What is an appropriate price for a multivitamin?

[Amarillyde]

Is there a price below which one should consider a multivitamin likely to be unsafe? Or are there any resources to establish which brands are reputable enough to be trustworthy?
I've recently purchased this https://www.amazon.co.uk/gp/product/B07 ... UTF8&psc=1 while comparing against lots of others, so I didn't notice it was actually a yearly supply – thus is seems alarmingly inexpensive. Will I die a horrible death?

[brimstoneSalad]

That's a good question. The price on those doesn't look like a big red flag to me. It's only half the price of DEVA: https://www.amazon.com/Deva-Vegan-Vitam ... B001GAOHVG
It's comparable to centrum: https://www.walmart.com/ip/Centrum-Adul ... /912436365

Of course it's a smaller company so their scale is probably more like DEVA. Centrum hits those prices by selling in huge volumes.
There's apparently a difference from DEVA that justifies the lower price: these are probably just a bunch of powders pressed together in a pill making machine. The manufacture is much cheaper than a coated tablet like DEVA (which also contains a bunch of more expensive super foods), and the reviews show it (mentioning the taste).
(EDIT: Apparently they are glazed, just maybe not very well? The comments and ingredients are conflicting)
DEVA tastes nasty if you hold it in your mouth too long, but coating gives you a few seconds to swallow it. I gather that these provide no such luxury.
I personally don't think I could physically swallow them if that's the case.

If you get them and they seem kind of rough or powdery like touching chalk on the outside instead of smooth like touching lacquered/polished wood, that probably explains it. You usually get what you pay for, and there's more to vitamins than the nutrients inside.

That said, just because the price isn't too low to manufacture doesn't mean they're not just fillers. Less reputable companies might skimp on the vitamins and give you what amounts to a starch pill. Not dangerous exactly, but it could mislead you on the amount of nutrients you're getting from it.

The real danger comes from herbal weight loss and body building supplements, which are often doped with real drugs to make them actually work.
Some herbal sleep aids have also been shown to have actual sleeping drugs in them.
That is, things that normally *wouldn't* work but are made to work by putting drugs in them.

Vitamins don't really have the same expectation, although if they advertise energy a lot it wouldn't be impossible that it has caffeine in it. But they probably don't have caffeine in them. They're probably just bad tasting vitamins.

I'd 100% trust Centrum and other big brands. I also trust DEVA since they've been around a long time and are well known. NOW is also pretty well established.
I also trust store brands (those with the store's branding, not just brands sold in stores), since they have a large corporate body to be accountable they're not going to be selling fake stuff.

Reputable brands often have third party testing you can check on. It takes a little detective work.
At least when I find a new brand, I try to check up on their certification and manufacturing, look into who founded the company, etc.

That said, surprisingly even without much oversight most vitamins (herbal weight loss and muscle supplements aside) being sold online are what they say they are, or at least mostly so. The ingredients for multivitamins are mostly just naturally cheap, so it's not worth the risk for a brand to fake it if they are a brand and not just trying to cut and run.

They're probably fine.

That said...

I think their site is nutraacure.com and it doesn't work.
But this is the address in the cache:
Address:
1st Floor, Udyog Vihar phase -1,
Gurugram, 122016
icon_mobile
Phone:
+91 981 167 7175
icon_mail_alt
Email:
info@nutraacure.com

That's in India. Is there any evidence these are really UK manufactured?

The company is registered in the UK: https://beta.companieshouse.gov.uk/company/11658401
But incorporated less than a year ago so that doesn't look good...

The address they give, "59 York Avenue, Crosby, Liverpool, United Kingdom, L23 5RN", is literally just a house.

It's totally possible they had them locally manufactured and just have boxes in there from which they fulfill these orders... or they're made in India and that's just somebody's uncle's cousin's brother in law's house who agreed to accept their mail.

If it's legit, even if they're working from home, I respect the hustle. A lot of good and reputable businesses started from home. They might even have a pill press in the back room.
I will email them for more info to see if I can sort out what's going on. Assuming it reaches them since their site is down, email might bounce.

[brimstoneSalad]

Yep, bounce:

This message was created automatically by mail delivery software.

A message that you sent could not be delivered to one or more of its
recipients. This is a permanent error. The following address(es) failed:

noreply@nutraacure.com
(ultimately generated from info@nutraacure.com)
LMTP error after RCPT TO:<noreply@nutraacure.com>:
<noreply@nutraacure.com> Mailbox is full / Blocks limit exceeded / Inode limit exceeded
info@nutraacure.com
LMTP error after RCPT TO:<info@nutraacure.com>:
<info@nutraacure.com> Mailbox is full / Blocks limit exceeded / Inode limit exceeded

So that's a dead end unless somebody wants to try to call them.

If it were me, given that, I'd give them a 50-50 chance of being real vitamins vs. being bitter starch pills with little to nothing in them.

I'd probably get something else unless somebody can get in touch with them. I'd worry more about it just not having any vitamins in it than it being dangerous... the unknown is just hard to deal with. I wouldn't want to risk thinking I'm taking a good vitamin and it ending up being nothing, thus e.g. still low on Zinc despite thinking I got enough from topping it off with the vitamin. Of course a blood test would ultimately reveal this fact, but it's still potentially several months on a fake vitamin which has an opportunity cost of missing out on a real one.

[Amarillyde]

Thank you! Some serious detective work

[Lay Vegan]

@brimstoneSalad Do you think programs like USP Dietary Supplement Verification are a good tool to rely on to avoid those kinds of scams?

https://www.usp.org/verification-services/verified-mark

[Jebus]

I'm wondering why anyone would want to/need to take a multivitamin (even if it's legit). Is there any evidence that a multivitamin provides health benefits?

[Amarillyde]

@Jebus I'm not completely clear on that, either. I know that there are some nutrients that I struggle with on most days, or at least I am unsure about when I do not use cronometer for a prolonged period of time (vitamin E, maybe calcium and zinc, some B vitamins); and others like iodine are a genuine problem, because of the unreliability of seaweed as a source of it (I eat nori only a few times a month, and so far I've been trying to compensate with kelp, but even a tiny bit is supposed to have lots of iodine, and I think there are studies on people who consumed it twice a week and had bad thyroid responses; so I wouldn't consider it a reliable way to deal with the iodine problem). So, I'm assuming that the supplement is going to provide those nutrients which I would not be getting at all or enough of. That being said, it's just an experiment for me at the moment (and I feel uneasy relying on something which is not food to get nutrients).

[brimstoneSalad]

Thank you! Some serious detective work

Thanks, I'm glad to help.

@brimstoneSalad Do you think programs like USP Dietary Supplement Verification are a good tool to rely on to avoid those kinds of scams?

https://www.usp.org/verification-services/verified-mark

Yes, I think so. But I don't think we need to be limited by vitamins that are certified by a third party as long as it's a reputable company in itself that has been around for a while.
It's one of many things to look at/consider. USP can help with peace of mind for a smaller or newer company.

Like I don't think I'd trust DEVA any more with additional certifications, since they're a pretty established company and have been around for many years.
http://www.devanutrition.com/about-us.html

I'm wondering why anyone would want to/need to take a multivitamin (even if it's legit). Is there any evidence that a multivitamin provides health benefits?

The epidemiological evidence suggests a slight reduction of mortality. However, this is probably only due to filling nutritional gaps. We don't want to make a Linus Pauling fallacy here and assume exponential improvements with more vitamins.

Theoretically if you ate a very high nutrient diet with lots of greens and hit or exceeded all of your nutrient goals (particularly minerals like zinc and iron) when you track it you would only need B-12. Additional vitamins would probably just go down the toilet and be a waste of money. Our bodies just stop absorbing them once we've gotten enough, or our kidneys just dump the extra in our bladders/urine.

However, given how expensive vegetables are and how difficult it can be to eat so well for somebody with a busy life in a country that doesn't have the healthiest dietary traditions... a multi makes a lot of sense. It's a safety net. A safety net is only useful if you fall, but we kind of live in a world where life knocks us over a lot in practice.

If we lived in a world where the typical fast food option was an affordable whole-grain/multi-grain wrap filled with steamed kale, collards, hummus with mixed nuts/seeds butter, and baked multi-bean tempeh then vitamins would probably not be needed (again, aside from B-12... and maybe DHA for older people).

As it stands, it's just a lot cheaper to take a multi at around 10-25 cents a day than to buy, cook, and spend time eating several pounds of vegetables and a precise mix of nuts and seeds. And it's even harder to make all of that yummy. Not impossible if you're a good cook, but it takes time and skill.

We shouldn't use a vitamin as an excuse to eat not vegetables at all (they contain important fiber and phytonutrients you can't get from a vitamin), but it can make life a bit more practical until we get to the point where we're surrounded by convenient healthy food options and no longer need them.

[cornivore]

Is there any evidence that a multivitamin provides health benefits?

I think the evidence which made multivitamins popular to begin with was from the initial success of food fortification, which reduced the incidences of malnutrition (or micronutrient deficiencies) that used to be common. Although this can result in children getting too many vitamins also, which may be about as common as malnutrition had been in the past: How Much is Too Much?

"The report focused on vitamin A, zinc and niacin because they are nutrients to which children are most over-exposed." https://static.ewg.org/reports/2014/chi ... _thing.pdf

Given the fact that accidental iron overdose is common enough for warning labels to be on vitamin bottles—if they are mandated—this proves that multivitamins can work too well also (because things like this usually aren't mandated until something goes wrong). Which probably means that they could have health benefits from preventing deficiencies too (if not abused somehow), since they are clearly potent enough to be the most common cause of death in children under age 6, as they say.

I was reading elsewhere that vitamin overdose in general can cause symptoms like that of a foodborne illness, which likewise indicates that the other vitamins included can be potent enough to be too much at times. Another example was about getting too much Vitamin C from drinking a bunch of juice at once (which everyone thinks is perfectly harmless, until they pee it out of their ass—uh yeah, orange juice burns in my experience, and I pretty much never drink juice now, between that and reports of arsenic in there).

The thing that I keep in mind is that serious malnutrition from lack micronutrients doesn't tend to occur unless they are completely absent from the diet for a long time. So I'd plan on supplementing with a multivitamin once a week, instead of potentially megadosing on them daily. I think this is how food fortification was expected to work on average, as people don't often eat a lot of the same thing everyday (and if they do, then fortified foods can be excessive as well).

It's like the questions of how beneficial macro-nutrients are, such as carbohydrates lately, because they are more often over-eaten than deficient in the diet. This doesn't mean that carbohydrates are altogether unnecessary for health though, whether from refined sugar or whatever else (but they can be equally unhealthy in excess; as they say, it is only the dose that distinguishes between what is and isn't a poison). People have even died of licorice poisoning, and that wasn't fortified with vitamins, but they still say "It is difficult to determine a safe level, due to many varying factors from person to person". For licorice! Yeah, I no longer eat that (or use it as a juice straw)... it was recalled for lead poisoning also.

Anyway, I don't think the recommended daily allowances (or whatever they call them these days) are all that important for basing multivitamin use off of, since they can't even decide what to call them, let alone what they are, while fasting for half the time may prove to be more healthy for some people. Just saying, I'd suspect such figures are most important for how much you don't want to eat beyond that, versus having to eat that much on any given day, let alone everyday.

[cornivore]

Is there a price below which one should consider a multivitamin likely to be unsafe?

Beyond what has already been said, I'd compare this to what I've read about adulterated foods. The price of the spice, for instance, did not indicate how likely it was to be adulterated. They found that inexpensive spices were cut with other ingredients, as well as some expensive gourmet spices. I would be more wary of imported spices though, because there are higher incidences of sickness from adulterated spices in countries where the spice trade originated, ironically.

All too similar, Consumer Reports lists 10 surprising dangers of vitamins and supplements, which includes adulteration with prescription drug ingredients. I guess the idea there would be to get people addicted, rather than going for a placebo effect. Even worse, they say that laws have made it difficult for the FDA to remove dangerous supplement products from the market, and typically they'll only issue "warnings", such as one for an imported multivitamin that made people sick, because it had megadoses of fat soluble vitamins in it. You can't trust that the FDA will do much about it, when the supplements aren't regulated as food or drugs. As far as who to trust, they say "If you choose to take vitamins, botanicals, or other supplements, look for those with the “USP Verified” mark, which means they meet standards of quality, purity, and potency set by the nonprofit U.S. Pharmacopeia."

For the most part, the article does not draw any comparison between multivitamins and fortified foods, and instead they imply that there is no proof whatsoever that vitamin supplements do anything to prevent major diseases. I find this odd, because food fortification with vitamins is known to have prevented major diseases related to malnutrution. They only mention that you wouldn't need a Vitamin D supplement if you regularly consumed something like fortified dairy products. Yet they give plenty of examples of people getting too much of any vitamin from supplements. So it's kind of paradoxical (on one hand they say there's no proof that supplements do anything to prevent hypovitaminosis, and on the other hand there's plenty of proof that people can take too much of them to cause hypervitaminosis). Otherwise, the FDA has recalled fortified rice in school luches, for excessive vitamin content. So it doesn't mean that fortified foods are automatically safer for having more oversight. Just that there will be more of a response after the fact that they are not always safe either.

What seems to be likely is that nothing involving concentrated vitamins is necessarily safe, compared to their natural concentration or bioavailability in foods (although foods generally have to be cooked to be safe from food poisoning, which reduces the vitamins available there). I seem to recall hearing something about common food pathogens occuring in prescription drugs, but I'm not finding reports of actual food poisioning from vitamin supplements. I suppose that's possible too, since they aren't typically cooked off the shelf (besides the fortified pastas and such). Oh, I found one about gummy vitamins recalled for lack of proper salmonella and staph testing (but who's to say everyone has to test for that...). Well it would appear that gummy vitamins are more regulated like a food then, and the FDA has tested vitamins for women and children concerning lead content, so perhaps those kinds could be safest (for being tested more often).

How about "Spider-man Complete" there?

If that doesn't say it all, another paradox to me would be a question of what other creature on earth has a diet including every vitamin or nutritional nugget known to man? Yet perhaps all other lifeforms are physically stronger, relative to their size, and some live a long time too. Well, people have long gone vitamin crazy, that's for sure, "live long and lick fish liver", alrighty then... and you know that had to hurt!

Speaking of which, this led me to wonder about the lifespan of people who practice the Jain religion (of non-violence through regular fasting, etc.), and they probably don't take multivitamins. What do you know... Census data show Jains outlive others: "A team of 20 doctors from the institutes visited the state recently and interacted with Jain monks and experts to learn about Jain diet, way of life and concept of health. Jitendra Shah, director of LD institute of Indology, said, 'I feel that simple lifestyle coupled with rules has led to increase in lifespan of Jain community members. They stay away from unhealthy habits and even stop eating at night after a certain age. This helps them to reduce various stomach related disorders. The religion has a number of ethoses such as respect to life, vegetarianism and practices like always consuming filtered water among others, that have played a major role in increasing longevity.'"

That's awesome!

So yeah, maybe boiling the water around here would help too, since millions of people have already pissed millions of vitamins or minerals into it (a whole other kind of awesome). In that case they're already free... (well, there may not be as much B12 in the water these days...).