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With so many options, it can be challenging for patients to navigate the benefits and potential risks of vitamins, minerals and supplements, writes Kathy Oxtoby…

The vitamins and minerals market in the UK has been “experiencing steady growth in recent years”, according to Statista.1

“Customer preferences for health and wellness products, along with an increasing awareness of the importance of a balanced diet, have contributed to the development of this market,” Statista adds.

Vitamins, minerals and supplements is “a very important category for pharmacy”, says Kenny Chan, Numark’s lead information services pharmacist.

“More and more people are becoming mindful of the importance of healthy eating and living and are using supplements to maximise potential.

“An aging population is also driving an interest in this category. This is simply because it covers such a wide range of conditions.” 

Making the right choices

“Pharmacists are well placed to support patients in making informed decisions about vitamins, minerals and supplements,” says Alwyn Fortune, the Royal Pharmaceutical Society’s policy and engagement lead.

“They can offer tailored advice based on an individual’s health needs, existing conditions and discuss any potential interactions with any medicines they are taking.”

Lila Thakerar, the superintendent pharmacist at Shaftesbury Pharmacy in Harrow, says advice should be provided based on the individual supplement - “it’s not one size fits all”.

“It’s important to understand why a patient is asking for a supplement,” she says.

It may be that the patient has had a blood test identifying a deficiency, such as iron or vitamin D. The patient could be feeling run-down and has made a self-diagnosis that they need a certain vitamin. Or a clinician may have recommended they take a particular supplement.

“A background consultation should take place before the pharmacist can recommend a supplement,” says Ms Thakerar.

When talking to individual patients asking for supplements, pharmacists need to outline their benefits and risks, she says.

It is important for patients to know that large doses of supplements can have side effects. “Some people think that the more supplements they have the healthier they will be. But pharmacists need to discuss the harm each supplement can do if taken excessively,” she says.

Excessive iron, for example, can cause toxicity and can also lead to gastrointestinal upsets, and nausea. And excessive magnesium can lead to increased urination, stomach bleeds and an erratic heart rate, says Ms Thakerar.

“People need to understand that not every vitamin is good for you in high doses, and that they need to take only what the body requires.

“They need to be aware that with supplements, it’s not more that is good, it’s about the right dose,” says Ms Thakerar.

As part of the patient consultation, potential side effects and recommended dosages should be discussed. Pharmacists should also advise on how the supplement should be taken, such as with or straight after meals, and mornings or evenings, she says.

“Always check if the customer is taking any other medication, including over the counter medicines and other VMS products,” says Mr Chan.

“For example, St John’s wort helps with moods and depression but can interact with many medications.”

Maximise the nutritional supplements category

Cara Shaw, a nutritionist for liquid iron supplement brand BlueIron, has some advice for pharmacists looking to make the most of VMS.

“Collaborate with specialists. Partnering with nutritional therapists can help tailor advice and build customer trust,” she says.

“Offer high-quality, evidence-backed supplement brands that cater to a range of needs, from general wellness to niche health concerns like gut or hormonal health.

“Host workshops or use social media to educate customers on the benefits of supplements. Clear, science-based guidance will differentiate your pharmacy from competitors.

“And stay updated on popular supplements and emerging research to remain relevant and attract customers looking for the latest solutions.”

Branded products and generic options

The cost effectiveness of supplements is also a consideration.

“Branded products are often more expensive than generic products, so it is important to compare prices and value for money,” says Ms Thakerar.

Pharmacists should give people choices, including well-known brands and generic options with equivalent ingredients, she says.

“Ensure your pharmacy is adequately stocked with a full range of brand names and generic products that are competitively priced.”  

She advises they should also stock a range of product sizes, from bumper packs to smaller sizes for the cost conscious.

And they need to stock products that can be taken in a variety of ways to suit patient preferences, from tablets and soluble supplements to chewable and gelatine free formulations.

Patients should also be made aware that these products will “supplement their daily lifestyle and assist with minor aspects of conditions, but will not reverse or cure conditions”, says Ms Thakerar.

Multivitamins are a popular choice for patients

The popularity of supplements “reflects public awareness and proactiveness in taking care of their health and wellbeing”, says Mr Fortune.

“Supplements can offer benefits when used appropriately, but they should not replace a balanced diet. Most people can get the essential vitamins and minerals they need by having a healthy and balanced diet.

“But if your diet doesn’t provide enough or you have specific health needs, supplements can be useful for providing this and staying healthy.”

Multivitamins are a popular choice for patients who do not have any specific supplement requirements. Containing the recommended daily allowance (RDA), multivitamins are “a combination of everything you need on a daily basis”, says Ms Thakerar.

“However, they should only be taken if the patient needs them.”

Vitamin D is “a main focus, especially in Winter, due to the increase in poor diets and lifestyles which can result in a lack of sunlight - where natural vitamin D comes from - more people are being diagnosed with vitamin D deficiency”, says Mr Chan.

“Often doctors will prescribe a loading dose which would be a high strength vitamin D and once this course is complete, they expect many people to keep taking a maintenance dose of vitamin D which can be purchased in a pharmacy,” he says.

Probiotics are becoming increasingly popular

Omega-3, usually obtained from oily fish, has “many health benefits including reducing the risk of heart disease and improving circulation, but may also help with brain and eye function, as well as reducing inflammation in rheumatoid disease”, says Mr Chan.

Probiotics are becoming “increasingly popular, as they provide beneficial microbes for the body to aid in the digestion of food”, he adds. “Probiotics can help ease some symptoms of irritable bowel syndrome (IBS).”

Mr Fortune says the rise of the supplement industry means “there is a wider range of products, but the industry isn’t regulated as tightly as prescription medicines and therefore the quality of products can vary.

“It’s always best to get supplements from trusted brands and shops to be sure they’re safe and good quality.”

An emerging trend is personalised nutrition, with companies offering customers tailor made supplements. Online consultations, at-home nutrition testing and supplements on subscription are just some of the services available.

Supplements are a “booming market”, says Ms Thakerar. Demand is fuelled by people self-diagnosing from information found online and via social media.

“Some of the potential benefits are justified, however some are just hearsay.”

Pharmacy teams should personally assess needs of every patient 

Managing patient expectations about supplements can be challenging for pharmacy, she says.

“But whatever the reason for their supplement purchase, the pharmacist needs to give the patient appropriate advice that is evidence-based.” 

She says pharmacy teams should personally assess the needs of every patient asking for supplements, so they are sold the right product for them.

“This will help to build faith in your pharmacy and encourage patients to become long term customers.” 

Reference

1 1. Statista (n.d.) Vitamins & Minerals - United Kingdom.