Americans shift from multivitamins to vitamin D, collagen, probiotics

Clinical takeaway: Ask patients about specific supplements. Use is shifting toward single-ingredient and specialty products with variable evidence and interaction potential. This matters most in older adults, who report the highest use.

Dietary supplement use is widespread and rising among US adults, but most prior data captured usage at single time points or for short windows. That has left the longer arc unclear of not only how many people take supplements, but how the mix has changed. This analysis tracked 25 years of national survey data to map shifting use across product categories and demographic subgroups.

Most supplements are taken for general health rather than a diagnosed deficiency, and only about one in four products is used under professional guidance, leaving behavior largely self-directed and market-driven. With more than 100,000 products available and no routine FDA premarket review, shifts in what people take can carry real clinical weight. This analysis used NHANES, the long-running national survey that links self-reported use to a supplement product database.

Overall use rose to 60% from 51% of adults between 1999-2000 and 2021-2023, but the more striking change was in composition. Multivitamin use fell (to 31% from 35%), while use of single vitamins, minerals, and botanicals outside multivitamins climbed. Excluding multivitamins, vitamin use rose to 39% from 25% and mineral use to 27% from 18%. The inflection came around 2009-2010, after a flat decade before it.

Vitamin D use rose nearly 6-fold (to 29% from 5%), and zinc more than doubled. Newer specialty products emerged from near-zero, including turmeric, collagen, probiotics, ashwagandha, and elderberry. Meanwhile, older trace minerals and botanicals such as nickel, boron, ginseng, and ginkgo fell sharply. The rise was steepest in adults 65 and older, whose use climbed to 78% from 62%, the highest of any age group.

Supplement use runs consistently higher among women, older adults, and those with more education, income, and insurance, a longstanding pattern. In the latest cycle, use reached 66% in women versus 54% in men, 78% in adults 65 and older versus 46% in those 20 to 39, and 69% among college graduates versus 48% in those without a high school diploma. The highest-income group used supplements at roughly 68% versus 38% in the lowest.

The largest absolute increases came in some lower-use groups: adults without a high school diploma rose to 48% from 33%, and Mexican American adults to 49% from 32%, both outpacing the overall climb. This repeated cross-sectional analysis pooled 11 NHANES cycles from 1999-2000 through August 2023, covering 63,442 adults aged 20 and older who reported on supplement use in the prior 30 days.

Consumers are moving from one-size-fits-all multivitamins toward targeted, self-selected products, often ahead of the evidence supporting them. For many specialty supplements, benefits remain unproven and data on drug interactions are thin.

Source: Lam CS, et al. JAMA Netw Open. 2026 Jun 15. Emerging patterns in dietary supplement use among US adults, 1999-2023