It’s an ongoing debate with no definitive right answer. The question is, do you need to consider taking a supplement – either a vitamin or a specific nutrient- if you eat a healthy diet? Ideally, any supplement you reach for should be just that- a supplement to your regular diet, rather than a replacement for eating healthily. But, as one recent article on this topic remarked, “Is there anything more confusing in this life than standing in the supplements aisle at CVS?” Confused or not, there’s strong evidence that for a good portion of the country, supplements are a part of a regular diet. According to the CDC, more than ½ of all US adults take a dietary supplement, with a daily multivitamin being the most popular, closely followed by a vitamin D pill. This use of supplements comes despite the inconclusive evidence of the value of many supplements, their cost, and even their safety. While there is some FDA regulation of the supplement industry so that supplements cannot make outright medical claims, they are not considered drugs, so they do not come under the more stringent regulations used to protect consumers from unreliable producers or outright fraud. Nonetheless, the supplement industry in the United States is massive, with about 59 million Americans regularly using some type of vitamin or supplement, spending an average of $510 each year.

Experts seem to disagree about the need for supplements except in certain circumstances, and myths about the value of taking supplements abound. For example, Newsweek recently busted a few myths about taking a daily multivitamin (no, not everyone needs it), ingesting a magnesium supplement because it’s hard to get sufficient magnesium in food (plenty of foods have magnesium), or even the myth that you can never take too much Vitamin D (news flash: you can). In a recent podcast from the Mayo Clinic, holistic medicine expert Dr. Brent Bauer stated that most older adults turn to supplements due to pain, sleep problems, or stress. While he acknowledged there may be a role for supplements to address these issues in certain circumstances, he advised that more healthy aging lifestyle choices, including good nutrition, exercise, social engagement, and time in nature were just as likely to (safely) address these issues as any supplement could. Dr. Bauer emphasized the need to work with your primary care team before reaching for a supplement, especially if you are on other medications that could negatively interact with a supplement. He also emphasized the need to do your homework to ensure you’re ingesting the best quality supplement you can. So put aside your glass of water and find out more here. His one exception to this caution? Vitamin D, given its diminished presence in older adults, its importance for bone health, and its absence from many diets. There is even a new study that links the value of Vitamin D supplementation with improvements in blood pressure, cholesterol, and insulin, with adults over 50 being one of the prime beneficiaries of these Vitamin D benefits.

Despite this mixed message on the need for, or value of, supplements, recommendations continue to appear in the popular press. For example, a recent post from Consumer Reports listed 7 supplements that might be valuable, along with recommendations of specific brands known to be reliable producers. Among the recommended supplements? Calcium (especially as older adults are at greater risk for osteoporosis), Vitamin D, Magnesium, Fish Oil (for brain and heart health), collagen (another nutrient that decreases as you get older), melatonin (for sleep problems), and Vitamin B12 (for red blood cell formation and nervous system function). At the same time, the article suggests you skip the regular intake of vitamin C, probiotics, and glucosamine. But as an example of how opinions can differ on supplements, a recent post in Fortune, outlining the supplement recommendations of longevity experts, does suggest a probiotic for gut health!

There’s no disagreement, however, that some supplements can truly put you at risk and need to be taken with extreme caution. For example, a recent study in JAMA Network Open outlined the liver toxicity risks that arise from some commonly used herbal supplements, including a green tea supplement and turmeric. The study, out of the University of Michigan, found that over 15 million adults have taken one of these herbal supplements in the last month and thus put themselves at risk for liver damage. Underscoring that just because a supplement is natural does not mean it’s safe, this study reflects the fact that some supplements may do more harm than good. To read more, put away your pill bottle and click here.