5 Things You Need to Consider Before Taking Any Supplement

5 Things You Need to Consider Before Taking Any Supplement
5 Things You Need to Consider Before Taking Any Supplement
Supplements can pose risks.
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If your morning routine involves tossing down a handful of dietary supplements in vague hopes of boosting your energy or warding off illness this week or disease down the line, you might want to dial back and rethink your approach—especially if you’re of the mindset that you don’t need to discuss your supplements regimen with your doctor.
Here’s why: Although dietary supplements can play a role in remedying a vitamin deficiency or nutritional imbalance, they’re generally unnecessary for people who have a well-rounded diet, and supplements might even pose health risks, Donald Hensrud , M.D., MPH, director of the Mayo Clinic Center Healthy Living Program, tells SELF.
“The irony is that people often take supplements to improve their health, but there’s little evidence to suggest that they do,” Dr. Hensrud says. “And some supplements can actually cause harm—either through direct toxicity or in combination with prescription or over-the-counter drugs or other supplements.”
So whether you’re eyeing supplements to improve your health or you’re already taking a few, here’s how to make sure that you’re doing so in a way that’s helpful rather than harmful.
1. As a general rule, try to get your vitamins and nutrients from food over supplements.
Before dropping a lot of money on supplements, you should know that a balanced diet will usually supply enough of the necessary vitamins and nutrients, says Dr. Hensrud, unless a deficiency has been diagnosed.
In other words, eat your vegetables and fruits, whole grains and nuts, and healthy protein sources, and you’re probably pretty much set, says Lauren Grossman , M.D., director of the UCHealth Integrative Medicine Center in Denver and assistant clinical professor with the University of Colorado School of Medicine. “We know that nutrients are best utilized when they’re taken as a whole food and not from a bottle. Trained integrative medicine physicians won’t usually recommend a slew of vitamins and supplements without a targeted purpose,” she tells SELF. “Supplements are just that—usually extras.”
That said, if you have a particular deficiency, or if your access to a variety of nutrient-rich foods is limited, supplements can be a way to make sure you’re getting the vitamins and nutrients you need. Still, this should ideally be something you discuss with a health care provider before you head to the health food store.
For example, if a blood test finds that you’re deficient in calcium, Vitamin D, or iron, your doctor may recommend a specific supplement and amount, Dr. Grossman explains: “I think that any guidance on supplements has to be done in the context of nutritional counseling.”
2. Know that supplements aren’t as safe and regulated as most people assume.
There are two major misconceptions about supplement safety that can cause trouble for unwitting customers. The first is the assumption that if it’s available over the counter at a pharmacy or “natural” food store, it must be safe to take. Unfortunately, over-the-counter status or even a label that says “all natural” doesn’t mean that it won’t have harmful side effects in certain people or when combined with certain substances.
The other common misconception is that the U.S. Food and Drug Administration regulates supplements to ensure their safety. While pharmacies and other retail outlets may vet their supplement products to the extent feasible before putting them on their shelves, that’s no guarantee that the quality and concentration are as advertised. Plus, the FDA’s role in regulating dietary supplements is somewhat limited: The agency inspects manufacturing establishments themselves for product quality, labeling, and claims, and it monitors adverse-events reports after the products are on the market. But that’s about the extent of it.
“By law, the FDA doesn’t approve dietary supplements or product labeling. The companies that manufacture or market the supplements are responsible for ensuring that their products are safe and lawful,” says FDA spokesperson Courtney Rhodes. Consumers should be aware, Rhodes adds, that companies can introduce new supplements to the market without FDA approval or even notification. That’s because dietary supplements are regulated under different, less stringent rules than those covering conventional foods or drug products. The FDA is proposing stronger regulation of supplements—there’s been little change since 2010—but that hasn’t happened yet.
In the meantime, you should opt for a buyer-beware and buyer-be-informed stance, according to clinical pharmacist Monika Nuffer , Pharm.D., a faculty member at the University of Colorado School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences. Supplement labels, Dr. Nuffer tells SELF, must include the following disclaimer: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.” That statement, however, might differ markedly from what supplements manufacturers claim, she cautions. “Manufacturers might include structural or functional claims to market their product. Sometimes those can be misleading, so keep that in mind if it sounds too good to be true.”
The FDA’s Rhodes adds that consumers should be especially wary of product claims such as “works better than [a prescription drug],” “totally safe,” or has “no side effects.” “Throughout the pandemic, the FDA has found many nefarious actors seeking to exploit consumers by selling unproven medical products, often with fraudulent claims,” she tells SELF.
3. Always check with your doctor before starting a supplement.
The main reason for discussing your supplement usage with your provider is safety. Dietary supplements—and that includes vitamins and minerals—can interfere with prescription medications, and taking a larger daily dose than recommended can cause side effects, according to the Mayo Clinic . The same goes for botanical or herbal supplements, says Dr. Grossman.
“My recommendation to patients is to make sure that they share with their health care provider what they are taking in line with over-the-counter products, supplements, or essential oils,” Dr. Nuffer tells SELF. “This is critical to ensuring that the combination of everything is safe. For example, the G herbs—garlic, ginger, ginseng, and gingko—can increase risk of bleeding and bruising if you take them in combination with prescription or over-the-counter blood thinners.”
Another reason to talk to your doctor about supplements is because what your physician doesn’t know about what you’re taking could compromise your care if you do become ill, Dr. Grossman tells SELF. “We know, for example, that approximately 80% of cancer patients use complementary medicine tools, but only 14% communicate this with their traditional practitioners,” she says. “We are also lacking in much-needed research so, fairly, the oncologists are concerned about potential supplement interactions or conflicts with chemotherapeutic and immunologic agents, or radiation therapy.”
4. Know how much you’re supposed to take—and how much you’re actually taking.
Another common misconception about dietary supplements is that if a vitamin or mineral is good for you, increasing your intake might deliver additional health benefits. Rebecca Ruud , M.D., a Bellevue, Wash., internist and associate professor of medicine at the University of Washington, sometimes encounters this view—she calls it “vitaminosis”—in her patients. “They think that if a little bit is good, a lot must be better, but that’s not the case,” Dr. Ruud tells SELF, because the body absorbs only what it needs. Aside from being a waste of money, taking in more than you need can also be harmful.
Too much vitamin D over time can actually weaken the bones, Dr. Ruud notes. Biotin—a popular supplement that people take to improve skin, nails, and hair—can interfere with lab-test results when taken at high levels, making them read falsely high or falsely low, she cautions. Dr. Ruud suspects that many of her patients disclose any supplements that they take, and she always asks about usage. But she also knows that patients often rely on peers’ recommendations regarding supplements, particularly trendy ones like biotin. She recommends that patients who are thinking of using  supplements seek reliable information first, like the Mayo Clinic website’s Drugs and Supplements section.
“You truly can have too much of a good thing,” Craig Hopp , Ph.D., deputy director of the Division of Extramural Research for the NIH National Center for Complementary and Integrative Health, tells SELF. “Consumers should keep in mind that vitamins [as supplements] are meant for people who are deficient.” Dr. Hopp’s center is currently conducting a large study on possible interactions between prescription drugs and dietary supplements, to try to provide much-needed guidance in this area.
All of the experts we interviewed for this piece agreed that they’ve noticed a recent rise in supplement use or interest fueled by word-of-mouth recommendations and a plethora of unreliable information hitting the internet since the pandemic started. That response is understandable, Dr. Grossman says, but she worries that patients don’t disclose supplement use because they fear their doctors might disapprove.
“Patients may feel judged, so they don’t share,” she tells SELF, adding that most doctors are unlikely to respond that way and are more interested in “advocating for their patients’ health.”
In the context of COVID-19, Dr. Grossman reports, many people have flocked to supplements believed to boost the immune system . For example, she notes, elderberry, zinc, vitamin D, and vitamin C have been popular. “It’s a detriment to the patient—and the clinician—in this case,” she cautions, explaining that there is some concern certain supplements may be harmful in people who have COVID-19. “Your physician can’t guide you if they don’t have accurate information.”
5. Still want to take supplements? Go for it—but do your research.
If you’re exploring supplements or are already taking them, make sure you consult science-based information. Here are some reliable resources: