Supplements are a polarizing topic. While some people swear by them, others think they're a total waste of time and money.
But the US' top supplements expert, Stefan Pasiakos, told Business Insider that neither view is helpful.
"You need to come at it from an objective standpoint and let the evidence speak for itself," said Pasiakos, who leads the Office of Dietary Supplements at the National Institutes of Health, a government body that assesses the latest scientific findings on supplements to strengthen public understanding.
Pasiakos, a nutritional scientist by training, joined the ODS in July 2023 with the goal of bringing a high level of scientific objectivity to the supplement field, he said. By providing people with clear information, he hopes he can help them make informed choices that optimize their health.
Dietary supplements from multivitamins to probiotics have become staples in our bathroom cabinets, with almost 58% of Americans saying they had taken some kind of supplement in the past 30 days, according to the latest data from the CDC published in 2021. It's no surprise, then, that the US dietary supplement market had an estimated value of $45.1 billion in 2023, according to Statista.
But the FDA doesn't approve supplements before they hit the market, meaning, unlike drug manufacturers, companies don't have to conduct multiple clinical trials to prove their products work, quantities of ingredients don't always have to be listed, and products are sometimes contaminated by or cut with other substances not mentioned on the packaging. One 2023 study published in JAMA Network Open found that 89% of the 57 dietary supplements tested didn't accurately list their ingredients.
While this means doing your homework before taking a supplement is crucial, it doesn't mean they can't play a role in supporting and promoting health, Pasiakos said.
He shared three common misconceptions about supplements that could prevent people benefiting from them.
1) The more supplements, the better
When it comes to vitamins, minerals, and nutrients, more is not always better, Pasiakos said. It's common for people to think that because something is "natural" you can't have too much of it, but that's untrue, he said.
There are instances where consuming above and beyond what's recommended is unsafe, and for a lot of natural products, we simply don't know where those upper levels are, Pasiakos said.
When people take above the recommended daily limit of a supplement, the effects can be serious. In May 2023, a man died after taking too much vitamin D over nine months.
Overdosing on magnesium, meanwhile, can in extreme cases, cause paralysis and death, while overdosing on vitamin C can lead to kidney problems and vitamin B12 deficiencies, professor Rob Chilcott, the head of toxicology at the University of Hertfordshire, UK, previously told BI.
2) Supplements are 'tainted and adulterated'
People tend to fall into two camps, those who think all supplements are "tainted and adulterated" and others who think they all work, Pasiakos said.
Pasiakos said that certain resources, such as the ODS's supplement fact sheets, can help people make informed decisions about supplements, while the third party NSF Product Certification program can guarantee a product contains what the label says it does.
But it's important to know that verification programs are not backing any health claims a company might make about their product. "It's simply saying that what's on the label is in the dietary supplement," he said.
"All I would say is that people make sure that they become educated on these products, understand what's in them, and know that the industry is not out to get them. But there are certainly aspects of certain dietary supplements that may be considered unsafe," he said.
3) Supplements are a silver bullet
Pasiakos said people are always looking for a silver bullet to make them healthy, but they won't find it in dietary supplements.
Like many dietitians, Pasiakos takes a food-first approach to his health. He sees supplements as complementary to a healthy diet, not as a way to replace or substitute one.
"You can't look at dietary supplements without understanding the underlying diet," he said. If you don't know what a person is eating and getting from their diet nutrient-wise, you can't advise them on what dietary supplements they should take, he said.
"I can't just ignore that. So that's why I look at it that way."