Dietary supplement use is common in the United States, but it varies substantially by age, sex, income, education, and the number of products used. During August 2021–August 2023, 60.2% of U.S. adults ages 20 and older and 35.7% of youth ages 0–19 reported using at least one dietary supplement in the past 30 days. The figures below summarize national survey estimates, market estimates, and emergency-department surveillance findings while keeping each measurement period and population explicit.
Contents
- U.S. use and recent trends
- Age and sex differences
- Using multiple supplements
- Race, income, and education
- Multivitamins and vitamin D
- Nonvitamin supplements and market scale
- Adverse-event patterns
U.S. use and recent trends
The newest national estimates come from the National Health and Nutrition Examination Survey (NHANES), as reported by the National Center for Health Statistics, “Dietary Supplement Use: United States, August 2021–August 2023”. They describe the U.S. civilian, noninstitutionalized population and measure products taken during the previous 30 days.
During August 2021–August 2023, 35.7% of youth ages 0–19 used at least one dietary supplement. Among adults ages 20 and older, the comparable estimate was 60.2%. These figures describe recent use, rather than the percentage of people who take supplements continuously throughout a year.
Earlier NCHS estimates show a gradual upward pattern in reported use, although comparisons across survey cycles should be interpreted with the source’s caveats. Youth use was 33.1% in 2013–2014, 34.1% in 2015–2016, and 34.8% in 2017–March 2020. Adult use was 53.8%, 55.9%, and 58.5% across those same periods.
The 2021–2023 estimates also show that supplement use is not limited to one product. In that cycle, 11.3% of youth and 38.7% of adults reported taking two or more supplements in the past 30 days. For context, use of two or more products among adults was 30.9% in 2013–2014, 33.4% in 2015–2016, and 35.5% in 2017–March 2020. Among youth, the corresponding earlier estimates were 6.4%, 8.5%, and 7.0%.
The August 2021–August 2023 NHANES cycle used a changed telephone interview mode. Consequently, comparisons with earlier cycles should be read with the source caveats rather than treated as a perfectly uniform time series.
Age and sex differences
Age is one of the clearest dividing lines in the recent data. Among youth in August 2021–August 2023, supplement use was 28.6% at ages 0–1, 41.9% at ages 2–11, and 30.1% at ages 12–19. Among adults, use rose from 46.3% at ages 20–39 to 60.3% at ages 40–59 and 75.9% at ages 60 and older.
The same age gradient appeared in the earlier 2017–March 2020 estimates. Adult use was 44.5% at ages 20–39, 58.8% at ages 40–59, and 75.2% at ages 60 and older. Among youth, use peaked at 45.2% for children ages 2–5 during that period.
Sex differences were modest among youth but larger among adults in the newer cycle. During August 2021–August 2023, 35.0% of female youth and 36.4% of male youth used at least one supplement. Among adults, use was 66.1% for women and 53.9% for men.
The earlier cycle showed a similar adult pattern. In 2017–March 2020, adult use was 65.0% among women and 51.5% among men, compared with 38.3% among female youth and 31.3% among male youth. Among adults ages 60 and older, 80.4% of women and 68.9% of men used at least one supplement.
| Population and period | Overall or subgroup estimate |
|---|---|
| Youth ages 0–19, Aug. 2021–Aug. 2023 | 35.7% |
| Adults ages 20+, Aug. 2021–Aug. 2023 | 60.2% |
| Adult women, Aug. 2021–Aug. 2023 | 66.1% |
| Adult men, Aug. 2021–Aug. 2023 | 53.9% |
| Adults ages 60+, Aug. 2021–Aug. 2023 | 75.9% |
| Youth ages 0–19, 2017–March 2020 | 34.8% |
Source: NCHS, “Dietary Supplement Use: United States, August 2021–August 2023” and National Health Statistics Reports, Number 183.
Using multiple supplements
Counting products separately gives a more detailed view of supplement routines. During August 2021–August 2023, 5.9% of youth ages 0–1 used two or more supplements, compared with 13.0% of children ages 2–11 and 10.5% of adolescents ages 12–19.
Among adults, two-or-more use increased markedly with age: 23.4% at ages 20–39, 38.5% at ages 40–59, and 56.4% at ages 60 and older. Overall, 23.9% of adults used three or more supplements, while 15.4% used four or more.
The age pattern continued at higher product counts. Three-or-more use was 10.6% among adults ages 20–39, 23.2% among those ages 40–59, and 39.9% among those ages 60 and older. Four-or-more use was 6.4%, 14.7%, and 26.5% in those three age groups, respectively.
The 2017–March 2020 distribution provides another way to see the difference between youth and adults. Among youth, 65.2% used no supplements, 27.7% used one, and 7.0% used two or more. Among adults, 41.5% used none, 23.0% used one, 13.6% used two, 7.3% used three, and 14.7% used four or more.
These are counts of products reported for the relevant recall period. They do not indicate whether products were medically necessary, effective, or appropriate for a particular person.
Race, income, and education
The 2017–March 2020 NCHS estimates show differences across race and Hispanic-origin groups. Youth use was 26.5% among Hispanic youth, 37.8% among non-Hispanic Asian youth, 21.7% among non-Hispanic Black youth, and 41.9% among non-Hispanic White youth.
Among adults, use was 47.9% among Hispanic adults, 55.6% among non-Hispanic Asian adults, 48.6% among non-Hispanic Black adults, and 63.4% among non-Hispanic White adults. For adults, 36.6% of non-Hispanic White adults used no supplement, the lowest no-use percentage among the adult race and Hispanic-origin groups shown.
The number of products also varied among youth groups. Two-or-more use was 8.8% among non-Hispanic Asian youth and 8.8% among non-Hispanic White youth, compared with 2.6% among non-Hispanic Black youth and 5.2% among Hispanic youth. Among adults, one-supplement use was 22.8% for Hispanic adults, 22.3% for non-Hispanic White adults, 25.2% for non-Hispanic Asian adults, and 25.6% for non-Hispanic Black adults.
Income and education were also associated with reported adult supplement use. Among youth, use was 22.2% below 130% of the federal poverty level, 36.0% at 130% to below 350%, and 46.0% at 350% or more. Among adults, the corresponding estimates were 45.4%, 56.7%, and 67.3%.
For adults, use increased across education categories: 43.2% among those with less than a high-school education, 50.4% among those with a high-school diploma or GED, 59.4% among those with some college, and 70.1% among those with a college degree or higher. The NCHS report also found that adult use of two, three, or four or more supplements increased with income and education level. Four-or-more use was 25.0% among adults ages 60 and older.
Source: National Health Statistics Reports, Number 183. Percentages retain that report’s definitions and categories.
Multivitamins and vitamin D
Multivitamin-mineral products accounted for a substantial share of supplement use in the 2017–March 2020 estimates. They were used by 23.5% of youth ages 0–19 and 31.5% of adults ages 20 and older. Vitamin D supplements were used by 3.0% of youth and 18.5% of adults.
Among people who used these products, regularity differed by product and age group. Of youth multivitamin-mineral users, 44.9% reported taking the product on all 30 days. Among adult multivitamin-mineral users, 63.7% reported taking it on all 30 days. For vitamin D, the corresponding all-30-days figures were 33.9% among youth users and 66.9% among adult users.
A separate 2017–2018 NHANES analysis cited by the NIH Office of Dietary Supplements’ Multivitamin/mineral Supplements fact sheet estimated multivitamin-mineral use at 24.0% among adults ages 20–39, 29.8% among ages 40–59, and 39.4% among ages 60 and older. Because this analysis has a different period and source presentation, it should not be combined mechanically with the 2017–March 2020 estimates.
Nonvitamin supplements and market scale
The available statistics also cover products beyond vitamins and minerals. The 2012 National Health Interview Survey found that 17.7% of U.S. adults had used a dietary supplement other than vitamins and minerals during the past year. This annual measure is not directly equivalent to the 30-day NHANES measures above.
The official NCHS report cited an estimate of $55.7 billion in U.S. dietary supplement sales in 2020. Of that estimated total, $21.2 billion was for supplements containing vitamins, minerals, or both. These are market estimates cited in the report, not a government sales census.
Source: NCCIH, “Complementary, Alternative, or Integrative Health: What’s in a Name?” for the 2012 survey statistic, and National Health Statistics Reports, Number 183 for the 2020 sales estimates.
Adverse-event patterns
Emergency-department surveillance offers a different perspective from prevalence surveys. In a published FDA staff study covering 2004–2013, and after excluding unsupervised child ingestion, herbal or complementary nutritional products accounted for 65.9% of emergency-department visits for single-supplement-related adverse events. Micronutrients accounted for 31.8%.
Within the relevant visits, herbal or complementary nutritional products marketed for weight loss were implicated in 25.5%, while products for increased energy were implicated in 10.0%. Weight-loss or energy products caused 71.8% of supplement-related adverse events involving palpitations, chest pain, or tachycardia. People ages 20–34 accounted for 58.0% of these cardiovascular-symptom-related events.
The pattern differed among older adults. For people ages 65 and older, choking or pill-induced dysphagia or globus caused 37.6% of supplement-related emergency-department visits. Micronutrients were implicated in 83.1% of those choking or pill-related visits.
These figures describe emergency-department visits in the published 2004–2013 surveillance study period. They do not measure the prevalence of all supplement use, the frequency of all adverse events, or the risk associated with every product. Product category, age, symptoms, and study definitions all matter when interpreting the percentages.
Source: Scientific Publications by FDA Staff.