By Carolyn Crist

(Reuters Health) – Most people don’t need to take vitamins or nutritional supplements because they can get all the nutrients they need by eating a healthy diet, a new patient resource published in JAMA Internal Medicine underscores.

Nevertheless, there are more than 90,000 supplements on the U.S. market that include a wide range of vitamins, minerals and chemicals, and many of them don’t live up to their advertised health benefits, the author writes.

“Anybody who works in healthcare comes across folks who are taking numerous supplements and spending a lot of money to do so,” said Dr. Michael Incze of the University of California, San Francisco, who wrote the one-page primer for patients.

“Direct-to-consumer advertising and even popular media suggest benefits, but many of the claims have been disproven,” he said in a phone interview. “There’s a lag between medical recommendations and popular culture, and people become reluctant to give them up.”

Available for free, the new patient page ( offers practical advice and answers to questions about vitamins and nutritional supplements that patients often bring up with their doctors. The resource includes facts about how little safety testing and regulation there is on these products.

“The supplement industry is like the Wild West right now,” Incze said. “There’s not much regulation that happens before companies put these products on the market.”

The products often advertise health benefits such as improved thinking, better heart health and a stronger immune system, and for years, doctors have recommended certain supplements such as fish oils and multivitamins. However, medical research doesn’t tend to support the claims, he writes.

Most basic vitamins and minerals are presumed safe at the recommended doses, but bad reactions are possible. About 23,000 emergency department visits each year are related to nutritional supplements, often resulting from toxic ingredients such as heavy metals, steroids and stimulants, Incze writes.

“With supplements that come from overseas or certain stores in the U.S., it can be hard to know what’s in them, and some have strong medicines or potent steroids mixed in,” he told Reuters Health.

Although the U.S. Food and Drug Administration oversees the vitamin and dietary supplement industry, the products are assumed to be safe without testing, unlike prescription drugs, which undergo an approval process. This lack of upfront safety and efficacy testing often makes regulation of the market impossible, Incze writes.

In the U.S., people who generally eat a balanced diet already receive the vitamins and nutrients they need, and the body is typically better at absorbing nutrients from food than from supplements, Incze writes.

Likewise, vegetarian, vegan, gluten-free, paleo and other special diets generally provide adequate nutrients without a need for supplementation. Although vegans face a risk of vitamin B12 deficiency, almond milk and other replacements are usually fortified with the vitamin to ensure adequate daily intake, he notes.

In fact, even those who eat out somewhat regularly or have less-than-stellar diets likely consume what they need simply because foods in the U.S. are often fortified, said Dr. Pieter Cohen of the Cambridge Health Alliance in Somerville, Massachusetts, who wasn’t involved in the patient resource.

“More than half of adults in the U.S. use some type of supplement, and it’s important to take a moment and think about what we’re actually putting into our bodies,” Cohen said in a phone interview.

Over-the-counter drugs require label information about ingredients, directions for use and potential adverse effects. Supplements should have similar labeling, he said.

“What we need to work on is this regulatory framework,” he said. “Consumers should have the information they need to make wise choices.”

SOURCE: JAMA Internal Medicine, online January. 7, 2019.