Health Concerns about Use of Dietary Supplements

There is considerable publicity about potential benefits of dietary supplements but there is less awareness of their possible harmful effects. Today's dietary supplements are not only vitamins and minerals but include other less-familiar substances such as herbals, botanicals, amino acids, enzymes, and animal extracts. They are marketed as tablets, capsules, softgels, gelcaps, powders, and liquids. Our WWURA members have heard of them, may have used them or recommended them to friends and family. Some supplements have been well researched; others have not. The list of highly marketed supplements keeps growing without scientific evidence to support they are healthful.

Unlike prescription and over-the-counter drugs, supplements are not permitted by federal law to be marketed for the purpose of treating, diagnosing, preventing, or curing diseases. Supplements should not make disease

claims such as “treats heart disease,” “lowers blood pressure and cholesterol,” or “prevents cancer.” If you read such claims, note that these are not legal and have no research to support the claims. There is no safety testing or FDA approval required before a new supplement goes on the market. Also, there are no requirements that dietary supplement packaging lists potential adverse effects, nor are there standards for maximum pill size (dosage), a clear risk especially for older adults.

The risks in taking supplements. Supplements contain active ingredients which have biological effects in the body, making them unsafe in some situations. Combining supplements, using supplements with prescription and/or OTC medications, substituting supplements for prescription medications, or taking too much of a supplement (such as vitamin A and D, or iron or calcium) can have negative health consequences.

Unwanted side effects, such as elevated blood pressure, racing or irregular heartbeat, headache, dizziness, or digestive symptoms can occur and may be misdiagnosed by health care providers if they do not know the extent of patient usage of supplements. If choosing to use supplements, be a smart shopper.

• Using the internet? Select noncommercial sites (e.g., National Institutes of Health, Cleveland Clinic, Mayo Clinic, Harvard Newsletter, professional nutrition organizations).
• If claims sound too good to be true, they probably are.  Be wary of words/claims such as “works better

than,” “totally safe,” or “has no side effects.” Be aware that the term “natural” doesn’t necessarily mean “safe.”

• Ask health care provider, including the pharmacist, is the supplement safe and beneficial. Examples: Coumadin (a prescription blood thinning medicine), ginkgo biloba (an herbal supplement), aspirin, and vitamin E (a vitamin supplement) can each thin the blood. Taking any of these products alone or together can increase the potential for internal bleeding or stroke. St. John's wort may reduce the effectiveness of prescription drugs for heart disease, depression, seizures, certain cancers, or HIV.
• Planning surgery? Let doctors know if vitamins, minerals, herbals, or any other supplements are being taken.
• Remember: combined intake from all supplements (including multivitamins, single supplements, and combination products) plus fortified foods (some cereals and drinks), could cause health problems. (https://www.fda.gov/Food/DietarySupplements/UsingDietarySupplements/ucm109760.htm)

Resources:

https://www.health.harvard.edu/blog/harmful-effects-of-supplements-can-send-you-to-the-emergency-department-201510158434 

https://www.nia.nih.gov/health/dietary-supplements#herbal