Welcome back to Wellness Wednesday everyone! A couple of weeks ago, I asked what you’d like to know about wellness. Several people mentioned that they’d like to know more about supplements. Dietary supplements are big business. Everywhere we look, we’re being urged to try this all-natural ‘cure’ or being promised that this amazing supplement will improve our health in some way. But do they really work? And most importantly, are these supplements even safe?
According to Dr. Pieter Cohen, who is a dietary supplement safety researcher and assistant professor of medicine at Harvard Medical School, “A lot of people are spending unnecessary sums for things that in most cases will do nothing.” (1)
That’s not to say that all supplements are bad, though. Some dietary supplements can help us get adequate amounts of essential nutrients if our diet is not ideal. Sometimes we need supplements to improve overall health or manage certain health conditions. (2)
One thing that comes immediately to mind is taking calcium and Vitamin D to support bone health, folic acid to support fetal development, or probiotics to support gut health.
Of course, the preferred way to get most of our required nutrients is through a well-balanced diet. Unfortunately, it’s almost impossible for us to eat well all the time. That’s when we might need to look at supplementing our diet.
When Are Supplements Appropriate?
Healthcare providers often recommend supplements for people with “elevated nutrient needs and people who may not always eat well.”(3)
Here are some instances where doctors might recommend supplementation:
- Pregnant and/or breastfeeding women. As mentioned above, folic acid is critical for healthy fetal development, and pregnant mothers also have increased needs for iron and other nutrients. When mothers are breastfeeding, they may have even greater needs than when they were pregnant.
- Children. Do you have a picky eater? If you do, you know how hard it can be to get them to eat a balanced diet. A basic multi-vitamin may ensure they get the nutrients they need.
- People with severe food restrictions. Whether it’s because of a health issue or if you’re severely restricting calories or eliminating certain food groups, supplementation might help.
- Elderly people. Inadequate stomach acid (which is essential for the proper absorption of vitamin B12) is common among older adults. They may also have low levels of vitamin D and calcium, which are critical for bone health.
Not only are people supplementing with vitamins, minerals, etc., they’re also looking for natural alternatives for pain relief, energy, weight loss – any number of things.
It’s All-Natural, So It Must Be Safe, Right?
The thought is often, “It’s natural, so it’s safe. Even if it doesn’t help, it won’t hurt me.” That’s not necessarily the case though.
Do you remember the news reports around the supplement ephedra (also known as ma huang) years ago? It was widely used in natural weight-loss supplements because it decreases appetite. It also has life-threatening side-effects like dangerous increases in blood pressure, heart attacks, seizures, strokes, and even some serious psychiatric illnesses.(4) That doesn’t sound very safe, does it?
We also need to be cautious about taking supplements when we’re taking prescription medications. Some supplements can interact with medications we’re already taking and cause serious problems. For instance, vitamin K can interfere with the drug Warfarin’s ability to prevent blood from clotting, St. John’s wort can speed up the breakdown of medications, and some antioxidants can reduce the effectiveness of chemotherapy.
So how do we know the supplements we’re buying are safe?
The short answer? We don’t. Herbal supplements are not regulated by the Food and Drug Administration. This means they’re not subjected to the same rigorous safety and efficacy (does it work?) testing that new medications are.
In 2007, the FDA did issue regulations that require dietary supplement manufacturers to implement Current Good Manufacturing Practices (CGMPs) by 2010. These CGMPs don’t “address supplement safety or their effect on health”(4) but they do ensure consistency in manufacturing, which helps avoid dosing errors, wrong ingredients, etc..
If You’re Considering Using A Supplement
Do your homework.
Research any supplements you’re considering. Remember that the supplement companies want to sell you their product, so it’s not enough to take their word for whether their supplements are safe or work as they claim.
When evaluating scientific studies conducted on the supplement in question, take note of who commissioned and conducted the study. Those conducted or financed by product manufacturers are not always credible.
Look for the U.S. Pharmacopeia (USP) mark. This still doesn’t guarantee safety or efficacy, but it does let you know that the ingredients are “consistent with those stated on the label; that the supplement has been manufactured in a safe, sanitary, controlled facility; and that the product dissolves or disintegrates to release nutrients in the body.”(3)
Another source of unbiased information about supplements is ConsumerLab. Their stated mission is, “to identify the best quality health and nutritional products through independent testing.” Their website is a wealth of information.
Consult your medical team.
Talk to your doctor before taking a supplement if you’re taking it to help treat a health condition or if you’re already being treated for a health condition. As we’ve already discussed, supplements can interact with medications you’re already taking. They may also cause certain medical issues to worsen. It’s important that we talk to our doctors ahead of time.
The National Institutes of Health recommends you have the answers to these questions before you start to take a new supplement:
- What are its potential benefits for me?
- Does it have any safety risks?
- What is the proper dose to take?
- How, when, and for how long should I take it?
Talking with your doctor and pharmacist can help you answer them.
The Bottom Line
Dietary supplements can help prevent deficiencies in our diets and perhaps, improve our wellness. We just need to do our homework and make sure we’re using supplements that are safe and effective. We definitely don’t want to cause ourselves harm or waste our money on things that don’t work. As always, knowledge is power – in this case, power to make wise decisions for our wellness.
How do you ensure the supplements you take are safe and effective? Please share!
(3) Nutrition, Fourth Edition, Certification Manual, 2013; Paul Inset; Don Ross; Kimberley McMahon; Melissa Bernstein; Jones and Bartlett Learning; Burlington, MA
(4) Sports Nutrition for Health Professionals, 2015; Natalie Digate Muth; F.A. Davis Company; Philadelphia, PA