Let's Talk About Dietary Supplements (And what precautions to take when they are marketed to you all over social media)

Hello to my wonderful friends from all corners of the internet! Today we are going to be chatting about dietary supplements. I get a lot of questions from friends, family members, and followers about supplements. Should you take a multivitamin? Which brand? Do supplements work? What about if I workout? Do diet pills work? Etc etc. I get it. There’s a lot of confusion out there.

And then, of course, I frequently see people on my Facebook feed, or influencers on my Instagram suggested page, selling all sorts of lovely supplements, making various promises that range from weight loss to improved brain function to increased muscle strength to better sleep. Suddenly it seems like many people feel well-qualified to give dietary advice and sell supplements!

There’s also this extremely bizarre-to-me trend of influencers ingesting all sorts of pre-workout powdery concoctions, bulking up frothy beverages with all sorts of mystical potions, and getting IV “vitamin cleanses,” and acting as if these activities are not only glamorous, but also totally normal ways to improve one’s health.

All of this adds to the noise and confusions about what – if any – supplements are the best for consumers to take. And with the multi-billion dollar supplement industry continuing to grow at a rapid pace, it seems like every day we’re infiltrated with advertisement for a new “essential” supplement to add to our daily routines.

If you know me at all, you know that the spread of illegitimate nutrition information and trends is one of my biggest peeves. So rather than continuing to suppress all my feelings, or end up thrashing out irrationally, I thought it was time to use my platform to shed some truth about nutrition-related issues. Including supplements.

So let’s get into it. The highs, lows, unknowns, and in between of dietary supplements.

Disclaimer: As always, this is general information intended for healthy adults who are not pregnant or breastfeeding. Your needs may vary based on medical status, lifestyle, or life-stage. Please never replace generalized health information you’ve read online with individualized clinical care.

No One Regulates Supplements Before They Hit Shelves

If there’s one thing you should be aware of as a consumer, it’s that no one regulates supplements before they hit the market. That’s right – no one – not the FDA, USDA, etc – regulates dietary or herbal supplements for quality, safety, or purity before you’re able to pick up a bottle at your local drug store.

The FDA does prohibit companies from marketing adulterated or misbranded supplements, meaning they have a legislation in place that prohibits tainted products from hitting store shelves, and outlaws manufacturers from selling products that aren’t as advertised. However, since there is no pre-sale testing required for a product to hit the market, a lot of stuff very easily slips through the cracks.

That means you could, quite literally, be spending your hard earned money on sugar pills, pills that don’t actually contain the amount of supplements advertised on the bottle, or contaminated supplements that contain all sorts of unwanted components, including prescription drugs and heavy metals. All of these have happened, and all of them are worrisome.

Now, you may be wondering why the FDA doesn’t do more to regulate dietary supplements the way they do food or drugs. It’s not a matter of apathy – in fact there have been several attempts to grant the FDA authority to increase regulation of dietary supplements, but legislation granting said rights requires congressional approval. Heavy supplement industry pushback and political lobbying have prevented these regulations from ever being passed.

So, as a result, supplements hit the shelves untested for safety or efficacy. The FDA has the ability to recall supplements that have been deemed dangerous, but this usually happens as a result of complaints or documented illnesses. This system has resulted in disastrous consequences – including numerous hospitalizations and deaths from various supplements (like the famous Hydroxycut incident of 2009) throughout the years.

There is an ongoing push by many nutrition scientists advocating for at least some form of dietary supplement regulation – whether it be by the government or a third party. Until then, proceed with caution when buying supplements; or at the very least, when buying into the claims the brands make.

Supplements and Alleged Health Benefits:

I’m going to say this a couple times in this post, but please be clear that I’m not saying there is no use for supplements and that nobody should ever take them or has a legitimate need for them. Being curious about supplements is not wrong either. If you’re reading this, you are probably interest in health. There’s nothing wrong with wanting to improve your well-being.

Unfortunately, a lot of supplement companies know this, and health is a vulnerable topic, so they try to take advantage of impressionable consumers innocently looking to lead healthier lifestyles. That’s why, for the general population, if you are debating purchasing a supplement or not, I beg you to do some self reflection and ask yourself: Why you I think I need this supplement?

Did some influencer tell you that all 18 of the potions he or she adds to their morning matcha concoction will give you superpowers? Well, before you purchase those products through their link or use their code, ask yourself if there’s any real data to support their claims. More often than not, there isn’t.

And even though the person who is trying to sell you a supplement product may very well have the best intentions, ask yourself this: do I really trust this person, advertisement, or company with my health? Do they have a legitimate nutrition education from a legitimate university? Are they a physician with nutrition training? Can they explain to me precisely how this supplement works in my body? Are they genuinely interested in my health? Do they have anything to gain from my sale?

I think a good test is as follows when confronted with an Influencer promotion or third-party Facebook sale: can this person explain the biochemistry behind the micronutrient or supplement’s absorption? Do they know how it will affect other medications or supplements I’m taking? Can they point me to rigorous, well-designed, amply-powered, peer-reviewed scientific studies that were not funded test the safety and efficacy of the product?

If the answer is no, personally, I wouldn’t take the risk. I’ve had many people – influencers, cashiers at juice shops, medical professionals, and even baristas – try to give me unsolicited supplement advice that I knew wasn’t scientifically sound. I have the privilege of a graduate-level nutrition education. However, I realize not everyone does, and that these messages are very confusing to even very smart, educated, and well-read people. Which is why I want to help others understand the potential risks associated with dietary supplement use.

Which brings me back to my original question: if you are still tempted to buy a supplement from an influencer or facebook post, ask yourself why you are purchasing the product – do you wish to be healthier? Are you feeling insecure and vulnerable right now? Is my motivation for this to improve my health? Or is it something aesthetic? What else can I be doing to take care of myself in a way that I know will benefit me long-term?

For most people, the way to improve health likely isn’t by slamming expensive potions, supplements, and diet pills. A more sustainable, sound way to health is a bit less showy, and involves doing stuff you already know is good for your health, like eating a nutrient-rich, robust and balanced diet, getting an appropriate amount of exercise (not too little, nor too much), taking care of your mental health, reducing stress levels, sleeping enough, and abstaining from toxin exposure.

These are really the things that will improve your health today, tomorrow, and in the future. And they come with awesome side effects. For example, when you get your micronutrients from whole foods, such as fruits, vegetables, whole grains, legumes, and other plant foods, you also benefit from things like fiber, antioxidants, and plant sterols, which often aren’t found in supplements.

*Even when certain supplements have clinical trials conducted to test their efficacy – they are often times funded by supplement or pharmaceutical companies. Even when they are not, many studies that test supplements do a poor job of controlling for confounders (want a whole post on what confounders are? Let me know!)

Supplements and Toxicity:

When it comes to supplements, there seems to be this misconception that more is always better. Often times, that’s not the case. To make things even harder for consumers, many supplements are sold in mega-doses, containing 500-1000% of the daily value, even though very few people actually need such high doses, with the rare exception of people being treated for a clinical deficiency.

For some water soluble vitamins, including Vitamin B12, ingesting large doses hasn’t been documented to cause a lot of harm.

Because beyond a certain point for many micronutrients, your body reaches a threshold ceiling of absorption. It can only take in so much of the supplement at a time, and the rest goes where the rest of your waste goes – into the toilet.

So yes, the best worst-case scenario for some supplements is what many nutrition scientists call “expensive urine” – meaning once your body gets all it can get from a supplement, you pee out the rest.

But for other vitamins, including fat-soluble vitamins (A,D,E,K) and some water soluble vitamins (including vitamin C), and minerals, overconsumption can cause adverse side effects ranging from mild annoyances to increased rates of cancer, to toxicity and death.

Take, for example, vitamin C. Some people think that taking mega-dose vitamin C packets helps prevent or shorten a cold, despite the fact that there is little evidence to support this claim (I wrote a whole post about it here). One packet of emergen-C contains half the daily toxic dose of vitamin C. Yes, you read that correctly. While most people think vitamin C is safe to slam because it is water soluble, excess vitamin C consumption can cause diarrhea, heartburn, nasua, dental erosion, and increase risks of kidney stone formation.

This isn’t the only example of how too much of a good thing can actually be a bad thing. For example, high levels of antioxidants may become pro-oxidants at certain doses. Large trails that have studied doses of various antioxidant micronutrients, including vitamins E and beta-carotene, have routinely been ended early due to increased risk of cancer and death in the experimental group (those taking the supplements) compared to the control group (those not taking the supplements).

Overconsumption of certain vitamins and minerals can also interact with medications, and even prevent absorption of other micronutrients. For example, high levels of dietary calcium can inhibit iron absorption, and overconsumption of iron supplements can inhibit zinc absorption, to name a few (yes, nutrition is very complicated!)

These are just a few examples of how micronutrient supplement overconsumption can lead to less-than-ideal outcomes. There are many other proven ways in which supplements have lead people to illness and even death.

For example, in 2009, the FDA recalled Hydroxycut due to reported liver injury, live failure, death, and other serious health problems associated with Hydroxcut consumption.

Even though Hydroxcut has since been recalled and reformulated, the company is still in business, and people still continue to purchase their products among other weight-loss “magic pills.”

Tainted dietary supplements are another problem. FDA reports and scientific studies have shown that many dietary supplements contain unlisted ingredients, ranging from sugar, to prescription drugs to heavy metals. You can check out their database here of tainted supplement products if you’re curious.

Do I Need a Supplement?

Well, I do not know you personally, and it’s highly unethical, and in many parts of the country illegal, to give you personalized dietary advice over the internet without a clinical evaluation (something I wish more influencers realized…I digress…), so I can’t answer that question to you, individually, in this blog post.

What I can tell you is this: for most people who eat a healthy, varied diet, large doses of supplements are not necessarily necessary. Certain people (see below) may benefit from or require supplements. For the general population, however, I can’t stress this enough – supplements are no substitute for a varied, robust, healthful diet. Besides, your body absorbs most micronutrients better from food than from supplements.

Your best bet is to eat a variety of nutrient-rich food on a regular basis. Personally, I also select fortified food products (including cereals and milks) to incorporate into my diet. Fortified foods, unlike supplements, are actually regulated for quality, purity, and amount of micronutrients, so you know exactly what you’re getting. Be aware that some organic and gluten-free grain, cereal, and plant-based milk brands don’t fortify their foods. I tend to select ones that do, most of the time, especially for micronutrients I watch out for myself (namely B12).

Also, I’m just going to state the obvious here: if you eat nothing but packaged chips and cookies and fast food and think a multivitamin makes up for it, I am sorry to inform you that it is still in the interest of your health to replace at least part of your ultra-processed food diet with a diet rich in whole and plant foods.

So Are Supplements A Total Waste of Time and Money?

No. While I do hope you walk away from this post feeling more educated to make informed choices about what you put in your body, I also certainly hope you don’t leave this post thinking absolutely no one under any circumstances should take supplements. Some individuals with various lifestyles, health conditions, or those at certain stages of life may benefit greatly from supplementation.

For example, vegans, vegetarians, and elderly people should monitor their B12 levels – and supplement as needed. Pregnant women should take prenatal vitamins. Individuals with malabsorptive disorders may need to take supplements, or have them injected intramuscularly. Not all supplements are bad, and not all supplements are unnecessary.

But again, and I can’t stress this enough, for most healthy people, they do not replace a well-balanced daily diet. If you want to take a supplement to fill in a micronutrient gap (the way I do with B12), personally, I try to select a made-in-the-USA or Canada brand that doesn’t contain 8000% of what I’m looking for.

And as far as multivitamins go, if you want to take one as a form of dietary insurance, look for ones that don’t contain 8000% of each micronutrient, but rather 50-70% of each, to help you avoid overdoing it.

Take home:

I hope you leave this post feeling more confident to make informed decisions when it comes to what you put in your body. Remember that actual foods are your best source of micronutrients and that the supplements constantly being promoted to you are part of a multi-billion dollar, for-profit industry that makes a large portion of its revenue from vulnerable individuals looking to improve themselves.

If you are not suffering from a clinical micronutrient deficiency and looking to improve your health, I’d suggest trying to eat well most of the time (while not being overly obsessive about it), resting enough, managing stress, taking care of your mental health, and getting a moderate amount of exercise. If you need supplements, try to avoid mega-dose ones, unless you are directed to do so by a clinician.

Thanks for reading! Please feel free to leave comments, other questions, or suggestions for future posts on this blog, or on Instagram, Twitter, or YouTube!