What you need to know about dietary supplements: part 1

by Amy Renee
What you need to know about dietary supplements: part 1

Should you be taking supplements?

Maybe you take a daily multi vitamin and mineral supplement because you want to make sure you meet all of your daily requirements for good health. Or maybe you’ve heard of the benefits of fish oil for heart health and started taking that daily. Your best friend whom has gorgeous, healthy hair told you her secret is a daily biotin supplement combined with a prenatal vitamin even though she’s not pregnant. Antioxidant supplements to prevent cancer, melatonin for better sleep, St. John’s wart to reduce anxiety, ephedra, bitter orange, chromium picolinate, and chitosan for weight loss…the list goes on. But do they work? Do we really need them? Are they doing more harm than good?

There are certain circumstances in which vitamin and/or mineral supplementation is an absolute necessity. For example in cases of malnutrition or malabsorption patients will most definitely need supplements until adequate health status has been established. And for individuals who have certain health conditions, supplements can be very helpful. But if you are eating a nutrient-poor diet that is full of processed, nutrient-poor foods no single or even handful of pills is going to save you from a health status that matches your poor lifestyle habits. So instead of spending tons of money on a bunch of pills and powders maybe you should try a delicious plant-based diet rich in whole grains, legumes, and fruits and vegetables? That is what several well established and reputable physicians recommend. And of course I do too.

If you consume a well-varied plant-based diet (or mostly plant-based diet) you will easily get all of the required nutrients your body needs from the food you eat. As for vitamin B12 (a vitamin that is primarily found in animal foods) – Dairy free milks such as almond, soy, or coconut milk it is fortified with a good amount of vitamin B12 (unless you make it yourself), as are most brands of nutritional yeast, so if you consume these things you probably easily meet your requirements for this vitamin. If you don’t then this is one vitamin I would recommend those on a strict vegan diet take.

Do they work? Are they safe?

Most individuals think that because you can purchase supplements without a prescription that they are safe. Additionally, many supplements are labeled as “all natural” so people mistakenly think this means they are safe. Both of these misconceptions are understandably common, but incorrect. Although I am a firm believer in avoiding pharmaceutical drugs as much as possible by living a healthy lifestyle that includes a sufficient amount of physical activity and a healthy plant-based diet, sometimes they are necessary and what a lot of people don’t realize is that many times pharmaceutical drugs are actually safer than supplements.

Why you ask? Good question.

First of all, pharmaceuticals are by law required to undergo vigorous clinical research studies before manufacturers can even market them let alone provide them to the public. Note: This does NOT mean that serious, potentially deadly side effects do not still occur.

As far as supplements that are labeled “all natural” go – well, this is another BAD story. Sometimes they are in fact “all natural” but the components of the herbs used are not safe. For example the botanical Kava is marketed for its anti-anxiety benefits, however several research studies have found this herb to cause liver damage. One of the major reasons for this is due to the fact that some manufacturers of Kava use inappropriate parts of the plant (kava stumps, aerial parts, and peelings from above the rhizome) which are much cheaper (approximately 1/10 the cost) of the traditionally used parts of the kava plant (rhizome and root). The cheaper parts of the plant contain a substantially higher amount of the toxic alkaloids that are responsible for liver damage. Unfortunately this is true for many herb and botanical supplements.

Other times supplements bear the Department of Agriculture’s “Organic” seal even though they are synthetic. Manufacturers can get away with this because according to the FDA vitamins do not have to come from nature in order to perform the same biologically.

HOW ARE SUPPLEMENTS REGULATED?

You would be shocked to find out how supplements are regulated (or not regulated rather) in this country. Manufacturers are pretty much regulated using an honor system. Yep! You read that right. Unlike for pharmaceuticals, manufacturers of supplements do not need to provide the FDA with proof of safety or efficacy of their products before they market and sell them to the public unless they contain a new ingredient. They are supposed to provide the FDA with information that they are properly labeling their products, but often supplements are found to be mislabeled. This may not seem like a serious offense, but as you read on you’ll discover just how dangerous this can be.

SUPPLEMENT LABELS

There are three types of claims that supplement companies can put on their labels; however if a manufacturer chooses to put one of these on their label they must follow it with, “This statement has not been evaluated by the U.S. Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure, or prevent any disease.

  1. Health Claims – this type of claim describes a relationship between two major components: a substance (the supplement) and a disease or health-related condition. Health claims must be based on scientific evidence. For example, “diets high in calcium reduce the risk for osteoporosis.”
  2. Structure/Function Claims – this is a claim that describes how the supplement affects a structure or function within the body. For example, “this supplement opens the blood vessels.”
  3. Nutrient Content Claims – this type of claim describes the level of a specific nutrient in the product. For example, “high in calcium.”

As noted above, supplement manufacturers CANNOT make claims that their products can diagnose, cure, mitigate, treat, or prevent a disease.

Supplement manufacturers ARE NOT required to put warnings on their labels about any possible adverse reactions such as undesirable or serious side effects, unknown adverse effects during pregnancy, or supplement-drug interactions. These are very important things to consider when using dietary supplements. Usually the only way the FDA will ever find out about adverse reactions caused by a specific supplement is if patients and/or patients’ doctors contact the FDA to report such effects. Unfortunately side effects often go unreported.

Even though a label might say that a specific amount of a substance is in each capsule or pill, that amount could be off by a significant amount.

Many supplements contain ingredients that are not included on labels. This is called “contamination” or “adulteration” and can be intentional or unintentional. This can be very dangerous. Read more about this in What you need to know about dietary supplements: Part 2 (to be published later this week).

MARKETING STRATEGIES USED BY SUPPLEMENT COMPANIES

The supplement business is a multi-billion dollar business. According to national surveys more than half of Americans use supplements with the most common ones being fish oil, omega-3, glucosamine, Echinacea, flaxseed oil, ginseng, and multivitamin/mineral supplements. Most people don’t need supplements but purchase them because of marketing ploys.

Clinical research proves supplement “XYZ” to be AWESOME…

Keep in mind that when a supplement advertisement discusses a “clinical study” that found “this awesome benefit of their product” – GUESS WHO PROBABLY FUNDED THAT STUDY?!?! Yep, the supplement company. And the doctor or doctors who are recommending that particular supplement are PAID TO DO SO! Don’t be fooled. Manufacturers will go to great lengths to make their “clinical research study” sound reputable, but the fact is not only is the study extremely biased, but the entire setup of the research is most likely not up to the standards of an actual research study that would be considered for peer review. It is simply a ploy to get you to buy their product.

Even reputable research studies do not always provide strong evidence

Another thing to consider is that when you hear little blurbs on the news or in magazines about a single research studies’ findings you should not take it as being conclusive. There could be several factors that come into play that throw off data in a study. Good scientists and medical professionals gather evidence from SEVERAL studies, preferably ones with specific study designs that match their clinical question (an example of a clinical question: does a daily omega-3 supplement reduce arthritis symptoms in adults over age 60?).

News media LOVES to make a single research finding sound over-the-top exciting with a blanket statement like, “In a new study out this past week researchers at Harvard Medical School found that a daily dose of omega-3 in supplement form reduced arthritis pain in 99% of patients!” This is so incredibly misleading and causes SEVERAL people to go out and purchase omega-3 supplements with the belief that their pain will go away even though several other factors likely played a role in the findings that were not even discussed in the article. And even if the omega-3 supplement doesn’t help, many individuals will have a placebo effect and continue using it because they think the supplement is working when it could be doing more harm than good!

“The marketers of supplements like to use the scientific evidence the way a drunk uses a lamp-post: more for support than illumination.”

– Norman J. Temple

WHAT IS THE U.S. PHARMACOPEIA (USP)?

Quoting straight from the USP website: “The U.S. Pharmacopeial Convention (USP) is a scientific nonprofit organization that sets standards for the identity, strength, quality, and purity of medicines, food ingredients, and dietary supplements manufactured, distributed and consumed worldwide. USP’s drug standards are enforceable in the United States by the Food and Drug Administration, and these standards are used in more than 140 countries.”

If a supplement company volunteers to have the USP examine their product(s) they are then able to place the USP stamp on their product label after the product is deemed safe and meets all of the standards. However, because this quality verification program is completely voluntary and cost the manufacturer money only few companies participate and therefore have the USP label. This is a great program and it is unfortunate that this is not a required process of all dietary supplement products before going to market.

 

Risks associated with supplement use

The only way adverse events from supplement use can be known is if they are reported to the FDA by individuals who experience these events, physicians who have patients who have had effects, or supplement companies themselves (unlikely). Therefore, most side effects associated with supplement use probably go unreported since consumers most likely simply stop using the supplement and go back to their normal life. According to an article published by Consumer Reports magazine over 6,300 serious adverse events from supplement use (heart, kidney, or liver problems, aches, allergic reactions, fatigue, nausea, pains, and vomiting) were reported to the FDA between 2007 and early 2012. Of those cases 2,100 people required hospitalization and 315 died.

You have got to watch this:

The popular news television show Dateline NBC aired a fantastic episode showcasing the dangers of supplements back in 2012. PLEASE take the time to watch this episode of “The Hansen Files” in which journalist Chris Hansen goes undercover to reveal the hidden dangers of how current good manufacturing practices are not always being followed.

Here are the YouTube videos for all three parts. See how a simple mineral (selenium) can be lethal in high amounts? Crazy! And pantyhose? Gross. Also, how about part 3 – would you want this guy testing the supplements you take?

I wonder if you’ll reconsider your supplement use after watching this episode of Dateline NBC…

Click here for part 1, and here for part 2, and here for part 3 to watch the Dateline clips.

I know this was a long post, but hopefully you weren’t too bored and found the information useful. It could potentially save your health or the health of those you love.

Look out for Part 2 of this post to be published later this week. It has even more VERY IMPORTANT information. And it doesn’t have any videos, so I promise it won’t take up as much of your time. 😉

Thanks for reading.

 

References

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