Which vitamins and supplements actually work?

St. John’s wort makes the cut, but stop wasting your money on raspberry ketones

by Julia Belluz

Jon Feingersh/Blend Images/Getty

There’s a tendency to divide the world of pills in two: evil pharmaceuticals and nice supplements. When we’re looking at the outrageous claims on the labels of supplements—that they’ll help us lose weight, clear-up acne, live long lives—we somehow forgot that the natural-health business is a business like any other, and that in Canada, while there are loose regulations around these products, they are not necessarily safe or effective.

Unlike pharmaceuticals—which admittedly have their own evidence problems—”natural” pills don’t undergo rigorous testing before they reach the market. So some of the claims about them are simply lies or not based in good science. As Dr. Edzard Ernst, one of the world’s foremost experts on the evidence for alternative complementary medicine, told Science-ish: “It is a myth to assume that the supplement industry behaves any differently from any other industry. It is about making money, and all too often people are less than responsible in the pursuit of this aim.”

The good news is that there is strong evidence to either back or refute some common notions about supplements. Science-ish sifted through the research to identify indications for capsules that have compelling science behind them. Here’s the Science-ish guide to supplements:

Antioxidants for preventative health
Don’t mean to be alarmist here but the evidence suggests antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) may actually kill you quicker.

Vitamin C for colds
This is a myth. As Science-ish has explained in the past, this regularly updated Cochrane review on vitamin C and the common cold shows that popping these pills every day does nothing to prevent colds and only maybe shortens their duration.

Vitamin D for a range of indications
From combating chronic pain to staving off cancer, this celebrated supplement seems to be recommended for everything. Unfortunately, the evidence for most vitamin D-related claims is weak. It doesn’t help reduce the risk of a range of cancers. There’s little evidence that these pills can alleviate chronic pain. As well, no link has been found between vitamin D and reductions in blood pressure, improved cardiovascular outcomes, and the prevention of fractures in older women. People whom vitamin D can help: those who have tested positive for a deficiency.

Evening primrose oil for a range of indications
In a word: useless. Read here about uses for menopausal symptoms, here about eczema, and here about premenstrual syndrome.

Glucosamine for osteoarthritis
According to high-quality studies, these supplements appear to help manage pain and improve physical function in people suffering with this joint disorder.

Melatonin for jet lag
Melatonin supplements are the closest thing we have to a cure for jet lag. As a 2009 systematic review pointed out, “Melatonin is remarkably effective in preventing or reducing jet lag, and occasional short-term use appears to be safe.” What’s more, melatonin may also be effective for treating a number of sleeping problems, as well as cluster headaches.

Probiotics for gut health
For some very specific indications—managing diarrhea in hospital settings or antibiotic-induced diarrhea—probiotics seem to be helpful. But despite their popularity for improving gut health, the jury is still out.

St. John’s wort for depression
The use of this stuff to manage depression is actually backed by strong evidence. A synthesis of 29 studies in over 5,000 patients from several countries found that those who took the plant extract in the trials “were superior to placebo, similarly effective as standard antidepressants, and had fewer side effects than standard antidepressants.”

Weight loss supplements
Lies, damned lies. Raspberry ketones, green coffee beans: don’t waste your money! If there was a tablet that could help with weight loss, we would not be in the midst of an obesity epidemic. In fact, Science-ish has yet to come across claims about a weight-loss supplement that are backed by good evidence. As a general rule, when a study about one of these “fat busters” suggests it’s effective, that’s probably because the experiment was poorly designed or it was done in animals or cells but not in people.

Your supplement of choice isn’t listed here?
Check out this user-friendly, science-based website for more information about a range of supplements.

Science-ish is a joint project of Maclean’s, the Medical Post and the McMaster Health Forum. Julia Belluz is the associate editor at the Medical Post. Got a tip? Seen something that’s Science-ish? Message her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto




Browse

Which vitamins and supplements actually work?

  1. Although the scientific evidence for these compounds taken as supplements (in pill or capsule form) is not very strong, getting these compounds from your food in a well-balanced, plant based diet (which includes meat, fish, whole grains, and dairy) is VERY advisable!

  2. YAY – LOOK HOW GREAT BIG PHARMA TESTING IS! IT’S SO SAFE AND AMAZING!

    http://247wallst.com/2010/12/10/the-ten-worst-drug-recalls-in-the-history-of-the-fda/2/

    Science-ish <– you got that right, you are only an "ish". Have you taken Bio-Chemistry or Nutrition courses at all? Have you ever submitted a label claim to Health Canada? Do you know how many clinical trials are done on ingredients before a claim can be made? Do you know what an NPN is? Have you ever had a serious condition be attempted to be treated by big pharma, only to have something simple and natural change your life?

    Have you looked into how many DEATHS have been cause by pharmaceuticals compared to natural supplements? You don't seem to point any blame on that industry, which is truly about making money and only money. Of course supplement makers need to make money, money gets the best ingredients, the best manufacturers, the best marketing budget to educate consumers. No natural heath ad has to have a narrative speed through all the possible adverse side effects for 1 minute.

    Sounds like you are just another person in big pharmas pocket, helping to keep north americans dumbed down, with no power. Just helping to herd the sheeple.

    • I’m gonna go out on a limb here and guess that you work in the “natural health” industry. So when you say “No natural heath ad has to have a narrative speed through all the possible adverse side effects for 1 minute”, I’m going to assume you know that the only reason that’s true is because there’s no law which mandates it.

    • Please refute the actual evidence linked to above with your own evidence. Also, if you knew this publication you’d know the expose they recently did on the poor tracking system within Canada on negative prescription side effects. Take a pill as it were!

      • I’m the opposite – tried all that stuff, just got worse, finally got approved for one of Big Pharma’s Big Buck meds – doing 100% better. Side effects, there are risks, haven’t had any (yet), but not being too ill to do much of anything was worse.

        • scratch “not” being to “being to ill to do much…”

      • That’s it. Change the topic. Not very convincing (and a logical error known as the red herring).

  3. I’ve got the inside scoop on the secret to fat-busting weight loss : watch your calories and get some exercise.

    • Derek is so right-it is the only health safe way to lose weight. I am following the meal plans for Diabetics and have lost 10lbs plus in a month. Reduce carb intake, have smaller meal portions and a daily 40 to 60 minute walk, and the weight drops off. It’s not rocket science- just plain, good old common sense. Try it!!

  4. All right!! This is the opposite of ANOTHER article which says taking a multi every day staves off certain types of cancer. Fed up with media on nutrition, really.

    • That article said that taking a multi-vitamin everyday showed a mild protective effect against cancer for older healthy men. It also emphasized that the cancer risk-reducing effect was pretty small compared to exercise and healthy diet! I can understand how the nutrition media can be frustrating, but I think it is generally it’s because journalists read scientific articles and don’t always understand the information or properly present the context.

      • So you are arguing against Susan’s comment that another article claims taking multi-vitamins staves off some cancers but saying that her article claims that the cancer risk-reducing effect was noticeable but, in your view, small. In short, if multi vitamins work. You not only are not very convincing but you are making yourself look foolish.

        • No, I don’t think this sounds foolish at all. How can you refute that a healthy diet and exercise isn’t better than popping a multi-vitamin that claims to be a one-stop-shop of all your daily vitamin requirements?! Isn’t it perplexing that multi-vitamins are generic, essentially presupposing that all our needs are essentially the same? Multi-vitamins may be great for those living in impoverished countries where optimal nutrition is not an option. We are SO lucky to have access to all the natural vitamins we need. Flooding your body with unnecessary chemicals leaves your body with the task (as if it doesn’t have enough to deal with!) of excreting what it cannot use – and with fat-soluble vitamins, well, they can just build until they reach toxic levels. There are numerous medical reports that have been published recently that have ascertained that certain supplements may in fact excite and fuel cancer cells – so why play with fire? It’s always best to err of the safe side and have your bloodwork tested to determine any deficiencies instead of trying to overload your body with synthetic junk. Think about it logically. Our best line of defence against illness is a balanced diet, regular exercise, routine visits to the doc, and a happy state of mind! Nobel Prize please :)

          • “Think about it logically”. I agree. The article apparently said that there were measurable, noticeable cancer-reducing effects to taking multi-vitamins. Your plea for healthy diets and exercise instead is merely a red herring logical fallacy as you try to change the topic to one you agree with. By the way, the prospects of being able to have a healthy diet diminishes as more GMO foods including meat and fish are produced, not to mention contamination of the food supply with pesticides, herbicides and anti-biotics, plus the injection of fat-producing compounds into animals. Your so-called healthy diet is actually poisoning those who eat it and impairing their immune functions. In addition, as the population ages, seniors’ incomes will decline leaving them unable to afford the unhealthy food you are promoting. Better they should take a multi-vitamin.

      • Your arrogance at claiming to be one of a select few able to read scientific articles is noted. As for your promotion of a healthy diet, there is no such thing as a healthy diet any more. The prospects of being able to have a healthy diet diminishes as more GMO foods including meat and fish are produced, not to mention contamination of the food supply with pesticides, herbicides and anti-biotics, plus the injection of fat-producing compounds into animals. Your so-called healthy diet is actually poisoning those who eat it and impairing their immune functions. In addition, as the population ages, seniors’ incomes will decline leaving them unable to afford the unhealthy food you are promoting. Better they should take a multi-vitamin.

  5. Secret – quit eating wheat, and read Wheat Belly. Also stop rye, and barley; gluten causes a ton of problems.

    • I’d like science-ish to look at that one. The evidence is thin at best.

  6. I always find it difficult to read an article on natural health and supplements by someone who apparently has little first hand connection with either.

    All you have to know is that the majority of supplements are synthetic and thus not nearly as helpful as they could be, and perhaps even harmful. Most tests are done with these synthetic supplements.

    Whole food supplements provide a full range of photo nutrients that aren’t found in synthetics and can really be helpful.

    As for the writers statement that supplement companies are guided by making money just like big pharma, my experience is that is only partially true. Some are, especially the larger ones owned by Big Pharma companies. Centrum would be an example of a poor quality vitamin that exists to make money and has little health benefit. Stay away.

    However, many smaller, owner operated supplement companies are committed to making high quality supplements that provide nourishment not found anywhere else.

    My firsthand experience is that taking natural, whole food supplements makes a huge positive difference, causes no problems and allows me to live my life to it’s fullest. Two months shy of 65 I take no meds and all my tests are normal, I play hockey twice a week and other than normal aches and pains, I feel good.

  7. A very poor article.
    Natural supplements that have been used for thousands of years are already tested by life.
    Much better than the garbage modern medicine have dreamed up. Many have so many side affects that they are clearly dangerous.

    • Um. Is it any wonder that the average life expectancy has increased astronomically in the last 100 years? And is it a coincidence that major breakthroughs in modern medicine have been made in the last century? Sure, there are side effects to pharmaceuticals but do you even realize how many lives, say, penicillin has saved? I’m not exactly pro-pharmaceutical but I can’t even count on my fingers and toes how many people I know that have lived or are currently living longer and more qualitative lives due to “garbage modern medicine”. Cost-benefit analyses are always to be considered before taking medication. You mustn’t generalize modern medicine to be garbage – that is insulting to people working in the medical discipline. Good luck to you and your faith in “natural” supplements…by the way, not to sound patronizing but I hear oil of oregano is good for respiratory health. Maybe give it a go if you ever get pneumonia? Don’t forget to sprinkle some garlic on that – I hear it’s good for raging infections. Good luck to ya!

  8. Didn’t have a cold for 25 years, but I guess it wasn’t because of the vitamin C. Darn!

  9. The medical system (side effects of pharma drugs, botched surgeries, infections contracted in hospital) now kills more people in the US every year than heart disease, or cancer, or traffic accidents. Conversely, vitamins and herbal supplements have never killed anyone. But watch out for those deadly vitamins!!!

    • Dear Jim,
      That non-number that you just quoted came from a survey of three American hospitals in one city, in one year (sometime in the early ’80′s, if I recall), which was then extrapolated to include all American hospitals, and then scaled up based on the number of hospitalizations each year; it also just counted the number of people who died in hospital, not who died due to some failure of the system. When alt med people quote the “number” of people that they claim are killed (not die, but are killed) in hospitals every year, it usually ends up being more than the actual number of Americans that die every year. It makes a great big scary number that has absolutely no basis in the real world. [The reason I don't include the number is that it depends on who's decided to "quote" it and how they've decided to manipulate it mathematically].
      I strongly recommend that you and anyone else who reads the alt med literature engage your skeptical side and ask yourself whether what they say really makes sense – and whether they have something to gain from giving you a one-sided perspective on health care. If they’re linking to stuff in their online store as they tell you how horrible the doctors and pharmaceutical companies are….

    • While there is certainly room for improvement in the healthcare system, it saves millions of lives and to simply pass it off as being harmful completely misses the many essential benefits. I would also contend that while vitamins and supplements have never directly killed anyone, the false promises often made by the manufacturers of alternative remedies (at higher margins than many pharmaceuticals) have very likely caused people to defer from getting modern/science-based help until it was too late (Steve Jobs comes to mind). In this respect, there is harm caused by unproven alternative medicines but carry on popping the supplements. They are not illegal.

  10. Hello Julie. Has it occurred to you that “science-based” sources have agendas that drive, read pre-determine, their “conclusions”? They are promoting science and their truncated version of rationality as the ONLY ways of knowing. They are promoting the established allopathic medical system of drugs and surgery and therefore are focused on the disease after it has become established. They do not focus on prevention because they don’t make any money from that. So much for, “First, do no harm”.

    Next time, trying using Aurvedic sources. Aurveda, as a discipline, has been around saving lives for many centuries longer than the western model.

  11. I won’t take what he’s taking, because looking at the picture, it looks like a man with boobies

  12. First of all, it’s illegal for supplement manufacturers to place health claims for products on the bottle or anywhere else. In fact it would be illegal for a bottle of water to have a label stating that it “prevents dehydration”. Where in the world do you get your info., Julia?

    Oh, wait, from people like Edzard Ernst? This guy has been trying to make a name for himself bashing non-mainstream medical treatments for years and has performed no original research whatsoever while attempting to discredit the work of others. The Cochrane Collaboration he ain’t.

    There are 2 studies on PubMed (for example) that show a positive effect for green coffee bean extract on weight loss. Why are you misleading readers?

    There is a whole body of peer-reviewed research, not to mention ongoing research into the phenomenal impact of gut flora on the immune system — in fact,it comprises about 80% of our immune system. It becomes seriously compromised when someone takes antibiotics, especially for non-life-threatening conditions.

    Medline, the resource you refer people to, has precious little info. on nutraceuticals, despite repeated requests from researchers to archive tens of thousands of peer-reviewed studies!

    With all the lawsuits and recalled pharma products over the last decade (never mind going back 50 years) please don’t insult our intelligence by inferring that this crap actually undergoes “rigorous testing”. There is so much wrong with how pharma companies manipulate their data to squeak their products into the marketplace there are now outright calls to have these tests conducted independently by outside labs.

    People can access over 40 years and at least 50,000 peer reviewed studies at the Journal of Orthomolecular Medicine website http://orthomolecular.org/library/jom/

  13. I have liked your article very much.Most of the people are not aware of these facts.
    Thanks for sharing this information with us.

  14. NOW really, you have like Dr. Oz! TV’s medical pitchman. He needs to go back to work at the hospital. Not bad for a Turk lol

  15. I found a supplement called Makardhwaj. It’s absolutely marvelous stuff. It’s full of mercury and great for your health.

  16. It’s just to thieve your money. None of the products actually work.

  17. There were lots of supplements and vitamins in the market now a days. We should be really careful in choosing what’s best for us. It’s much better if we consult our physician first.
    ________________
    Ct Driveway Paving Contractors

Your email address will not be published. Required fields are marked *