Every year, people in the U.S. spend $35 billion on dietary supplements -- including vitamins, herbs, minerals, and botanical extracts. These supplements can be sold in the form of tablets, capsules, powders, shakes, and bars.
Around 75% of people in the U.S. take these vitamins and supplements in an effort to improve their health and wellness, though many studies have shown that in most cases, taking vitamins and supplements does not increase life expectancy or improve overall health. Here’s the truth about the products many people are taking.
The FDA regulates dietary supplements as food, not medication
The Food and Drug Administration (FDA) has strict regulatory standards for medications manufactured in the U.S. The FDA oversees clinical trials, inspects manufacturing facilities, and performs quality control checks. These safety precautions are known as “premarket” regulations because they take place before medication is distributed to consumers.
However, the FDA regulates vitamins and supplements as food, not as medications. So, they are only regulated “post-market.” There are no required clinical trials, inspections, or quality control checks to ensure dietary supplements’ quality, safety, or efficacy.
Vitamins and supplements are useful in patients who have a measurable deficiency or increased requirement or dietary restriction
Dietary supplements play an important role in patients who have a measurable deficiency, an increased requirement, or dietary restrictions that prevent them from getting necessary nutrients from their diet.
For example, iron supplements are used to treat iron-deficiency anemia. Folate is included in prenatal vitamins because it has been proven to reduce the risk of neural tube defects in developing fetuses. Vitamin B12 is often recommended for vegans since this vitamin is only found in animal products.
Calcium supplements can reduce the risk of osteoporosis. And Vitamin D supplements are used to treat patients with a Vitamin D deficiency.
Although supplements are useful in these cases, most people who take dietary supplements do not meet these criteria. A survey conducted by The Harris Poll in 2019 found that 86% of people surveyed took a vitamin or supplement, but only 24% of them had been diagnosed with a nutritional deficiency by a healthcare professional.
The body excretes nutrients it doesn’t need
Most vitamins are water-soluble, meaning they dissolve in water and are quickly metabolized by the kidneys. If someone takes a vitamin, mineral, or supplement when they do not have a deficiency, their kidneys filter it out and excrete it in the urine.
If dietary supplements are medically indicated in only 24% of people taking them, then $26.6 billion of the $35 billion spent on these products every year is wasted. Instead of improving health or wellness, these products are transformed into very expensive urine that is literally flushed down the drain.
Vitamins and supplements can do more harm than good
Many people think that because these products are available over the counter, they are harmless. So they take vitamins or supplements every day because they think that even if a vitamin doesn’t help, it certainly couldn’t hurt.
But the truth is that these over-the-counter supplements can cause dangerous complications. For instance, excess iron can cause heart disease in men, and can also cause fatal overdoses. Creatine and other supplements can cause kidney damage. Vitamins and supplements can interact with prescription medications. Some herbal products can cause liver damage.
And some vitamins can increase the risk of certain diseases rather than reduce them, as evidenced by the fact that beta carotene increases the risk of lung cancer in smokers or people who have been exposed to asbestos. And Vitamin E, zinc, and selenium can increase the risk of prostate cancer in some patients.
There is little evidence that increasing your intake of these supplements is beneficial. In some cases, it’s actually harmful to your immune system because your body has to work overtime to metabolize what you ingest.
They should not be used as a substitute for a healthy diet
It’s important to note that taking a multivitamin or dietary supplement every day isn’t a substitute for healthy eating habits.
First, vitamins don’t undo the unhealthy effects of eating high-fat, high-calorie, or processed foods. And second, vitamins don’t have the added health benefits of naturally-occurring foods, including antioxidants, fiber, and amino acids.
Written by Sarah Thebarge, Physician Assistant