Are dietary supplements effective? Are nutritional supplements safe?

Those are complicated questions without easy answers. There are so many products and substances that fall into the dietary supplement category. Vitamins, minerals, herbals, botanicals, even amino acids, and hormones are all marketed as dietary supplements with different purposes and health claims. In fact, three in four Americans use a dietary supplement. Still, not all supplements are created equal. They can be beneficial, but they can also be harmful, particularly for very young children, pregnant patients, people with autoimmune diseases, and the older adults. And patients need to be aware of potential complications with ongoing medications or treatments.

Ultimately, anyone working to gain greater control of their health is taking a step in the right direction. But a person considering a dietary supplement should understand the potential harms as well as benefits, how to find reliable information, and if there are more effective ways to improve their overall health. Here are four things to know.

1. There are often other ways to realize the benefits of dietary supplements

The first thing to understand about dietary supplements is that, in many cases, it may be better to adjust your diet and lifestyle rather than take a daily pill. Different foods contain a wide range of nutrients and vitamins and are typically a better way of getting those beneficial substances into your body. For example, it’s typically better to eat salmon or another healthy fish a few times a week than it is to take a fish oil or omega-3 fatty acid supplement. For a vast majority of patients, consistent exercise is better than a dietary supplement that promises to help with weight loss.

In some cases, companies will sell fortified foods to increase the micronutrients present (think milk with added vitamin D or breakfast cereals with added vitamins and minerals). These foods can help people get more vitamins and minerals and may be better than supplements in many cases. They’re often more affordable than whole foods. But generally, whole foods are the best way for most people to get a majority of the nutrients their body needs.  

2. Supplements aren’t regulated like medications

A common critique of dietary supplements is that they’re not regulated. That’s not exactly true. They are regulated as foods, not medications. Dietary supplement makers are required to follow good manufacturing processes, and they are required to report adverse effects under the Consumer Protection Act. Manufacturers are not required to disclose information to consumers, and the Food & Drug Administration does not analyze products before they’re marketed and sold.

Dietary supplements are often popular with individuals who are seeking “natural and organic” solutions to health issues, rather than taking medications. Yet this is often a false comparison – many drugs are derived from natural sources, and many supplements have active pharmacological ingredients. With dietary supplements, there’s less oversight into what’s actually going into the bottle, and the reality is they are not as tightly regulated as prescription medications or even over-the-counter products.

3. Some dietary supplement categories are more dubious than others

Given the relative lack of regulations and oversight, it’s important to make sure any dietary supplement is coming from a reputable manufacturer. That’s easier said than done. But there are some general guidelines people can follow. In general, weight loss supplements, anything promoting bodybuilding, and “men’s health” products (sexual performance aids) can be particularly risky. On the other hand, supplements like fish oil, vitamin D, folic acid, and zinc can all be useful for patients with specific health concerns and in certain parts of the world when taken in proper doses.

For specific products, check the label for a “USP” emblem, which shows that it was evaluated by the U.S. Pharmacopeia. That doesn’t verify efficacy, but it means it’s been evaluated to ensure the ingredients reflect what’s listed on the bottle and has undergone other safety checks. ConsumerLab is another useful option. Another good step is to check the manufacturer’s website and see if there’s a way to contact the organization directly. If you have questions, ask them.

4. Consult a doctor before starting – or stopping – a supplement

It cannot be overstated: Dietary supplements can have negative effects and negative interactions with medications and treatment plans. Before starting a dietary supplement, it’s important to have a conversation with your doctor. The first question the doctor is likely to ask is, “Why do you want to take that supplement?” Often, there are other treatments and options worth discussing.

It’s also absolutely essential to talk to a doctor before stopping any prescribed medications or dietary supplements. Some supplements can interact with the effectiveness and dosing of medications. Supplements can interact with anesthesia or other medications used during surgery, so the recommendation is typically to stop taking them two weeks before surgery.

Ultimately, dietary supplements are not magic, and they’re not inherently safer or more natural than any other medical treatment. But they should be considered just as potentially impactful. It’s important to have a frank conversation with your doctor about the underlying goals you’re trying to achieve with supplements and how best to find a solution and a product that works for you.