"Supplements don’t work” is a misguided trope

    Blanket statements help no one.

    Quiz of the week!


    If you Google “do supplements work”, many of the results suggest or straight up declare that supplements don’t work, and are a waste of time and money.

    Sure, many supplements are ineffective in a variety of contexts. But do you know what else can be ineffective in a variety of contexts? Literally anything and everything: pharmaceuticals, diets, surgeries, and so on.

    You should never judge an entire category based on attributes of individual components of that category. That’s a logical fallacy called the fallacy of composition.

    Over the past few years, headlines like these routinely outrank Examine’s pages, even though we dedicate so many resources to ensure the linguistic and scientific accuracy of our content. Examine may not be a university, hospital, government organization, or huge corporation, but our independence and transparency makes us credible. We’re obligated by our founding charter to reject all outside funding or influence. If anybody reading this works at Google and wants to advocate for us, don’t be shy to reply to this message!

    There are a few more important reasons why these headlines are misleading and potentially even harmful:

    1. Only a Sith deals in absolutes

    In the famous Star Wars scene, Anakin tells his former mentor and BFF Obi-Wan, “If you’re not with me, then you’re my enemy.”

    Absolute statements like that are a great way to get attention and make a splash.

    But if you’re looking for truth, the more qualified the statement is, the better. Here’s an example:

    Let’s say Examine had a podcast. (Pssst we’re actually starting one this year, hosted by a couple members of our awesome research staff.) If I hopped on for a few minutes, you’d notice that the tone of conversation would be very unlike a typical podcast. That’s because I’m addicted to qualified statements, which gets annoying.

    Let’s say we’re talking about probiotics. I’m unlikely to even use the blanket term “probiotics”, because each individual probiotic strain has different effects and risks. In fact, I’m dubious about the term “probiotic” itself, since the pro prefix means that it inherently benefits you. Here’s the official definition, according to the International Scientific Association of Probiotics and Prebiotics:

    “Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”

    That’s kind of weird. So what’s a strain called if you personally take an adequate amount and there’s no health benefit, or maybe there’s harm? Can a probiotic lose its title if a new study finds that it doesn’t work for its main indication? I’d rather they were called ingested microorganisms (maybe we can call them IMOs?), but I have a feeling that wouldn’t catch on.

    Here’s another example. Let’s say we’re talking about an extreme diet. I’ll rarely call a diet extreme in the first place (except maybe breatharianism), because in my mind, extremeness is context-dependent, and “extreme diet” is sort of a pejorative that stacks the conversational deck against constructive discussion.

    You can see how annoying I am. People want to know what works; they don’t want to get stuck on finding the absolute most precise terminology. They want confidence, not someone who’s rarely certain of their viewpoint.

    Examine is full of researchers who question everything and wouldn’t dream of generalizing just to make a convincing point.

    We don’t even say that any particular supplement “works” — we only say that the evidence currently supports usage for one or more specific, measurable health outcomes. And your mileage will certainly vary, as supplements rarely work for each and every participant in a controlled trial setting, let alone real life.

    In summary: absolutes may sell, but to Examine, they’re absolutely incorrect.

    2. Common supplements have lesser-known uses

    The claim “supplements don’t work” is flawed in more than one way: it doesn’t take into account that every year, new uses are found for existing supplements.

    A good example is creatine.

    Creatine was among the most popular muscle-building supplements in the 1990s, and then, all of a sudden, its other potential uses began to be studied in earnest, especially brain-related ones.

    When your muscles need more energy than is readily available, they turn to creatine. The same is true of your brain.

    Your brain sucks up about 20% of your overall energy needs despite being about 2% of your body weight. Energy flux can be a limiting factor for the brain when it’s trying to adapt to certain situations.

    While creatine isn’t a slam dunk for brain related outcomes (but what is?), there’s an increasing amount of evidence for creatine potentially improving cognition, depression, and recovery after traumatic brain injury. These potential benefits are all highly context-dependent though, so don’t expect to take creatine and find brain-related benefits as easily as you’d get its muscle-related benefits.

    Much of creatine’s non-muscle potential benefits were totally unknown as little as 10-20 years ago. So when search engines boost messages like "supplements don't work," they’re glossing over exciting new areas of research and decreasing the usefulness of search results.

    3. Supplements can be more useful than even Examine readers know

    I was at an airport one day, and a toddler got all up in my space. Not knowing that I love little toddlers, the mom apologized profusely.

    We got to talking (me and the mom, not me and the toddler), and she had a very interesting and unfortunate background.

    After being diagnosed with an incurable genetic eye condition that would progressively reduce her field of view (called retinitis pigmentosa), she completed a PhD program to help advance research on this condition.

    After the conversation ended, I immediately looked up studies on retinitis pigmentosa. There weren’t any gene therapies or devices yet shown to slow progression. But three supplements had a moderate amount of trial evidence for slowing progression: vitamin A, lutein, and DHA.

    That kind of knocked my socks off. These are low-cost, widely-available, and safe supplements with potentially life-changing benefits.

    You may be thinking that supplements for rare conditions aren’t very applicable to you. Perhaps this doesn’t apply to more common conditions that you’re at risk for.

    But even within the field of eye conditions, there’s a good example of a common condition.

    Age-related macular degeneration (AMD) affects around 1 in 10 Americans. In 2001, a landmark trial showed that taking a specifically-formulated high dose vitamin and mineral supplement significantly reduced the risk of developing advanced AMD.

    Clickbait headlines such as “Don’t waste time (or money) on supplements” may be eye-catching and rank highly on Google, but they have important downsides.

    This kind of message may turn people off from exploring tested and useful options for their health conditions and health goals, or prevention of a future health condition.

    It’s also a great example of language that scientists don’t (or shouldn’t) use, so seeing this kind of language on esteemed university websites is off-putting. Do better, non-Examine headline creators!

    As always, let me know if you liked or hated this email.


    Kamal Patel
    Co-founder, Examine

    Quiz of the week


    Answer: True

    In a 2-year randomized controlled study, daily multivitamin supplementation improved episodic memory, but not executive function or attention, in a cohort of older adults. However, it’s not clear which specific vitamin(s) or mineral(s) in the supplement were responsible for the cognitive benefits in this study. Moreover, analyses regarding the study’s secondary outcomes (i.e., episodic memory, executive function, and attention) were not adjusted for multiple comparisons, so these findings should be considered exploratory. Read more about the study