Supplements can play a legitimate role in supporting health, but they work best as an addition to a healthy lifestyle, not a replacement for it. According to nutrition expert Claire Turnbull, who has worked in the field for 26 years, the global supplement industry is now worth around US$200 billion annually, and surveys suggest up to 80% of people in New Zealand have used supplements in the past year. Yet many admit they don't know if these pills and powders actually help them, taking them anyway "just in case". Why Are So Many People Taking Supplements That Don't Work? The supplement industry has become a victim of its own marketing success. Consumers are sold the promise that a single pill or powder can deliver better sleep, more energy, stronger immunity, balanced hormones, clearer thinking, improved gut health, and glowing skin. The reality is far more complicated. "If supplements always work the way the marketing suggests, wouldn't we all feel amazing by now?" Turnbull asks. The problem isn't that supplements are inherently useless, but rather that people treat them as a primary solution when they should be a secondary support. Think of supplements as "the sprinkles on the cake," Turnbull explains. They can enhance a good foundation, but they're far from enough on their own. If someone is sleeping poorly, chronically stressed, eating a lot of ultra-processed foods, and seldom moving their body, a handful of supplements is unlikely to solve their problems. At best, they may work as a temporary band-aid. At some point, the root causes of those issues and behaviors need to be addressed and managed before anyone can feel good and function well. When Do Supplements Actually Make Medical Sense? There are specific situations where supplements move from optional to medically necessary or strongly recommended. Pregnancy is one clear example. Women planning pregnancy or who are pregnant are advised to take folic acid leading up to pregnancy and for the first trimester. Iodine is also recommended throughout pregnancy and while breastfeeding to support the baby's brain development and growth, and for some women vitamin D is recommended as well. Certain dietary choices also make supplementation important. People following a vegan diet, for example, need to ensure they get vitamin B12, which can be very challenging to get without animal products. Vegans and vegetarians might also need to consider iron supplementation. Having regular blood tests is helpful for knowing where your iron levels are at, especially if you're feeling tired or run down, as iron deficiency might well be the issue. Medical conditions that affect nutrient absorption also create a legitimate need for supplements. These include coeliac disease and inflammatory bowel disease. Additionally, people who have had bariatric surgery will need long-term supplement support. People on GLP-1 (glucagon-like peptide-1) weight loss medications like Wegovy may also need supplements to support their nutrient intake, as appetite is often significantly reduced and overall food intake can become quite low. Older people with small appetites can sometimes benefit from additional nutritional support as well. Tips for Choosing Supplements That Actually Make Sense - Focus on real food first: It's always best to focus your attention and finances on real food before reaching for supplements. While you can get vitamin C in a pill, getting it from fruits and vegetables brings so many added benefits: fiber, antioxidants, and the many other vitamins and minerals they contain. It is the interconnected matrix of real food that makes it magical. - Consider evidence-based supplements: Beyond clear medical need, there are times when the evidence suggests supplements may be helpful for some people. Omega-3 supplements may be required to meet the suggested dietary target of around 430 milligrams per day for women and 610 milligrams per day for men, especially for those who don't eat fish regularly. Vitamin D may benefit those who have very little sun exposure, people with darker skin, older adults, and those who live in the South Island of New Zealand where sun exposure is limited. - Watch out for supplement stacking: The dose, the form, and time you take supplements all need to be considered carefully. So many supplements these days are a combination of different vitamins, minerals, and other compounds. When you start combining products, something known as "supplement stacking," these little bits can add up to too much and may lead to problems. While some vitamins are excreted if we have more than we need, others are stored in the body and can become toxic if levels get too high. - Evaluate magnesium and creatine cautiously: Magnesium has modest evidence supporting its role in helping some people with sleep and muscle cramps, so it's worth checking out if you have those issues. There are many different forms which work for different things, some better for sleep and others that will soften your stools. Creatine is one of the most well-studied supplements and is considered safe when used appropriately, with strong evidence supporting its role in improving muscle strength and performance, and emerging research suggests it may also have benefits for brain and bones. Turnbull notes that multivitamins deserve special attention. These can have a place in situations where dietary intake is poor or nutritional deficiencies are likely. For example, studies from the University of Canterbury have explored how broad-spectrum micronutrient supplements may support mental health in certain groups. However, if you're mostly eating a balanced, varied diet, multivitamins aren't the insurance policy people often think they are. She suggests spending your money on quality food instead. The supplement industry's explosive growth reflects a real human desire to feel better and live longer. But the path to better health rarely comes from a bottle. It comes from the fundamentals: eating real, whole foods, managing stress, moving your body, and getting adequate sleep. Supplements can support these efforts, but they cannot replace them. Before adding another pill to your daily routine, ask yourself whether you've optimized the basics first.
