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The dietary supplements market was worth £3 billion in 2024 and is projected to grow to £4.8 billion by 2030. Steve Titmarsh assesses the opportunities for independent pharmacists…

Ideally everyone should try to achieve a healthy balanced diet. However, there may be circumstances in some individual lives where supplements may be beneficial.

Pharmacists are ideally placed to help customers identify if they need to take vitamins, minerals or supplements to complement their nutritional intake.

Supplements are not generally needed for those who have a balanced diet and healthy lifestyle.¹ However, in certain circumstances vitamins, minerals and supplements may have some benefit.

The dietary supplements market was worth around £3 billion in 2024 and is projected to grow to around £4.8 billion by 2030.² Vitamin and mineral supplements accounted for around £650 million in sales in 2024 – eight per cent higher than in 2023.³

Evidenced-based advice on supplementation

With a shift in emphasis in the NHS from treatment to prevention⁴ supplementation fits neatly into the picture. Add to that the move to more personalised medicine, and community pharmacists are well placed to offer customers evidenced-based advice on supplementation that is specifically tailored to individual circumstances.

They are also well placed to advise patients about drug-supplement interactions.⁵ In the first instance it is important to encourage people to adopt a healthy balanced diet that provides for all their nutrient needs.

However, it is generally acknowledged that there are situations where supplements may be beneficial. For example, people following a vegan or vegetarian diet may be deficient in vitamin B12; some older adults may need vitamin D, vitamin B12 and calcium as their ability to absorb these nutrients declines with age.

People with chronic diseases such as heart disease, diabetes, cancer, HIV/AIDS and some autoimmune diseases may need additional supplementation to their diet.

Pregnant women are advised to take folate supplements to prevent neural tube defects in their newborn babies and some infants may need more vitamin D than is available in breast milk.⁶

Some advocate that adults in the UK should take a daily dose of vitamin D because of the relatively low light levels in the UK, particularly in winter. People with darker skin, for example from South Asian, African or African-Caribbean backgrounds could benefit from taking a vitamin D supplement year-round.⁷ 

It’s a bug’s life

Awareness of the microbiome has grown in recent years as has the proposed link between the body’s microbial inhabitants and disease (including psychiatric conditions) helped in part by the high-profile marketing campaigns behind so-called probiotics and other ‘gut-friendly’ products.

While there is some evidence to suggest that probiotics can be beneficial there is a lot more research needed to establish the link with health benefits and details of the microbiome’s role. And unlike supplements, that are mainly taken for prevention, it is thought that probiotics are not necessary for people who are healthy.

They are thought to be helpful for diseases such as irritable bowel syndrome and antibiotic-associated diarrhoea, for example. However, it is important to choose the correct probiotic: for example, there is evidence that Saccharomyces boulardii can reduce antibiotic-associated diarrhoea in some people, and Lactobacillus plantarum LP01 and Bifidobacterium breve BR03 have been found beneficial in people with constipation.⁸

Suggestions that omega-3 fatty acid supplements may help prevent heart disease seem to be unfounded as yet, indeed the National Institute for Health and Care Excellence (NICE) advises against offering omega-3 fatty acid compounds to prevent cardiovascular disease.

The exception is a licensed formulation – icosapent ethyl, an ethyl ester of the omega-3 fatty acid, eicosapentaenoic acid – which is recommended as an option for reducing the risk of cardiovascular events in adults.

It is recommended for those with a high risk of cardiovascular events and raised fasting triglycerides (1.7 mmol/litre or above) who are taking statins, but only if they have:⁹ 

• established cardiovascular disease (secondary prevention), defined as a history of any of the following:

• acute coronary syndrome (such as myocardial infarction or unstable angina needing hospitalisation)

• coronary or other arterial revascularisation procedures

• coronary heart disease

• ischaemic stroke

• peripheral arterial disease, and

• low-density lipoprotein cholesterol (LDL‑C) levels above 1.04 mmol/litre and below or equal to 2.60 mmol/litre.

Many other claimed specific health benefits for omega 3 fatty acids still lack conclusive evidence.¹⁰ Nevertheless people who do not regularly eat oily fish may wish to take an omega-3 supplement. People following a vegan or vegetarian diet can obtain omega-3 from nuts, seeds, vegetable oils, soya and soya products.¹⁰

High doses of fish oil can have antiplatelet effects although it is probably less than that seen with aspirin. So, for example, people taking 3–6g of fish oil supplements a day are unlikely to see any impact on their anticoagulant status if they are taking warfarin.¹¹

Pharmacists as nutritional experts

Rather than simply offering a range of vitamins and supplements for customers to purchase pharmacists can position themselves as a place to go for evidence-based information about supplements and how they might play a role in an individual’s health based their particular circumstances, health status and other aspects of their lifestyle.

The National Pharmacy Association (NPA) says: “Pharmacists can use brief, structured questioning including diet, lifestyle, life stage, medical conditions, and medicines, to identify potential nutrient gaps and determine whether supplementation, dietary advice or referral is most appropriate for individual patients.”

The NPA pharmacy team adds: “Multivitamins, vitamin D, iron, vitamin B12 and folate supplements are frequently encountered in community practice. Pharmacy First consultations also provide an opportunity to explore symptoms, identify red flags and support early intervention or onward referral.

“Multivitamins may be suitable as general nutritional supplementation, where appropriate, but targeted supplements (e.g. vitamin D, iron, omega-3s) should be recommended based on identified need, appropriate dose, and duration.

“For certain supplements such as omega-3s and probiotics, pharmacists can explain the evidence base, clarify intended use, and avoid unnecessary or prolonged supplementation.

“Pharmacists can also check for interactions, contraindications and excessive dosing part of providing safe, person-centred care.”

Professor Amira Guriguis, the Royal Pharmaceutical Society’s chief scientist, says: “Pharmacists are well placed to provide personalised, evidence-based advice on vitamins, minerals and supplements.

“They begin by understanding why someone is considering a supplement, alongside a review of their medical history and current medicines to identify potential risks, interactions or contraindications.

“Diet, lifestyle and symptoms such as tiredness or recurrent infections are also explored, with referral to a GP or other healthcare professional where appropriate.”

Professor Guriguis says pharmacists can then guide people through the wide range of products available, from everyday multivitamins to more targeted supplement options.

For example, vitamin D is often considered for people with limited sun exposure, and probiotics where gut health support may be beneficial. Importantly, supplements such as iron should only be taken where a deficiency is confirmed or strongly suspected, as unnecessary use can be harmful.

“Crucially, pharmacists reinforce that supplements are intended to complement, not replace, a balanced diet or prescribed medicines,” she says.

“They provide clear, practical advice on appropriate dosing, duration of use and safety, and advise when further assessment is needed if symptoms persist or worsen.”

References

1. NHS.UK. Overview – vitamins and minerals (www.nhs.uk/conditions/vitamins-and-minerals; accessed January 2026).

2. Grand View Research. UK Dietary Supplements Market Size & Outlook, 2025–2030 (www.grandviewresearch.com/horizon/outlook/dietary-supplements-market/uk#:~:text=The%20dietary%20supplements%20market%20in,market%20from%202025%20to%202030.&text=U.S; accessed January 2026).

3. Proprietary Association of Great Britain (PAGB). PAGB Highlights 2024 (www.pagb.co.uk/content/uploads/2025/03/PAGB_Highlights_2024_WEB.pdf; accessed January 2026).

4. (GOV.UK. 10 Year Health Plan for England: fit for the future (www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future#:~:text=Details,sickness%20to%20prevention; accessed January 2026).

5. National Library of Medicine. Dietary supplement : a framework for evaluating safety (www.ncbi.nlm.nih.gov/books/NBK216072; accessed January 2026).

6. NIH (National Institutes of Health). Do you need dietary supplements? Vitamins, minerals, and more (https://newsinhealth.nih.gov/2021/12/do-you-need-dietary-supplements#:~:text=Your%20body%20needs%20different%20amounts,you%20have%20a%20nutrient%20deficiency; accessed January 2026).

7. British Nutrition Foundation. Vitamins and minerals (www.nutrition.org.uk/nutritional-information/vitamins-and-minerals; accessed January 2026).

8. Which? Probiotics and gut health: what you need to know (www.which.co.uk/reviews/nutrition-and-supplements/article/probiotics-and-gut-health-what-you-should-know-ank9n5F5VzfQ?source_code=911CTJ&utm_source=google&utm_medium=cpc&utm_content=generic&gclsrc=aw.ds&gad_source=1&gad_campaignid=22161481645&gbraid=0AAAAADoAS41BMlgDiN1utDAYHUUgLak87&gclid=CjwKCAiAmePKBhAfEiwAU3Ko3Da7kAMi7ybLDXnY6iDBY1hjfYG__2bdB3xgOVNYFgja7Hg4y4Os3hoCcj4QAvD_BwE; accessed January 2026).

9. National Institute for Health and Care Excellence (NICE). Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides. Technology appraisal guidance (TA805) (www.nice.org.uk/guidance/TA805/chapter/1-Recommendations; accessed January 2026).

10. BDA – The Association of UK Dietitians. Omega 3 (www.bda.uk.com/resource/omega-3.html; accessed January 2026).

11. NIH (National Institutes of Health) Omega-3 fatty acids (https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional; accessed January 2026).