SuppCo | The Supplement Map Has Been Redrawn
SuppCo crossed 900,000 users this week. Across those stacks, we see what people are reaching for in real time.
But a study just published in JAMA Network Open gives us something we can't see internally: 25 years of national data on how American supplement habits have changed. Eleven cycles of the National Health and Nutrition Examination Survey, 63,442 adults, 1999 through 2023.
The headline number?
Approximately 60% of US adults now report taking at least one supplement, up from 51% in 1999. But the bigger finding isn't that more people are taking supplements. It's that what they're taking has completely changed.
The Multivitamin Is Losing Its Grip
From 1999 to 2000, 35% of US adults took a multivitamin. By 2023, that dropped to 31%. At the same time, standalone vitamin use outside of multivitamins rose from 25% to 39%, and standalone mineral use climbed from 18% to 27%.
People aren't quitting supplements. They're quitting the one-pill-covers-everything approach in favor of more specific, single ingredient choices. The science adds more nuance to this shift: a 2013 meta-analysis found no significant reduction in mortality from multivitamin use in randomized controlled trials. A 2024 study that followed over 390,000 people found the same thing. When the broad case for multivitamins seems to weaken, the specific case for individual nutrients deserves closer attention.
The Two Numbers That Define the Last Decade
Vitamin D use in 1999: 5.1%
Vitamin D use in 2023: 29%.
That 5.6-fold increase is the largest of any supplement in the dataset. It tracks almost exactly with the surge in vitamin D research starting around 2009 to 2010, covering bone health, autoimmune disease, and diabetes risk. Vitamin D is the clearest example of science influencing what people actually buy.
The multivitamin is out. Targeted, single-ingredient supplements are in.
Zinc tells a similar story. Use grew from 4.6% in 1999 to 11% in 2023. But the pandemic may have accelerated that climb sharply. Standalone zinc use doubled in the two years after COVID compared to the three years before it. Elderberry and ashwagandha jumped in the same window. From our own data at SuppCo, we know those habits haven't fully reversed. Which suggests the immune-supplement surge wasn't just a panic buy. It changed behavior.
What's New on the Map
Several supplements had no measurable use in 1999 and are now mainstream. In a country of ~270 million adults, these numbers represent tens of millions of people:
Fish oil: 1.4% to 12.0% (6.5-fold increase)
Turmeric/ curcumin: 0.60% to 5.2% (8.6-fold increase)
Probiotics: not measurable in 1999 to 6.7%
Collagen: not measurable in 1999 to 3.6%, grew ~157% from 2015
Prebiotics: not measurable in 1999 to 3.2%
Ashwagandha: not measurable in 1999 to 1.9%
The evidence behind each one varies. Probiotic support for antibiotic-associated diarrhea is backed by multiple RCTs. Hydrolyzed collagen's effects on skin hydration are supported by a 2021 systematic review in the International Journal of Dermatology. These aren't supplements without any science behind them. They're supplements where the science ranges from solid to still early.
What the Evidence Supports
The data shows what people are buying. Here is what clinical research says about which supplements can work, and at what doses:
Vitamin D: 1,000 to 2,000 IU daily for most adults to support adequate levels. Deficiency (commonly considered below 20 ng/mL in the research) may warrant higher doses under clinical guidance.
Zinc: 80 to 90mg via lozenges within 24 hours of first cold symptoms. Zinc can inhibit copper absorption, which is why guidelines generally recommend not to exceed 40mg/day long term.
Omega-3: 1 to 2g combined EPA and DHA daily for general use. Higher-risk patients with cardiovascular disease may benefit from up to 4g EPA based on the 2019 REDUCE-IT trial.
Magnesium: 310 to 420mg daily. Glycinate or malate are forms with higher bioavailability.
Collagen: 8 to 10g hydrolyzed Type I with vitamin C, for at least 8 to 12 weeks for skin. For joints, 10g hydrolyzed or 40mg undenatured Type II… not the same thing.
Ashwagandha: 300 to 600mg of KSM-66 or Sensoril. Avoid during pregnancy.
Where This Leaves Us
The largest increase in supplement use over the past 25 years happened in adults aged 65 years and older, who went from 62% to 78%. That's the fastest-growing group of supplement users in the dataset and it is usually the one most likely to be managing multiple prescriptions at the same time.
78% of adults 65 and older are now taking supplements. That's the fastest-growing group and the one most likely to be on multiple medications.
The NHANES data shows a population that has gotten more deliberate about supplementation overall. The old default of throwing everything into a multivitamin is giving way to targeted choices built around specific health goals. That's a palpable shift, and scientific research is increasingly focused on the same questions.
What the data can't tell us is whether those choices are working. Prevalence is not the same as outcome. Sixty percent of Americans taking supplements doesn't mean sixty percent are benefiting from them. My read of this research is that people are asking better questions than they were 25 years ago. Whether they're getting better answers depends on the quality of information they're working from.
Hopefully we can close that gap next.
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Personal note from Jordan
78% of Americans 65 and older now take supplements. That's nearly four in five people in the age group most likely to be on five or more prescription medications (and least likely to have mentioned it to their doctor). When I saw that number, my first thought was the people I spent years studying: senior Olympians… and yes this is a very real thing.
For most of my research career, I was deep in a niche. Athletes in their 60s, 70s, and 80s competing at an elite level, trying to get bigger, faster, and stronger while fighting everything aging does to muscle, bone, and recovery. Supplements were table stakes in that world. Creatine, vitamin D, omega-3, collagen, magnesium. These weren't wellness products to that population. They were performance tools, used deliberately, with real attention to dose and timing. Those athletes had coaches, sports dietitians, and researchers paying close attention to every choice.
The 78% of Americans 65 and older taking supplements mostly don't have that. They're making the same category of choices with a fraction of the support around them. Getting smarter about which supplements to take is progress. But knowing what to take and knowing what it might interact with are two different problems. If you are over 65 and taking supplements, your doctor should know every single one. The list on your nightstand and the list in your medical chart should be the exact same.