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• U.S. Department of Health and Human Services
• National Institutes of Health

Vitamins and Minerals

Vitamins and minerals are essential substances that our bodies need to function normally. The known vitamins are vitamins A, C, D, E, and K and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), cobalamin (B12), biotin, and folate/folic acid. A number of minerals are essential for health, including calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, sulfur, cobalt, copper, fluoride, manganese, and selenium.  

• The Dietary Guidelines for Americans 2020–2025 recommends that people should aim to meet their nutritional requirements through a healthy eating pattern that includes nutrient-dense foods. In addition to vitamins and minerals, foods provide other important components beneficial to health, such as fiber. The guidelines provide recommendations for specific populations, including women who are or may become pregnant, women who breastfeed, and people ages 60 and over.  
• Some people who don’t get enough vitamins and minerals from food alone, including people who are on low-calorie diets or who avoid certain foods (such as strict vegetarians or vegans), may want to consider taking a vitamin and mineral supplement. Health care providers may recommend supplements for people with certain medical conditions.  

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• If you consume fortified foods and beverages (such as cereals or drinks with added vitamins and minerals) along with dietary supplements, you should make sure that your total intake of vitamins and minerals is not more than the safe upper limits for any nutrients. You can find information about the safe upper limits on specific nutrients from the NIH Office of Dietary Supplements Dietary Supplement Fact Sheets .  
• Taking excess amounts of vitamin A (preformed retinol form, not beta-carotene) during pregnancy has been shown to increase the risk of birth defects. 
• Women of childbearing age, pregnant women, infants, young children, and teenage girls are at risk of obtaining insufficient amounts of iron from their diets. Iron supplements are a leading cause of poisoning in young children, so they should be kept out of children’s reach. 

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Multivitamins/multiminerals (MVMs) are popular dietary supplements taken by approximately one-third of adults and one-quarter of children and adolescents in the United States. MVMs cannot take the place of eating a variety of foods that are important to a healthy diet.  

Taking a daily dose of a basic MVM is unlikely to pose a health risk for healthy people. However, taking them at high doses or taking many different supplements may cause adverse side effects. 

• The effects of MVMs on the risk of health problems are hard to study because products vary and because people with healthier lifestyles are more likely to take MVMs. 
• Most studies have shown little or no effect of MVMs on the risk of health problems. 
• There’s no standard or regulatory definition for what nutrients MVMs, or any dietary supplement, must contain or at what levels. Manufacturers choose which vitamins, minerals, and other ingredients, as well as the amounts, to include in their products. However, MVMs are required to provide nutrition information on a Supplement Facts panel and list all ingredients on the product label (ingredients not in the Supplement Facts panel must be listed under “Other Ingredients”). 
• MVMs providing nutrients at or up to 100 percent of the Daily Value (DV) do not typically interact with medications. However, if you take a blood thinner, such as warfarin (Coumadin and other brand names), talk to your health care provider before taking any MVM or other dietary supplement that contains vitamin K . 
• Smokers, and possibly former smokers, should avoid MVM products that provide large amounts of vitamin A (as preformed retinol or beta-carotene or some combination of the two). A few studies have linked high supplemental doses of these nutrients with an increased risk of lung cancer in smokers. 
• The National Institutes of Health sponsored the Age-Related Eye Disease Study (AREDS), which showed that a dietary supplement formulation containing high doses of vitamins C and E, beta-carotene, zinc, and copper can help slow the progression to advanced age-related macular degeneration (AMD) . A second study, AREDS2, showed that removing beta-carotene from the AREDS formulation didn’t lessen its protective effect against developing advanced AMD. AREDS2 also showed that adding omega-3 fatty acids did not improve the effectiveness of the formulation. 

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There is not enough scientific evidence to clearly show that taking any dietary supplement helps to prevent or cure COVID-19 . The NIH Office of Dietary Supplements has detailed information (in English and Spanish ) about specific dietary supplements and COVID-19. 

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Vitamins and Minerals

Vitamins and minerals are micronutrients required by the body to carry out a range of normal functions. However, these micronutrients are not produced in our bodies and must be derived from the food we eat.

Vitamins are organic substances that are generally classified as either fat soluble or water soluble. Fat-soluble vitamins ( vitamin A , vitamin D , vitamin E , and vitamin K ) dissolve in fat and tend to accumulate in the body. Water-soluble vitamins ( vitamin C and the B-complex vitamins , such as vitamin B6 , vitamin B12 , and folate ) must dissolve in water before they can be absorbed by the body, and therefore cannot be stored. Any water-soluble vitamins unused by the body is primarily lost through urine.

Minerals are inorganic elements present in soil and water, which are absorbed by plants or consumed by animals. While you’re likely familiar with calcium , sodium , and potassium , there is a range of other minerals, including trace minerals (e.g. copper , iodine , and zinc ) needed in very small amounts.

In the U.S., the National Academy of Medicine (formerly the Institute of Medicine) develops nutrient reference values called the Dietary Reference Intakes (DRIs) for vitamins and minerals. [1] These are intended as a guide for good nutrition and as a scientific basis for the development of food guidelines in both the U.S. and Canada. The DRIs are specific to age, gender, and life stages, and cover more than 40 nutrient substances. The guidelines are based on available reports of deficiency and toxicity of each nutrient. Learn more about vitamins and minerals and their recommended intakes in the table below.

What about multivitamins?

A diet that includes plenty of fruits, vegetables , whole grains , good protein packages , and healthful fats should provide most of the nutrients needed for good health. But not everyone manages to eat a healthful diet. Multivitamins can play an important role when nutritional requirements are not met through diet alone. Learn more about vitamin supplementation .

Did you know? 

Vitamins and their precise requirements have been controversial since their discovery in the late 1800s and early 1900s. It was the combined efforts of epidemiologists, physicians, chemists, and physiologists that led to our modern day understanding of vitamins and minerals. After years of observation, experiments, and trial and error, they were able to distinguish that some diseases were not caused by infections or toxins—a common belief at the time—but by vitamin deficiencies. [2] Chemists worked to identify a vitamin’s chemical structure so it could be replicated. Soon after, researchers determined specific amounts of vitamins needed to avoid diseases of deficiency.

In 1912, biochemist Casimir Funk was the first to coin the term “vitamin” in a research publication that was accepted by the medical community, derived from “vita” meaning life, and “amine” referring to a nitrogenous substance essential for life. [3] Funk is considered the father of vitamin therapy, as he identified nutritional components that were missing in diseases of deficiency like scurvy (too little vitamin C ), beri-beri (too little vitamin B1 ), pellagra (too little vitamin B3 ), and rickets (too little vitamin D ). The discovery of all vitamins occurred by 1948.

Vitamins were obtained only from food until the 1930s when commercially made supplements of certain vitamins became available. The U.S government also began fortifying foods with specific nutrients to prevent deficiencies common at the time, such as adding iodine to salt to prevent goiter, and adding folic acid to grain products to reduce birth defects during pregnancy. In the 1950s, most vitamins and multivitamins were available for sale to the general public to prevent deficiencies, some receiving a good amount of marketing in popular magazines such as promoting cod liver oil containing vitamin D as bottled sunshine.

• Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); and Dietary Reference Intakes for Calcium and Vitamin D (2011) . These reports may be accessed via www.nap.edu .
• Semba RD. The discovery of the vitamins. Int J Vitam Nutr Res . 2012 Oct 1;82(5):310-5.
• Piro A, Tagarelli G, Lagonia P, Tagarelli A, Quattrone A. Casimir Funk: his discovery of the vitamins and their deficiency disorders. Ann Nutr Metab . 2010;57(2):85-8.

Last reviewed March 2023

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Micronutrient Facts

Micronutrients, often referred to as vitamins and minerals, are vital to healthy development, disease prevention, and wellbeing. With the exception of vitamin D, micronutrients are not produced in the body and must be derived from the diet 1 .

Though people only need small amounts of micronutrients, consuming the recommended amount is important. Micronutrient deficiencies can have devastating consequences. At least half of children worldwide younger than 5 years of age suffer from vitamin and mineral deficiencies 2 . The World Health Organization recommends multiple types of interventions to address nutrition deficiencies external icon 3 .

The role of six essential micronutrients is outlined below.

• Iron is critical for motor and cognitive development. Children and pregnant women are especially vulnerable to the consequences of iron deficiency 3 .
• Iron deficiency is a leading cause of anemia which is defined as low hemoglobin concentration. Anemia affects 40% of children younger than 5 years of age and 30% of pregnant women globally 4 .
• Anemia during pregnancy increases the risk of death for the mother and low birth weight for the infant. Worldwide, maternal and neonatal deaths total between 2.5 million and 3.4 million each year 5 .
• Babies fed only breast milk, only formula, or a mix of breast milk and formula have different needs  when it comes to iron.

Iron Fact Sheet external icon | Hierro Hoja Informativa external icon

Preventing iron deficiency helps improve children's learning ability and cognitive development.

• Vitamin A supports healthy eyesight and immune system functions. Children with vitamin A deficiency face an increased risk of blindness and death from infections such as measles and diarrhea 6 .
• Globally, vitamin A deficiency affects an estimated 190 million preschool-age children 6 .
• Providing vitamin A supplements to children ages 6-59 months is highly effective in reducing deaths from all causes where vitamin A deficiency is a public health concern 6 .

Vitamin A Fact Sheet external icon | Vitamina A Hoja Informativa external icon

• Vitamin D builds strong bones by helping the body absorb calcium 7 . This helps protect older adults from osteoporosis.
• Vitamin D deficiency causes bone diseases, including rickets in children and osteomalacia in adults 7 .
• Vitamin D helps the immune system resist bacteria and virsues 7 .
• Vitamin D is required for muscle and nerve functions 7 .
• Available data suggest that vitamin D deficiency may be widespread globally 8 .
• Bodies make vitamin D from sunlight, but this varies based on geography, skin color, air pollution, and other factors. Also, sunlight exposure needs to be limited to avoid risk of skin cancer .
• All children need vitamin D  beginning shortly after birth.

Vitamin D Fact Sheet external icon | Vitamina D Hoja Informativa external icon

• Iodine is required during pregnancy and infancy for the infant’s healthy growth and cognitive development 9 .
• Globally an estimated 1.8 billion people have insufficient iodine intake.
• Iodine content in most foods and beverages is low.
• Fortifying salt with iodine is a successful intervention – about 86% of households worldwide consume iodized salt 10 . The amount of iodine added to salt can be adjusted so that people maintain adequate iodine intake even if they consume less salt 11 .
• The American Thyroid Association and the American Academy of Pediatrics recommend that pregnant or breastfeeding women take a supplement every day containing 150 micrograms of iodine. The American Thyroid Association recommends women who are planning a pregnancy consume a daily iodine supplement starting at least 3 months in advance of pregnancy.

Iodine Fact Sheet external icon | Yodo Hoja Informativa external icon

Fortifying salt with iodine successfully increases intake of iodine.

• Everyone needs folate (vitamin B9) to make new cells  every day.
• Folate is essential in the earliest days of fetal growth for healthy development of the brain and spine 12 . Folic acid is another form of vitamin B9. Women of reproductive age need 400 micrograms of folic acid every day 12 .
• Ensuring sufficient levels of folate in women prior to conception can reduce neural tube defects such as spina bifida and anencephaly 12 .
• Providing folic acid supplements to women 15-49 years and fortifying foods such as wheat flour with folic acid reduces the incidence of neural tube defects and neonatal deaths 13 .

Folate Fact Sheet external icon | Folato Hoja Informativa external icon

Folate is especially important before and during pregnancy.

• Zinc promotes immune functions and helps people resist infectious diseases including diarrhea, pneumonia and malaria 14,15,16 . Zinc is also needed for healthy pregnancies 14 .
• Globally, 17.3% of the population is at risk for zinc deficiency due to dietary inadequacy; up to 30% of people are at risk in some regions of the world 17 .
• Providing zinc supplements reduces the incidence of premature birth, decreases childhood diarrhea and respiratory infections, lowers the number of deaths from all causes, and increases growth and weight gain among infants and young children 17 .
• Providing zinc supplementation to children younger than 5 years appears to be a highly cost-effective intervention in low- and middle-income countries 18,19 .
• When children are about 6 months old, it is important to start giving them foods with zinc .

Zinc Fact Sheet external icon | Zinc Hoja Informativa external icon

• Kraemer K, , Badham J, Christian P, Hyun Rah J, eds. Micronutrients; macro impact, the story of vitamins and a hungry world external icon . Sight and Life Press; 2015.
• The state of the world’s children 2019; children, food and nutrition: growing well in a changing world external icon . UNICEF; 2019.
• World Health Organization. e-Library of evidence for nutrition actions external icon . Accessed June 18, 2021.
• World Health Organization. WHO global anaemia estimates, 2021 edition external icon . Accessed June 3, 2021.
• Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data external icon .  Lancet Glob Health . 2013;1(1).
• World Health Organization. Guideline: vitamin A supplementation in infants and children 6-59 months of age; 2011 external icon . Accessed June 18, 2021.
• National Institutes of Health Office of Dietary Supplements. What is vitamin D and what does it do? external icon  Accessed June 18, 2021.
• Roth DE, Abrams SA, Aloia J, et al. Global prevalence and disease burden of vitamin d deficiency: a roadmap for action in low- and middle-income countries external icon .  Ann N Y Acad Sci . 2018;1430(1).
• Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. external icon   J Nutr . 2012;142(4):744-750.
• Iodine Global Network. What is being done internationally about iodine deficiency? external icon Accessed June 18, 2021.
• World Health Organization. Iodization of salt for the prevention and control of iodine deficiency disorders external icon . Accessed June 18, 2021.
• Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities. Folic acid helps prevent some birth defects . Accessed June 18, 2021.
• Blencowe H, Cousens S, Modell B, Lawn J. Folic acid to reduce neonatal mortality from neural tube disorders external icon .  Int J Epidemiol . 2010;39 Suppl 1(Suppl 1):i110-i121.
• Ackland ML, Michalczyk AA. Zinc and infant nutrition external icon .  Arch Biochem Biophys . 2016;611:51-57.
• Lassi ZS, Moin A, Bhutta ZA. Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months. external icon Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD005978.
• Liu E, Pimpin L, Shulkin M, et al. Effect of zinc supplementation on growth outcomes in children under 5 years of age. external icon   Nutrients . 2018;10(3):377.
• Wessells KR, Brown KH. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting external icon .  PLoS One . 2012;7(11):e50568.
• Fink G, Heitner J. Evaluating the cost-effectiveness of preventive zinc supplementation external icon .  BMC Public Health . 2014;14:852.
• Brown KH, Hess SY, Vosti SA, Baker SK. Comparison of the estimated cost-effectiveness of preventive and therapeutic zinc supplementation strategies for reducing child morbidity and mortality in sub-Saharan Africa. external icon   Food Nutr Bull . 2013;34(2):199-214.

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Are you getting the vitamins and minerals you need?

Essential nutrients for your body, micronutrients with a big role in the body, a closer look at water-soluble vitamins, a closer look at fat-soluble vitamins, a closer look at major minerals, a closer look at trace minerals, a closer look at antioxidants, vitamins and minerals.

There so many different vitamins and mineral supplements available, it can feel overwhelming trying to decide what you should take. Here’s how to ensure you’re getting the right amounts of everything you need.

Adapted with permission from Making Sense of Vitamins and Minerals , a special health report published by Harvard Health Publishing.

Vitamins and minerals are essential nutrients because they perform hundreds of roles in the body. There is a fine line between getting enough of these nutrients (which is healthy) and getting too much (which can end up harming you). Eating a healthy diet remains the best way to get sufficient amounts of the vitamins and minerals you need.

Every day, your body produces skin, muscle, and bone. It churns out rich red blood that carries nutrients and oxygen to remote outposts, and it sends nerve signals skipping along thousands of miles of brain and body pathways. It also formulates chemical messengers that shuttle from one organ to another, issuing the instructions that help sustain your life.

But to do all this, your body requires some raw materials. These include at least 30 vitamins, minerals, and dietary components that your body needs but cannot manufacture on its own in sufficient amounts.

Vitamins and minerals are considered essential nutrients—because acting in concert, they perform hundreds of roles in the body. They help shore up bones, heal wounds, and bolster your immune system. They also convert food into energy, and repair cellular damage.

But trying to keep track of what all these vitamins and minerals do can be confusing. Read enough articles on the topic, and your eyes may swim with the alphabet-soup references to these nutrients, which are known mainly be their initials (such as vitamins A, B, C, D, E, and K—to name just a few).

In this article, you’ll gain a better understanding of what these vitamins and minerals actually do in the body and why you want to make sure you’re getting enough of them.

Vitamins and minerals are often called micronutrients because your body needs only tiny amounts of them. Yet failing to get even those small quantities virtually guarantees disease. Here are a few examples of diseases that can result from vitamin deficiencies:

• Scurvy. Old-time sailors learned that living for months without fresh fruits or vegetables—the main sources of vitamin C—causes the bleeding gums and listlessness of scurvy.
• Blindness. In some developing countries, people still become blind from vitamin A deficiency.
• Rickets. A deficiency in vitamin D can cause rickets, a condition marked by soft, weak bones that can lead to skeletal deformities such as bowed legs. Partly to combat rickets, the U.S. has fortified milk with vitamin D since the 1930s.

Just as a lack of key micronutrients can cause substantial harm to your body, getting sufficient quantities can provide a substantial benefit. Some examples of these benefits:

• Strong bones. A combination of calcium, vitamin D, vitamin K, magnesium, and phosphorus protects your bones against fractures.
• Prevents birth defects. Taking folic acid supplements early in pregnancy helps prevent brain and spinal birth defects in offspring.
• Healthy teeth. The mineral fluoride not only helps bone formation but also keeps dental cavities from starting or worsening.

The difference between vitamins and minerals

Although they are all considered micronutrients, vitamins and minerals differ in basic ways. Vitamins are organic and can be broken down by heat, air, or acid. Minerals are inorganic and hold on to their chemical structure.

So why does this matter? It means the minerals in soil and water easily find their way into your body through the plants, fish, animals, and fluids you consume. But it’s tougher to shuttle vitamins from food and other sources into your body because cooking, storage, and simple exposure to air can inactivate these more fragile compounds.

Interacting—in good ways and bad

Many micronutrients interact. Vitamin D enables your body to pluck calcium from food sources passing through your digestive tract rather than harvesting it from your bones. Vitamin C helps you absorb iron.

The interplay of micronutrients isn’t always cooperative, however. For example, vitamin C blocks your body’s ability to assimilate the essential mineral copper. And even a minor overload of the mineral manganese can worsen iron deficiency.

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Water-soluble vitamins are packed into the watery portions of the foods you eat. They are absorbed directly into the bloodstream as food is broken down during digestion or as a supplement dissolves.

Because much of your body consists of water, many of the water-soluble vitamins circulate easily in your body. Your kidneys continuously regulate levels of water-soluble vitamins, shunting excesses out of the body in your urine.

Water-soluble vitamins

B vitamins:

• Biotin (vitamin B7)
• Folic acid (folate, vitamin B9)
• Niacin (vitamin B3)
• Pantothenic acid (vitamin B5
• Riboflavin (vitamin B2)
• Thiamin (vitamin B1)
• Vitamin B12

What they do

Although water-soluble vitamins have many tasks in the body, one of the most important is helping to free the energy found in the food you eat. Others help keep tissues healthy. Here are some examples of how different vitamins help you maintain health:

• Release energy. Several B vitamins are key components of certain coenzymes (molecules that aid enzymes) that help release energy from food.
• Produce energy. Thiamin, riboflavin, niacin, pantothenic acid, and biotin engage in energy production.
• Build proteins and cells. Vitamins B6, B12, and folic acid metabolize amino acids (the building blocks of proteins) and help cells multiply.
• Make collagen. One of many roles played by vitamin C is to help make collagen, which knits together wounds, supports blood vessel walls, and forms a base for teeth and bones.

Words to the wise

Contrary to popular belief, some water-soluble vitamins can stay in the body for long periods of time. You probably have several years’ supply of vitamin B12 in your liver. And even folic acid and vitamin C stores can last more than a couple of days.

Generally, though, water-soluble vitamins should be replenished every few days.

Just be aware that there is a small risk that consuming large amounts of some of these micronutrients through supplements may be quite harmful. For example, very high doses of B6—many times the recommended amount of 1.3 milligrams (mg) per day for adults—can damage nerves, causing numbness and muscle weakness.

Rather than slipping easily into the bloodstream like most water-soluble vitamins, fat-soluble vitamins gain entry to the blood via lymph channels in the intestinal wall (see illustration). Many fat-soluble vitamins travel through the body only under escort by proteins that act as carriers.

Absorption of fat-soluble vitamins

• Food containing fat-soluble vitamins is ingested.
• The food is digested by stomach acid and then travels to the small intestine, where it is digested further. Bile is needed for the absorption of fat-soluble vitamins. This substance, which is produced in the liver, flows into the small intestine, where it breaks down fats. Nutrients are then absorbed through the wall of the small intestine.
• Upon absorption, the fat-soluble vitamins enter the lymph vessels before making their way into the bloodstream. In most cases, fat-soluble vitamins must be coupled with a protein in order to travel through the body.
• These vitamins are used throughout the body, but excesses are stored in the liver and fat tissues.
• As additional amounts of these vitamins are needed, your body taps into the reserves, releasing them into the bloodstream from the liver.

Fatty foods and oils are reservoirs for the four fat-soluble vitamins. Within your body, fat tissues and the liver act as the main holding pens for these vitamins and release them as needed.

To some extent, you can think of these vitamins as time-release micronutrients. It’s possible to consume them every now and again, perhaps in doses weeks or months apart rather than daily, and still get your fill. Your body squirrels away the excess and doles it out gradually to meet your needs.

Fat-soluble vitamins

Together this vitamin quartet helps keep your eyes, skin, lungs, gastrointestinal tract, and nervous system in good repair. Here are some of the other essential roles these vitamins play:

• Build bones. Bone formation would be impossible without vitamins A, D, and K.
• Protect vision. Vitamin A also helps keep cells healthy and protects your vision.
• Interact favorably. Without vitamin E, your body would have difficulty absorbing and storing vitamin A.
• Protect the body. Vitamin E also acts as an antioxidant (a compound that helps protect the body against damage from unstable molecules).

Because fat-soluble vitamins are stored in your body for long periods, toxic levels can build up. This is most likely to happen if you take supplements. It’s very rare to get too much of a vitamin just from food.

The body needs, and stores, fairly large amounts of the major minerals. These minerals are no more important to your health than the trace minerals; they’re just present in your body in greater amounts.

Major minerals travel through the body in various ways. Potassium, for example, is quickly absorbed into the bloodstream, where it circulates freely and is excreted by the kidneys, much like a water-soluble vitamin. Calcium is more like a fat-soluble vitamin because it requires a carrier for absorption and transport.

Major minerals

One of the key tasks of major minerals is to maintain the proper balance of water in the body. Sodium, chloride, and potassium take the lead in doing this. Three other major minerals—calcium, phosphorus, and magnesium—are important for healthy bones. Sulfur helps stabilize protein structures, including some of those that make up hair, skin, and nails.

Having too much of one major mineral can result in a deficiency of another. These sorts of imbalances are usually caused by overloads from supplements, not food sources. Here are two examples:

• Salt overload. Calcium binds with excess sodium in the body and is excreted when the body senses that sodium levels must be lowered. That means that if you ingest too much sodium through table salt or processed foods, you could end up losing needed calcium as your body rids itself of the surplus sodium.
• Excess phosphorus. Likewise, too much phosphorus can hamper your ability to absorb magnesium.

A thimble could easily contain the distillation of all the trace minerals normally found in your body. Yet their contributions are just as essential as those of major minerals such as calcium and phosphorus, which each account for more than a pound of your body weight.

Trace minerals

Trace minerals carry out a diverse set of tasks. Here are a few examples:

• Iron is best known for ferrying oxygen throughout the body.
• Fluoride strengthens bones and wards off tooth decay.
• Zinc helps blood clot, is essential for taste and smell, and bolsters the immune response.
• Copper helps form several enzymes, one of which assists with iron metabolism and the creation of hemoglobin, which carries oxygen in the blood.

The other trace minerals perform equally vital jobs, such as helping to block damage to body cells and forming parts of key enzymes or enhancing their activity.

Trace minerals interact with one another, sometimes in ways that can trigger imbalances. Too much of one can cause or contribute to a deficiency of another. Here are some examples:

• A minor overload of manganese can exacerbate iron deficiency. Having too little can also cause problems.
• When the body has too little iodine, thyroid hormone production slows, causing sluggishness and weight gain as well as other health concerns. The problem worsens if the body also has too little selenium.

The difference between “just enough” and “too much” of the trace minerals is often tiny. Generally, food is a safe source of trace minerals, but if you take supplements, it’s important to make sure you’re not exceeding safe levels.

Antioxidant is a catchall term for any compound that can counteract unstable molecules such as free radicals that damage DNA, cell membranes, and other parts of cells.

Your body cells naturally produce plenty of antioxidants to put on patrol. The foods you eat—and, perhaps, some of the supplements you take—are another source of antioxidant compounds. Carotenoids (such as lycopene in tomatoes and lutein in kale) and flavonoids (such as anthocyanins in blueberries, quercetin in apples and onions, and catechins in green tea) are antioxidants. The vitamins C and E and the mineral selenium also have antioxidant properties.

Why free radicals may be harmful

Free radicals are a natural byproduct of energy metabolism and are also generated by ultraviolet rays, tobacco smoke, and air pollution. They lack a full complement of electrons, which makes them unstable, so they steal electrons from other molecules, damaging those molecules in the process.

Free radicals have a well-deserved reputation for causing cellular damage. But they can be helpful, too. When immune system cells muster to fight intruders, the oxygen they use spins off an army of free radicals that destroys viruses, bacteria, and damaged body cells in an oxidative burst. Vitamin C can then disarm the free radicals.

How antioxidants may help

Antioxidants are able to neutralize marauders such as free radicals by giving up some of their own electrons. When a vitamin C or E molecule makes this sacrifice, it may allow a crucial protein, gene, or cell membrane to escape damage. This helps break a chain reaction that can affect many other cells.

It is important to recognize that the term “antioxidant” reflects a chemical property rather than a specific nutritional property. Each of the nutrients that has antioxidant properties also has numerous other aspects and should be considered individually. The context is also important—in some settings, for example, vitamin C is an antioxidant, and in others it can be a pro-oxidant.

Articles and advertisements have touted antioxidants as a way to help slow aging, fend off heart disease, improve flagging vision, and curb cancer. And laboratory studies and many large-scale observational trials (the type that query people about their eating habits and supplement use and then track their disease patterns) have noted benefits from diets rich in certain antioxidants and, in some cases, from antioxidant supplements.

But results from randomized controlled trials (in which people are assigned to take specific nutrients or a placebo) have failed to back up many of these claims. One study that pooled results from 68 randomized trials with over 230,000 participants found that people who were given vitamin E, beta carotene, and vitamin A had a higher risk of death than those who took a placebo. There appeared to be no effect from vitamin C pills and a small reduction in mortality from selenium, but further research on these nutrients is needed.

These findings suggest little overall benefit of the antioxidants in pill form. On the other hand, many studies show that people who consume higher levels of these antioxidants in food have a lower risk of many diseases.

The bottom line? Eating a healthy diet is the best way to get your antioxidants.

More in Healthy Eating

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Organic Foods

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• National Institutes of Health NIH
• Division of Program Coordination, Planning, and Strategic Initiatives DPCPSI

Nutrient Recommendations and Databases

• Dietary Reference Intake (DRI) Reports and Tables
• Online DRI Tool   
• Daily Value (DV) Tables   

USDA FoodData Central

Usda databases, nutrient recommendations: dietary reference intakes (dri).

These documents are issued by the Food and Nutrition Board of the National Academies of Sciences Engineering, and Medicine. The Food and Nutrition Board addresses issues of safety, quality, and adequacy of the food supply; establishes principles and guidelines of adequate dietary intake; and renders authoritative judgments on the relationships among food intake, nutrition, and health.

DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and sex, include:

• Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
• Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
• Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
• Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects.

• Recommended Dietary Allowances and Adequate Intakes, Elements
• Recommended Dietary Allowances and Adequate Intakes, Vitamins
• Recommended Dietary Allowances and Adequate Intakes, Total Water and Macronutrients
• Estimated Average Requirements
• Acceptable Macronutrient Distribution Ranges
• Tolerable Upper Intake Levels, Vitamins
• Tolerable Upper Intake Levels, Elements

Online DRI Tool

Daily values.

Recommended intakes of nutrients vary by age and sex and are known as Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs). However, one value for each nutrient, known as the Daily Value (DV), is selected for the labels of dietary supplements and foods. A DV is often, but not always, similar to one's RDA or AI for that nutrient. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers determine the level of various nutrients in a standard serving of food in relation to their approximate requirement for it. The label actually provides the %DV so that you can see how much (what percentage) a serving of the product contributes to reaching the DV.

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Who Does Need Vitamin and Mineral Supplements?

Most people don't, but there are times when one might be called for, sharing is nice.

We respect your privacy . All email addresses you provide will be used just for sending this story.

A vast majority of us can get all the vitamins, minerals, and other nutrients we need from food. A large orange provides all the vitamin C the average person requires each day, for example, and a small carrot has more than a day's worth of vitamin A.

But research shows that there are some people who may need supplemental doses of certain nutrients, says Consumer Reports' chief medical adviser, Marvin M. Lipman, M.D. If testing reveals that you do need a supplement, your best bet is to take the type and dosage recommended by your doctor. That may be an actual "prescription" supplement, which, unlike over-the-counter versions, must adhere to the same standards for safety and quality as other prescription drugs. In some cases, when no prescription version is readily available, Lipman advises choosing a product that bears the seal of a reputable independent testing group, such as the  U.S. Pharmacopeia . (Read " What Supplement Labels Mean, and Don't .")

Talk with your doctor about taking these vitamin or mineral supplements if you are:

Planning on becoming pregnant within a month:  400 mcg of folic acid daily. Folic acid reduces the risk of brain and spinal-cord abnormalities, called neural tube birth defects, that can occur in the first month of  pregnancy .

Pregnant:  400 mcg folic acid to help protect against neural tube defects and 800 IU of vitamin D to help prevent pre-eclampsia. Depending on your risk, your  doctor  may recommend higher doses. Prenatal vitamins contain a range of vitamins and minerals, but new research casts doubt on their necessity for women who eat a nutritious diet.

A strict vegan who consumes no meat, fish, eggs, or dairy:  A daily B12 supplement.

A person who rarely gets out in the sun:  A daily 800 IU vitamin D3 supplement. (Our bodies make  vitamin D  from sunlight.)

Taking certain drugs:  Vitamin B12 and magnesium supplements may be needed if you regularly take  heartburn drugs such as lansoprazole (Prevacid and generic) or diabetes medication such as metformin (Glucophage and generic).

Diagnosed with osteoporosis:  800 IU vitamin D3 supplements (or a higher dosage as recommended by your doctor), and at least 1,000 to 1,200 mg of calcium from calcium-rich foods such as dairy products and green leafy vegetables, to slow  bone loss .

Diagnosed with age-related macular degeneration:  A specific blend of vitamins C and E, plus copper, lutein, zeaxanthin, and zinc, known as AREDS, can slow the progression of the disease.

Diagnosed with gastrointestinal disorders, such as inflammatory bowel disease or celiac disease, or serious conditions such as cancer or HIV/AIDS:  Talk with your doctor about specific nutritional  supplement  needs.

More on Dietary Supplements

• Supplements Can Make You Sick
• 15 Supplement Ingredients to Always Avoid
• What 'USP Verified' and Other Supplement Seals Mean
• What Supplement Labels Mean, and Don't
• We Made This Weight-Loss Supplement
• The Truth About Calcium and Vitamin D Supplements  

Editor's Note:  This article also appeared in the September 2016 issue of  Consumer Reports  magazine .

Lauren Cooper

I cover health and food at Consumer Reports, helping consumers to make smarter choices, whether they're shopping for shrimp or searching for a top-notch doctor. A native New Yorker, I've also lived and worked in London and Hong Kong. Lifehacking is my passion: I always think there's a way to do everything better. Follow me on Twitter  (@LaurenCooper72).

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Children and adults are gobbling supplements. Do you know the risks?

Among some population groups, it’s not unusual to down four or more vitamins or supplements every day, new research shows

Americans spend billions of dollars every year on dietary supplements that claim to promote almost every aspect of our health. But how much do you know about the supplements you’re taking?

A recent government study found that nearly 60 percent of adults take vitamins, minerals, fish oil, herbal capsules, melatonin, probiotics and other types of dietary supplements. While most people used just one or two supplements — multivitamins and vitamin D were the two most popular products — it was not uncommon for people to report using three, four or more supplements at a time.

Among some parts of the population, it’s not unusual to down a handful of vitamins or supplements every day. About 15 percent of adults said they used four or more dietary supplements. Among older adults, the number reporting multi-supplement use is even higher — about 25 percent of adults 60 or older use four or more. About 35 percent of children and adolescents used dietary supplements, and nearly 10 percent of children between 2 and 5 years old were given two or more dietary supplements.

Experts say that vitamin and mineral supplements are generally safe when taken in small to moderate doses, like the amounts found in a basic multivitamin. Dietary supplements can be beneficial for pregnant women and for people with nutrient deficiencies and other health conditions. A clinical trial earlier this year found that for people who are 60 and older, taking a daily multivitamin helped to slow memory loss. Other studies have found that probiotic supplements can help with gastrointestinal disorders such as irritable bowel syndrome.

But taking supplements comes with risks, and for many healthy adults, it’s not always clear from research that the benefits outweigh the risks.

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In fact, some randomized trials have found that assigning people to take supplements with large doses of beta-carotene, selenium, and vitamins A, C, and E actually increased mortality rates. Rigorous clinical trials have also failed to support the hype around vitamin D, finding that people who were assigned to take the popular supplement did not develop lower rates of cardiovascular disease, cancer or bone fractures despite widespread marketing claims to the contrary.

Supplements don’t follow the same rules as drugs

Many people assume that the Food and Drug Administration tests supplements for safety. But that’s not how it works .

“Dietary supplements enter the market before there’s any real review of them by the FDA,” said Amy B. Cadwallader, the director of regulatory and public policy development at the United States Pharmacopeia, a nonprofit organization that examines the quality of drugs, food and dietary supplements.

Under federal law, companies are allowed to operate on the honor system. The FDA’s role in regulating supplements mostly involves trying to make sure products are safe and accurately labeled after they have already entered the marketplace.

Are you getting what you paid for?

In the United States, companies sell an estimated 90,000 dietary supplements, representing a roughly $50 billion industry . As a result, some experts say, consumers who buy supplements can’t always be sure that they are getting what they paid for. Studies of melatonin , fish oil , probiotics , ginkgo biloba , and other supplements have found that the doses and compounds listed on their labels are often not what are found in their bottles.

• In one study in the journal Pediatric Research , researchers tested 16 probiotic supplements and found that only one of them contained the specific bacterial strains listed on its label.
• In another study , researchers tested 30 dietary supplements that claimed to strengthen immune health and found that 17 of the products were “misbranded.” These supplements either lacked key ingredients listed on their labels — such as vitamin B12, garlic extract, ginger root and folate — or they contained a variety of unlisted ingredients.
• One study by the FDA estimated that the agency is notified of less than 1 percent of all adverse events linked to supplement use. Another study by the federal government estimated that injuries caused by supplements are responsible for about 23,000 emergency room visits each year.

Howard Luks, an orthopedic surgeon and sports medicine specialist in New York, said he routinely encounters patients who worry about potential side effects from medications but have no problem taking 10 or 20 supplements that they heard about from health influencers on social media. He said that many people who lost trust in public health authorities during the pandemic have turned to social media influencers for health advice.

“They view supplements as being holistic, natural, and therefore not potentially harmful for them,” he said.

In one case study published in March, doctors in New Jersey described a 76-year-old woman who went to an emergency room after experiencing heart palpitations, dizziness and fainting episodes. It turned out she had been taking black cohosh, an herbal supplement often used to treat hot flashes. A few days after stopping the supplement, her heartbeat returned to normal, and her other symptoms disappeared.

In another recent case , a 47-year-old woman in Houston suffered jaundice and liver damage after taking a supplement containing a blend of probiotics and herbal extracts. The case report noted that dietary supplements account for about 20 percent of drug-induced liver injuries nationwide.

How to shop smarter for supplements

Here are some tips when buying supplements.

Look for third-party certifications: The United States Pharmacopeia, or USP, vets dietary supplements to ensure they are meeting high standards for factors such as purity and potency. USP has a voluntary program through which companies can have their supplements and facilities routinely tested and examined. Companies that meet the organizations high standards are allowed to use a black and yellow “USP Verified” logo on their products. You can find them using the product-finder search tool on USP’s website. NSF is another independent group that tests and reviews dietary supplements. You can look for the blue and white “NSF” logo on your supplements or go to the group’s website to look up products.

Do your homework. Consumerlab.com is an independent laboratory that tests dietary supplements to see if they contain the ingredients and doses listed on their labels. The company publishes reports with their findings on a wide variety of supplements, which you can access on their website for a fee.

Talk to your doctor or pharmacist . Many people don’t realize that a lot of supplements and medications use the same metabolic pathways and that they can cause dangerous side effects when you combine them, said Michael Schuh, an assistant professor of pharmacy, family medicine and palliative medicine at the Mayo Clinic in Florida.

Vitamins E and K, ginseng, ginkgo biloba, resveratrol, turmeric and CoQ10 for example can interact with blood thinning medications. Vitamin C can interact with statins, niacin, estrogen, warfarin and chemotherapy drugs. St. John’s wort can make antidepressants and birth control pills less effective.

“We see it with a lot of supplements,” Schuh said. “Even something like resveratrol from grape skins: When you take it in concentrated form, it can interact with a lot of medications.”

Do you have a question about healthy eating? Email [email protected] and we may answer your question in a future column.

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Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomised, placebo-controlled trial

Affiliation.

• 1 University Laboratory of Physiology, University of Oxford, UK.
• PMID: 12091259
• DOI: 10.1192/bjp.181.1.22

Background: There is evidence that offenders consume diets lacking in essential nutrients and this could adversely affect their behaviour.

Aims: To test empirically if physiologically adequate intakes of vitamins, minerals and essential fatty acids cause a reduction in antisocial behaviour.

Method: Experimental, double-blind, placebo-controlled, randomised trial of nutritional supplements on 231 young adult prisoners, comparing disciplinary offences before and during supplementation.

Results: Compared with placebos, those receiving the active capsules committed an average of 26.3% (95% CI 8.3-44.33%) fewer offences (P=0.03, two-tailed). Compared to baseline, the effect on those taking active supplements for a minimum of 2 weeks (n=172) was an average 35.1% (95% CI 16.3-53.9%) reduction of offences (P<0.001, two-tailed), whereas placebos remained within standard error.

Conclusions: Antisocial behaviour in prisons, including violence, are reduced by vitamins, minerals and essential fatty acids with similar implications for those eating poor diets in the community.

Publication types

• Clinical Trial
• Randomized Controlled Trial
• Research Support, Non-U.S. Gov't
• Dietary Supplements*
• Double-Blind Method
• Fatty Acids, Essential / therapeutic use
• Patient Compliance
• Prisoners / psychology*
• Psychometrics
• Social Behavior Disorders / diet therapy*
• Trace Elements / therapeutic use
• Treatment Outcome
• Vitamins / therapeutic use
• Fatty Acids, Essential
• Trace Elements