Americans spend $28 billion annually on vitamins and dietary supplements. What many don’t know is that the industry is not regulated or obligated in any way to prove its products are safe or effective. The 1994 Dietary Supplement Health & Education Act prohibits the FDA “from interfering with the marketing of any product defined as a dietary supplement – including vitamins, minerals, herbals, botanicals, and amino acids.” There were just 4,000 of these products on the market in 1994. Today there are over 55,000. Be skeptical of the often exaggerated claims made in supplement advertising. Here are eight basic guidelines:
1) Do your research before buying. Several web sites provide reliable
and comprehensive information. Three of them are: MedlinePlus.gov, http://www.fda.gov/food/dietarysupplements/,
and ConsumerReports.org.
2) Make sure the supplement is labeled “USP Verified”. The US
Pharmacopeia is a non-profit that sets realistic standards and confirms the
purity, effectiveness and quality of the supplements. Many manufacturers refuse
to participate and submit their products for testing, for obvious reasons. For
a complete list of companies that do comply, see: http://www.quality-supplements.org/verified-products/verified-products-listings
3) A supplement labeled “natural” does not mean it is safe. So-called
natural supplements have been linked to liver disease, kidney problems, and
nerve damage. A 2013 National Institutes of Health study of 400,000 men and
women age 50 to 71 “linked supplemental calcium to an increased risk of death
from heart disease in men.”
4) Be extra vigilant of supplements making exaggerated claims for weight
loss and muscle building. The FDA has forced many companies to discontinue or
recall their products because of prescription drug additives.
5) Very few studies support the efficacy of supplements. For example, an
exhaustive study on various fish oil supplements published in The New
England Journal of Medicine (May 9, 2013) found the participants
didn’t reduce their rate of heart attacks and strokes any more or less than
those who were given a placebo. Similar comprehensive studies on multivitamins
had the same result.
6) Many supplements have negative or harmful side effects when taken
with a prescription. Vitamin E and Ginkgo, for example, should never be taken
with aspirin or blood thinners. Tell your doctor which supplements you are
taking. Many Americans mistakenly believe supplement companies are required to
provide warnings of the harmful side effects of their products.
7) Avoid doctors who want to sell you their own personal brand of
supplements. Most of them fall into the category of quack medicine. See: http://www.mybestbuddymedia.com/2013/08/12-quick-guidelines-for-uncovering.html
8) Report any adverse reactions to your supplement to the FDA at 800-332-1088. When there is a trend they can take action. An April 27, 2012 press release reads in part: FDA challenges marketing of DMAA products for lack of safety evidence. Agency cites ten companies in warning letters.
UPDATE (October 2013)
Children’s Hospital of Philadelphia Becomes First in Nation to Disallow
Use of Dietary Supplements
“Because vitamins and dietary supplements are essentially unregulated,
there is no sound information about adverse side effects, drug interactions, or
even standard dosing for the vast majority of them,” said Sarah Erush, PharmD,
BCPS, Pharmacy Clinical Manager and a member of the hospital’s Therapeutic
Standards Committee. “Administering these medications — particularly to
children with serious health complications — is unethical when the risks are
unknown, and when there are alternative treatments that have been proven in
clinical trials to be safe and effective.” http://www.chop.edu/news/chop-updates-policy-on-dietary-supplements.html
UPDATE (November 2013)
Herbal Supplements Are Often Not What They Seem
"DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds."
"DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds."
http://www.nytimes.com/2013/11/05/science/herbal-supplements-are-often-not-what-they-seem.html?_r=1&
UPDATE (December 2013)
Editorial from the Annals of Internal Medicine
"The message is simple: Most supplements do
not prevent chronic disease or death, their use is not justified, and they
should be avoided," says the editorial, signed by two researchers from
Johns Hopkins University in Baltimore, one British researcher and one of the
journal's senior editors. After years of study and mostly disappointing
results, the editorial says, "enough is enough."
Spike in Harm to Liver Is Tied to Dietary Aids
"New data suggests that his is not an isolated case.Dietary
supplements account for nearly 20 percent of drug-related liver injuries that
turn up in hospitals, up from 7 percent a decade ago, according to an analysis
by a national network of liver specialists."
UPDATE (January 2014)
New FDA web site is now accepting dietary supplement adverse event reports
FDA safety issues involving:
Human or animal foods
Animal drugs
Animal foods
Tobacco products
Dietary supplements
Orly Avitzur, M.D., M.B.A., “Should You Be Wary of Supplements?” Consumer Reports on Health, November 2013
Marvin M. Lipman M.D., “The Perils of Dietary Supplements”, Consumer Reports on Health, June 2012
Photo: http://healthyandstylish.com/the-effects-of-nutritional-supplements-energy-boosters/ CC
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