Americans are more health conscious than ever. A recent poll found that 7 in 10 people say they are more aware of how they treat their bodies since the COVID pandemic, and have dramatically increased the use of supplements. But these “natural” remedies may actually be causing more harm than good. The adverse reactions from supplements and over the counter (OTC) drugs can be serious, like acute liver failure, liver toxicity, and heavy metal poisoning.
Dietary supplements are extremely popular and are a common staple in American’s wellness routines. According to the 2017–18 National Health and Nutrition Examination Survey, 58% of U.S. adults 20 and older use dietary supplements. And more recently, a 2024 poll from the Council for Responsible Nutrition (CRN) suggests that usage is even higher, with 75% of U.S. adults taking supplements regularly.
The draw of a supplement can be strong; they promise essential nutrient needs, quick fixes, and lower cost alternatives to medication. But they come with toxicity and contamination risks—especially when taken with prescription medications.
Why Did Supplements Become So Popular?
Supplements are a go-to for many people and the reasons vary from economics to the deeply personal.
- The Quick Fix: People want to boost energy, immunity, or fill nutrient gaps. Taking a pill feels like an easy step toward better health.
- Influencers: Celebrity endorsements and social media make certain supplements seem more credible and safer.
- Convenience: Busy lifestyles and processed diets make supplements an easy alternative to dietary changes.
- Preventive Care: Aging adults often use OTC supplements to support bone health.
- Limited Healthcare Access: When healthcare and prescriptions are too expensive, people see supplements as an accessible health solution.
- Cultural Traditions: Herbal remedies remain popular in many cultures and alternative medicine practices.
Many supplements can be helpful, or at least not harmful, but it is critical to understand that they can come with serious risks and are not required to be proven safe.
Why Supplements Aren’t FDA-Approved (and Why That Matters)
As many as 75% of US adults that take supplements regularly are assuming that OTC vitamins, minerals, and herbal remedies are safe to use. This is not a good assumption to make. Unlike prescription drugs, dietary supplements are not required to prove their safety or efficacy through a rigorous FDA testing regimen.
Dietary supplements are considered a “food product” and fall under the Dietary Supplement Health and Education Act. This means they hit shelves without any testing or FDA approval. While the supplement manufacturers are supposed to ensure their products are safe and accurately labeled, the FDA only steps in after receiving a consumer complaint.
Supplements can be very risky, and people may not realize it. The journal Liver Transplantation published a study in 2022 that found herbal and dietary supplements had increased drug-induced acute liver failure by a factor of eight between 1995 and 2020. The following list of supplements that are taken to address issues like inflammation, weight loss, and stress accounted for approximately 20% of liver toxicity cases nationwide:
- Turmeric
- Green tea extract
- Ashwagandha
- Garcinia cambogia
- Red yeast rice
- Black cohosh
While some supplements may be safe, the manufacturer may not be. Ingredient labeling could be way off. Researchers at the University of Michigan discovered that nearly half of the supplements they tested contained ingredients that were not listed on the label. Mislabeling can lead to unexpected side effects, especially when the product contains unknown substances that interact with prescriptions.
Senior author Dr. Robert Fontana, a Michigan Medicine hepatologist, said in a news release, “We performed analytical chemistry and found about a 50% mismatch between stated ingredients on the label and what they actually contained, which is quite alarming. If you buy a supplement and it says it has a certain ingredient, it’s basically a coin flip if that’s true or not.”
Contamination is another concern. Toxic heavy metals were found in some supplements, which pose serious long-term health risks.
Undermining Prescription Treatments
Supplements by themselves may be perfectly safe, but taken with a prescription could render the medication ineffective or toxic. These are some common supplements and the adverse interactions they may have with prescription drugs:
- Vitamin K may reduce the effectiveness of Warfarin, a blood thinner.
- St. John’s Wort has been shown to interfere with effectiveness of antidepressants and birth control pills.
- Calcium and Magnesium may reduce the effectiveness of certain antibiotics.
- Antioxidant supplements, such as vitamins C and E, might reduce the effectiveness of some types of cancer chemotherapy.
Bottom Line
To use dietary supplements safely, individuals need to keep their healthcare provider in the loop about every product they are ingesting. The easiest way to track supplement use is to keep a complete record of all dietary supplements and medicines. The Office of Dietary Supplements website has a useful form, My Dietary Supplement and Medicine Record, that members can print and fill out at home. For each product, there is room to note the name, dosage, timing, and the reason for use. The record can easily be shared with health care providers to discuss what’s best for members’ overall health. Further, there is room to note any side effects, which should immediately be reported to their healthcare provider and the FDA’s Safety Reporting Portal to protect other people from the risk.
Dietary supplements promise great health benefits, but they are not without risk. It is best to stay informed and be transparent with healthcare providers to avoid the negative consequences of supplement use.
