Supplements have never looked more seductive. Instagram and TikTok Shop feeds are overflowing with capsules and powders promising glowing skin, deeper sleep, balanced hormones, sharper focus—and sometimes all of the above. What was once the domain of naturopaths and dedicated fitness enthusiasts has become a $177 billion global industry projected to nearly double by 2030, according to Grand View Research.
And we’re consuming them at unprecedented rates. In 2023, the Council for Responsible Nutrition Consumer Survey found that approximately 74% of U.S. adults say they use dietary supplements, with 55% qualifying as regular users—and 92% of those users believe supplements are essential to maintaining their health.
As I inch deeper into perimenopause, I’ve felt the impulse to fill the gaps—energy, sleep, mood, and focus. But the deeper I looked into the supplement space, the more it felt like a well-intentioned but largely buyer-beware ecosystem.
I’m not anti-supplement. But like many women entering a new hormonal era, I’m asking harder questions: What am I putting into my body? Does it work? Is it safe? And who is looking out for consumer safety?
What Exactly Are Supplements?
Under U.S. law, supplements are defined as products meant to “supplement” the diet—a broad category that ranges from multivitamins and minerals to protein powders, botanical extracts, probiotics, hormone-support blends, adaptogens, and longevity compounds. These fall into several core categories—nutritional, botanical, performance, and condition-specific—each with its own promise and pitfalls.
“Supplements can absolutely play a supportive role—especially when they correct what’s missing, like vitamin D or magnesium. But they must not be mistaken for primary medical treatment. Used with intention, and in coordination with a clinician, they can be beneficial,” Vanessa Coppola, DNP, FNP-BC, MSCP, licensed nurse practitioner and board-certified menopause practitioner, explains to me over email.
In other words: supplements can help—but they’re not magic wands.
How Supplements Are Monitored (And How They Aren’t)
CLP Holistic Health
Edward Fury
Unlike pharmaceuticals, supplements fall under the 1994 Dietary Supplement Health and Education Act (DSHEA)—a framework that gives companies broad freedom to self-regulate. They do not need FDA approval before hitting shelves, and oversight typically occurs only when something goes wrong.
“DSHEA doesn’t require the FDA to approve supplements before they’re sold. Quality and safety become the manufacturer’s responsibility—and not all companies take that seriously,” nutritionist Toby Amidor, MS, RD, tells me over email.
The gaps show up in real-world testing. Recent analyses continue to find inconsistencies between what’s on the label and what’s actually in the bottle. In one 2023–24 review of weight-loss supplements, 82% had inaccurate labels—and none carried a third-party certification seal. While that study focused on a single category, it underscores how limited verification can be across the broader market.
Andrew Shao, Ph.D., SVP of Global Regulatory & Scientific Affairs at Niagen Bioscience and the makers of Tru Niagen (patented nicotinamide riboside), believes the policy is outdated. “DSHEA hasn’t been updated since 1994—and it was written before the explosion of the modern internet. Today, anyone can launch a product online. AI will only make deceptive marketing easier. Without policy reform, this problem will worsen.”
When ‘Safe’ Isn’t So Simple: Recent Supplement Scares
Even supplements perceived as harmless have made headlines, reminding us that “natural” doesn’t always equal risk-free. Recent studies highlight how complex supplement safety can be.
Melatonin and Heart Health
A 2025 observational study presented at the American Heart Association’s annual meeting found that long-term melatonin users had significantly higher rates of heart failure and hospitalization compared to non-users. The study can’t prove causation, but it highlighted a bigger issue: melatonin is sold OTC in the U.S. with no standardized dosing and no pre-market safety testing.
Contaminants in Popular Powders
Independent testing has also detected heavy metals like lead and arsenic in certain greens powders—an issue tied to soil contamination and inconsistent testing requirements.
Botanical Blends and Liver Injury
Herbal “detox” and weight-loss products continue to appear in FDA adverse-event reports, often due to contamination or interactions with medications.
These incidents don’t mean supplements are unsafe across the board—but they reveal how often problems surface only after consumers report harm.
Supplements And The Trust Economy
Ancient + Brave
In a marketplace this noisy, trust has become its own form of currency. Consumers analyze labels, chase “clinically proven” ingredients, and Google unfamiliar terms—but still must rely heavily on brands to tell the truth.
Some companies are leaning into transparency. “Getting certified as a B Corp wasn’t a marketing badge—it was a framework for embedding purpose into sourcing, governance, and transparency. When we certified in 2021, our score of 107.3 was the highest of any U.K. supplement brand,” says Kate Prince, founder and CEO of Ancient + Brave.
Others emphasize scientific rigor. Shao explains, “Our ingredient, Niagen, has been reviewed by the FDA under the NDI program and listed as Generally Recognized as Safe. It’s been featured in 40 peer-reviewed human clinical studies—over 95% independently funded. We publish all of our certificates of analysis openly.”
Switzerland’s Clinique La Prairie, one of the leading longevity clinics in the world, has also recently entered the supplement space with its CLP Holistic Health line, rooted in clinical research. “We work with Swiss research labs and evaluate ingredients through in-vitro and in-vivo studies,” Olga Donica, Director of Longevity Science and Innovation tells me. “Bioavailability, delivery format, and traceability matter just as much as the ingredient itself.”
Not all brands can operate this way—but the ones that do are setting a higher bar.
The Boom—and the Blind Spots With Supplements
Three categories, in particular, are booming so quickly they’ve become especially vulnerable to hype. The menopause and hormone-health market is expected to reach roughly $24 billion by 2030, according to Grand View Research. Longevity boosters such as NAD+, NMN, spermidine, and polyamines are gaining momentum despite varying levels of human data. And gut-health supplements now dominate wellness culture, even as science often lags behind marketing.
“This is a perfect storm for predatory marketing. Some supplements have supportive roles, but no pill can replace individualized menopause care. Women should demand evidence—and be skeptical of anything that claims to ‘fix’ hormones naturally,” Coppola tells me.
“The gut–brain–immune axis is evolving fast, but many detox or reset claims oversimplify a very dynamic ecosystem. The strongest evidence supports nutrients and compounds that work with our biology,” adds Jenna Macciochi, PhD, Director of Science & Innovation at Ancient + Brave.
“Disparities in quality practices and regulatory enforcement across the industry result in significant variability in product quality,” explains Shao. “We test top-selling NAD+ and precursor products on Amazon for label claims, and results are troubling: nearly three out of four NMN products tested fail to meet their own label claims—with many containing little or no active ingredient. Fifty-five percent of the most popular NAD+ products on the marketplace contain little to no actual NAD+.” Furthermore, Shao tells me that the publish the results of these tests on their website and that some of these products have no detectable levels of NAD+ at all.
Innovation attracts pioneers—but it also attracts opportunists.
A Shift Toward Accountability From Supplement Brands
Still, a quiet shift is underway. Instead of promoting aspiration alone, more brands are emphasizing verification, traceability, and evidence. Certifications like USP, NSF Certified for Sport, and B Corp aren’t perfect, but they enforce a minimum standard of ethics that consumers increasingly expect.
“Supplements must be transparent and grounded in precision science. Too many companies rely on clickbait claims instead of research. Verified testing and higher quality standards are essential,” Shao says.
Macciochi echoes Shao’s sentiment. “Independent third-party testing should be baseline. The future of the industry depends on translating science responsibly—and building products that deliver measurable outcomes without exploiting consumer vulnerability.”
For consumers—especially women navigating midlife—the stakes feel especially personal. “Look for verification, sourcing transparency, and third-party testing from USP or NSF. Supplements can help, but they are not the whole story. Women deserve both symptom relief and proper medical evaluation; these are not mutually exclusive,” says Coppola.
Accountability isn’t just regulatory—it’s human.
The Future of Supplements
Experts agree that two forces will define the next decade: technology and transparency. “AI-driven personalization opens extraordinary opportunities, but it raises the bar for quality assurance and ethics. Consumers now expect brands to show their data, not just tell a story,” Macciochi says.
“Personalized nutrition and AI will play a major role, and regulatory oversight will likely tighten to ensure safety and efficacy,” adds Shao.
Donica points to another crucial frontier—formulation science. “It’s not just what’s in the supplement—it’s how it enters the body. Delivery systems, natural versus synthetic forms, and dose thresholds all matter. Some ingredients need specialized formats, and others can be harmful in excess,” she says.
In other words: future supplements may be smarter—but consumers will need to be, too.
The Verdict On Supplements
Supplements sit at the intersection of empowerment, hope, and vulnerability. They speak to our desire to feel better, live longer, and take charge of our own health—especially when traditional systems fall short. Some absolutely work. Some absolutely don’t. And many fall somewhere in the middle.
The question now is whether the industry will evolve from self-policed promises into something more transparent, science-driven, and safe.
When it comes to supplements, due diligence—and clinical guidance may be the best bet.