The vitamin business is booming in the United States, with Americans spending billions of dollars each year — often out of pocket — on vitamins and dietary supplements.

Seniors in particular are big consumers. According to a 2013 poll, 68 percent of Americans aged 65 and older take vitamin supplements. A 2017 study found that 29 percent of seniors take four or more dietary supplements.

While vitamins can be beneficial, there’s scant evidence they can actually prevent chronic disease — to the point that the U.S. Preventive Services Task Force (USPSTF) doesn’t recommend the regular use of any multivitamins.

It’s tough to conclusively pin down the reasons for the vitamin dependency, but a trip to any pharmacy shows that numerous supplements are marketed to seniors.

“When I see my patients coming in for their appointments, they’ll sometimes bring in ads. Or the ones that are more internet-savvy will let me know that there’s some product that they’ve been looking up, touting some sort of benefits, and they’ll wonder what my input is,” Dr. Tanya Gure, a specialist in internal and geriatric medicine at The Ohio State University Wexner Medical Center, told Healthline.

Vitamin products can be a helpful supplement to overall health, but seniors should be mindful that these pills are merely supplements and not a miracle cure, Gure said.

“There’s definitely an emphasis on marketing toward seniors, and I’m mindful of discussing it in an open-minded way with my patients,” said Gure. “To me, I think [advertisers] try to leverage a lot of the common fears that older adults have about memory decline as they age. There’s also advertising about enhancing mobility, reducing pain, and improving a person’s ability to maintain functional independence when walking. Those seem to be the main areas where I tend to get asked for input regarding vitamin supplements.”

The right reasons

Gure said that patients who are interested in taking supplements tend to have the right attitude.

They want to prioritize their health and take proactive steps to maintain their quality of life.

But, she added, it’s important to emphasize that vitamin supplements are generally not the best, or only, way to improve health.

“A perfect example is related to cognitive function,” she said. “Many patients will have concerns about wanting to prevent memory decline, so I will emphasize the things that they’re already doing to help mitigate that. I will also reassure them, because I am a geriatrician, that they can have memory testing, or that in our last review that there were no concerns.”

Another part of the education process includes breaking down the individual compounds within vitamin supplements and recommending a more targeted approach that cuts down on the number of extraneous supplements a person takes.

“I’m often surprised at the number of patients who are taking prescribed medications in addition to these non-prescribed vitamin supplements, so sometimes I’ll emphasize that they can trim back their pill burden by focusing on the medicines that really have a benefit,” she said.

Benefit vs. harm

While multivitamins, taken as recommended, tend to be safe, there are complicating factors with some vitamins, particularly when it comes to older adults or when someone takes too much of a particular supplement.

Like all other health issues, the best practice for patients is to talk with their doctor.

“There are vitamin levels that we will check periodically,” said Gure. “Many of those you can monitor for toxicity, and if it’s getting toward a range where it could be getting toxic, or the high end of normal, then we will advise patients to consider cutting it back.”

Some of the components found in vitamin supplements, or even within the gel caps that contain them, can cause nausea, affecting appetite and causing weight loss, said Gure.

Despite these potential drawbacks, targeted vitamin regimens can still be helpful.

Gure noted that many seniors have low iron levels, and supplements that include iron can help mitigate potential deficiencies.

“A general health maintenance approach would be that you can use any multivitamin that has iron in it on a daily basis, and it probably will be fine,” she said. “But many of those dosing levels are at a recommended daily allowance that’s appropriate. I don’t see that there’s significant risk or hazard in terms of getting too much of something if they’re just using the recommended amount, as opposed to super dosages.”

Keep expectations reasonable

As noted, vitamin supplements aren’t inherently harmful, and can even provide the body with compounds that it’s lacking.

But it’s important for people to realize that supplements aren’t miracle drugs and should be seen as what they are — supplements to a healthy lifestyle.

“I think from a physician’s standpoint, our goal is really to try to support patients in healthy behaviors,” said Gure. “It’s just important to balance those goals that patients have with what is really practical and what really bears out in the evidence and the data. So we try to provide that education and inform patients so that they’re making educated decisions, rather than going off of hype or some ad that’s designed to play on their vulnerabilities and insecurities.”