Summary
Health supplements are vitamins, minerals, herbs or other botanicals and other substances which are intended to supplement your normal diet. Supplements are generally used for a specific purpose, such as gaining or losing weight, adding muscle, or improving energy.
As their name suggests, health supplements are intended to supplement, not replace, a healthy, balanced diet. Supplements are also not intended to prevent, treat or cure disease. Manufacturers are not allowed to claim that their product will diagnose, cure, mitigate, treat or prevent a disease. Supplements should not be taken for any of those purposes.
In fact, it is advisable to use caution in purchasing and using health supplements. Unlike drugs:
- Supplements can be marketed without any proof that they are safe.
- Dietary supplements do not need approval from the FDA before they are marketed (except in the case of a new dietary ingredient.)
- Some ingredients in supplements can cause serious side effects. Consumer Reports suggests skipping the following 12 supplement ingredients: Aconite, Bitter organce, Chaparral, Colloidal Silver, Coltsfoot, Comfrey, Country mallow, Germanium, Greater celandine, Kava, Lobelia and Yohimbe.
- Supplements can be marketed without any proof that they will do what people think they will ("efficacy").
- Manufacturers do not have to make consumers aware of potential side effects or drug interactions.
- Quality of dietary supplements and herbal products is not regulated. Studies suggest that:
- A sizable percentage of herbal products are not what they are labeled to be
- Quality and actual content may vary from bottle to bottle
- The FDA must prove that a product is dangerous before it can require that it be withdrawn from the market. Supplements are generally only pulled from shelves after complaints of serious injury.
When purchasing a supplement, consumer advocates suggest looking for products which:
- Have the ingredients you are looking for. (You can find this information on the label.)
- Do not have an excess of extra ingredients.
- Are manufactured by a good quality company.
- Have a "USP" or "ConsumerLab" certification. While such a designation does not mean that the product is safe or effective, it does mean that Supplements with either of these verifications: meet standards of quality, purity and potency; are screened for harmful contaminants; are manufactured using safe, sanitary and well-controlled procedures. USP certification standards are set by the not-for-profit U.S. Pharmacopeia. To learn more about the mark and the organizati0n, see: www.uspverified.org . For information about the consumerlab certification, click here .
- Preferably are recommended by a trained professional.
Following are guidelines for taking a supplement based on recommendations are from Dr. Alan R. Gaby, a specialist in nutritional medicine and a past president of the American Holistic Medical Association.
- It is best to take multivatimins and fish oil with meals.
- This helps avoid stomach upset while taking multivitamins.
- The fats included in the average meal enhance the absorption of fish oil.
- If you take vitamin C, it is not advisable to take more than 500 mg of vitamin C in one dose. It may lead to diarrhea and/or stomach cramps. Instead, divide the dose over the course of a day.
- Buffered forms of vitamin C are less likely to cause stomach upset than unbuffered forms.
- Vitamin C is less likely to cause stomach upset or diarrhea if taken with food.
- Taking B vitamins at night can cause insomnia.
- Take Vitamin E with food. It requires the presence of fat for optimal absorption.
- Take calcium in the evening or before bed.
For information about what to do before starting to take a supplement, as well as information about supplement myths, see the other sections of this article.
NOTE:
- If you notice any new symptoms or side effects from taking a supplement, stop taking the product immediately. Contact your doctor (or at least your doctor's office) and report what happened.
- When you are asked what medications you take, be sure to include supplements, as well as vitamins and herbs. Survivorship A to Z provides a List of Medications form to help you keep track.
To Learn More
Myths About Supplements
It is a myth to think that:
- Supplements can diagnose, cure, mitigate, treat or prevent a disease.
- Because a supplement is natural, it is safe. Cyanide is also natural.
- Long term use means that a supplement is effective.
- The effect from taking a supplement will always be the same. The effect is unpredictable.
- Herbs and other Botanical supplements are unrefined pharmaceuticals. They aren't. There is no mandated consistency in the way any supplement is made. A supplement from a plant grown in one condition may have different properties than a supplement from a plant grown in a different condition or soil.
What To Do Before Starting To Take A Supplement
Before starting to take a supplement, it is advisable to take the following steps:
- Check with your doctor to find out his or her opinion about:
- The usefulness of the supplement
- Whether it negatively impacts your physical condition or the drugs you are taking.
- Check to see if the information that comes with the supplement has been tested in a scientific, double-blind placebo control trial. (A placebo looks like the acutal pill, but has no active ingredients in it). A double-blind placebo control trial means:
- That part of the test group took a placebo (generally a sugar pill) instead of the actual supplement, while the other group took the supplement.
- Neither the participating patients nor the doctors know who is receiving the supplement and who is receiving the placebo.
- The results of the two different groups are tested over time in a controlled situation.
- Look at evidence based information about supplements you are considering. For instance, see:
- "About Herbs, Botanicals and Other Products" at www.mskcc.org/aboutherbs
- The Office of Dietary Supplements of the National Institutes of Health's information sheets and publications: http://dietary-supplements.info.nih.gov , Tel.: 301.435.2920
- U.S. Department of Agriculture's Food and Nutrition Information Center provides information at www.nal.usda.gov/fnic , Tel.: 301.504.5719. Click on "Dietary Supplements".
- The information on the Memorial Sloan Kettering websirte about herbs, botanicals and vitamins: www.mskcc.org/aboutherbs
- Also see The Internet: Respected Comprehensive Sites.