Millions of people take one or more dietary supplements every day. In fact, some of the most common questions I get are about supplements like calcium, vitamin D, fish oil, etc. Should you be taking a dietary supplement? Are any of them right for you? Are you wasting your money? Are you doing yourself harm by taking one or more of them? The answers are “maybe,” “maybe,” “maybe,” and “maybe.”
Let’s start with some basics. First of all, what exactly is a dietary supplement?
It’s a product taken by mouth that contains one or more ingredients not provided in sufficient quantity in your diet. It can be in tablet, capsule, liquid, gel, powder, or whatever form. It can be one or a mixture of vitamins, minerals, amino acids, herbs, plant extracts, or a host of other ingredients.
How much do you know about dietary supplements? Take this quiz and find out…
1. Many of these products are natural, so they are safe.
True or False?
2. Supplements must be approved by the U.S. Food and Drug Administration before being sold.
True or False?
3. The regulation of supplements is the same as drugs/medicines.
True or False?
4. You can trust that the label on a supplement tells you the exact ingredients and the amount of each.
True or False?
5. Supplements must carry warning labels about possible side effects.
True or False?
6. If a supplement works, taking more will work even better.
True or False?
How do you think you did? No cheating. If you haven’t answered the questions yet, go back and do it now. That will make the information stick in your mind better.
Number 1… many of the products are natural so they are safe… FALSE!
Those “natural” products filling the shelves at your local pharmacy may be plant extracts and herbs. And sure, they may have medicinal value. In fact, many of the medicines we use today are based on herbs and plants that were discovered to have particular effects. But just as prescription medicines can cause unwanted side effects, so can “natural” products. They can cause serious illness, allergies, increased blood pressure, organ damage, and even death! They can interfere with other medications and supplements, making their actions stronger or ineffective.
You must tell your doctor(s) about ALL the medications you are taking. That includes over-the-counter medicines like that baby aspirin you decided to take because your friend told you it was a good idea. It also includes those supplements, like ginkgo biloba, vitamin E, garlic, fish oil, etc. I can’t tell you how many times I review a patient’s list of medications before surgery and once I finally elicit ALL of the medicines, supplements, herbal products, “natural” products, etc. I find two, three, or more different products that can increase the risk of bleeding!
So natural does not mean safe. Got it?
Did you get the answer to question number 1 right?
Let’s look at number 2…
Supplements must be approved by the US Food and Drug Administration, (the FDA, or USFDA), before being sold… FALSE!
How about number 3…
The regulation of supplements is the same as drugs/medicines… FALSE again!
In 1994 the Dietary Supplement Health and Education Act was passed after intense lobbying by the suppplements industry. This changed the regulation of supplements by the FDA. They are now regulated as foods, and not drugs.
Drugs are strictly regulated whether they are prescription or nonprescription, brand name or generic. They must be tested for safety and for efficacy before they can be sold. All ingredients must be listed. Possible side effects have to be clearly stated. Drug companies must keep track of “adverse events.” These have to be reported to the FDA so that the FDA can swiftly take a drug off the market if necessary. (Okay, sometimes it may not seem so swift. And then on the other hand, we in the United States often wait years for a medicine that people in Europe seem to be using with no problem. It may not be a perfect system but for the most part, it works.)
By contrast, neither safety nor efficacy have to be proven with supplements. The manufacturer has to send the FDA a copy of the label. The law limits the claims that can be made on the label. Only rare supplements can state that they actually treat or cure a disease. But labels do not have to list the exact ingredients, and they don’t have to list possible side effects. The supplement manufacturers are supposed to inform the FDA of reported problems, but it isn’t clear that they always do.
So you see that number 4… you can trust that the label on a supplement tells you the exact ingredients and the amount of each, is… FALSE!
And so is number 5… supplements must carry warning labels about possible side effects.
All false! Are you looking at supplements in a different way now? I hope so. I cannot think of a single supplement, herb, etc. that is 100% free of possible side effects. You must arm yourself with information and education. But you cannot rely on the supplement manufacturer to tell you what you need to know. You can’t necessarily rely on your friends and relatives either. They may mean well, but their body is not your body. And be careful about what you find on the internet. You know what they say… if it sounds too good to be true, it probably is.