A large and genuinely mixed literature. Baseline nutrient status is the dominant variable and is frequently unmeasured, which explains much of the disagreement between trials. Structure/function only.
How it works
Maintain — a combination product whose mechanism is repletion, not pharmacology; its effect depends entirely on whether the person was short of the nutrients it contains
Exchange — population intake surveys repeatedly find shortfalls in magnesium, vitamin D, vitamin E, calcium and potassium, which is the gap a broad formula is designed to close
Build — supplies cofactors that many enzymes require simultaneously, so a single-nutrient trial design cannot capture what a combination does
Transform — trial results are heterogeneous by design, because a repletion intervention in an already-replete population has little room to move an outcome
Form matters
The same nutrient can be made in very different forms — and a study done on one form does not automatically apply to another. Methylcobalamin is not cyanocobalamin; magnesium glycinate is not magnesium oxide; a whole-food extract is not the synthetic isolate that was studied. Two things decide whether what is in the bottle behaves like the research: the exact form, and independent lab verification (a Certificate of Analysis) that the form and dose on the label are truly what is inside. Without a COA, you are trusting a label, not the science.
The science on Multivitamin-mineral
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