With cold and flu season in full swing, ’tis the season for many Americans to ditch one or more supplements in hopes of warding off illness. And it’s not just a winter habit; for many, they have become routine, with nearly 58% of people over the age of 20 reporting using at least one supplement.
But do all those little pills — which make up a multibillion-dollar industry — actually do anything?
Supplements versus food
Experts say that food trumps supplements as the best source of nutrients. Dr. Marilyn Tan, a clinical associate professor of medicine at Stanford University, explains the benefits of getting nutrients gradually throughout the day rather than getting “most of it all at once” via a pill.
“I think if you can take it throughout the day — for example, in nutrients through food — it’s just absorbed better. Because there is a maximum amount that can be absorbed by the body at one time,” he said. “For example, for calcium, if you take more than 500 to 1,000 milligrams, your body will just throw it away. And a lot of vitamins are like that, where you can’t absorb such a large amount at once.”
Tan said most Americans already get the nutrients they need from food alone.
“Most people on a standard American diet, unless they’re on a very strict diet, get enough nutrients through their diet,” he says. “Vitamin deficiencies can occur with certain conditions like malabsorption or pernicious anemia, for example, but for the average, otherwise healthy American, they get plenty of nutrients through diet.”
Lisa Moskovitz, registered dietitian, CEO of NY Nutrition Group and author of “The Core 3 Healthy Eating Plan,” told Yahoo News that for someone who already eats a fairly healthy diet, supplements probably won’t make much of a difference and “could be a waste money and just really expensive urine,” because your body is excreting all those excess nutrients. And for those who already get enough nutrients through their diet, adding vitamin supplements doesn’t necessarily give them the extra boost they might be hoping for.
“If you already have sufficient levels in your body and you take a B12 supplement, for example, you won’t feel more energy than taking B12 if you already have enough B12 in your system to begin with,” he says. .
When can food supplements be a good idea?
Experts emphasize a “food first” approach to nutrients, meaning supplements should do just that – supplement but not compensate for bad eating habits. They may help fill nutritional gaps in certain circumstances, such as if you are restricting your food intake for weight loss or if you follow a vegan diet, have limited access to healthy foods or suffer from certain vitamin deficiencies, which your doctor can diagnose with a blood test.
Iron deficiency, for example, is not uncommon, especially in menstruating women or people with sources of blood loss. Iron is also sometimes harder to get just through food if you are a vegetarian.
And for many people, vitamin D can also be difficult to obtain through diet alone. We get vitamin D mostly from sunlight, but if you wear a thick layer of sunscreen while in the sun or if you don’t get enough outside, you may not absorb as much. How dark or light your skin is can also affect vitamin D absorption.
“Vitamin D is very difficult to get enough from food. There are not many sources of nutrition,” said Tan. “But for most other vitamins, we can get them in food.”
Vitamin B12 is another example, he says, where a doctor might recommend an oral supplement if you have a mild deficiency, which becomes more common as people age.
And folic acid, a B vitamin, is one of the supplements that has broad support from public health experts, even among those who are skeptical about supplements. It has been shown to prevent serious birth defects in babies’ brains and spines, and because the benefits of folic acid are most important in the early days and weeks of fetal development — before many women know they are pregnant — the CDC recommends that “all women in reproductive age should get 400 micrograms (mcg) of folic acid daily, in addition to consuming foods with folate from a varied diet.”
“The risk is too great to take a chance on a woman who thinks they are getting enough folic acid [through their diet] but they don’t,” said Moskovitz. “It’s just because the research is very, very strong.”
So do supplements actually work?
Although folic acid supplements have proven benefits, the jury is still out on the merits of most other supplements.
In 2013, researchers at Johns Hopkins published an editorial titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” with one of the editorial’s authors saying he does not recommend any supplements other than folic acid for women who may become pregnant. .
Earlier this year, the US Preventive Services Task Force issued updated guidance saying that vitamin, mineral and multivitamin supplements are unlikely to prevent cancer or heart disease, or affect overall mortality.
“Usually it doesn’t hurt to take multivitamins, but many studies have looked at whether multivitamins can help improve mortality or quality of life or sense of well-being or things like that, and none of them are very conclusive,” Tan said. “There are no large randomized controlled trials that show significant health benefits of taking multivitamins.”
Tan says if you have a diagnosed deficiency that affects your health — such as a B12 deficiency that affects memory, for example — supplementing it can help. But taking supplements solely in the hopes of gaining health benefits down the road may not amount to much.
“Many studies have tried to examine, for example, whether vitamin D can help with heart disease, or help with infections like COVID,” said Tan. “Studies have been mixed, but nothing has been conclusively proven that a particular vitamin supplement will help you live longer.”
When using supplements to treat or shorten the duration of illnesses such as the common cold, the results are also mixed. Zinc is a mineral that has been touted by some for its ability to shorten the duration of a cold if taken in lozenge form within the first 24 hours of symptom onset, but nothing has been conclusively proven. While some studies have shown that zinc can shorten colds by a few days, other studies have concluded that zinc has no effect on cold duration or severity.
Most over-the-counter vitamin supplements are safe in limited amounts, so if they make you feel better, there’s probably no harm in taking them. But they are unlikely to cure your disease, says Tan.
“Are they necessarily going to cure or reverse the infection? No, probably not,” he said. “They are also not a substitute for any recommended treatment [from your doctor]. For example, if you have the flu and your doctor recommends taking Tamiflu because you’re at high risk, taking vitamin C might help or taking zinc might help, but it’s not a substitute for whatever your doctor recommends.”
Too much of a good thing?
It’s also possible to have too much of a good thing, experts say. Excess water-soluble vitamins are usually excreted in the urine, but excess fat-soluble vitamins can remain in your body and have adverse effects.
Long-term use of zinc in high doses, for example, can cause copper deficiency; high doses of vitamin A should not be taken during pregnancy because it can harm the fetus; and excess vitamin D can cause high and unhealthy calcium levels.
Some supplements may also interfere with medications.
“If you are taking certain medications, you need to be careful, especially with herbal supplements like ashwagandha [or] herbal supplements like St.-John’s-wort,” says Moskovitz. “It can affect psychotropic drugs, so antidepressants [or] anti-anxiety medication. Some can actually interfere with heart medications [or] blood thinning. So that’s why it’s also very important to check with a professional.”
How can you make sure you’re taking the right supplements?
Dietary supplements are not regulated by the US Food and Drug Administration the way drugs are; they are considered a subcategory of foods, not drugs, so anything that manufacturers feel is safe can enter the market without prior FDA approval.
One way to get some assurance that the supplement you’re taking lives up to its claims is to look for the ConsumerLab or United States Pharmacopeia seal on the label, which indicates that the product has been tested and certified for quality. And if a product makes “magical claims” that it can improve your health, take it with a grain of salt, says Tan.
You should also consult your healthcare provider before taking any supplements, Tan and Moskovitz say, because chances are, you may not need them.
“For someone who wants to add more supplements to their diet, who wants to explore and see if they can benefit, it’s always helpful to first talk to a professional doctor and a dietitian, especially a doctor who can order blood work,” Moskovitz said. . “Test your level before you spend your hard-earned money on something you might not need and might just throw away.”