Nutritional supplements are everywhere. From pharmacies and grocery stores to health food shops and online retailers, consumers are surrounded by products promising more energy, better immunity, stronger bones, sharper thinking, and a healthier heart, all packed into a pill, powder, or gummy. But how many of those supplements does the body actually need, and how many simply become what medical professionals jokingly call “expensive urine?”
Samuel Mathis, MD, a primary care physician at The University of Texas Medical Branch (UTMB Health), divides the vast array of nutritional supplements into three categories: those worth considering, those that may benefit specific people, and those that are just marketing.
Because dietary supplements are not subject to the same premarket regulatory oversight as prescription drugs, consumers need to understand what the science says, what their bodies may need, and how to read a label before spending their money.
“Dietary supplements are not regulated the same way prescription drugs are,” Mathis said. “That means there is no FDA requirement to prove a supplement is effective before it reaches store shelves, and manufacturers are responsible for ensuring what is listed on the label is in the product. The first thing I do when I speak about supplements with my patients is tell them not to fall prey to food fraud, where the supplement may not contain what it says it does, or may contain ingredients they didn’t intend to take.”
He said a 2015 investigation by the New York State Attorney General’s Office raised concerns about the accuracy of supplement labels. The investigation found that roughly four out of five store-brand herbal supplements tested did not contain DNA from the plant species listed on their labels.
The supplements were sold at major national retail outlets, raising questions about how consumers can know what they are actually getting when they purchase a supplement.
Look for independent testing
So how should consumers make the best choice when searching for a supplement?
Mathis said consumers should look for products that have been tested by an independent third party.
“Read the labels and look for certain logos,” Mathis said. “USP (United States Pharmacopeia), NSF, and ConsumerLab are three reputable independent sources consumers can look to for supplement quality testing. If one of these logos is on the bottle, you can be reasonably confident that the product contains what it claims to contain.”
Third-party testing does not necessarily mean a supplement is effective or appropriate for everyone. Rather, it provides additional assurance that the product contains what the label says it contains.
Do you really need a multivitamin?
Mathis said many people keep a multivitamin in their cabinets and take it daily as a form of “nutritional insurance.” They may believe a multivitamin fills nutritional gaps when their diet falls short or provides nutrients their bodies might otherwise lack.
“There’s no evidence that shows that a person who eats a healthy, balanced diet needs a multivitamin, and a person who’s not eating well isn’t going to make up for the nutritional deficiencies by taking a vitamin,” Mathis explained. “My primary recommendation is to get your nutrition from whole foods, proteins, vegetables, and fruits instead of taking a multivitamin.”
There are, however, situations in which a person may need a specific vitamin or mineral because of a deficiency, medical condition, dietary restriction, or other individual circumstance. Those decisions are best made with a healthcare provider.
Some supplements may have a role
For patients who are considering supplements, Mathis said fish oil is one option he recommends.
He generally recommends taking 2,000-3,000 milligrams a day.
“There are studies that show that can be a helpful supplement,” he said. “It was originally marketed for heart health, and although it may not be as effective in that area as once thought, it may still be helpful for inflammatory conditions such as arthritis and may be helpful with mood, anxiety, or depression. It’s one of my favorite supplements to recommend.”
For poor sleep or mood concerns, Mathis also suggests 300 to 400 milligrams of ashwagandha daily.
“It’s a supplement with few side effects,” he said.
Mathis cautioned that consumers should be skeptical of supplements that make claims that seem to be too good to be true.
“If a supplement promises better sleep, improved libido, stress reduction, or weight loss, stop and ask your healthcare provider.”
While some supplements may have a role, Mathis emphasized that they should complement appropriate medical care, treatment or lifestyle changes, rather than a replacement for them.
“These are not intended to replace medical advice or treatment,” he said. “People might believe that if they take a supplement, they won’t have to do the hard work of eating healthy, getting more physically active, or consulting with their doctor. No supplement is better than those things.”
More isn’t necessarily better
People can also become accustomed to taking supplements every day, a practice Mathis said is not always necessary.
“If you take a supplement for a few months and then stop, pay attention to how you feel. If you can’t tell a difference when you’re taking it versus when you’re not, it may be worth asking whether you need it.”
It is also important to determine whether a supplement could interact with prescription medications. Mathis said the more supplements a person takes, the greater the potential for interactions, side effects, and other complications.
That is why he recommends limiting the number of supplements a person takes at one time.
“If a patient of mine is taking up to 10 supplements, I will try to narrow the list to the ones that are most effective and appropriate for that person,” he explained. “That reduces the risk of interference or complications with prescription medications.”
Know what you’re taking
Mathis said there is some science behind certain supplements, but the evidence varies, and it is often more limited than the marketing surrounding the products suggests.
That makes it important for consumers to do more than simply reach for the bottle with the most impressive claims.
Read the label. Look for independent testing. Know why you are taking a supplement and ask whether it is actually making a difference. Most importantly, talk with your doctor about any supplements you take, particularly if you also take prescription medications.
When it comes to supplements, more is not necessarily better, and a longer list of pills, powders, and gummies does not necessarily mean better health. The best place to start may be much simpler: Know what your body needs, get as much nutrition as possible from whole foods, and use supplements when there is a clear reason to do so.