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These days, it seems like there’s a supplement to address just about everything — digestion, sleep, skin health, hair health, bone health, mental health, stress…the list continues on forever.
It’s nearly impossible to hop on social media without encountering an incredibly persuasive testimonial about a supplement.
Maybe an influencer will share before-and-after photos and rave about how a gummy supplement completely reversed her chronic bloating (and tasted amazing!). Then another creator will appear on your feed to let you know that her hair shedding totally resolved after she began incorporating a different supplement. And later, another video will appear on your feed from someone who “balanced” their hormones thanks to — you guessed it — yet another supplement.
But the supplement bubble is beginning to burst. Recent research had poked holes in claims surrounding creatine, colostrum, melatonin, and CBD supplement products. And larger conversations about the unregulated nature of the supplement industry — combined with the unchecked claims influencers and social media users are able to make about these supplements — are finally taking place.
When it comes to supplements, it’s nearly impossible to wade through all the claims, to find out what’s real and what’s not, and to determine what is actually worth your hard-earned money.
But now, there’s an even more compelling reason to approach supplements with caution: Because more and more, we’re learning that supplements may not just be a waste of money and energy, they may pose real dangers to our bodies (potentially even damaging our livers, according to recent findings).
So what’s the right way to approach all this? We’ve enlisted registered dietitian Anna Bohnengel to help us make sense of the wild world of supplements.
Let’s talk about regulation (or lack thereof) around supplements
Supplements are regulated by the FDA.
“However, the regulation of supplements is less strict than that of prescription and over-the-counter (OTC) drugs,” says Bohnengel. “Unlike drugs, supplements do not require FDA approval before being sold. Manufacturers do not have to prove that their products are effective or safe before they hit the market.”
The FDA and Federal Trade Commission regulate how supplements are marketed, though: Supplements must label their ingredients and the amounts of those ingredients. Supplement labels can include general claims about what the product supports, but they must avoid making disease claims and include a disclaimer noting that these support claims haven't been evaluated by the FDA. For example, a supplement can claim it “supports reproductive health”, but not that it “cures infertility”.
What are the risks of taking supplements?
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According to Bohnengel, toxicity (which can occur when high doses of fat-soluble vitamins accumulate in the body), imbalance (when taking too much of one nutrient can deplete another), and interactions (when certain supplements interfere with medications) are among the biggest risks.
“The more supplements you take, and the longer you take them, the greater the risk of nutrient imbalances, interactions, and toxicity,” says Bohnengel.
That’s partly because many supplements contain overlapping ingredients, meaning you may unknowingly be getting double (or even triple) your dose of certain nutrients.
Some ingredients to look out for
According to Bohnengel, vitamin A (retinol) can be toxic to the liver in excess and harmful during pregnancy; too much iron can cause constipation or even organ damage; and high-dose B6 (over 100mg daily) can lead to nerve damage over time.
So, should you always check in with a doctor before incorporating a supplement?
It’s not a hard and fast rule that you should check in with a medical professional before starting on a supplement. With that being said, it’s always better safe than sorry, and people with health conditions, who take medications, or are pregnant or breastfeeding should always check in with a professional before starting a supplement.
It’s also a good idea to run your lineup by a medical expert if you’re taking multiple supplements, as too many at once can lead to nutritional imbalances.
Supplements can be helpful, but caution is key
Getting your nutrients in via food is the first line of defense. However, sometimes supplements can be really helpful in providing everything your body needs.
“While a food-first approach is ideal, in my clinical experience, most women would benefit from strategic supplementation,” says Bohnengel. “After over a decade of nutrient testing among women who come to me already eating a ‘healthy’ diet, nutrient deficiencies are much more common than one might expect.”
According to Bohnengel, our nutritional needs change over time (for example, people who exercise a lot or are pregnant may need more nutrients than they’re getting from food).
“Declining soil and food quality make it harder to get the nutrients we need from food alone,” she adds. “Then, poor gut health and certain medications can make it harder to absorb the nutrients we do get. Not to mention restrictive diets (like vegan / plant-based, or intermittent fasting, keto, etc. can make it nearly impossible to get all of the nutrients needed from food alone).”
But as with everything, there’s a balance, and excessive supplement usage is real and risky.
The social media of it all
“I see how social media is exploding as a driving force behind supplement trends. Supplements have become more mainstream as influencers purport too-good-to-be true benefits,” says Bohnengel.
The problem is, the influencers who post about supplements aren’t medical professionals, and in many cases, they’re getting paid to promote products and claims that haven’t been evaluated.
“Short-form videos make it easy for quick supplement trends to go viral. [Think] ‘chlorophyll water for clear skin’ or ‘ashwagandha for anxiety’,” says Bohnengel. ”But this short-form content makes it nearly impossible to include all the need-to-know nuances about dose, who it's effective for, who it's not safe for, etc.”
Some tips for smart supplementing
“Start with food,” advises Boghnenegel. “Whole foods provide nutrients in their most bioavailable form.”
Take a personalized approach, she adds: Bloodwork can alert you to any deficiencies (“test, don’t guess” she advises), and don’t overdo it.
“The average woman does not need a cabinet full of supplements,” says Bohnengel. “A targeted approach based on diet, lab work, and health goals is more effective than taking multiple random supplements.”
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.