Supplements Don’t Work
There’s something almost mythical about taking a multivitamin. We walk down the isle and pick out the pill that screams “healthy!” the loudest, and then set aside a meditative moment first thing in the morning, or late at night, to make sure that we are the healthiest person we can be.
Sure, they’re expensive, but that’s a small price to pay for health, right?
Supplements may seem like cutting-edge science, but they have been around for centuries. From the sugar pills of Hahnemann, to the infamous snake oil salesmen of the early 1900’s, we have been supplementing our diet with exotic-sounding products which promise to make amazing improvements to our lives.
There are many, many supplements currently on the market. I counted more than 20 different multivitamins alone at the local supermarket the other day, and there were at least 10 other types of supplement to choose from.
There was krill oil, which is apparently better than fish oil, promising to decrease my inflammation, promote heart and brain health, and generally make my life better. There was blackcurrant concentrate, promising “pure and potent bioavailability” which sounds pretty damn cool. There were so many more that I don’t have time to go into.
There’s only one thing similar about all of these supplements.
None of them work.
Where Supplements Fail
It’s at this point that you’re thinking “But (x) said that a supplement had done (y) for them! They must work!”. If you’ve read more on the subject, you might even have a study to back up your claims.
There’s only one thing similar about all of these supplements. None of them work.
It’s important to understand why supplements don’t work. It’s not that none of them have an effect on your health — many of them do. Iron supplements (for example) have been shown to help women who are menstruating feel less tired and exercise more. There are hundreds of conditions (many of them caused by malnutrition) where a supplement might make you feel better, or even help you to be cured.
But that isn’t what a supplement is whispering to you when you pick it up off the shelf. Most people don’t browse the aisle for the best pill to give to their HIV-infected 5 year old. Dietary supplements are sold to us all on the basis that they will improve our health, wellbeing, and ultimately our lives.
This is great marketing, but largely untrue.
Selling a Cure For Life
Fish oil pills have an almost magical significance in our society. It’s been ingrained into me by daytime television and comics of my youth that cod liver oil is a universal panacea for any problem that I might have.
I’m sure you’ve seen the massive buckets of fish oil tablets; health, happiness and wellbeing for less than 50 cents a pill!
Isn’t it wonderful?
Taking fish oil supplements makes a lot of sense. Fish oils have been demonstrated to be extremely beneficial for our health, particularly because they contain fatty acids that are pretty scarce from other foods. And if a little bit of fish oil is good, taking a supplement with a whole bunch of the stuff must do wonders for your health.
Here comes the distinction. There’s some good evidence that taking fish oil (or krill oil if you’re feeling fancy) tablets can help people who have certain conditions. A very large study showed that fish oil tablets can help reduce your risk of stroke and ischemic heart disease if you suffer from high blood pressure. The benefit is very small (about .5% lower absolute risk), but at a population level where lots of people have heart disease that’s pretty significant*. If you’ve got high blood pressure, your cardiologist might advise you to take fish oil tablets as well as your other medications.
But what about the health, happiness and wellbeing? Most people don’t buy fish oil pills for tiny improvements in blood pressure!
This is not from lack of trying. The studies I’ve cited above cover everything from intelligence, asthma, pregnancy complications and more. The only one that was positive for fish oil supplementation was a systematic review that found that there was low-quality evidence suggesting that fish oil supplements may be useful in helping with pain caused by some types of arthritis, but even that was inconclusive.
There’s no evidence that fish oil pills are beneficial for the vast majority of things that people take them for.
In short, the evidence is there, and it’s mostly negative.
Supplementing The Truth
This is a story repeated over and over again. A couple of small studies show a minor benefit for people taking a supplement. The industry starts pumping out the new miracle cure, accompanied by a huge marketing campaign in their often poorly-regulated space. Doctors (and pharmaceutical companies) are interested, and so much bigger studies are done which come back negative.
10 years later, and the evidence is forgotten because we all “know” that fish oil tablets are good for us.
And we spend billions each year on that false belief.
I’m not telling you to stop taking your supplements. But before you take anything, see a doctor. That’s what they’re there for, after all.
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*UPDATE: Since this blog was published in 2017, several new studies have been released showing that fish oil is likely ineffective for treating high blood pressure. So, even the one thing that it might’ve been good for it probably isn’t.