly reduced anxiety and perceived stress compared to a placebo. Participants also reported feeling less tired and better able to concentrate, indicating that multivitamins can positively impact psychological well-being 4. Similarly, another study found that multivitamin supplementation reduced stress, physical fatigue, and anxiety in healthy young adults, particularly when assessments were conducted post-dose 9.
Nutritional Status and Bone Health in Elderly
In aged care residents, multivitamin supplementation improved serum levels of vitamin D, folate, and vitamin B12, and was associated with better bone density and a trend towards fewer falls. This suggests that multivitamins can enhance nutritional status and bone health in older adults 8.
Dosage Considerations
Vitamin D Content in Multivitamins
A survey of children's multivitamins revealed that only 25-36% of products provided the recommended 400 IU/day of vitamin D. This indicates a need for careful selection of multivitamin products to ensure adequate vitamin D intake, especially in children 3.
Combined Use with Ocular-specific Vitamins
When combining general-purpose multivitamins with ocular-specific supplements, it was found that most components did not exceed tolerable upper intake levels (TUILs), except for vitamin A and zinc. This suggests that while most combinations are safe, caution is needed to avoid excessive intake of certain nutrients 6.
Conclusion
The research indicates that standard RDA dosages of multivitamins are generally sufficient for various health benefits, including improved pregnancy outcomes, psychological well-being, and nutritional status. High-dose supplementation may not provide additional benefits and could pose safety risks, particularly in specific populations such as those with HIV. Careful consideration of product selection and dosage is essential to ensure safety and efficacy.
Sources and full results
Most relevant research papers on this topic
Safety assessment of a new multivitamin.
The new multivitamin is safe for long-term consumption and may enhance individual health when dosed at 1.4 4.2 mg/kg BW/day.
Non-RCT
Animal StudyA randomized trial to determine the optimal dosage of multivitamin supplements to reduce adverse pregnancy outcomes among HIV-infected women in Tanzania.
A single dose of the Recommended Dietary Allowance may be as effective as multiple doses in decreasing the risk of adverse pregnancy outcomes among HIV-infected women.
RCT
Large Human Trial
Very Rigorous JournalVitamin D supplementation: are multivitamins sufficient?
Few children's multivitamin products supply the recommended 400 IU/day vitamin D, highlighting the need for clinicians to advise parents on choosing a supplement with higher vitamin D content.
Observational StudyThe effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial
Berocca® significantly reduces anxiety and perceived stress, improving psychological well-being and concentration in healthy young male volunteers.
RCT
Highly CitedThe Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for a National Institutes of Health State-of-the-Science Conference
Multivitamin and mineral supplements are effective in primary prevention of cancer and chronic diseases in adults, with no known adverse effects.
Systematic ReviewHighly CitedDosage considerations in the combined use of ocular-specific vitamins and nutrients and multivitamin products: A systemic review and analysis.
Combining ocular-specific vitamins and multivitamin products can create a substantial vitamin or mineral burden that may not be appropriate for all older adults, particularly those with comorbidities.
Literature ReviewEffect of high-dose vs standard-dose multivitamin supplementation at the initiation of HAART on HIV disease progression and mortality in Tanzania: a randomized controlled trial.
High-dose multivitamin supplementation did not reduce HIV disease progression or death in adults receiving HAART, but may have increased ALT levels.
RCTLarge Human TrialMultivitamin supplementation improves nutritional status and bone quality in aged care residents
Multivitamin supplementation improves nutritional status and bone quality in aged care residents, with a trend towards reducing falls and fractures.
RCTThe effects of multivitamin supplementation on mood and general well-being in healthy young adults. A laboratory and at-home mobile phone assessment
Multivitamin supplementation may reduce stress, physical fatigue, and anxiety in healthy young adults, but its long-term effects remain unclear.
Non-RCT
Rigorous JournalThe effects of multivitamins and minerals on children with Down syndrome.
High-dosage multivitamin and mineral supplements may improve general appearance and skin freshness in children with Down syndrome, but may slow developmental progress and have side-effects.
RCT