The Truth About Supplements: What Works and What Doesn't

Understanding the Supplement Industry

Critical context before evaluating individual supplements:

Supplements are NOT regulated like drugs:

FDA oversight:

• Drugs: Rigorous testing required before approval (safety, efficacy)
• Supplements: Manufacturers self-regulate; FDA intervenes only after problems arise

What this means:

• No guarantee products contain what labels claim
• Quality varies wildly between brands
• Health claims often exaggerated or unsupported
• Contamination possible (heavy metals, undisclosed ingredients)

"Natural" doesn't mean safe:

Many supplements have side effects:

• Drug interactions
• Overdose potential (fat-soluble vitamins especially)
• Allergic reactions
• Liver/kidney damage (some herbs)

Natural substances are chemicals—can be powerful and dangerous

Most people don't need most supplements:

If you:

• Eat varied, nutritious diet
• Get adequate sunlight
• Don't have diagnosed deficiencies
• Aren't pregnant/breastfeeding
• Don't have absorption issues

You probably don't need supplements (with few exceptions noted below)

Food first, supplements second

Supplements That Actually Work (Evidence-Based)

1. Vitamin D

Who needs it:

• People with limited sun exposure
• Dark skin (melanin blocks vitamin D synthesis)
• Living in northern latitudes (especially winter)
• Elderly (reduced synthesis)
• People with diagnosed deficiency

Evidence: ✅ Strong evidence for bone health ✅ Immune function support ✅ May reduce depression risk ✅ Cardiovascular benefits emerging

Dosage: 1,000-2,000 IU daily (or as directed by doctor based on blood test)

Form: Vitamin D3 (cholecalciferol) more effective than D2

Test first: Get blood levels checked; aim for 30-50 ng/mL

Note: Deficiency extremely common (estimated 40%+ of Americans)

2. Omega-3 Fatty Acids (EPA/DHA)

Who needs it:

• People who don't eat fatty fish 2-3x weekly
• Vegetarians/vegans (algae-based DHA)
• Heart disease risk
• High triglycerides

Evidence: ✅ Cardiovascular health (reduces triglycerides) ✅ Brain health and development ✅ Anti-inflammatory effects ✅ May reduce depression risk

Dosage: 1,000-2,000 mg combined EPA/DHA daily

Form: Fish oil, krill oil, or algae oil (vegan)

Quality matters: Look for third-party testing (IFOS, USP), molecular distillation (removes contaminants)

Better option: Eat fatty fish (salmon, mackerel, sardines) regularly

3. Magnesium

Who needs it:

• People with diagnosed deficiency
• Athletes (lost through sweat)
• Chronic stress (depletes magnesium)
• Poor sleep quality
• Constipation

Evidence: ✅ Muscle function and recovery ✅ Sleep quality improvement ✅ Stress and anxiety reduction ✅ Blood pressure regulation ✅ Bone health

Dosage: 200-400 mg daily

Forms:

• Magnesium glycinate: Best for sleep, anxiety (well-absorbed, gentle)
• Magnesium citrate: Good absorption, laxative effect (helpful for constipation)
• Magnesium oxide: Poorly absorbed, cheap (avoid)

Timing: Evening (promotes relaxation)

4. Creatine (for athletes/active people)

Who needs it:

• Athletes and strength trainers
• Older adults (muscle preservation)
• Vegetarians/vegans (lower dietary creatine)

Evidence: ✅ Increases muscle mass and strength ✅ Improves high-intensity exercise performance ✅ May improve cognitive function ✅ Safe long-term (most-studied supplement)

Dosage: 3-5 grams daily (no loading phase necessary)

Form: Creatine monohydrate (cheapest, most effective, most studied)

Note: One of the most evidence-backed supplements

5. Protein Powder (conditionally useful)

Who needs it:

• Athletes with high protein needs
• Older adults (difficulty consuming enough protein)
• Convenience supplement for busy people

Evidence: ✅ Supports muscle growth/recovery ✅ Convenient protein source

Dosage: As needed to meet protein goals (0.7-1g per lb body weight)

Forms:

• Whey: Complete protein, fast-digesting (dairy-based)
• Casein: Slow-digesting (before bed)
• Plant-based: Pea, rice, hemp (combine for complete amino acids)

Better option: Whole food protein sources (meat, fish, eggs, dairy, legumes)

6. Probiotics (conditionally beneficial)

Who might benefit:

• People taking/recently finished antibiotics
• Digestive issues (IBS, some cases)
• Certain infections (C. diff)

Evidence: ✅ May restore gut bacteria after antibiotics ✅ Some strains help specific conditions (evidence varies by strain)

Caution:

• Strain-specific effects (what works for one condition may not work for another)
• Quality varies wildly
• Expensive
• Whole foods (yogurt, kefir, sauerkraut, kimchi) often better

If taking: Look for multi-strain, high CFU (25+ billion), third-party tested

7. Iron (if deficient)

Who needs it:

• People with diagnosed iron deficiency/anemia
• Women with heavy menstrual periods
• Pregnant women
• Vegetarians/vegans (plant iron less bioavailable)

Evidence: ✅ Treats iron deficiency anemia ✅ Improves energy in deficient individuals

CAUTION: ❌ Don't supplement without testing—excess iron is toxic ❌ Can cause constipation, nausea

Test first: Ferritin blood test

Dosage: As prescribed by doctor

8. B12 (for specific populations)

Who needs it:

• Vegans/vegetarians (B12 only in animal products)
• People over 50 (absorption declines)
• People on metformin or PPIs (interfere with absorption)

Evidence: ✅ Prevents deficiency in at-risk populations ✅ Essential for nerve function, energy

Dosage: 1,000-2,500 mcg weekly (or as directed)

Form: Methylcobalamin or cyanocobalamin (both work)

Supplements with Mixed/Limited Evidence

Multivitamins

Evidence: Mixed and mostly negative for healthy people

Large studies show:

• No reduction in heart disease, cancer, or mortality for people eating balanced diets
• May provide "insurance" for poor diets (but fixing diet is better)

Who might benefit:

• Elderly with poor appetite
• Restrictive diets
• Diagnosed deficiencies

Most people: Waste of money

Vitamin C

Evidence: Limited benefits for most people

✅ May reduce cold duration slightly if taken before symptoms ❌ Doesn't prevent colds in general population ✅ Beneficial for athletes (reduces post-exercise infection risk)

Dosage: 200-500 mg (more excreted in urine)

Better: Eat fruits and vegetables (vitamin C + other beneficial compounds)

Collagen

Evidence: Preliminary but promising

✅ May improve skin elasticity and hydration (small studies) ✅ May reduce joint pain (some evidence) ❌ More research needed

Skepticism: Digested into amino acids (not guaranteed to reach skin/joints as collagen)

Alternative: Consume protein + vitamin C (body makes collagen from amino acids)

Turmeric/Curcumin

Evidence: Anti-inflammatory properties in lab, mixed in humans

✅ May reduce inflammation and pain (arthritis) ❌ Poor bioavailability (not well absorbed) ❌ Requires piperine (black pepper) for absorption

If trying: Look for enhanced bioavailability formulations

Caution: Can thin blood (don't combine with blood thinners)

Supplements That Don't Work (Despite Marketing)

Detox/Cleanse supplements

Marketing claim: "Flush toxins," "cleanse liver"

Reality: ❌ Your liver and kidneys detox naturally—don't need help ❌ No evidence these supplements do anything ❌ Often just expensive laxatives

What works: Adequate water, fiber, limiting alcohol

Fat burners/Weight loss supplements

Marketing claim: "Melt fat," "boost metabolism"

Reality: ❌ Minimal effect at best ❌ Often contain stimulants (heart risks) ❌ Expensive and ineffective

What works: Calorie deficit through diet and exercise

Testosterone boosters (for healthy men)

Marketing claim: "Naturally boost T," "build muscle"

Reality: ❌ Most ingredients don't increase testosterone meaningfully ❌ If you have healthy T levels, raising them slightly doesn't help ❌ If you have low T, see doctor for real treatment

What works: Sleep, exercise, healthy weight

Brain/Nootropic supplements (most)

Marketing claim: "Enhance focus," "boost memory"

Reality: ❌ Little evidence for most ingredients ❌ Caffeine is main active ingredient (just drink coffee)

Exceptions: Creatine has cognitive benefits, omega-3s support brain health

Immune boosters (most)

Marketing claim: "Strengthen immune system," "fight colds"

Reality: ❌ Zinc lozenges may reduce cold duration if taken early ❌ Elderberry has minimal evidence ❌ Most ingredients don't affect immune function

What works: Sleep, nutrition, exercise, stress management, vaccines

Who Actually Needs Supplements?

Specific populations benefit:

✅ Pregnant/breastfeeding: Prenatal vitamins (folate, iron crucial) ✅ Vegans: B12, possibly iron, omega-3 (algae), vitamin D ✅ Elderly: Vitamin D, B12, possibly protein ✅ Diagnosed deficiencies: Whatever is deficient ✅ Certain medical conditions: Malabsorption disorders, post-surgery ✅ Athletes: Creatine, protein (if needed), vitamin D

Healthy adults eating balanced diets: Very few supplements needed

How to Choose Quality Supplements

If you decide to supplement:

1. Third-party testing:

Look for certifications:

• USP (United States Pharmacopeia)
• NSF International
• ConsumerLab
• Informed Choice (for athletes)

Means: Independent verification of contents and purity

2. Avoid proprietary blends:

Red flag: "Proprietary blend" with undisclosed amounts

Why: Can't verify effective dosing of active ingredients

3. Reasonable claims:

❌ "Cure disease" ❌ "Miracle results" ❌ "Secret ingredient"

✅ Modest, evidence-based claims

4. Check dosages:

Many supplements under-dose active ingredients (cheaper to manufacture)

Research effective doses, compare to product

5. Expiration dates:

Supplements degrade over time—check dates

The Bottom Line: Food First

The best "supplement" is a nutritious diet:

✅ Fruits and vegetables: Vitamins, minerals, fiber, phytonutrients ✅ Protein sources: Animal products, legumes, dairy ✅ Whole grains: B vitamins, minerals, fiber ✅ Healthy fats: Nuts, seeds, fish, olive oil ✅ Adequate sunlight: Vitamin D

Supplements called supplements for a reason—they supplement diet, not replace it.

When to Consult a Doctor

Before supplementing, especially if:

• Taking medications (interactions possible)
• Pregnant/breastfeeding
• Chronic health conditions
• Planning surgery (some supplements thin blood)
• Experiencing symptoms (get tested, don't self-diagnose)

Don't assume safe because "natural"

Most supplements lack evidence for healthy adults eating balanced diets. Evidence-backed exceptions: vitamin D (especially northern latitudes, dark skin), omega-3s (if not eating fish), magnesium (sleep, stress), creatine (athletes), protein powder (convenience), probiotics (post-antibiotics), iron (if deficient), B12 (vegans, elderly). Multivitamins offer minimal benefits for most people. Avoid detoxes, fat burners, testosterone boosters, and most brain supplements—they don't work. Choose third-party tested brands, avoid proprietary blends, verify effective dosages. Prioritize whole foods over supplements. Test for deficiencies before supplementing. Consult doctors before adding supplements, especially with medications or health conditions.