Partners in Health - Working With Your Health Care Providers
With the abundance of conflicting information available about dietary supplements, it is more important than ever to talk with your doctor and other health care providers (dietitian, nurse, pharmacist, etc.) to help you sort the reliable information from the questionable.
Dietary Supplements - More Than Vitamins
Today's dietary supplements are not only vitamins and minerals. They also include other less familiar substances, such as herbals, botanicals, amino acids, and enzymes. Dietary supplements come in a variety of forms, such as:
- energy bars or drinks
If you do not consume a variety of foods, as recommended in the Dietary Guidelines for Americans, some supplements may help ensure that you get adequate amounts of essential nutrients or help promote optimal health and performance. However, dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure diseases; therefore, manufacturers may not make such claims. In some cases, dietary supplements may have unwanted effects, especially if taken before surgery or with other dietary supplements or medicines, or if you have certain health conditions.
Unlike drugs, but like conventional foods, dietary supplements are not approved by the Food and Drug Administration (FDA) for safety and effectiveness. It is the responsibility of dietary supplement manufacturers/distributors to ensure that their products are safe and that their label claims are accurate and truthful. Once a product enters the marketplace, FDA has the authority to take action against any dietary supplement product that presents a significant or unreasonable risk of illness or injury.
Scientific evidence supporting the benefits of some dietary supplements (e.g., vitamins and minerals) is well established for certain health conditions, but others need further study. Whatever your choice, supplements should not replace prescribed medications or the variety of foods important to a healthful diet.
How To Recognize a Dietary SupplementAt times, it can be confusing to tell the difference between a dietary supplement, a food, or an over-the-counter (OTC) medicine. An easy way to recognize a dietary supplement is to look for the Supplement Facts Panel on the product.
Products Marketed as Dietary Supplements
Because many products are marketed as dietary supplements, it is important to remember that supplements include vitamins and minerals, as well as botanicals and other substances. The list below, adapted from A Healthcare Professional's Guide to Evaluating Dietary Supplements, the American Dietetic Association & American Pharmaceutical Association Special Report (2000), gives some examples of products you may see sold as dietary supplements.
It's not possible to list them all here.
Vitamins, Minerals, Nutrients:
- Multiple Vitamin/Mineral
- Vitamin B Complex
- Vitamin C
- Vitamin D
- Vitamin E
- Omega-3 Fatty Acids
- Folic Acid
Botanicals and Other Substances:
- Black Cohosh
- Evening Primrose Oil
- Ginkgo Biloba
- Fish Oil
- Glucosamine and/or Chrondroitin Sulfate
- St. John's Wort
- Saw Palmetto
Note: the examples provided do not represent an endorsement or approval by any organization that contributed to this material.
Potential Risks of Using Dietary Supplements
Although certain products may be helpful to some people, there may be circumstances when these products can pose unexpected risks. Many supplements contain active ingredients that can have strong effects in the body. Taking a combination of supplements, using these products together with medicine, or substituting them in place of prescribed medicines could lead to harmful, even life-threatening results. Also, some supplements can have unwanted effects before, during, and after surgery. It is important to let your doctor and other health professionals know about the vitamins, minerals, botanicals, and other products you are taking, especially before surgery.
Here a few examples of dietary supplements believed to interact with specific drugs:
- Calcium and heart medicine (e.g., Digoxin), thiazide diuretics (Thiazide), and aluminum and magnesium-containing antacids.
- Magnesium and thiazide and loop diuretics (e.g., Lasix, etc.), some cancer drugs (e.g., Cisplatin, etc.), and magnesium-containing antacids.
- Vitamin K and a blood thinner (e.g., Coumadin).
- St. John's Wort and selective serotonin reuptake inhibitor (SSRI) drugs (i.e., anti-depressant drugs and birth control pills).
If you suspect that you have had a serious reaction to a dietary supplement, you and your doctor should report it to FDA Medwatch:
- Phone: 1-800-FDA-1088
- Fax: 1-800-FDA-0178
- Internet: www.fda.gov/medwatch/how.htm