I’m a doctor – menopause supplements are the biggest rip-off of them all

He’s best known as a perky children’s television presenter but, at 48, Dr Xand van Tulleken is feeling his age. “My knees are creaky. I’m tired. My hangovers are worse,” he says, explaining he spent most of last night with his youngest child Daphne, not yet one, awake and screaming. We’re meeting on Zoom to discuss his new book, Make Me Well: A Quest to Understand the Confusing World of Wellness, a scrupulously researched, engaging and amusing read despite the shocking weight of the revelations. Supplements? Snake oil. Blood tests? Don’t bother. Wearable tech? You may as well consult the stars. Best known as the presenter of CBBC’s Operation Ouch! and Radio 4’s What’s Up Docs? with his twin brother Chris, van Tulleken says he has a vested interest in feeling better. He has battled weight gain, health scares and incredibly stressful working environments. “I’m the perfect customer for the wellness industry. I want to feel young and healthy for my children.” He married Dolly, who works in food policy, in 2023 and they are now parents to Rex, two, and months-old Daphne. He also has a 17-year-old son, Julian, who mostly lives in Canada with his mother and stepfather. Shorts He insists he’s “not anti-wellness,” and “set out to find the stuff that works”. But, spoiler alert: he failed. From vitamins and supplements to wearable tech such as the ZOE programme and household name influencers, he investigated many aspects of the complex wellness industry and found them all lacking. The book scrutinises supplements – something we spend £50 a head or £3.6bn annually on in the UK – including a collagen supplement called ejiao. It’s one of the best known and most expensive collagen products in China, yet is made from donkey skin, technically a waste product. As global demand for collagen has soared, so has demand for donkey hides. There are an estimated 50 million donkeys in the world and ejiao production needs over a tenth of these. If you’re feeling sorry for the donkeys, he points out that the gummies in all our high street chemists are made from pigs that have suffered just as much, if not more. “There are two ways of thinking about collagen for me,” van Tulleken says. “One is to go and look at all the evidence and read the trials. Even the industry paid-for trials don’t actually show much benefit. But if you take away the trials the industry doesn’t fund, the benefit really evaporates.” Perhaps more unsettling is a look at who profits. “What an amazing stroke of good fortune,” he says, “that the one product some of the biggest companies in the world can’t get rid of, all the hides and hooves and claws and skins and scales and spines and fish heads, turned out to contain a cure for two problems that affect everyone on earth, joint pain and wrinkles.” Despite the huge number of published trials on the efficacy of collagen, no serious medical organisation recommends it. And van Tulleken points to common industry practice whereby if results aren’t actually falsified, they are cherry-picked, with studies often designed to produce the desired results. He found much of the research confusing himself, despite his medical background. He trained at Oxford, Harvard and the Liverpool School of Tropical Medicine and is a honorary associate professor at University College London. He worked in acute medicine in the NHS for a decade and has spent time in humanitarian crisis regions in Myanmar, Uganda and Sudan. ‘Women have been catastrophically let down by the medical profession, and been thrown into the arms of the wellness industry, which has sold them stuff which is ineffective’, says Xand van Tulleken, who travelled the world researching his book He is an optimistic chap: “I wanted to give the people I met the benefit of the doubt. I think most people don’t want to live their lives ripping people off.” But the research that made him the angriest was into menopause supplements. He makes it clear that as a middle-aged man he’s no expert in this field. “I had this terrible feeling of, ‘Oh, wow. This is so much more than the men experience.’ Women have been catastrophically let down by the medical profession, and by research, and been thrown into the arms of the wellness industry, which has welcomed them and sold them a load of stuff which is ineffective.” The industry, he argues, flooded the void left by poor medical research and reporting, after the 2002 Women’s Health Initiative trial, which is now widely accepted to have overstated the link between HRT and breast cancer. “The Women’s Health Initiative drove women away from HRT and towards the supplement aisle,” he writes. “In the early noughties, 80 per cent of women aged between 40 and 65 reported using non-prescription therapies for menopausal symptoms.” Within a year of the WHI findings, sales of black cohosh, linked to acute liver injury, had soared and the menopause supplement market began to grow into the huge industry it is today. It is projected to be worth $30 billion globally by 2030. In an analysis of 201 menopause supplements, the researcher found no consensus as to what ingredients might help symptoms. Even vitamin D, the one supplement the NHS recommends everyone take daily in autumn and winter, comes under fire. There were hopes it might treat everything from tuberculosis to cancer and cardiovascular disease, but van Tulleken says it hasn’t turned out to be the panacea researchers believed. It remains vital for bone health, he says – and a few babies born to vitamin D-deficient mothers tragically die every year – but we only need to supplement if severely deficient, which most of us are not. Supplements are pricey, but even more expensive are devices that claim to deliver essential health data to users, such as the Apple Watch’s atrial fibrillation alert, and personalised health company ZOE, run by professor Tim Spector. ZOE collects and interprets data from users via stool samples, blood tests and a continuous glucose monitor (CGM), then provides personalised diet advice. He spent around £2,500 subscribing to ZOE three times, creating profiles with different ages, sexes and weights. He sent in the same stool samples and bloods and provided simultaneous data from the CGM, but the results varied. “The answers were different to the point where if you were a couple living together and getting this data, you’d go ‘Oh, we need to eat differently and live differently now.’” He says following the regime made him “fixate on my weight and my diet in a way that I don’t think was very healthy”. In Make Me Well, van Tulleken compares the way ZOE interprets data to astrology. Is that fair? He considers the question for a few moments. “I think that’s right,” he says. “Maybe I’m being too generous as I think at least with astrology they plot the position of the stars accurately.” Tim Spector is a reputable figure in his field. The van Tullekens crossed paths with him as part of his ongoing research into twins and they have worked together in television. “I think Tim Spector’s got lots of good advice,” van Tulleken says. “I’ve admired him for many years. But for reasons that I don’t understand, that product is not delivering the things that I think its users imagine it will.” A spokesperson for ZOE said: “ZOE is a personalised programme, so different profiles produce different outputs. That isn’t a glitch: it’s the product doing exactly what it is built to do. Your ZOE results combine your gut microbiome test results, sequenced from your own stool sample, along with your age, sex, body measurements and other health information collected in our quiz. “The new ZOE membership no longer requires the use of a CGM so that data wouldn’t have been contributing to Xand van Tulleken’s ZOE experience. Our methods are set out in more than 30 peer-reviewed publications, including a randomised controlled trial of 347 adults published in Nature Medicine, which shows that following ZOE’s personalised programme led to improvements in blood fats, waist circumference, weight and gut microbiome composition compared with generic advice. “A major landmark paper published in Nature shows how the gut microbiome is linked to diet and improved health markers, such as blood cholesterol levels, inflammation, and body fat distribution. This research is the same microbiome ranking that underpins the ZOE app and Gut Health Test, making it the only current gut microbiome test with clear published standards relevant to human health.” Van Tulleken also takes on other the so-called experts filling our feeds, from influencers such as “Glucose Goddess” Jessie Inchauspé and MAGA bro doctor and testosterone evangelist Peter Attia. None of us are immune to wellness marketing. He says there was hardly anything he wasn’t a little persuaded by and was close to giving testosterone a go before an expert diverted him. “He walked me through how it is very much not a miracle cure in terms of side effects, and it is very expensive, and there are lots of other things I could do instead.” He hopes Make Me Well will save us all a few quid, “but also some confusion and anxiety, which is probably more important than the money”, he says. The book has led him to approach life differently, he says. Before Rex and Daphne, van Tulleken would retreat to his pottery studio and he’s looking forward to getting back to his clay. He tries to schedule workouts but doesn’t always succeed. Eating well, he says, is not about following a personalised plan based on your stool sample – but home-cooked food around the table with his family. “Unfortunately, there are no shortcuts. In the end, it’s about taking a long hard look at your life and not letting people exploit your vulnerabilities.” ‘Make Me Well: A Quest to Understand the Confusing World of Wellness’ by Xand van Tulleken is published by Cornerstone Press on 10th September (£22)