$35 billion. We collectively spend approximately that much money on dietary supplements each year.1 Another fascinating numerical value? Over 85,000 dietary supplements sit on shelves and appear in advertisements in the United States alone.2 As it turns out, supplements can be sketchy as heck.
These figures may make it seem like dietary supplements serve some importance, that they provide the key to our health. This rings especially true when we think we don’t “get everything we need” from our diets. In one survey, about 86 percent of adults in America take a vitamin or supplement, yet only about 21 percent of those adults had a clinically-defined nutritional deficiency.3
That means that, according to this survey, about 65 percent of U.S. adults took a supplement on their own accord because they feel that they need it. Not because their lab results and bloodwork showed they needed it, and not because a qualified health professional told them they did. Instead, supplement marketing agencies and diet culture convinced them this particular supplement would provide just what they needed.
Some decided to began taking supplements based on what their trainers told them at the gym, what interested them at the store, or what celebrities and influencers recommended. If you want to read more about the results of the survey, I highly encourage you to take a look. I felt fascinated and terrified throughout the entire report.
One reason why I find Americans’ obsession with supplements so terrifying is that I was right there with most people. The marketing and sketchy articles I read got to my head, and made me shell out my hard-earned dollars on a regular basis.
My History With Supplements
Whenever I noticed a “symptom”, where my body wasn’t “working” properly, I’d take to the internet and look for a dietary reason. Usually, this led me down a rabbit hole to find what I deemed “adequate” evidence to support my preconceived belief that I just needed this next supplement to solve my problems. I was just looking for confirmation of what I already believed.
I popped fish oil, iron, turmeric, aswanganda, multivitamins, skin-clearing supplements, and even the odd herbal “hangover prevention” supplement before a night out with friends. As a future dietetic professional, I knew that I had to be careful with supplements, so I always did my research before purchasing them.
Unfortunately, I wasn’t honest with myself about the research I conducted. I would utilize what I thought of as proper resources, like NIH and Pubmed, but I would only look for studies that confirmed my beliefs that this supplement could reduce my anxiety, help my sleep, or clear my skin. If I came across studies that stated this or that didn’t significantly affect the supposed condition in question, I dismissed it, and dug until I found at least a few that supported my beliefs. That’s bad science.
It always felt like I was just one new supplement away from having eternal beauty, health, and happiness. I wonder how much of my hard-earned money I have spent on supplements, especially now that I take exactly zero, and my body and mind have genuinely never felt better. Maybe it’s better that I don’t know how much money I basically flushed down the toilet.
The hope that I felt so close to happiness and contentment, and one more thing would get me there, coincides directly with diet culture. Whether we believe one more supplement, diet, exercise routine, or juice cleanse will get us where we want to be, diet culture drives us to make these purchases and take these actions. The fitness industry loves that we never feel content with ourselves and that we always want the next thing. I know that makes me sound like a conspiracy theorist, but that’s just how things are here at The Diabolical Dietitian sometimes.
My goal with this blog post, and this blog in general, is to help you avoid the mistakes I made, or at least prevent you from spending another dime on a supplement that doesn’t even contain what it says it does on the label. That scary fact seems like a great place to kick off three of my main problems with purchasing and taking most supplements.
1. Supplements Can Be Sketchy Because They Aren’t Regulated by the Government
The Food and Drug Administration basically views supplements as food instead of as drugs. This means that supplements don’t have to adhere to nearly as strict of guidelines as drugs do, and this presents a terrifying scenario for many reasons. The supplement aisles many of us frequent don’t differ much from the wild, wild west.
For starters, your supplement of choice may not even contain the herb or vitamin you think it does. The label may say you are holding a St. Johns Wort supplement, but how do you know for sure that the label tells the truth? Unless you are lucky enough to have intricate, expensive lab equipment to conduct a full analysis, you have to simply trust that what label claims.
Even if the supplement does contain the compound(s) stated on the label, the dose on the bottle may not reflect accuracy. In fact, a scientific evaluation of over-the-counter melatonin supplements (hormone that helps one fall asleep) can have a melatonin concentration anywhere from 83% – 478% of what the label claims.4 Melatonin has no associations with major negative side effects right now, but that doesn’t mean a 478% concentration higher than what is on the label is not problematic.
Looking past the potential fraudulent concentration claims, some supplements contain contaminants that the label also fails to mention. Unfortunately, professional athletes have fallen victim to this time and time again when they inadvertently dope due to contaminants (like banned steroids) in their innocent supplements like protein and other nutrient drinks. If you’d like to learn more about this particular phenomenon, check out this NIH article on the subject.
The fact that some athletes have taken supplements with contaminants should scare everyone. We really don’t know what kinds of malicious substances may contaminate our supplements, but there are some steps we can take to protect ourselves. Unfortunately, the strategies for weeding out sketchy supplements require constant vigilance. If you are sure that you want to buy supplements, or if they have been prescribed by your doctor, look for brands that are tested by a third-party organization.
Third-party testing means a company, who has no special interest in the supplement in question, tests and verifies that a supplement does indeed contain what the label states. Some third-party testers ensure good manufacturing practices, consistent batches, and more. Third-party testing only goes so far, however. It does not ensure or guarantee that particular supplements have shown effectiveness or do what they claim to do. Please keep this in mind.
“USP Verified”- this label means that the supplement in question has been tested and approved from the United States Pharmacopeial Convention, which is a non-profit organization that tests supplements from companies who voluntarily submit samples. USP verification also takes place regularly, so a company cannot get the certification once, and then resort to unsavory practices as soon as testing ceases.
Instead, USP checks up on supplement brands and companies repeatedly, ensuring that companies adhere to general good manufacturing practices and quality assurance. USP helps protect people from all kinds of supplement-related calamities, and they work with the FDA to prevent major adverse health outcomes from supplements. Unfortunately, seeing the letters U, S, and P cannot to guarantee your supplement actually underwent testing by the USP.
When I stated that weeding out supplements requires constant vigilance, I wasn’t joking. It is legal for supplement companies to put these letters on their label, even if they are only put there to deceive consumers using a flashy and official-looking seal that doesn’t actually belong to USP. If you see a product that has these letters, double check using USP’s official listing to determine whether the supplement in question has, in fact, been verified by USP.
NSF International provides a seal on their approved products that lets athletes know their supplements contain what is stated on the label, and that they are free from banned substances. NSF also ensure good manufacturing practices, and they check for unsafe levels of contaminants.
Just like with USP, use good judgement when picking up products that simply have the letters NSF on them. Refer to NSF International’s Certified Product Search to make sure your product actually went through the rigorous testing it should.
Beyond this, I have to make one more major point. Make sure you purchase your supplements from trustworthy retailers. Avoid buying your supplements from Amazon or other sketchy websites, because you don’t know if the pills you get in the bottle of the brand you have carefully chosen are actually what you have ordered.
I’d recommend shopping in stores or from the actual supplement’s website instead of a website where anyone can sell things, like Amazon, Ebay, or Craigslist. I feel the need to mention this here because you may think you are buying a bottle of pills from the official retailer on Amazon, but you may accidentally purchase the version listed and sold by a sketchy dude filling capsules with dirt or worse.
Here is a summary of the steps you should take when buying a supplement:
- Your doctor tells you to take a certain supplement because your blood tests show you need it
- You find a supplement with the appropriate dose that your doctor recommended, and you look for an NSF or USP seal
- You check on NSF’s or USP’s website to make sure the product in your hand or virtual shopping cart is actually listed
- You purchase the supplement from an official retailer
- You take your supplement as directed
That’s four more steps than most people take when buying supplements, but each step here is just as important as the others. Phew, this was a lengthy reason why I encourage you to avoid supplements, but we are just getting started. Next up, they can cause great harm.
2. Supplements Can Be Sketchy Because They Can Be Dangerous
After years of taking various supplements, I feel incredibly lucky that nothing bad ever happened to me. I did purchase a supplement from Amazon many years ago, and I recently got an email from the company selling them that said there was major contamination issues with a recent batch. They recommended I throw my bottle away. Fortunately, I received this email years after I stopped taking them, but I really feel like I dodged a bullet after all of my irresponsible supplement use over time.
Aside from potentially taking a pill with contaminates or unidentified mystery particles, the supplements that actually contain what they say they do aren’t always much safer. Vitamin A, for example, is a fat-soluble vitamin. This means that your body absorbs it and stores it, so you can ingest too much of it. When it accumulates in your body, you may undergo vitamin A toxicity. Vitamin A toxicity only really occurs when people take vitamin A supplements. It’s nearly unheard of in people who simply eat lots of foods high in vitamin A.
Even if you do not “overdose” on a particular nutrient, you still may not have proper awarenes of adverse reactions supplements can have in your body with other medications or other supplements.
For example, St. John’s wort is common herbal supplement that people take to potentially help with depression. Unfortunately, mixing this supplement with anti-depressants, heart burn medication, chemotherapy drugs, anticonvulsant drugs, and more can have terrible consequences.5
Most often, St. John’s Wort decreases the effect of the prescription medication, but it can also made serotonin accumulate in the brain. Too much serotonin can cause a wide range of problems, from diarrhea to seizures, muscle rigidity, irregular heartbeat, and unconsciousness.6
This is just one example of several supplements that can have adverse reactions with the drug your doctor prescribes. Playing around with your supplement and prescription drugs can seem relatively harmless, but it can have serious consequences.
Additionally, most supplements can be put on the shelves or ordered online until enough problems arise to create adequate proof they may cause damage. As long as they are deemed “reasonably safe” (whatever that means) when a supplement company first begins manufacturing them, they can legally sell them until several instances of harm arise. If that doesn’t make you squirm a little, I’m not sure what will.
3. Supplements Can Be Sketchy Because They are Expensive AF, and Poor Substitutes at Best
The last of my three top arguments against supplements is that you can, and should, get all the stuff you need (and more) from the foods you eat, especially if you allow yourself to eat enough. I see people taking a handful of supplements everyday, and it makes me wonder what they believe they actually get from them. Many people truly believe that supplements contain more benefits than regular foods for some reason, but I seek to help you see otherwise.
One of my favorite examples is lycopene, a well-known carotenoid that is associated with heart health and cancer prevention. Sure, you can get it from a supplement that costs $25 for a 30 day supply. Or you could just eat the foods it naturally comes in, like tomatoes, red bell peppers, watermelon, and more. Why pay for a pill and food, when you can just get the whole package… in your food?
Another example of common supplements are flavonoids and/or antioxidants. These are considered non-essential nutrients that are associated with a stronger immune system and reduced cancer and heart disease risk. We do not quite understand their mechanisms yet, so we don’t exactly know how they work in the body. Regardless, smart business people bottle these compounds up and sell them for high profits to people who just want to stay healthy.
What many of us may not realize is that these compounds are highly prevalent in foods, like fruits and vegetables, that also contain tons of vitamins and minerals. For example, strawberries contain many different antioxidants and flavonoids, and they also possess high levels of vitamin C, manganese, potassium, and fiber. If you wanted to get all of those things from supplements, you’d have to take several different pills, and that would really add up in the checkout lane.
Even if you took all those supplements, it would still provide a poor substitute for actually eating strawberries. For starters, your body doesn’t absorb vitamins and minerals from supplements nearly as well as from food sources. Chances are good that you’d excrete a good portion of the nutrients in question, unless they are fat soluble, which can lead to dangerous consequences like we discussed earlier.
Relying on supplements for comprehensive health is like trying to form a cohesive paragraph with just a few of the letters from the alphabet. Maybe your supplements will give you a’s, b’s, c’s and d’s to work with, but you will still have a hard time producing many sentences that make sense. Eating a balanced diet with food is like having access to all 26 letters because you get essential nutrients like vitamins and minerals, but you also get flavonoids, antioxidants, fiber, and hundreds of other beneficial compounds found in food.
In addition, most vitamins, minerals, and other compounds are helpful to the body when they work together, not separately. The way vitamins, minerals, antioxidants, flavonoids, and every other compound in food interacts within your body is extremely complicated, and it’s not something researchers have sorted out. Popping a pill that contains one or a few of these nutrients probably won’t interact in your body the same way, and it might just lead to an expensive poop or pee in the end.
Some might argue that they don’t eat a balanced diet, so they take vitamins to “fill in the gaps.” Supplement companies have pounced on this idea, and taking a multivitamin can actually make some people feel that they don’t have to eat as well because the supplement has them “covered”. If you allow yourself to eat enough, and you nourish your body in the way that it asks, you likely don’t need a supplement. Unless your doctor determines that you do, of course.
Supplements, like most other aspects of diet culture, seek to target us at our most vulnerable. No wonder salespeople push testosterone-boosting supplements on men going through a mid-life crisis, or “metabolism-revving” pills for women who see themselves as unattractive.
To be clear, there are absolutely times and places for supplements. Older adults tend to struggle with vitamin B12 absorption because their bodies produce less intrinsic factor- a protein that helps facilitate B12 absorption in the small intestines. Not absorbing enough B12 can have negative consequences, so supplementation can be key in ensuring that older adults get enough of the stuff.
Additionally, many older adults struggle with appetite loss, so it’s difficult for them to ingest enough calories or other specific nutrients. For example, extra protein can be helpful when older adults deal with wounds, so a protein supplement may be warranted.
Many women also struggle with iron deficiency due to their lifestyles and “monthly gift”, so an iron supplement could be helpful in this situation as well. In all of these examples, a proper healthcare professional should be the one to determine if these supplements are needed. A quick internet isn’t enough.
Please, please, please be careful with your supplements, and take a critical look at why you feel you need to take them and where you are getting them from. You might be able to save hundreds of dollars a month by ditching them and favoring food instead, and you might be safer in the long run!
As Always, A Book Recommendation
Today’s blog post contains quite a bit of serious information, so I didn’t want my book recommendation to follow suit. Plus, I haven’t stumbled upon an excellent book related to supplements yet. Instead, I’m opting to share my favorite book of all time, I am the Messenger (affiliate) by Markus Zusak. This book has serious themes, but there is plenty of humor sprinkled throughout, and it’s an overall heart-warming story.
It delivers the captivating message that life improves dramatically when we focus on other people and building a community around us. Sometimes we isolate ourselves or even spend lots of time with other people without really getting to know them. I first read this book in high school, and it has stuck with me ever since. I have read it five or six times now, and some lines never fail to knock the wind out of me, like the following:
“Sometimes people are beautiful. Not in looks. Not in what they say. Just in what they are.”
“It’s not a big thing, but I guess it’s true–big things are often just small things that are noticed.”
If you were to ask me what one book has made the biggest impact on my life, it’s this one. Not because it deals with intuitive eating or food anxiety, which it doesn’t in the least, but because it deals with the idea that sometimes in life, we as humans become disconnected from one another. When it comes down to it, it doesn’t actually take much at all to step in and reconnect, and it doesn’t take much at all to help people who need it.
Even if you are someone who prefers to read non-fiction like I do, I still say the message of this book can absolutely change you as a person for the better.
As a proud Indie Bound affiliate, I get a small commission on books and products sold using the links on my website. It doesn’t cost you anything extra! I only recommend books that I truly love and believe in, and your purchases on Indie Bound through my website support both my work and small bookstores. Thanks!
- Most Dietary Supplements Don’t Do Anything… – The Washington Post
- Supplements and Safety- PBS
- Poll Finds 86% of Americans Take Vitamins or Supplements… – American Osteopathic Association
- Why We Sleep (affiliate) – Matthew Walker
- St. John’s Wort – Mayo Clinic
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