This supplement was written by William T. Elliott, MD, FACP, Chair, Formulary Committee, Kaiser Permanente, California Division; Assistant Clinical Professor of Medicine, University of California-San Francisco. In order to reveal any potential bias in this publication, we disclose that Dr. Elliott reports no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. For questions and comments, please e-mail: neill.kimball@ahcmedia.com.

“Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” is the title of an editorial in the December 17 issue of Annals of Internal Medicine. The strongly worded opinion piece is based on three studies in the same issue which suggest that vitamins and minerals are of no value for the healthy adult. The first study looked at use of high-dose oral multivitamins and minerals in more than 1700 patients who had a recent myocardial infarction and normal renal function. After an average follow-up of about 2.5 years, the supplements did not statistically reduce cardiovascular events. In the second study, nearly 6000 male physicians were given multivitamins or placebo over 12 years as part of the Physician’s Health Study II to see if vitamins affect cognitive health in later life. Over the course of the study, the participants were given four tests of verbal memory, a strong predictor of Alzheimer’s disease. Multivitamins had no effect on cognition and did not prevent cognitive decline. Finally, the U.S. Preventive Services Task Force did a systematic evidence review of vitamins and mineral supplements for the primary prevention of cardiovascular disease and cancer. They concluded that limited evidence supports any benefit from supplements, with two trials showing borderline-significant benefit for multivitamins on cancer in men only and no effect on cardiovascular disease (Ann Intern Med 2013;159:797-805, 806-814, 824-834, editorial 850-851).