“If I had a job with health insurance, I probably would have gone to see a doctor by now,” said Ms. Parham, 39, who lost her clerical job at American Greetings a while back. “But instead, I’m here buying echinacea. I hope it works.”
In flusher times, Ms. Parham said, she spent $50 a month on prescriptions for her asthma, allergies and other chronic problems. Now, she pays much less per month for over-the-counter protein supplements and oregano oil capsules. “That’s an important savings for me,” she said. “It means I can rent a movie or make the kids food that they actually like.” A lot of consumers seem to be doing the same math. Sales of vitamins and nutritional supplements, which have grown consistently for years, have surged in recent months, rising as the stock market has fallen. People are clearly cutting back on many items, from bread and milk to designer jeans and flat-screen televisions, but they are stocking up on pills that they think can spare them expensive doctor visits.
“When you go to the formal health system, you very quickly lose control over what this costs you,” said Uwe E. Reinhardt, a professor of economics at Princeton whose specialty is health care policy. Instead of turning immediately to a doctor, “people try to initially tough it out,” he said.
Professor Reinhardt sees the growing interest in vitamins and herbs as a logical extension of the concept of “consumer-directed health care” – the idea that people will take more preventative measures if their insurance deductibles are set higher – which has been working its way from conservative policy circles toward the mainstream over the last 20 years. Critics say this approach leads to predicaments like Ms. Parham’s, with people staying sicker longer and avoiding much-needed medical treatment.
The strong sales of vitamins and supplements have continued into this year. “Our best January and February in history are the ones that just happened,” said Tom Newmark, chief executive of New Chapter Inc., a 26-year-old supplements manufacturer in Brattleboro, Vt.
Direct evidence linking the rise in sales to the recession is more anecdotal than scientific, though industry analysts said they saw the same correlation – though less pronounced – in previous downturns.
“I don’t have health insurance, so I can’t go and see a doctor because it’s very expensive,” said Jacqueline Kreiss, an unemployed hairstylist and makeup artist in Manhattan. “The economy just really put me backward, so I started relying on the vitamins.”
Whether a testament to vitamins or the power of placebo, Ms. Kreiss, 40, said she was happy with the results. “I feel very energetic,” she said. “I feel strong again. I feel I’m in full form to go out there and get a job.”
Certainly, America’s interest in supplements did not begin with the current recession. The industry has accounted for as much as $23 billion in domestic sales annually in recent years.
Even so, the jump in sales last fall amid such widespread financial distress caught some people by surprise. “We didn’t expect that,” said Patrick Rea, publisher and editorial director of Nutrition Business Journal, a trade paper based in Boulder, Colo. “We were like, ‘What’s going on here?’ ”
Doctors caution against putting too much faith in supplements, and recent studies have cast doubt on the long-term effectiveness of products like multivitamins and vitamin E for certain cancers and heart disease. Dr. Edward L. Langston, a former chairman of the board of the American Medical Association, said he counseled his patients to take limited doses of vitamin C, but said supplements were no “panacea,” nor a substitute for traditional health care.
“A little common sense here goes a long way,” Dr. Langston said.
But science does not seem to have shaken everyone’s faith. Amy Breslin, who is 33 and studying to be a physician’s assistant, has pared back on fresh fruits and vegetables and stocked up instead on fish oil capsules and antioxidant supplements.
“Organics are expensive,” she said at a vitamin store in Los Angeles. “Supplements may be more of a bang for my buck.”
Because of consumers like her, supplement sales have been a rare bright spot for Whole Foods. “We just reported our first quarter of negative growth in our company’s history, but the supplement area is performing better than the rest of the store,” said Jeremiah McElwee, a senior coordinator who oversees supplements sales for the company.
While multivitamins and fish oil capsules have sold particularly well, many people have their own personal favorites. Monique Miedema, who is 42 and works in finance in Los Angeles, places her faith in a supplement called Adrenal Health, which its manufacturer, Gaia Herbs, describes as a mix of six herbal ingredients meant to “support calmness.”
“There was no salary increase this year, and I live in Santa Monica in a high-rent apartment,” she said. Holding up a little brown bag with her purchase, she added, “I’ve been doing this more.”
Rebecca Cathcart and Christopher Maag contributed reporting.
A version of this article appeared in print on April 5, 2009 of the New York edition.