Editor’s note: Use of dietary supplements is huge in the United States. More than half of U.S. adults use them and we spend more than $30 billion on them annually. But reports of the benefits/non-benefits of taking dietary supplements vary from day to day. What are we to believe? In this week’s blog, our own Dr. Erik Lundquist, MD, sheds some light on what you need to know when considering taking dietary supplements. Dr. Lundquist is Board Certified in both Family Medicine and Integrative and Holistic Medicine. He frequently incorporates lifestyle therapy, including diet, physical activity, and supplementation to treat his patients with chronic disease.

As a physician who commonly recommends supplements, I’m often asked, “Are supplements really necessary or beneficial?”

According to a survey of 956 adults published in JAMA Internal Medicine, the most commonly reported reasons for using supplements were to “improve” (45%) or “maintain” (33%) overall health. Women used calcium products for bone health (36%), whereas men were more likely to use supplements for “heart health or to lower cholesterol” (18%). Multivitamin-mineral supplements were the most frequently reported products used, followed by calcium and fish oil/omega 3 supplements.

Although there’s a wealth of science behind the benefits of fish oil (to address ADHD, cardiovascular disease and rheumatoid arthritis, for example); calcium (to support bone health), and multivitamins (to slow down aging of cells); and carnitine (to support heart health), recent studies of these and other supplements have brought into question not only their efficacy but also their safety.

With all of these conflicting reports, what are we to do?

First, keep in mind that supplements are just that-SUPPLEMENTS. They’re not meant to replace the benefits of a nutrient-rich, plant-based diet and regular physical activity. They only enhance them. If we don’t improve our foundation then we are unlikely to get much benefit from our supplements.

Second, all supplements are not created equal. There are over 60,000 dietary supplements currently on the market with variable levels of quality and safety. While all supplement manufacturers are required to abide by the Food and Drug Administration’s Good Manufacturing Processes (GMP) standards, there is no standard for scientific evidence or quality of ingredients. However, while not as stringent as the GMP requirements for pharmaceutical drugs, the supplement GMPs are a step in the right direction.

Not sure if the supplement you’re taking is of high quality? The website, Consumerlab.com, reports on whether the contents of popular supplements match what’s stated on the label. Their reports are often surprising-in one recent review they found defects in nearly 40% of multivitamins they reviewed.

Third, just because a supplement is “natural” doesn’t mean it’s “risk-free”. According to a recent Congressional report by the U.S. Government Accountability Office (GAO-13-244), the FDA received more than 6,000 adverse event reports regarding supplements over a 4-year period.  However, this is just a fraction of the nearly 300,000 adverse events due to pharmaceutical drugs reported to the FDA over just 3 months in 2012. Be sure to let your doctor know about any supplements you’re taking, especially if you have an existing health condition. For an interesting article on hidden dangers of some common supplements, see Consumer Reports’ article, “10 Surprising Dangers of Vitamins and Supplements.”

Fourth, our food supply is nearly devoid of minerals and vitamins. When I first started in medical school and even early in my practice, I held firmly to the belief that as long as we focused on eating a variety of plant foods and minimized our intake of “artificial or processed” foods that we would essentially get all of the nutrients and vitamins that we need from our diet.

That view changed once I learned more about modern agricultural and food production methods. Today much of our food is genetically modified, sprayed with larger quantities of pesticides and herbicides than ever before, exposed to heavy metals (arsenic in rice for example), and grown in a topsoil layer that is depleted of nutrients (there are 30 essential elements needed for healthy plants and animals and most fertilizers contain only three: nitrogen, phosphorus, and potassium and only 7% of farmland is considered prime). Then manufacturers process these nutrient-poor foods, adding salt, sugars and artificial ingredients that are wreaking havoc on our bodies.

If all of us could eat a nutrient-rich, organic, toxin free, all-natural, plant based diet we probably wouldn’t need much supplementation. But I know for me that’s not possible, despite having my own garden and eating locally-grown produce.

I recommend that you talk with your physician or a nutritionist who is knowledgeable about supplements who can advise you which supplements can help you optimize your health. The bottom line is that you have to change your lifestyle if you want to become healthy. Supplements are only there to help you along the way.