The Ins and Outs of Supplements

Understanding the proper use and varying qualities of supplements can help you use them properly—or not at all

Dietary supplements can be a powerful tool for health and wellness for those who may need to fill nutritional gaps.BearFotos/Shutterstock

Supplements have become a massive industry with plenty of enthusiastic promoters. But for all the research telling us how certain vitamins and nutrients affect our bodies, taking supplements can’t always deliver the results we may hope and expect.

“In my clinical experience, benefit from supplements is most successful when tailored to the unique nutritional needs of an individual,” said Dr. Tamara Darragh, a naturopathic physician licensed by the Minnesota Board of Medical Practice.

Darragh says given the range of benefits and needs, getting expert advice from a knowledgeable provider can be important in any supplement regimen.

Such an expert can take a wide variety of factors into consideration, including age, sex, genetics, family history, illness, lifestyle factors, and more. It may also be prudent to test for any nutrient deficiencies.

Value for Dollar

With so many different types of supplements available, and with new ones coming to market daily, beyond expert advice, how can you be sure that you’re choosing a safe and high-quality product that could actually provide some benefit?

One way to verify product quality is to look for products that have been tested by an independent third party, such as ConsumerLab, NSF, or Banned Substances Control Group (BSCG). Third-party testing isn’t required by law but some manufacturers still choose to have their products third-party tested as a sign of their commitment to quality and transparency.

These independent groups test for illegal substances, validate that the ingredients listed on the label are actually what’s in the bottle, test for product potency, and provide a certificate of analysis (COA) listing the results. Some manufacturers, such as Nutrigold, make the COA for their products available for consumers to easily access on their website or via a QR code on the product label.

Unlike prescription drugs, the Food and Drug Administration (FDA) doesn’t regulate the safety or quality of dietary supplements before they go to market. Instead, it’s the responsibility of each manufacturer to ensure that safety standards are met and that the supplement actually contains the ingredients and potency listed on the label.

Unfortunately, this isn’t always the case. According to the National Center for Complimentary and Integrative Health, a 2012 government study found that 20 percent of supplements marketed for weight loss or immune system support made illegal claims on the label. The FDA has also found prescription drugs in thousands of products being sold as dietary supplements.

The FDA does play some roles. It may inspect supplement manufacturing facilities, and it monitors reports of adverse events that are submitted by the companies themselves, health care professionals, or consumers. The agency also prohibits supplement manufacturers from making false claims or exaggerating the efficacy of their products.

But because the human body is so complex and people are so different from one another, sometimes the science itself is uncertain.

Study results on the safety and effectiveness of many supplements are mixed and often conflicting, and certain nutrients can carry serious health risks or be toxic in large doses. That’s why it’s important to consult with a trusted health care provider about your individual nutritional needs and to purchase supplements from a trusted manufacturer. Take any hyped-up health claims with a healthy dose of skepticism, and don’t assume that words such as “natural,” “standardized,” “clean,” or “verified” are a guarantee of quality.

Strictly Supplemental

According to Darragh, the quality of a supplement depends on a variety of factors, including the quality and purity of the raw materials, the formulations used, the inclusion or exclusion of unnecessary fillers and dyes, and quality control during the manufacturing process.

An important point to keep in mind is that dietary supplements, by definition, are intended to “supplement”—not replace—nutrients supplied through diet. Many health experts believe that, for most healthy individuals, it should be possible to get all the nutrients needed for good health through a varied, nutrient-dense diet.

According to the FDA, a supplement is a product that is taken orally and contains one or more “dietary ingredients.” It’s technically neither a food nor a medicine, but could include vitamins, minerals, amino acids, botanicals (plant derivatives), or live microbials (like probiotics). Supplements can also contain some combination of these ingredients.

Dietary supplements can be a powerful tool for health and wellness for those who may need to fill nutritional gaps. And when chosen and used carefully, they can play an important role in promoting health and wellness for many. But they aren’t the panacea some promoters, marketers, and so-called experts promote them to be.

There are conditions when getting extra nutritional support through supplementation may be needed. Those with nutritional deficiencies, or medical conditions that result in poor nutrient absorption, might need supplementation to meet all their nutritional needs.

Vegans may benefit from supplementation, especially with vitamin B12, which is found mainly in animal products. Also, pregnant or breastfeeding women, who have increased nutritional needs, and those with limited access to healthy foods may benefit.

The Backstory

It’s important to note that, even though dietary supplements may be “natural” in the sense that they are taken either from leaves, roots, or another substance found in nature, that doesn’t mean they are risk free. The same is true of those that are synthesized in more industrial processes.

And while herbs and other botanicals have been used medicinally for thousands of years around the world, it’s only in the past century that the dietary supplement as we know it today has risen to prominence.

It wasn’t until 1912 that scientists began to discover that the world of nutrients contained more than just the macronutrients of proteins, carbohydrates, and fats. Subsequent decades led to the gradual discovery of increasing numbers of vitamins, minerals, and other nutrients, which were gradually isolated, extracted, and shortly after synthesized in labs. In the years since, they have been commercialized.

The progression through the decades has taken the dietary supplement industry from obscurity to ubiquity. The Council for Responsible Nutrition, which conducts an annual Consumer Survey on Dietary Supplements, reported that its latest results, from 2021, showed a new high in supplement use, with 4 out of 5 Americans using some kind of dietary supplement.

And that shift isn’t without some risk.

Issues and Problems

Because supplements are concentrated forms of specific compounds, it’s possible to overdose by taking too much either in a short amount of time or over the long term.

For example, a study published on Dec. 22, 2016, in Advanced Pharmaceutical Bulletin showed that excessive amounts of vitamin A damages bone health, increasing the risk of fractures and osteoporosis.

And beyond the tremendous variance in quality of supplements, the simple fact is that sometimes the body can’t use certain vitamins or minerals effectively in supplement form. They may need to be taken with other nutrients, dietary fiber, or when certain biological conditions are met. That means you can spend a lot of money on supplements and get little to no results.

Multiple other studies found that taking various supplements including folic acid, retinol, and multivitamins had either no effect on disease prevention or actually had harmful effects. And, according to the FDA, some supplements can negatively interfere with prescription medications; others can interfere with lab tests and have dangerous effects during surgery.

One of the most popular forms of supplements is the multivitamin. And while taking a daily multivitamin may not do any harm, there’s not much evidence that it does any good, either. As the National Institutes of Health’s National Center for Complementary and Integrative Health states on their website, “Most research shows that taking multivitamins doesn’t result in living longer, slowing cognitive decline, or lowering the chance of getting cancer, heart disease, or diabetes.”

“I wish there was a magic supplement ‘insurance policy’ but the reality is health is much too complex,” said Darragh.

“Nutritional supplements can be part of this quest for preventing illness and health challenges, but I believe too much importance is placed on them. They work best when taken as part of a holistic plan consisting of daily habits that include, but are not limited to, a nutrient-dense diet, movement, sleep, stress resilience, balance, joy, and community.”

Zrinka Peters has been writing professionally for over a decade. She has a BA in English Literature from Simon Fraser University and has been published in a wide variety of print and online publications including Health Digest, Parent.com, Today’s Catholic Teacher, and Education.com