There are thousands of dietary supplements and “nutraceuticals” that compete for your attention and money, each claiming to be effective for common problems such as weight loss, insomnia, sexual enhancement, or even to help manage complex diseases like diabetes or hypertension. If you are considering or already taking one or more dietary supplements there are a few important things you and your Doctor should know and discuss. First, it’s important to be open in discussing what supplements you are taking or considering with your Doctor so that we can work together to help you make an informed and safe choice. Second, you should gather reliable information on the manufacturing and purity of the product you are considering. Some manufacturers may provide information on purity, safety and effectiveness on their web site, or you may need to investigate further (see resources below). Finally, you should search for valid independent information that support the claims of benefits listed on the label. Finding valid information can be quite difficult. Many manufacturers provide web based testimonials or other non-scientific data to support use of their products. Sorting through the vast amounts of information available on the internet makes smart decision making difficult at best when it comes to supplements and “nutraceuticals”. Importantly, there are numerous real and potential interactions between supplements and prescribed medications which can lead to unexpected outcomes, and some “natural” products have been found to contain contaminants like heavy metals or traces of drugs that have been removed from the pharmaceutical market for safety reasons.
Just because the label says “natural” does not mean that it’s safe. Dietary supplements contain a variety of ingredients, such as vitamins, minerals, amino acids, and herbs or other botanicals. Be aware that an herbal supplement in particular may contain dozens of compounds and that all of its ingredients may not be known. Research has confirmed health benefits of some dietary supplements but not others, and there are numerous “natural” products which have been removed from the market not only for lack of effectiveness for the claimed use but for toxicities that have resulted in serious injuries and even deaths.
Many natural products or dietary supplements make claims of benefits which may be overstated and some have been shown to be dangerous after marketing. Unlike prescription medications, makers of dietary supplements are not required to show proof of safety and efficacy before going to market. The Food and Drug Administration (FDA) does have regulatory responsibility for these products but the rules are much different than those by which prescription or over the counter drugs are regulated. Importantly, the FDA cannot step in to enforce safety requirements until after these products are sold. So be particularly wary of new products that sound too good to be true. Advertising with claims like “miracle cure” or “scientific breakthrough” should be viewed with skepticism. After all, if such statements were true, we would all be using the product.
In summary:
- Know what supplement you are taking and why you might need it.
- Be sure the supplement is prepared in a safe manner and does not contain unwanted contaminants.
- Investigate data to support the claims of benefits.
- Read and follow label instruction – more than recommended amounts or combinations of dietary supplements is not better and might be risky.
- Discuss use of dietary supplements with your Doctor, there may be significant side-effects or interactions with medicines you are already taking.
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Here are some helpful and reliable web sources:
The National Institutes of Health (NIH) National Center for Complementary and Integrative Health (NCCIH): provides information including publications and searches of Federal databases of scientific and medical literature.
The Office of Dietary Supplements (ODS), National Institutes of Health (NIH): seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public.
U.S. Food and Drug Administration (FDA): The FDA oversees the safety of many products, such as foods, medicines, dietary supplements, medical devices, and cosmetics.
The National Library of Medicine NIH search engine Pubmed: Search for scientific articles through the National Institutes of Health website.
The United States Department of Agriculture (USDA): Numerous resources and links from the USDA regarding dietary supplements.
— Dr. Smith