DIETARY SUPPLEMENTS
ARE WE COMPLETELY PROTECTED FROM UNSAFE SUPPLEMENTS? DO THEY REALY KEEP US HEALTHY?
If it sounds too good to be true, it most probably is not
The supplement industry is a very big business. In the USA alone, yearly sales surpasses $46 billion.
Dietary supplements are not completely safe. I remember two of my patients dying from taking supplements. The first patient was a middle age Chinese American male who was taking multiple Chinese herbal supplements thinking it was keeping him healthy. He came to see me with a deep jaundice. He was admitted to the hospital with acute liver failure and died few days later. The other patient was on anti-coagulant medicine but also taking Saint- John’s wart, on his own, for his depressive mood. He came in with massive intestinal bleeding. We were hardly able to save his life.
These two cases are good example showing that dietary supplements could have direct toxic effects on the body but also could interfere with the other medications a person is taking.
Especially now that dietary supplements are being overused by people to protect themselves against the coronavirus. We have to be extra cautious, and ask important questions as to why are the regulatory agencies of the government not controlling the safety and effectiveness of dietary supplements?
It is because dietary supplements are not promoted or sold as drugs but food supplements, which means that they are not subject for vigorous government’s control as drugs.
In the USA, the FDA (the Food and Drug Administration) which is in charge, considers dietary supplements as food additives and doesn’t strictly investigate their safety and effectiveness as drugs. It only issues advisory warnings to the consumers about the risks of supplements, after they are marketed and used by the consumers and caused serious side effects.
The FDA does this through its substructure of CAERS (the Center for Food safety and Applied Nutrition Adverse Events Reporting). However CAERS is not directly involved in data collection, instead it relies on voluntarily reported adverse events by consumers, health care providers and manufacturers. Because adverse event reporting is not obligatory, underreporting is the biggest hindrance for CAERS’s data collection. A study in this regard revealed that only 2 percent of adverse events, on yearly basis, were reported to CAERS. Additionally, reports are not in detail nor does it establish a cause–and–effect relationships, they are only considered possibilities.
Regulatory structures of the FDA for dietary supplements for some reasons are kept inadequate. The current system benefits manufacturers more than consumers. Therefore, a well-informed consumer who believes in taking dietary supplements should do some homework before deciding to take them.
Questions should be asked including:
1 – What is the effective ingredient in the supplement?
2 – How does it work?
3 – Is it safe to take?
4 – Is there a possibility that it could be contaminated with toxic chemicals or micro-organisms?
5 – What is the proper dosage to take?
6 – Could it interfere with my other medications?
There are two reliable websites for good information on this regard:
Medline Plus
https://medlineplus.gov/druginfo/herb_All.html
Consumer Reports
https://www.consumerreports.org/supplements/how-to-choose-supplements-wisely/?EXTKEY=YCRMAGSEP20
One also should remember that there is a strong placebo effects of any drugs or supplements. There has to be objective metrics to measure the effectiveness of any dietary supplements. But there is none. Therefore, as I see it, dietary supplements are nothing more than fool’s gold.
PS: Journal Watch: Chronic use of PPIs like Nexium and others may increase the risk of COVID – 19 infections. (Am J Gastoenterol 2020 Jul 7 )
