Walk into any retail pharmacy in Singapore, and you’re bound to notice rows upon rows of bottled supplements neatly arranged on shelves.
In 2015, Singaporeans spent almost S$6 million on supplements, and it's a growing figure showing no signs of letting up.
Health supplements include things like:
- Vitamin and mineral supplements (eg. vitamin C, folic acid, calcium)
- Amino acids (eg. creatine, L-lysine)
- Plant extracts (eg. garlic, soy isoflavones, gingko biloba)
- Animal substances (eg. fish oil, glucosamine, shark cartilage)
- Omega-3 fatty acids
Although many products are marketed as being beneficial for health (or even able to cure disease), I don't take any supplements myself, and I'd like to share with you why.
1. You don't need any supplements for better health (or so says science)
You, meaning most people. If you're taking supplements in an attempt to improve your health, surely there must be positive results from previous trials?
Unfortunately, multiple studies and reviews have not demonstrated an overall advantage from taking multivitamin or mineral supplements.
Accordingly, any claims that health supplements can heal and cure are completely unfounded.
Now having said all that, there's a small minority who can benefit from supplements – this group of people tend to be on a very limited diet, such as with strict vegetarians.
Others who may benefit from supplements are those with a poor appetite, or have higher nutrient needs (eg. elderly folks, and pregnant or breastfeeding women).
2. What about Vitamin C for colds, and glucosamine for the joints?
Feeling sniffly in the office? Chances are, some well-meaning colleague of yours will swivel round to hand you some vitamin C tablets "to boost your immunity and prevent a cold from coming on".
Just as common is for elderly Singaporeans to be on glucosamine supplements, which many claim to improve joint mobility and health, especially in those who experience knee weakness.
You already know where this is headed. A double-blind, randomised placebo-controlled clinical trial (that’s quite a mouthful, but basically refers to a gold standard method of assessing whether a treatment is useful) showed that glucosamine supplements have no more benefits than taking a placebo.
This could also mean that it’s probably more of a mind thing for those who find supplements useful.
3. Supplements are NOT regulated in Singapore
Health supplements do not require approval from the Health Sciences Authority to be sold locally, and do not undergo the same rigorous testing process as with medicines (this might hold clues to their effectiveness, I reckon).
Similarly, purchasing health supplements online is a surefire way to land your hands on a product that might be ineffective, unsafe, or even detrimental to your health.
Which brings me to..
4. Supplements can do you more harm than good
High doses of vitamins and supplements may increase your risk of heart disease and cancer.
Furthermore, if you’re on prescription medication for chronic conditions, taking additional supplements can run you the risk of potentially deadly interactions.
For those on warfarin (a commonly used blood-thinner), you need to be especially mindful of taking supplements. Many of them decrease the effectiveness of warfarin, resulting in an increased tendency for blood clots to form.
Examples of such supplements include:
- St. John’s Wort (a herb)
- Omega-3 fish oils
- Vitamin K
All of these supplements are commonly found in supplements sold by retail pharmacies. They may also have adverse interactions with some psychiatric medications.
This online tool can help you quickly identify possible interactions between medications and supplements, but its use does not substitute medical advice from a qualified doctor or pharmacist.
FYI, St. John’s Wort has the most documented interactions with medicines.
5. Supplements are not cheap (!!)
Michael Gannon, President of the Australian Medical Association, once commented that "people who use multivitamins just have very expensive urine".
Vitamin B and C are water-soluble, and hence if provided in excess will be washed out in your pee. B vitamins include folate, thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B6 and B12.
On the other hand, fat-soluble vitamins (everything else that's not B or C) CAN accumulate in your body to detrimental effect when taken in excessive amounts - so don’t be kiasu with your vitamins!
6. This is what you need instead
The Health Promotion Board in Singapore, as well as the NHS (a major health authority in the United Kingdom) have declared no need for supplements if you maintain a healthy, balanced diet.
You can find the recommended daily dietary allowances for Singaporeans here - it’s best to aim for 100%, not too much, not too little!
If you've obtained enough amounts of these vitamins in your diet, there’s no need for extra supplementation. Do bear in mind too that modern diets already consist of products fortified with vitamins, such as milk, bread and flour.
Otherwise, here are a few tips to make sure you're only taking supplements you truly need:
- Inform your doctor or pharmacist on what supplements you are currently taking before they prescribe any new medication (if you can’t remember the names, it always helps to take photos of the product labels, or just bring the bottles with you!)
- Speak to your neighbourhood pharmacist when considering a supplement to improve health, who will be more than happy to advice on which is most suitable for you, considering your needs, lifestyle and diet
- Only buy health supplements from reputable retail pharmacies and stores
I hope this post provides you with useful information that you can share with friends and family. And when in doubt, always discuss your concerns with your healthcare provider!
Sarah is a fully registered pharmacist with the Singapore Pharmacy Council. She’s currently working towards completing a further degree in public health. Things that excite her include a good book, a good cup of coffee and being able to help people use medicines safely.