With more than 100,000 dietary supplements sold in the U.S., the aisle of your local pharmacy or grocery store can be a perplexing place. And the hard-sell and hype around those supplements are endless.
Clinical pharmacist Erica Godley, whose job includes counseling patients at Novant Health Agnes B. and Edward I. Weisiger Cancer Institute in Charlotte on the safe use of supplements, says most Americans don’t need a supplement: They get the nutrients they need from the foods they eat.
But, she added, supplements can fill the gap when diet is poor or when certain health conditions or medical treatments leave the body without all the fuel it needs to function. Nutritional shortfalls can disrupt hormone levels, put bones at risk, make it harder to fight inflammation, and cause problems with sleep and mood.
Of course – and you’ve heard this before – check with your doctor or a pharmacist before you start any supplement to guard against possible reactions with other drugs you’re taking or other issues.
That said, these five are worth considering.
Good health starts with a visit to a primary care physician.
1. Melatonin
Some medications – beta blockers used to treat heart problems and control blood pressure, for example – can suppress the body's production of a hormone called melatonin, disrupting the body's internal clock. This can also occur when you travel across time zones.
Taking a melatonin supplement 30 minutes to one hour before bedtime may help you get to sleep. It’s often recommended to counteract the effects of “jet lag.” Godley recommends a very low dose — starting with 1 milligram (mg) up to a maximum of 5 mg. But talk to a pediatrician before giving it to a child. It is not appropriate, she said, for kids who just don't want to go to sleep, but it may benefit those with autism or attention deficit hyperactivity disorder (ADHD).
2. Magnesium
About half of Americans – especially teens and seniors – may not get enough magnesium in their diet. It's found in dark leafy greens, beans and seeds – especially pumpkin seeds. Magnesium not only plays an important role in bone health, but it is also a natural muscle relaxant and can promote a more restful sleep. Certain types of magnesium can help with constipation.
But conditions like diabetes and inflammatory bowel disease and medications called proton pump inhibitors that combat stomach acid can lower the body's magnesium levels, increasing the risk for the bone disease osteoporosis. Godley noted that magnesium comes in several forms. Ask a pharmacist or your doctor which may be right for you. The recommended dose of magnesium is 310 mg to 420 mg per day for adults.
3. Vitamin D
The sunshine vitamin is also essential for strong bones. "If you are a healthy adult getting 20 minutes a day outside in the sun without sunscreen, then you probably don't need a vitamin D supplement," Godley said. Otherwise, she added, you probably do.
Vitamin D deficiency increases the risk for osteoporosis, heart disease and poorer outcomes during cancer treatment. Godley recommends a supplement for people who may not absorb vitamin D well, including those who are dark-skinned, obese or living with conditions such as cystic fibrosis and pancreatic disease. Another way to get the vitamin D you need is to include fortified cereals, milks, orange juice and salmon in your diet.
4. Curcumin
The active ingredient in the spice turmeric, curcumin helps fight inflammation. Godley often recommends it to people who have inflammatory conditions such as osteoarthritis, ulcerative colitis and non-alcoholic fatty liver disease. It's sold both as curcumin and as turmeric, a great spice to include in the diet for its anti-inflammatory properties. But you'll find a more concentrated amount of the beneficial compounds, called curcuminoids, in a curcumin supplement, Godley said. Shop for products with 95% curcuminoids. She said the best ones come from the root or rhizome of a curcuma longa plant — look for that on the label.
How to report problems
If you have an adverse reaction to a dietary supplement, the U.S. Food and Drug Administration wants to hear about it. You can report it online.
5. Ashwagandha
Pronounced ash-wa-GON-da, and also known as Indian ginseng, this herb is an adaptogen, a substance that helps the body cope with stress. It has been found to ease anxiety, help users fall asleep faster and sleep better. It's sold in several forms. Godley recommends choosing a root extract with at least 1.5% withanolides, the active component. Take it later in the day, Godley recommended.
And, finally, if you are unable to get all of the nutrients you need through your diet because of food allergies, health restrictions or picky eating habits, a daily multivitamin supplement may help, she said.
As with any supplement, choosing products with the "NSF Certified" or "USP Verified" seal will ensure that you're getting what you pay for, Godley added.
Have a question about a supplement? The Office of Dietary Supplements at the National Institutes of Health has probably heard – and answered – it before. Check out their FAQs and resources.
Wonder what vitamins and minerals you need – and how much of each? The National Agricultural Library has a calculator that will gauge your needs based on your age, activity level, height and weight.
