Multivitamin Supplements Don't Help You Live Longer, Major Study Shows (go.com) 129
A study from the National Institutes of Health (NIH) analyzed data from nearly 400,000 healthy adults over 20 years and determined that "multivitamin use to improve longevity is not supported." The findings were published in JAMA Network Open. ABC News reports: The study found no evidence that daily multivitamin consumption reduced the risk of death from conditions such as heart disease or cancer. Rather than living longer, otherwise healthy people who took daily multivitamins were slightly more likely (4%) than non-users to die in the study period, according to researchers. Researchers reported nearly 165,000 deaths occurring during the follow-up period of the study, out of the initial group of 390,000 participants. The study, however, did not analyze data from people with pre-existing vitamin deficiencies. "What this study shows is that, generally, multivitamins aren't going to help you live longer," Dr. Jade A Cobern, MD, MPH, board-certified physician in pediatrics and general preventive medicine, told ABC News. "Even though the cost of many multivitamins isn't high, this is still an expense that many people can be spared from."
Helps you live better (Score:5, Informative)
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The problem is they put a lot of crap in multivitamins, too. I'm willing to believe that -4% could be whittled down to 0% by omitting just a couple of the ingredients, or at least dramatically decreasing their quantities. It's possible there's a genetic factor too, where literal nutritional guidelines aren't actually a "one-size-fits-all" type thing.
Re:Helps you live better (Score:5, Interesting)
Among other things, it could also be that people who know they are sick are hoping the vitamins will help. In other words a selection bias in the vitamin takers.
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Or conversely, maybe some people taking multivitamins don't feel they have to eat so healthily, don't bother with fruit, etc?
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this. not just celiac but Crohn's as well:
"Some studies suggest that low vitamin D levels may lead to an increased risk of surgery and hospitalisations, particularly in people with Crohn's. Another study found that giving vitamin D supplements to people with Crohn's reduced the risk of having a flare-up. Some people with IBD may be calcium deficient."
etc etc
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Re:Helps you live better (Score:5, Informative)
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This is also something to be c
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Studies show "eating....women" is not a significant source of dietary iron. Well, at least not while being legal in most places. /s
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This is also something to be considered by men...if taking a multi-vitamin, most men should avoid the ones that contain iron...we generally get plenty of iron from eating....women, can use the extra due to loss of blood during menstruation.
So, if you DO take a multi-vitamin, check the label if you are male.
Many men have a genetic issue called hemochromatosis, which causes them to absorb iron really easily. It is very likely a genetic variation that is helpful for women for the reason you point out. Wasn't a super problem until things like Geritol came out.
A friend is into weightlifting, and he took iron supplements. Fatigue and skin turning a bronze color, and a visit to a doctor who had him stop the supplements, and start phlebotomy - now he's a constant blood donor. Fortunately caught in time.
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Not so fast. Excessive intake of Vitamin C and Vitamin E can be harmful to more than just the kidneys.
https://www.science.org/conten... [science.org]
https://www.science.org/conten... [science.org]
As those medicine chemists show, excessive intake of antioxidants can in some cases actually accelerate the spread of cancer, instead of inhibiting it. Which is decidedly harmful.
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A lot of /. readers don't get enough sunlight either... supplements can help!
Re: Helps you live better (Score:2)
Sunlight *is* the best disinfectant. I'm trying not to disinfect my biome is all.
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A lot of /. readers don't get enough sunlight either... supplements can help!
Vitamin D deficiency id a big one now. Since people are told to stay out of the sun, and if they don't drink D fortified milk, they can be lacking.
Also, for deeply pigmented people living in northern latitudes - they have problems synthesizing enough D from available sunlight - and often need D supplements,
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Doc might suggest an ordinary fish oil supplement (Score:2)
It will not be an off-the-shelf supplement.
Actually it may be so. For example the doctor might simply recommend taking a fish oil supplement.
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For people with a healthy cardiovascular profile, regular use of fish oil supplements, a choice of primary prevention, was associated with an increased risk of atrial fibrillation. For participants with a diagnosis of atrial fibrillation, however, regular use of fish oil supplements, as secondary prevention, had a protective effect or no effect on transitions from atrial fibrillation to major adverse cardiovascular events, atrial fibrillation to death, and major adverse cardiovascular events to death.
TLDR: If you are healthy, don't use supplements, including fish oil supplements.
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The doctor will specify what to take - that's true. But you must buy it OTC in most cases. I've tried and pharmacies are confused and insurance won't pay - you just have to go get the Vitamin E or whatever OTC.
I've changed from a multi to the specific things my doctor recommended after blood tests mostly to save money, but also to hit the right things.
Re:Helps you live better (Score:5, Informative)
Thats a different thing. I take a multivitamin when I'm on a diet because I'm getting less than my bodies preferred amount of nutrients and shit, so I'll take a multivitamin to keep the liver happy.
But for most people who have a healthy and sufficient diet, and don't have other conditions associated with vitamin deficits (eg mensturating women, or one of the conditions you mention etc) theres no scientific justification.
The thing this study looked at was folks who dont *need* a multivitamin taking them for longetivity reasons, and it turns out that actually , your statistically shortening your lifespan (marginally) and are better off getting your vitamins from a better diet rich in vitamins and stuff.
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Nitroglycerin might be 'good for you' if you have certain heart problems, neurochemical issues; for the rest of us not so much..
This should come as a surprise to nobody. We are highly complex organisms, designed or evolved, you pick. At any rate introducing chemicals not naturally occurring or in different forms, ratios, and quantities than present in the foods we are generally inclined toward eating, and the atmosphere we live in are unlikely to be useful and very possibly to be harmful without careful co
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The thing is, vitamin pills are mostly useless. The useful method for giving vitamins in cases like that, or for dementia patients for example, is via injection.
British Navy studied supplementation (Score:3)
Long story short, the nickname of "limeys" resulted.
https://www.merriam-webster.co... [merriam-webster.com]
Re:British Navy studied supplementation (Score:4, Informative)
Well adding limes to our ship food did prevent scurvey and made sailors live longer as well as being able to keep their teeth.
I think if you were on the high seas eating nothing but ships biscuits and weavels a multivitamin pill would have a much more pronounced effect!
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Weevils. With an I. Weavels are what Brits shout out when they spot good fishing (We 'have eels!).
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"Two weevils crept from the crumbs. 'You see those weevils, Stephen?' said Jack solemnly.
I do.'
Which would you choose?'
There is not a scrap of difference. Arcades ambo. They are the same species of curculio, and there is nothing to choose between them.'
But suppose you had to choose?'
Then I should choose the right-hand weevil; it has a perceptible advantage in both length and breadth.'
There I have you,' cried Jack. 'You are bit - you are completely dished. Don't you know that in the Navy you must always choose the lesser of two weevils? Oh ha, ha, ha, ha!"
-- Patrick O'Brian
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This is the key point. They aren't magic, but if you are suffering from a deficiency in something then they can help with that.
There is little harm in taking them (except perhaps to your wallet, although they are pretty cheap), and can help cover gaps in your diet. Arguably if your diet is not great then you have bigger problems than just making up for the missing vitamins, but modern life is what it is.
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This is the key point. They aren't magic, but if you are suffering from a deficiency in something then they can help with that.
There is little harm in taking them (except perhaps to your wallet, although they are pretty cheap), and can help cover gaps in your diet. Arguably if your diet is not great then you have bigger problems than just making up for the missing vitamins, but modern life is what it is.
In most countries if you're identified by a doctor as suffering a deficiency, iron, potassium and Vitamin D are common in the UK, a doctor will usually prescribe lifestyle changes. Supplements are only prescribed if lifestyle changes are not enough and the supplements will be pharmacist only medicine. We've known for years that OTC vitamin supplements don't work and definitely don't do anything if you're getting anywhere near your required intake of vitamins and minerals (and if you're not, a change in die
Japanese Navy had a nutrition problem too (Score:2)
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Are you currently suffering from scurvy? No? Then you aren't in any real need of a vitamin C supplement.
A Lime is not a multi-vitamin (Score:2)
Long story short, the nickname of "limeys" resulted. https://www.merriam-webster.co... [merriam-webster.com]
One is a fruit, one is a pill. The fruit has a measured effect, the pill doesn't. Does that not concern you? Perhaps a pill is not the optimal way to get that nutrient into your body?...or as the evidence shows...even an effective one?
fuck these articles (Score:2)
there have been some recent studies showing
* multivitamins dont help you live longer
* multivitamins dont prevent heart disease
and they seem to inspire journalists to come to the conclusion that multivitamins are worthless
this is fake news
Imagine living with a vitamin D deficiency, or scurvy or a magnesium deficiency because of articles like this ðY
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Most people on western countries are vitamin D defficient without realising it, especially during the winter months and especially those with darker skin tones.
We all should be supplimenting vitamin D, or fortifying our foods with it.
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Milk is commonly fortified with vitamin D. So if you drink even a modest amount of milk you are covered. But a lot of the reporting about vitamin D deficiency (it is about the only vitamin people in advanced nations show up with clinically low levels for) turns out not be actual deficiency as supplementation does not help. Low vitamin D levels turns out instead to be a marker for general poor health -- and the the underlying health issues are what must be addressed,
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> Milk is commonly fortified with vitamin D
Thats a US thing, we dont do that in the UK. Some breakfast cereals are fortified with Iron and others, not sure about vitamin D.
> Low vitamin D levels turns out instead to be a marker for general poor health -- and the the underlying health issues are what must be addressed,
The low vitamin D levels are due to the fact it's hard to make it. You cant not get vitamin D from the diet, besides a few souces such as eggs, cod liver oil and fortified foods and eve
Deficiencies: yes, but they are rare (Score:2)
inspire journalists to come to the conclusion that multivitamins are worthless
Vitamin supplements are worthless for anything but compensating vitamin deficiencies. Period.
Imagine living with a vitamin D deficiency,
Yes, okay I get it. This /. and the average basement dweller whose only light source is their computer's screen is probably indeed heavily deficient in vitamin D.
But the minimal necessary daily exposition to sunlight to synthetise enough vitamin D is counted in minute.
A very large proportion of the general population does not neet vitamin D supplementation, no matter what impression you might get from fellow baseme
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Supplementing D vitamin in the winter if you live far enough north where the days are short is a pretty normal recommendation in official government recommendations. But it doesn't have to mean pills; vitamin D is added to milk for example, so if you drink 2-3 glasses of milk every day, you migth be getting all you need already.
Old people often have some deficiencies due to worsening digestion over time, so they are in a completely different situation to younger healthy adults.
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Drink 2-3 glasses of milk a day? My toilet isn't going to be happy.
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Lactose-free then, or something else enriched with vitamin D. :)
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If you're any sort of athlete you also need more D3. If you're older and any sort of athlete, you really need more D3.
VItamin D deficiency can cause all sorts of problems.
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This study showed they do something. Taking vitamins actually increases your mortality. WTH? Large long-term study too. Maybe they didn't correctly sample or normalize?
"On the contrary, mortality risk was 4% higher among multivitamin users, compared with nonusers, in the initial years of follow-up (multivariable-adjusted hazard ratio, 1.04; 95% CI, 1.02-1.07).1"
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Don't Toss those Multivitamins Just Yet (Score:5, Informative)
So, multivitamins still have a function, but as the title says, it isn't longevity. In particular, the following vitamins and minerals were listed as having health benefits - even when consumed via supplement:
Beta carotene, vitamins C and E: slowing the progression of age-related macular degeneration
Vitamins B12 and D: a convenient source of nutrients
General multivitamin-mineral supplements: significantly more favorable change in episodic memory and global cognition (Effect of multivitamin-mineral supplementation... [sciencedirect.com])
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Might be a problem with Beta carotene. It's been shown to be a pro oxidant in certain circumstances.
https://pubmed.ncbi.nlm.nih.go... [nih.gov]
https://www.mdpi.com/2076-3921... [mdpi.com]
It could be that cofactors, found in regular food, can be responsible for preventing damage by beta carotene.
https://www.ncbi.nlm.nih.gov/p... [nih.gov]
The short take, make sure you eat your fruits and veggies. Try to eat well, in preference to relying on vitamin supplements. If you have a condition that needs supplements, that's all fine, but you sho
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I recently was told to have at least 100mcg of selenium a day, either as a pill (which I'll prefer) or 1 or 2 brazil nuts (and not much more than that) a day due to my suspected Thyroid Eye Disease.
The Thyroid is the largest concentration of selenium in the body and it's becoming clear that it's essential for correct immune system function. TED is an autoimmune response and may indicate the thyroid may develop issues. I've been having the nuts for the moment, but someone who was allergic to nuts would nee
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There are also studies focusing on the elderly that show the older you are, the stronger the indication in epidemiological data of benefits from vitamin supplements. So as you hit retirement age, probably a good idea to take vitamins. But you might consider breaking them in half or taking them every other day as the levels in vitamin pills are pretty high. Even if the amount is only the RDA that means it provides all the vitamin needed by 97% of the population, and you are also - like everybody - already ge
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Longevity is not the best measure of good health. Modern medicine can keep someone who is seriously ill alive for a long time, thus dying about the same age as someone who is healthy.
Ok (Score:2)
Well I don’t think many thought they would make you live longer.
Surely the purpose of the multivitamin was to ensure all the bases were covered with getting the RDA of as many vitamins and minerals as possible without having to rely on keeping a specific diet?
A healthy diet is essential regardless, as that supports the gut health etc which is essential for letting these vitamins through in the first place. But not everyone can get all the Vitamin D they need from the sun and not everybody can get all
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I think I'd stick with the Brazil nut solution, except that they can be an utter pain in the ass to get out of the shell. Even parrots get tired of dealing with it after a while, and it's not like they have anything better to do.
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Oh I just use the shelled ones.
I will get tired of eating them eventually however, the pill would be a lot better as I would easily have that with a meal.
I was also waiting for the prescription to be issued so I can compare costs. Holland & Barratt do 200mcg (twice what the doctor said I should have but well within the safe limits so ok to take) at £12.99 for 30 tablets. The prescribed 100mcg ones will be around £9, but I dont know how many tablets. I also havnt counted the number of nuts
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You could finely chop the nuts and put them in your food. I actually do this sometimes with my breakfast porridge. Also, I sometimes grab a handful of almonds when I get home from work to take the edge will occasionally put a couple of Brazil nuts in with them. It's easy enough to mix it up to avoid boredom, at least that's my experience.
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It's not breaking the shell that's hard, it's keeping the "meat" intact in the process that is a problem. Brazil nuts tend to stick to the inside of their own shells, and cracking one often results in half the worthwhile material remaining stuck to shattered shell.
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Thats why I've been prescribed 1-2 a day, or 100ug - 200ug tablets.
Cherry pick much (Score:2)
Healthy adults my ass - THIS STUDY IS BULLSHIT! (Score:5, Informative)
Results Among 390124 participants (median [IQR] age, 61.5 [56.7-66.0] years; 216202 [55.4%] male), 164762 deaths occurred during follow-up; 159692 participants (40.9%) were never smokers, and 157319 participants (40.3%) were college educated. Among daily MV users, 49.3% and 42.0% were female and college educated, compared with 39.3% and 37.9% among nonusers, respectively. In contrast, 11.0% of daily users, compared with 13.0% of nonusers, were current smokers. MV use was not associated with lower all-cause mortality risk in the first (multivariable-adjusted HR, 1.04; 95% CI, 1.02-1.07) or second (multivariable-adjusted HR, 1.04; 95% CI, 0.99-1.08) halves of follow-up. HRs were similar for major causes of death and time-varying analyses.
Design, Setting, and Participants This cohort study used data from 3 prospective cohort studies in the US, each with baseline MV use (assessed from 1993 to 2001), and follow-up MV use (assessed from 1998 to 2004), extended duration of follow-up up to 27 years, and extensive characterization of potential confounders. Participants were adults, without a history of cancer or other chronic diseases, who participated in National Institutes of Health-AARP Diet and Health Study (327732 participants); Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (42732 participants); or Agricultural Health Study (19660 participants). Data were analyzed from June 2022 to April 2024.
Fuckers were all with one foot in the grave already and we are supposed to be amazed that THREE DECADES LATER MOST 60-YEAR-OLDS WERE DEAD?!
Title of study should be "If 60 chances are you won't be 90 - well no shit Sherlock! Don't buy vitamins, buy grave plot!"
Also the fact that the number of people, in both groups, who inhaled poison daily was greater than the difference in mortality speaks volumes on the quality of dealing with "potential confounders".
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Supplement if deficient (Score:2)
Any sensible medical professional will tell you, supplements are only helpful if you are deficient in some way.
The majority of people in developed countries that eat a balanced variety of different foods, easily get all the vitamins they need. Unfortunately people hear about how someone that was deficient in something, because they were either not getting enough in their diet or had a health condition that c
POTUS Medical Advice (Score:2)
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Any sensible medical professional will tell you, supplements are only helpful if you are deficient in some way.
To expand on your comment a bit, that is basically true of everything we eat.
Irony (Score:3)
Just noticing that this is right next to the article on ultraprocessed food.
Aren't vitamins also a severely processed food? Your body needs so many nutrients that a simple vitamin can't be the cure for a bad diet. If you lack a particular nutrient in your diet, such as iron or calcium, sure. Supplements can help that. But if all you're eating is these "ultraprocessed" snack foods no vitamin in the world would help enough. Eat a proper diet, enjoy a treat once in a while, and you'll have a longer and better life.
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But if all you're eating is these "ultraprocessed" snack foods no vitamin in the world would help enough.
Why not? If you can't answer that, there are scientists doing studies like this one, trying to answer the question.
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Because the nutrients missing from ultraprocessed foods couldn't all be fit into one multivitamin, of course. You'd need something the size of a meal. At least a couple of protein shakes for starters. But then it's no longer "all you're eating is ultraprocessed foods" if you do that. And of course, nothing will remove the excess carbs except eating less of them.
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Because the nutrients missing from ultraprocessed foods couldn't all be fit into one multivitamin, of course. You'd need something the size of a meal. At least a couple of protein shakes for starters.
You're hypothesizing that the main problem with ultraprocessed food is that they don't have enough protein?
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Protein is only one nutrient, but probably the largest by weight.
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Comfortable shoes don't make you live longer (Score:2)
"more likely (4%) than non-users to die" Careful (Score:2)
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Yep, without cohort breakdowns by existing or diagnosed disease this is just another episode of "Backwards Science!!!".
News flash: people with disease are more likely to try vitamins.
News flash: people with disease are more likely to die sooner.
Who is shocked?
The only silver miming is that such researchers will eschew vitamins.
Or the science journalist if we're being lied to again.
So many correlations... (Score:2)
Multi-vitamins are superstitious trinkets (Score:3)
If taking a vitamin pill actually worked, there would be more effective and less effective formulations. Nearly anything that actually does something is poisonous if you get the dose wrong, so if Vitamins actually worked, there would be massive warnings all over the packaging about taking too many and news stories about weirdos who took too many pills 5 states away and died.
I know diet is what many atheists use to fill the god-shaped-hole in their life, but nutrition is largely bullshit. I spent my entire childhood in near poverty and when I was a teenager everyone was saying you'll be fitter and healthier if you ate better....thinking that if I could afford an expensive healthy diet, somehow I'd feel better...it would cure my depression, make me less fat, make me stronger, and my mediocre food would stop poisoning me.
So I graduated college, started earning good money, ate perfectly...and guess what...no noticeable difference. You can harm yourself by eating recklessly, obviously. Eat ice cream for dinner and your body won't thank you. However, eating 2000 calories of whole foods excellence or 2000 calories of poor person nutrition...all that matters is the number of calories and the macronutrient ratios (fat/protein/carbs).
During the pandemic, I worked from home and started eating near perfectly (as well as exercising perfectly). I eat salads and fruits and protein and little else. I almost never eat bread or pasta and have largely cut out desserts and chips and most of the common abuses. When I eat carbs, it's whole grain rice or low carb tortillas. I balanced macros perfectly and have gone months eating perfectly....no change. I don't feel better. It doesn't hurt less to get out of a chair if I had a good workout that week. I take my multivitamin daily as well as a mineral supplement.
Whether I ate 2 salads and protein shakes and no sweets that day...or the same number of calories of pizza and junk food....no difference. The only difference is that junk food is calorie-dense and often tastier, so it's much easier to overeat, but if you could control the calories, you won't see the difference (unless you really tried hard to wreck yourself, like lived off candy alone). I even bought into the glycemic index narrative...I can't tell the difference personally between whole wheat and white bread. I am not 100% sure that's bullshit, but I am skeptical and think the benefits of whole grains are exaggerated. I've stopped buying whole wheat hamburger buns for my kids (obesity runs in my family and my kids are a little overweight) and just buy them smaller white bread ones which have less calories and they like more anyway.
Diet is just religion for city folks (and some major religions as well)...we're wired to need to do gestures to make our lives better and ignore that there's no evidence. Jews and Muslims think that a bacon cheeseburger will harm their relationship with god. My coworker thinks the same about gluten. He doesn't have celiac disease, he probably doesn't even have "gluten sensitivity." He just wants to believe that if he will achieve glory if he bakes with rice flour instead of wheat flour. It's something intangible for him to believe in. Vegans are the same way....oooh, you had butter?...well no dietary nirvana for you, sinner!!!!!!. I was the same with the gylcemic index and eating fresh fruits and vegetables. I still eat them because I think they're tasty, but whether or not I get beets from a can or from a farmer's market...there's NO difference. There's no difference between a 500 calorie salad vs a 500 calorie ham sandwich on white bre
who cares about longevity (Score:2)
I mean, I do want to stay young as long as possible, but I don't care if I live longer than the average human.
What I DO want is to feel as good as possible as many days of my life as I can. For $2/day if a multivitamin improves your overall feeling of well-being it's not a waste of money.
Re:I hate these articles (Score:5, Informative)
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It's only a look at if there's any point in taking multivitamins if you're healthy. It's not about taking specific vitamins if you have a deficiency, for which there is varied study results for specific circumstances.
Exactly.
It's more or less the definition of a vitamin that it is a substance which if not present in small quantities in your diet, will cause some deficiency syndrome. No, you don't have to get it via a supplement, but you have to get it somehow.
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Why would they work when added to a food source but not taken on their own?
Go chew on some sodium and report back
Biology is complex. Digestion is complex. Some vitamins can't be taken raw.
If this is news to you, then you really should grab my ultra-dose, 24hour release, mega-bundle vitamin pill. Now with added Brawndo!
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Really? What is it with you chucklefucks thinking that trashing Biden makes Trump, who is worse in every way, look good?
Y'all are every bit as smart as your orange god.
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It seems that most people I know are not fond of either of the two individuals mentioned. But I don't spend a lot of time with drooling idiots, so that's likely a factor.
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Unless you're a male and doing weight lifting or a remotely physical job.
A normal diet contains adequate protein. You don't need supplements to build muscle, and there's no evidence that they help.
Protein supplements have no effect on strength or muscle growth [bbc.co.uk]
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But a lot of people don't necessarily have normal or balanced diets. Which is where a multivitamin can help. Maybe not live longer, but live a bit healthier. But agreed, the extra protein for body building is kind of a short cut for those wanting quantity over quality in their muscles. Protein supplements are good for some elderly people as well..
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That is NOT a peer reviewed or journal published study, and moreover it's silly to bring up one small study that showed lack of efficacy and conclude that there is no effect. There have probably been individual studies that lacked the explanatory power to prove smoking caused cancer, or that sugar caused obesity and NAFLD.
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How did they build the pyramids without protein shakes? Must have been aliens.
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I mean i am 6 foot tall and 100 pounds.
I eat nothing but candy sometimes for an entire week.
I have chrones disease, meaning pretty much everything I eat either isn't digested or absorbed properly. Since i started taking a multivitamin i am much less lethargic and even started gaining weight...
Clearly they aren't useless. And I am not an athlete.
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Wait, what? How does that make a difference in regards to whether vitamins work to you? Gendered vitamin intake recommendations do nothing to change the nature of vitamin supplements.
You assume you absorbed it-remember cholesterol? (Score:2)
If multi vitamins are not needed then why have daily values for them for men and women?
Needing a vitamin is different than absorbing it correctly. If you're old, like me, you remember the anti-cholesterol fad. Sometime when I was a small child (maybe earlier)....everyone was worried about dietary fat and cholesterol. Every news story was telling you how high cholesterol would give you a heart attack...so everyone stopped eating bacon and cut their meat and cheese intake and everything was available in fat free or no cholesterol variations...including increasing sales of margarine instead o
Still a placebo - can you observe they work? (Score:2)
The summary says vitamin supplements doesn't give you a LONGER life, but what about a BETTER life?
Are you confident your vitamin is more effective than a sugar pill? If someone switched them out, would you notice? If you switched my Tylenol with sugar pills, I'd notice. If you switched my coffee with decaf, I'd notice. We can objectively demonstrate the benefits with blood lab work and medical imaging for Tylenol and caffeine.
If there are any benefits of multi-vitamin pills, surely medical science could document and quantify them, shouldn't they?
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Are you confident your vitamin is more effective than a sugar pill?
Yes, I am.