Supplements are like the skincare serums of the wellness world — slick packaging, glowing reviews, and always somehow endorsed by someone who looks like they’ve never had a pimple or a bad day. Maybe it’s a green powder with a cult following, maybe it’s a gummy in millennial pink.
But here’s the catch: “So much of the supplement market is marketing or branding, and that can be deceptive,” says Dr. Disha Narang, M.D., an endocrinologist and obesity specialist with Endeavor Health Medical Group in Skokie, IL.
Still, not all supplements are snake oil in a capsule. Some actually do what they claim and have the science to back it up. So how do you tell what’s worth it? Let’s dig into the data.
A “loosey-goosey regulation situation”
If you only remember one thing about supplements, remember this: Just because a vitamin or mineral or plant-based supplement is available to buy online or from store shelves doesn’t mean it’s been vetted and verified by the U.S. Food & Drug Administration (FDA).
The FDA doesn't regulate supplements the way they do medication. Medications don’t go on the market until the FDA approves them and considers them safe and effective. This is different for supplements, which the FDA regulates more like a food, says Dr. Pieter Cohen, M.D., associate professor at Harvard Medical School and a national expert on the safety of dietary supplements. Cohen describes this process as “a very loosey-goosey regulation situation.”
As a result, “we don't have safety or efficacy data on supplements,” adds Narang. “People often feel as if they’re taking a milder option compared to medication, but it can be more risky to use various supplements for any issue, including weight loss, compared to something that is an actual FDA-approved medication.”
When and why the FDA gets involved
It’s illegal for manufacturers or distributors to market a product that is adulterated or misbranded, according to the FDA. The problem with this is that it puts the responsibility on the manufacturer to ensure that their product is labeled correctly, the ingredients within are safe, and it doesn’t have any ingredients in it that it shouldn’t. The FDA itself doesn’t require proof.
Contamination can occur during growth and harvest of raw materials (like botanicals), arise from supply issues, and happen during the manufacturing process. It may be accidental or purposeful to improve results. Research indicates that supplements can be contaminated with:
- Prescription drugs
- Herbs not listed on the label (one herb is substituted for another)
- Heavy metals
- Microbes like mold, fungus, yeast, or bacteria
- Lower concentration of ingredients listed
If a bad-actor supplement is on the market, the FDA can then step in and take action and may take it off the market — but not before it potentially harms people. That strategy has been dubbed “innocent until proven guilty.”
The FDA itself has raised alarm bells on contaminated weight-loss products, but the organization includes this caveat: “Unfortunately, FDA cannot test and identify all weight-loss products on the market that have potentially harmful contaminants in order to assure their safety.” Translation: It’s a toss-up as to whether or not it's safe.
Supplements that claim to help you lose weight are also susceptible to contamination and may be tainted with medications and chemicals that are not listed on their label, says the FDA. These can include unapproved or banned medications, antidepressants, laxatives, and more, such as:
- Sibutramine (an obesity medication that is no longer used in the U.S. due to heart-related dangers)
- Fenproproex (an appetite suppressant that’s not approved for use in the U.S.)
- Fluoxetine (an antidepressant medication)
- Bumetanide (a diuretic, or “water pill”)
- Phenolphthalein (a laxative)
All that said, supplements aren’t bad — and can be powerful tools to support your health during weight loss or menopause, or minimize nutrient deficiencies while taking a GLP-1 medication.
5 smart supplement shopping guidelines
Before you buy, follow these five tips. And before you take, talk to your doctor to make sure the supplement won’t negatively affect any of your medications or conditions.
- Choose third-party verified products. Since avoiding possible contaminants in your supplements is important for your health and safety, Cohen recommends looking for a seal of an organization that meticulously analyzes supplements, like USP and NSF.
“Companies will hire an independent third-party to analyze their products, make sure they’re not adulterated, are accurately labeled, and the ingredients are accurate,” he says. “This is the only way to be sure that what’s on the label is in the supplement.” On each of the company’s web pages above, you can use their product search tool to find a specific supplement that fits what you’re looking for. - Avoid too-good-to-be-true claims. A lot of the promises found on supplement labels are marketing — not science. “I recommend avoiding supplements that make bold health claims,” says Cohen. Manufacturers are not supposed to say outrageous things like “will cure your cancer,” or other statements about treating disease. They can, however, tell you that their supplement supports your immune system, which seems a little more believable and easier to prove. Still, says Cohen, these claims are “sometimes made up, and other times may be based on mouse cells in a petri dish.” Altogether, health claims may be true — but they’re often not.
- Focus on short ingredient lists. If you read a reliable source, like a study or reputable news story, that a specific ingredient does xyz for your health and you want to try it, Cohen recommends looking for and purchasing a supplement that only features that ingredient as opposed to a combination of lots of different things. “With the exception of multivitamins, avoid supplements that contain a complicated mix of ingredients,” says Cohen. “It’s difficult for anyone — even when analyzing it in a lab — to figure out all the different ingredients in there. Plus, this is when we often see hidden ingredients.”
- Remember that expensive isn’t always better. Price often has little to do with the quality of a product. In fact, many of the national, less expensive brands are the ones likelier to be third-party certified. Their packaging won’t be flashy, they aren’t as likely to be touted by influencers on social media, and they probably won’t look cool in your medicine cabinet, but they’re legit.
- Be careful when purchasing via the internet. Online supplements aren’t always “bad,” (and questionable products can be sold in stores), but internet purchases warrant special caution. In the past, the FDA has flagged supplements like weight-loss products sold from Amazon and eBay — including those labeled with things like “Amazon Choice” — as those that are adulterated and fraudulent. It doesn’t hurt to look at the FDA’s Health Fraud Product Database to ensure that what you’re buying hasn’t been flagged.
The bottom line
If you’re interested in taking a supplement, you want to make sure that what you’re buying is safe and contains exactly what it claims without additional ingredients or contaminants. The FDA doesn’t regulate supplements the same that they do medications, so you have to do some legwork yourself. Choose those that are independently, third-party certified specifically from USP or NSF, and don’t get lured in by too-good-to-be true health claims, whether from people selling the product online or on the supplements actual packaging.
This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.