Open any pantry or kitchen cabinet in America and it’s likely that you’ll find some sort of dietary supplement, probiotic or vitamin, according to a study by the Journal of the American Medical Association. The Journal of Nutrition states that Americans spend an estimated $30 billion a year on dietary supplements. These can include botanical powders, pills, multivitamins, probiotics, herbal remedies––the amount of available supplements is innumerable. Initially, it can be difficult to see any harm in taking supplements; after all, what can a gummy vitamin do to you besides curb your morning sweet tooth?

However, the Journal of the American Medical Association found in a 2016 study that supplements very rarely  benefit human health, and these natural remedies could even potentially be harmful. Misleading labels are common (and legal) in the supplement industry under the Dietary Supplement Health and Education Act, and with arguably empty promises of improved digestion, strong bones and shiny skin plastered across pill bottles, it’s becoming increasingly difficult for Americans to resist.

 

“Just to be safe, because I don’t want to be deficient in anything”

Natural and alternative medicine is an increasingly appealing concept, as the holistic approach to health has gained traction among pop culture. Celebrities such as Gwyneth Paltrow, the founder of natural health company Goop, and figures such as the Kardashians promote the use of vitamins and supplements to address certain desires of their audience, such as hair growth and weight loss. While some supplements target aesthetic desires, most are taken for the purpose of bettering one’s internal health, such as improved digestion, in a “natural” manner.

Junior Lena Hicks has been vegan for three years and takes daily vitamins to supplement her diet. Due to her dietary restrictions, Hicks is often lacking vitamin B12, which is essential to nervous system health and red blood cell production. Without the proper amount of B12, which comes mainly from consuming meat, symptoms of anemia and possible nervous system damage could be presented.

“I would get headaches, and my feet and hands would fall asleep a lot. That has to do with your nerves––I’m pretty sure that was a linking problem,” Hicks said. “I actually did end up fracturing my foot because my foot was asleep. It fell asleep in the matter of a minute from me sitting down and I stood up.”

Following her injury, Hicks began taking a daily B12 supplement and says that her symptoms have largely gone away. Hicks also takes Vitamin D and calcium supplements.

“I take Vitamin D and calcium just because. Even though it’s not completely necessary, because you do get it [from] plants, [I take them] just to be safe because I don’t want to be deficient in anything,” Hicks said.

Dr. Jacqueline Chan, a doctor of osteopathic medicine at the Marin Natural Medicine Clinic, believes Vitamin D is an important supplement and recommends it to many of her patients.

“[Vitamin D] really helps the intelligence of the immune system.… It also helps kill viruses,” Chan said. “You need Vitamin D to convert your thyroid hormone, which is one of the most important hormones in the body that helps you utilize oxygen and creates your metabolic rate. [Vitamin D] also is needed for serotonin [production].”

Vitamin D, naturally derived from sunlight, is often advertised as a method of improving one’s mood and even lessening the effects of depression, which can be caused by a lack of serotonin. According to a 2017 review by University of New South Wales psychiatrist Gordon Parker, low levels of serotonin have shown a correlation with low amounts of Vitamin D in one’s system. However, Parker found a lack of evidence to prove the benefits of taking Vitamin D. No research has been successful in proving the benefits of Vitamin D as an aid for mood improvement. Regardless, Chan finds Vitamin D to be successful in terms of aiding her patients.

Chan also often prescribes fish oil to her patients, stating that the Omega-3 fatty acid in fish oil is another component of health that should be supplemented. She cites the importance of the oil as an aid for cell health.

“You have things like autoimmune illness, so when you take more fish oil, you’re actually helping the fluidity of the cell membrane. That’s been shown to help reduce things like anxiety and depression by up to 75 percent,” Chan said.

While Omega-3 fatty acids are needed for proper brain function, there is no solid evidence that fish oil can effectively reduce depression, according to the Mayo Clinic. Taking too much fish oil can even increase one’s risk of nose and gum bleeds and harm the response of the immune system. The Mayo Clinic recommends taking fish oil under the supervision of a doctor, and states that while the supplement can be beneficial in some cases, it should not be used as a replacement for medical treatment for depression.

“What’s listed on the bottle is not actually what’s in the pills…”

In 1994, the Dietary Supplement Health and Education Act (DSHEA) was passed. This act filed supplements under the category of “food,” and therefore put the industry under the regulation of the the Food and Drug Administration (FDA). While the passage of the DSHEA increased the regulation of the supplement industry, the orders only require supplement producers to comply with the official Good Manufacturing Practices, meaning that while production is monitored closely, the actual contents of the supplements are under less scrutiny.

Producers of supplements are only required to submit a form to the FDA that states that the ingredients used in the products are “reasonably expected to be safe.” All ingredients previously used before the passage of the DSHEA were “grandfathered in,” according to the Council for Responsible Nutrition, meaning that these ingredients were permitted and continue to be used, unregulated, within the industry. The contents of any given supplement are by no means guaranteed to have been vetted by the FDA.

Dr. Pieter Cohen, an Assistant Medical Professor at Harvard and health journalist, believes that the regulation of supplement companies is insufficient, as potentially harmful ingredients could slip through the cracks.

“The requirements [of the DSHEA] were very basic, likely sufficient to sell vitamins and minerals. But, they included many other ingredients in the law, not only vitamins and minerals but also botanical treatments as well as probiotics, live bacteria and yeast, all thrown under using the same structure, the same laws,” Cohen said. “That led to big problems because laws that might be adequate to govern the sale of a multivitamin are not adequate to cover the sale of complicated botanical supplements or probiotics.”

The act effectively allows producers to make false claims about their products and market and sell them with little intervention from FDA. Some supplements, such as Sugar Bear Hair gummy vitamins, promise cosmetic results through the use of their product, which costs $30 for a 30-day supply. Sugar Bear Hair’s website states, “Just chew and swallow 2 gummy bears a day to get all the nutrients needed to meet your hair goals!” This statement is followed by a disclaimer that reveals to customers that this claim has not been evaluated by the FDA, and that the advice of the company is not meant to serve as a substitute for “conventional medical service.”

Cohen finds that the growing popularity of natural medicine and supplements has caused consumers to lean away from traditional medicine, and believes that the trend could keep some individuals from getting the treatment they require.

“They avoid appropriate treatment that is helpful, whether or not that’s avoiding vaccinations or it’s avoiding treating a serious illness like cancer. So [supplement use] could mean not getting a treatment that could help,” Cohen said.

While it’s unlikely that traditional medicine will become obscure at any point in the near future, Cohen is most concerned about the poor regulation of the supplement industry. He believes there is potential harm in taking vitamins that use unvetted ingredients.

“So often, what’s listed on the bottle it’s not actually what’s in the pills or in the powder,” Cohen said. “That’s a big problem, so it’s really, extremely hard to get accurate information about what’s [in the supplement].”

 

“Is there some reason I should take one of those products?”

A nearly $280 billion industry, the production and sale of dietary supplements is only growing. Despite little evidence to prove the effectiveness of supplements, consumption of supplements is only increasing and it is projected that growth will not cease over the next eight years, according to Grand View Research.

While it is true that some supplements promise benefits that go unchecked by the FDA and are not proven to provide results, there are many who are prescribed healthy, regulated supplements that are necessary for their health. Anemic patients are often given high-dosage iron supplements to regulate the symptoms of anemia, such as dizziness and fatigue. Cohen and Chan take two very different stances on the benefits and detriments of supplements, but they both agree that there is a safe way to go about getting your daily vitamin intake.

“Ideally it would be [through] your healthcare professional,” Chan said. “We use brands. Some of the brands you can get online on your own. But some of the brands are only sold through doctors or naturopaths or healthcare professionals.”

Cohen agrees that supplements should be provided through a doctor’s recommendation for safety reasons.

“There are some very specific situations where vitamins, minerals and probiotics are appropriate to treat various problems. Those are things that would come up with your doctor, so you would talk to your doctor [and ask], ‘Is there some reason I should take one of those products?’ and take a look at the research and they’re very well might be,” Cohen said.

Chan, Cohen and Hicks all believe that a healthy diet is the basis for gauging one’s vitamin intake, and that if a meal is balanced and natural vitamins can be derived through foods, a good diet should be sufficient.

“You don’t have to go crazy and get every single vitamin because when you’re eating a healthy diet and getting your food groups you’ll typically get most of what you need,” Hicks said.

According to Chan, a basic multivitamin recommended by a physician can help supplement a lackluster diet.

“If you’re eating five servings of vegetables a day and two servings of fruit, and most of those are organic, you probably don’t need a multivitamin,” Chan said. “But if you’re eating one serving of vegetable a day and only one of fruit, but none of them are organic, then I think you need a multivitamin.”

Cohen warns consumers to look closely at what ingredients are used in their supplements and stick to their doctor’s advice. He is a strong advocate for the regulation of the supplement industry and encourages people to demand stricter laws.

“If someone’s healthy there’s no need to take any Botanicals, probiotics or anything like that,” Cohen said. “The most important thing really is to realize the ways to get involved, to be active to change the law.”

 

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