It's been said for a while, and USPSTF agrees: vitamins give you expensive pee.
with two important outcomes in mind: cancer and cardiovascular death. Why vitamins? Because the observational data are clear and compelling. People with vitamin deficiencies are at higher risk for these bad outcomes.
To be honest, the effect is not even that impressive: a 7% relative reduction in the incidence of cancer. And relative risks really tend to overstate the effect size. In absolute terms, multivitamins reduced the incidence of cancer by around 0.2%. That means you'd need to treat 500 people with a multivitamin to avoid one case of cancer.
First, we need to acknowledge the fact that vitamins are generally pretty cheap and have a very low side-effect rate. They don't make you dizzy or nauseated, tachycardic, or tired. They don't feel like much of anything. Notable findings for the harm analysis included evidence that vitamin A use might increase the risk for hip fracture, that vitamin E use might increase the risk for hemorrhagic stroke, and that vitamin C or calcium use might increase the risk for kidney stones.
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