It’s time to tackle the nebulous topic of dietary supplements. Before I start, I’ll clarify that I have zero associations with any supplement companies. The purpose of this post is to help clear up confusion about dietary supplements in general as well as address some specific supplements. It is by no means comprehensive but I hope you walk away feeling a bit more informed and empowered to make the best supplement choices.

You should always discuss dietary supplements with your healthcare provider, especially before beginning any new supplements or medications.

You’ve likely seen headlines that Americans spend billions of dollars a year on dietary supplements that do nothing for them. Or you’ve seen articles promoting the latest miracle supplement that will take away all that ails you and leave you feeling super energized (and 10 pounds thinner). Or you’re getting hounded by friends and family (and strangers) in MLM schemes trying to sell you supplements. It’s likely you’ve experienced all of this.

I chatted with my friend Ginger Hultin, MS, RD, CSO, who has practiced in nutrigenomics and integrative oncology, about dietary supplements and what she wishes people knew about them. Here’s what she said: “I wish people knew that supplements aren’t cure-all pills. They simply ‘supplement’ a healthy diet and lifestyle. You have to have that base.”

So how do you separate fact from fiction in the world of supplements? Let’s start with…

3 Facts Everyone Should Know About Dietary Supplements

1. Dietary supplements are not meant to replace food
   

They are called supplements for a reason — they are to be used in addition to food, not in place of food. The nutrients in foods may behave differently than synthetic nutrients in supplements. Oftentimes the combinations of nutrients in foods lend a synergistic effect that is irreplicable in supplements. Not to mention the lovely fiber and phytonutrients that come with whole foods.

Some dietary supplements are associated with increased risk of certain health conditions in some populations. Ginger adds, “People should know which supplements they’re on that thin the blood. People should be taking supplements for targeted reasons and in the right dose.”

While it’s next to impossible to overdose on nutrients from food, it’s very possible to reach toxic levels from supplements. If you’re a generally healthy person, think “food first” before reaching for a supplement.

Ginger points out that supplements can be very useful for people who are sick, especially those with cancer. “Sometimes people can’t get enough nutrients from food for a variety of reasons. Sometimes the right supplements can be incredibly helpful to a person’s health,” she says.

2. Using dietary supplements is an individual choice and requires a personalized approach

Just because a supplement “worked” for your mom or your best friend doesn’t mean it will “work” for you, and vice versa. Many supplements have nasty interactions with other supplements and drugs. Safety is a real concern. Before taking any supplements, discuss them with your physician and consider working with a registered dietitian nutritionist to determine if and what supplements you may need (or not need).

3. Dietary supplements do not require FDA approval

Unlike drugs, dietary supplement manufacturers have to submit zero evidence to the U.S. Food & Drug Administration before their product goes to market. Look closely at a dietary supplement package and you’ll likely see the phrase “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

Dietary supplement manufacturers are responsible for composition and purity of their product and only after a product gets to market might it be investigated by the FDA (typically after a complaint is made). Also keep in mind that there currently is no regulated definition of the term “natural.” Take what you see on a dietary supplement label with a grain of salt.

On the flip side, Ginger says, “Not all supplements are dangerous or tainted. Some supplements are really high quality and some companies pay for third party testing to support that.” It’s up to you as the consumer to assess the quality of supplement products.

Busting Myths on 7 Common Dietary Supplements

Biotin

Biotin is a water-soluble B vitamin that is most popularly known for supporting hair, nail and skin health. Many foods contain biotin and deficiency is quite rare.

According to the National Institutes of Health, there is not enough evidence to support the effectiveness of biotin supplements for hair, nails and skin in healthy people. And according to the Natural Medicines Database, the only condition biotin supplements are “likely effective” for is…biotin deficiency.

In other words, unless you’re biotin deficient, it’s unlikely that taking a biotin supplement is going to improve your hair, nails and skin.

Ginger shares, “I recently had a patient who was taking biotin — I read the ingredient label and the first ingredient in the product was actually corn syrup followed by red food dye.”

Bottom line: Eat a balanced diet and it’s almost certain you’re getting enough biotin.

Collagen

Trend alert! People are adding ground up animal cartilage to their coffee in hopes of reversing the age of their skin (and who knows what else).

Collagen is a protein in our bodies that helps hold us together. Vitamin C helps our bodies make collagen. In fact, many of the manifestations of scurvy (vitamin C deficiency) are from a decrease in collagen synthesis.

Eating collagen from other animals does not necessarily equate to more collagen in our bodies.

While some human studies have shown promising results, there just isn’t enough evidence to suggest the use of collagen supplements at this time. The Natural Medicines Database says there is “insufficient evidence to rate” the effectiveness of both chicken (type II) and bovine (cow) collagen for acne, osteoarthritis, rheumatoid arthritis, ulcerative colitis and many other conditions. If you have an allergy to the source of the collagen, you shouldn’t consume it. People who are pregnant or breastfeeding also should not take collagen supplements.

Bottom line: Eat a balanced diet, stay hydrated, moisturize and use SPF daily to protect skin.

Coenzyme Q10 (CoQ10)

CoQ10 is an antioxidant our bodies produce on their own. While levels naturally decrease as we age, this doesn’t necessarily mean we need to supplement.

Low CoQ10 levels have been found in people with certain heart conditions, although research is mixed on how supplements can be used for these conditions. CoQ10 supplements have some side effects and people who are pregnant or breastfeeding should not take CoQ10 supplements.

The only conditions Natural Medicines Database rates CoQ10 as “likely effective” for are CoQ10 deficiency and mitochondrial encephalomyopathies (a brain condition). It rates CoQ10 as “likely ineffective” for athletic performance and all other conditions fall into “possibly effective,” “possible ineffective” and “insufficient reliables evidence to rate.”

Bottom line: Unless your physician recommends CoQ10 for a specific health issue, you can pass on this supplement.

Melatonin

It seems like we’re all walking zombies these days (who isn’t tired??) and I hear about more and more people reaching for the melatonin bottle to get better sleep. Melatonin is a hormone our bodies produce that helps with our sleep rhythms. But will taking it every night help us sleep better?

Melatonin supplements may help regulate your biological clock, such as with shift work and jet lag, and some sleep disorders, but are not meant for regular nightly sleep.

Bottom line: If you’re having trouble sleeping, take a look at your caffeine intake (don’t drink it past the morning), screen usage (don’t use them within an hour of bedtime), exercise patterns (regular exercise helps you sleep better at night) and stress (consider meditation, bedtime yoga and working with a therapist). Be sure to mention to your physician that you’re having sleep issues.

Turmeric

While turmeric has been used in Southeast Asian for centuries and vegans have been using turmeric powder to turn their scrambled tofu yellow for decades, it’s only recently become a trendy “superfood” in the U.S. From the cultural appropriation of “turmeric lattes” to popping turmeric supplements, it seems this colorful root is the latest anti-inflammatory craze among Westerners.

While some studies suggest turmeric supplements may be useful for people with high cholesterol and osteoarthritis, there isn’t strong evidence to support the use of turmeric supplements for any health conditions. In fact, the NIH states, “Claims that curcuminoids found in turmeric help to reduce inflammation aren’t supported by strong studies.”

Bottom line: Enjoy turmeric powder as you would any dried spice, but don’t waste your money on supplements.

Vitamin C

The darling of cold prevention, vitamin C has long been touted as the immune-boosting virus fighter. So is it true that popping vitamin C pills will prevent sickness?

The only condition the Natural Medicines Database rates vitamin C supplements as “effective” for is vitamin C deficiency. It rates it as “possible effective” for the common cold, explaining that studies have shown conflicting outcomes and, “Taking high doses of vitamin C orally might decrease the duration of cold symptoms by 1-1.5 days in some patients.”

Ginger points out that too much vitamin C can cause GI issues such as cramping and diarrhea. “Adults [who aren’t pregnant or breastfeeding] only need 65-90 milligrams per day and that’s very easy to get through food. Many supplements will be dosed at 500-1000 milligrams at a time so read the labels carefully to ensure you’re not getting too much,” she says.

Bottom line: Eat plentiful fruits and veggies to get all the vitamin C you need. Get enough sleep and exercise and manage your stress to decrease your risk of getting sick.

Zinc

Similar to vitamin C, zinc has been heralded as a cold-preventing supplement. But does this mineral really deserve those accolades?

There is some evidence that zinc (oral lozenges) can help treat the common cold, but not prevent it. When started within 24 hours, zinc supplements can help reduce the duration of a cold. Do not use zinc nose sprays as these can result in a permanent loss of smell.

Ginger points out, “Zinc interacts with several other minerals including calcium and iron so make sure you understand when and how to best take zinc with other supplements or medications on board.”

Bottom line: If you have a cold and want to pop a zinc lozenge when you first notice symptoms, it might help you. But taking a daily zinc supplement likely won’t help anything other than a zinc deficiency.

 

If you’ve made it this far you might think I have something against dietary supplements. The truth is I see more people using supplements unnecessarily than I see people using them for legitimate reasons. As Ginger pointed out, supplements definitely have a place with certain health conditions. And as a vegan, I take dietary supplements to cover gaps in my diet and lifestyle (namely, vitamin B12 and vitamin D).

 

Further reading:

Dietary Supplements: What You Need To Know via National Institutes of Health
Dietary Supplements: What You Need to Know via U.S. Food & Drug Administration
NIH National Center for Complementary and Integrative Health
NIH Office of Dietary Supplements