Here's a tough pill to swallow: supplements are a $32-billion-a-year industry, but are they necessary? Could it be that you’re literally peeing your hard-earned money down the toilet, or worse, doing more harm than good by consuming too many supplements? It’s certainly food for thought.

Some medical professionals and nutritionists argue supplements are necessary because:

  • Most people don't eat enough fruits and vegetables.
  • Most people eat processed foods, which lack essential nutrients.
  • The soil in which our food is grown is depleted, thus lacking essential minerals.
  • Pregnant women and the elderly need more vitamins than food provides.
  • The consumption of pharmaceuticals may interfere with vitamin absorption.

But what about for those who exercise regularly, eat balanced whole foods at every meal, don’t smoke and drink alcohol moderately? Are supplements necessary? Some research says not only are they unnecessary, they're unsafe.

Supplement safety

Supplements on store shelves Despite medical evidence indicating dietary supplements are not a safe choice for many people, supplements are a $32-billion-a-year industry. (Photo: Niloo/Shutterstock)

The Food and Drug Administration (FDA) points out that "millions of Americans responsibly consume multi-vitamins and experience no ill effects." However, dietary supplements are not regulated in the same way medications are because they're categorized as food under the 1994 Dietary Supplement Health and Education Act, which means the FDA considers them safe until proven unsafe. The FDA cautions that "many supplements contain ingredients that have strong biological effects, and such products may not be safe in all people. If you have certain health conditions and take these products, you may be putting yourself at risk."

Several studies have given weight to the FDA's words of caution. A recent Consumer Reports story outlined a tragic case from 2014. A baby was born two months premature and given a probiotic in the NICU to prevent an intestinal infection. However, the probiotic caused a severe fungal infection in his intestines instead, and the baby died at eight days old. The FDA investigated and found the probiotic was contaminated with the fungus, which led to a massive nationwide recall and a statement from the FDA urging doctors to exercise more caution when using supplements in people with compromised immune systems.

But the danger isn't just for babies. A 2005 study published in the British Medical Journal (BMJ) concluded, “The evidence for routine use of multivitamin and mineral supplements to reduce infections in elderly people is weak and conflicting.”

Another peer-reviewed study from 2009 was penned by several researchers at the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center in Seattle. After following up with more than 160,000 post-menopausal women during the 1990s, for an average of eight years, the researchers’ study “provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD (cardiovascular disease), or total mortality in postmenopausal women.”

Debunking supplements doesn’t stop there. Experts at the National Institutes of Health argued in 2006 that there’s no clear evidence that vitamins prevent chronic diseases.

So what have researchers concluded from supplements? They've inconclusively concluded the following:

  • Health benefits from taking multivitamins is still up for debate.
  • Some people may be getting too much of certain nutrients.
  • There may be possible interactions between multivitamins and minerals and prescribed or over-the-counter medications.

In addition, some supplements may not even contain the ingredients shown on the label. In September 2016, New York's attorney general cracked down on NBTY, which sells popular supplement brands including Solgar and Nature Bounty, reports USA Today. Per a new agreement, the company will now conduct more stringent testing to make sure the products actually contain the herbs promised on the label. Past reports had shown that the supplements often contained fillers such as powdered rice, instead of the herbs pictured. NBTY sells ginseng, ginkgo biloba and nearly 22,000 other products.

What about antioxidant pills?

Marketing gurus have helped companies make millions by touting the latest antioxidant product du jour, be it the acai berry, mangosteen, blueberry, Omega 3s…the list goes on.

But research published in the Journal of the American Medical Association says not only can some antioxidant supplements be ineffective, they can be hazardous to your health. The 2007 study of more than 232,000 people concluded that antioxidant supplements can "increase the risk of death."

Gulp. Talk about a bitter pill to swallow. Why would antioxidants be bad for you? Researchers theorize that we shouldn’t be as vigilant about free radicals as we are; our body actually needs some amount of them to perform certain functions like regulating blood sugar levels.

Are there any safe supplements?

Man taking supplements Not only can some antioxidant supplements be ineffective, they can be hazardous to your health. (Photo: Syda Productions/Shutterstock)

Perhaps. Nutritional experts would argue that not all supplements are created equal. Certain brands are derived from whole-food sources, while other, more mainstream brands are laced with synthetic ingredients. The aforementioned research did not indicate what brand of vitamins the subjects were taking.

Certain vitamin supplements are time-released, while others flood the digestive system all at once, jockeying for position to be absorbed by the body, only to be flushed out by the kidneys.

Confused? Talk to your doctor

If you’re pregnant, your doctor may advise you to take supplemental folate. Susceptible to cold sores? You may need supplemental lysine, an amino acid. Concerned about prostate health? Saw palmetto or a bevy of other natural supplements might be the right choice. Digest food poorly? Hydrochloric acid and pepsin might be beneficial. Taken antibiotics lately? Consider recolonizing your digestive tract with probiotics. Most of your immune system lies within your gut, so if you’re going to choose one supplement to take, consider one that aids digestive health. If you eat a poor diet, a multivitamin split in half and taken in the morning and evening might be more effective than a diet full of junk food. But do your research on which multivitamin to take.

Editor's note: This story has been updated since it was originally published in September 2011.