Every week, patients walk into my consultation room clutching a bag of supplements they've ordered online. Protein powders, greens blends, electrolyte sachets, collagen peptides. The list goes on. And every week, I find myself having a version of the same conversation.
So let me do something a little different here. Instead of another generic roundup of vitamins, I want to give you the honest, clinical perspective that most supplement content never does, because it's written by marketers, not doctors.
What the NHS Actually Recommends
The NHS keeps its official supplement guidance deliberately short. Here's what it currently recommends:
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Folic acid (400mcg daily) for all women trying to conceive and for the first 12 weeks of pregnancy, to reduce the risk of neural tube defects
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Vitamin D (10mcg / 400 IU daily) for everyone in the UK from October to March, and year-round for those who are housebound, wear covering clothing, or have darker skin tones
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Vitamin K, given as an injection or drops to newborns to prevent a rare but serious bleeding condition
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Vitamin D and iron for babies and young children depending on diet and age
That's it. It's a deliberately minimal list, and for good reason. The NHS recommends things when the evidence is strong enough to justify population-wide guidance. But as a practising GP, I'd argue there's a gap between what the NHS formally recommends and what I'm regularly seeing in my patients.
What I Think Should Be on That List (But Isn't)
Here's something I see repeatedly in clinic. A patient comes in feeling persistently tired and run-down. We run bloods. The results come back showing low vitamin D or low B12. We text them. They supplement. They feel better.
That whole cycle of appointment, bloods, results, text and supplement is avoidable for a large chunk of the population. And it consumes NHS resources we simply don't have to spare.
B12 is a particularly good example. In my experience, low B12 is far more common than most people realise, especially in older adults, vegetarians, vegans, and people on long-term metformin (a common diabetes medication). The symptoms of fatigue, brain fog and low mood are vague enough that patients often don't connect them to a nutritional deficiency. A low-dose B12 supplement, widely available and inexpensive, could prevent a significant number of these presentations.
My honest view is that proactive, low-dose B12 and vitamin D supplementation in adults over 45 would reduce GP consultations and improve quality of life at very low cost. The NHS guidance will get there eventually, because evidence-based institutions move slowly by design, but you don't have to wait.
When "Healthy" Supplements Cause Real Harm
A case from my clinic
I want to share something that happened recently, because I think it illustrates a risk that almost nobody talks about in the wellness space.
I saw a patient in their 40s who was doing everything right, or so they thought. They were exercising, eating well, and taking daily electrolyte supplements to stay hydrated and support their performance. On the surface, a perfectly reasonable choice.
The problem was that this patient had mildly reduced kidney function. Nothing severe, just the kind of result that often doesn't even get flagged prominently in a blood test letter. But over time, the regular electrolyte supplementation was contributing to a slow, silent decline in their kidney health, and was likely affecting their blood pressure too.
They had no idea. The product they were taking was marketed as a health product. Nothing on the label told them it might be contraindicated for someone with their kidney profile.
This is not a rare edge case. I've seen similar patterns with elderly patients using hydration tablets, products designed to help with fluid balance, that are loaded with sodium. For someone with declining kidney function, that extra salt load is the last thing they need. And yet these products are sold in health food shops and pharmacies, right next to the vitamins, without any meaningful clinical warning.
A supplement that's safe for most people can be actively harmful for you depending on your health background. This is especially true for anything involving electrolytes, minerals, or high-dose single nutrients.
The Supplement Industry Has a Transparency Problem
I'll be direct here, because I think patients deserve honesty on this.
The supplement industry is largely unregulated in the UK. Companies can legally put a tiny amount of an ingredient into a product and market it as "supporting" a health function. They can create elaborate names like "cellular hydration complex," "metabolic optimiser" or "greens blend" without defining what those things actually mean or providing meaningful evidence for their claims.
And sometimes it feels like the industry profits from your confusion deliberately. You're told you need X, Y and Z every day. You see an influencer taking ten different supplements in the morning. You read that a "greens powder" is essential, but what does that even mean? What's in it? At what dose? Tested against what outcome?
When I developed my own supplement, I started from a completely different question: not "what can we put in this and make claims about?" but "what do adults over 45 actually need, at what dose, in what form?" The result is a shorter ingredient list than most competitors, and that's deliberate. More isn't better. Putting in what's needed, at the right dose, in its best-absorbed form is what actually matters.
My Practical Advice
If you take one thing from this post, make it this: be a more informed supplement consumer. Here's how.
Be sceptical of marketing language
If a product says it "supports energy" or "promotes hydration" without citing a dose or a mechanism, ask yourself what that actually means. If a company can't explain it clearly, that tells you something.
Consider your individual health context
What's safe for a healthy 30-year-old may not be safe for someone with kidney disease, hypertension, thyroid issues, or who's on regular medication. If you have any underlying condition, speak to your GP before starting a new supplement, especially anything involving electrolytes, high-dose vitamins, or minerals.
Start with what the evidence actually supports
Vitamin D in the autumn and winter. Folic acid if you're pregnant or planning to be. B12 if you're over 50, eat a plant-based diet, or are persistently fatigued. These are low-risk, low-cost and evidence-backed.
Don't always wait for blood tests to confirm what you already suspect
If you're consistently tired, your joints are aching and your energy is low, consider trialling vitamin D and B12 supplement for eight to twelve weeks before booking a GP appointment. If it makes a meaningful difference, that's useful information. If it doesn't, then it's worth coming in and investigating further. You might save yourself weeks on a waiting list.
When in doubt, ask a clinician
Not a health influencer. Not the label on the back of a tub. An actual clinician who knows your medical history.
The Bottom Line
The NHS supplement list is short not because supplements don't work, but because population-level guidance requires a high bar of evidence. In clinical practice, I see plenty of patients who would benefit from supplementing before they ever reach a GP, and a handful who have been quietly harmed by supplements they thought were helping.
The gap between those two groups is information. And that's what I'm here to help bridge.
Nothing in this article constitutes individual medical advice. If you have an underlying health condition, consult your GP before starting any new supplement.