Dietary Supplements: Using Them Wisely

Post by Diane Danchi, R.D., L.D.N. Diane is a Registered Dietitian at Rex Wellness Center of Cary and Rex Wellness Center of Knightdale.

In 2011, results of a survey by the Centers for Disease Control (CDC) were released revealing that more than half of American adults were using dietary supplements of some kind, like vitamins, minerals, amino acids, herbs, etc. As a Registered, Licensed Dietitian, I not only keep my ears to the dietary supplement news wires for my clients and students, but for myself as well. In addition to healthy eating and exercise, yes, I do take some supplements. Though we know some supplements may be beneficial, some lead to dangerous waters that need careful navigation.
What are the possible dangers? There are several.

“Natural” doesn’t always mean safe. A lot of prescription drugs come from “natural sources” (i.e. aspirin), so taking them without dosage guidance could be harmful. Unknown affects – research isn’t complete on a lot of supplements. The National Institutes of Health has on-going research looking at the potential benefits and dangers of herbs and supplements. There are also known dangerous effects of some dietary supplements. For example, comfrey and kava can damage the liver. There could also be nutrient or drug interactions, i.e. – too much iron can interfere with calcium absorption; fish oil can act like a blood thinner. Supplements use is rarely researched with pregnant or lactating women or children, so affects on those 3 groups are unknown. Some herbal supplements can increase risk of bleeding and intensify affects of anesthesia. In addition, new supplements are hitting the market place every day with very little scientific information about them available.
So, ask these basic questions before starting a supplement. 1. Do I first need to think about improving the health of my diet overall? Nutrients, in most cases, are better absorbed from food than from supplements. 2. Do I need to talk to my doctor, pharmacist, nutritionist, or surgeon? 3. If purchasing from a website, is there any evidence of the business’ credibility?

A few other tips: Ask, “Is it too good to be true?” Think twice about sensationalized news reports of recent studies, as it takes time to prove safety and effectiveness. Also, check your assumptions. “If it doesn’t help, at least it won’t hurt me.” Not necessarily true! “Natural” doesn’t always mean healthy, and remember the famous baseball player who sadly died from an overdose of ephedra in 2004.

The FDA does not regulate supplements, so unless a manufacturer submits their product to the United States Pharmacopeia, there is no assurance that it contains what it says. Check out their website for the list of USP verified supplements. Once the manufacturing process has passed an on-site audit and product content has been verified, the USP does random follow-up checks for quality control.

For current safety information, check these web sites:
http://www.fda.gov/Food/DietarySupplements/Alerts/default.htm
http://nccam.nih.gov/news

For information about supplement use, effectiveness and safety, you can do research at these sites:
FDA
National Institutes of Health
Center for Food Safety and Applied Nutrition
CARDS database research site
Mayo Clinic
Tufts University
WebMD