We Americans do love our dietary supplements. More than half of the adult population have taken them to stay healthy, lose weight, gain an edge in sports or in the bedroom, and avoid using prescription drugs. In 2009, we spent $26.7 billion on them, according to the Nutrition Business Journal, a trade publication.
What consumers might not realize, though, is that supplement manufacturers routinely, and legally, sell their products without first having to demonstrate that they are safe and effective. The Food and Drug Administration has not made full use of even the meager authority granted it by the industry–friendly 1994 Dietary Supplement Health and Education Act (DSHEA).
11 supplements to consider
These popular supplements, listed in alphabetical order, have been shown to likely be safe for most people and possibly or likely to be effective in appropriate doses for certain conditions. Talk to your doctor or pharmacist before starting any supplement. Most supplements haven’t been studied in pregnant or nursing women. The list of interactions and side effects is not all-inclusive.
(also known as)
|EFFICACY FOR SELECTED USES||SELECTED POTENTIAL SIDE EFFECTS||SELECTED DRUG INTERACTIONS|
(calcium carbonate, calcium citrate, calcium gluconate)
|Likely effective in combination with vitamin D in preventing and treating bone loss and osteoporosis. Taken daily, appears to reduce some PMS symptoms.||Belching, gas.||Calcium can decrease the effectiveness of certain antibiotics, osteoporosis drugs, and thyroid drugs.|
(American cranberry, large cranberry, cranberry extract)
|Possibly effective for preventing recurrent urinary-tract infections.||Large amounts can cause stomach upset, diarrhea.||Might increase the effects of the blood thinner warfarin.|
(EPA/DHA, omega-3 fatty acids, PUFA)
|Effective for reducing triglyceride levels. Likely effective for decreasing the risk of heart attack, stroke, and progression of hardening of the arteries in people with existing heart disease.||Fishy aftertaste, upset stomach, nausea, loose stools. High doses can increase levels of LDL (bad) cholesterol in some people or increase the chance of bleeding.||Might increase the effect of blood-thinning drugs and high blood pressure medications.|
(G6S, glucosamine sulfate 2KCl, glucosamine sulfate-potassium chloride)
|Likely effective treatment for reducing symptoms of osteoarthritis of the knee. Might also help slow progression of osteoarthritis.||Nausea, heartburn, diarrhea, constipation, headache.||Might increase the blood-thinning effect of warfarin and cause bruising and bleeding.|
|Likely effective for reducing gastrointestinal symptoms in lactoseintolerant people when used before consuming lactose or when added to milk.||No reported side effects.||None known.|
(acidophilus, acidophilus lactobacillus, probiotics)
|Possibly effective for preventing diarrhea while taking antibiotics.||Gas. People with poor immune function should check with their doctor first.||Might cause infection in people taking immunosuppressant drugs.|
(blond plantago, blonde psyllium, plantago, isabgola)
|Effective as a bulk laxative for reducing constipation or softening stools. Likely effective for lowering cholesterol in people with mild to moderately high cholesterol.||Gas, stomach pain, diarrhea, constipation, nausea. Some people can have a serious allergic response that requires immediate medical attention.||Might decrease the effectiveness of carbamazepine, an antiseizure drug; digoxin, a heart drug; and lithium, for bipolar disorder. Might cause low blood sugar when taken with some diabetes drugs.|
(African plum tree, African prune, Prunus africana)
|Likely effective for reducing symptoms of an enlarged prostate.||Nausea, abdominal pain.||None known.|
(ademetionine, adenosylmethionine, S-Adenosyl-L-Methionine, sammy)
|Likely effective in reducing symptoms of major depression, reducing pain, and improving functioning in people with osteoarthritis.||GI symptoms, dry mouth, headache, mild insomnia, anorexia, sweating, dizziness, and nervousness, especially at higher doses. It can make some people with depression feel anxious.||Might lead to a toxic reaction when taken with the cough suppressant dextromethorphan, certain antidepressants, or narcotic pain relievers. Might worsen symptoms when taken with the Parkinson’s drug levodopa.|
|ST. JOHN’S WORT
(Hypericum perforatum, Saynt Johannes Wort, SJW)
|Likely effective for improving symptoms of some forms of depression.||Insomnia, vivid dreams, anxiety, dizziness, headache, skin rash, and tingling. It can cause skin to become extra-sensitive to the sun.||Can decrease the effectiveness of a wide range of drugs, including birth-control pills, heart medications, HIV/AIDS drugs, and warfarin. Might also increase the effects or side effects of certain antidepressants.|
(Cholecalciferol, vitamin D3, ergocalciferol, vitamin D2)
|Likely effective when taken with calcium to help prevent osteoporosis. Might help reduce falls in people with vitamin D deficiency and bone loss in people taking corticosteroids.||Extremely large amounts might cause weakness, fatigue, headache, and nausea, though side effects are rare.||Might reduce the effectiveness of some medications, such as atorvastatin (Lipitor), other heart medications, birth-control pills, HIV/AIDS drugs.|
Source: Natural Medicines Comprehensive Database, Professional Version, June 2010
How to choose the right multivitamin
Multivitamins (Most we tested were fine, so select by price)
Shopping for a multivitamin has crossed the line from being confusing to becoming mind-bending. On a recent visit to a CVS store in the New York City area, our reporter counted no fewer than 50 adult multivitamin/multimineral supplements (multivitamins, for short). One A Day is available in 15 formulations for everyone from teenage boys to women watching their “metabolism”; its competitor Centrum comes in nine versions.
If you think you can avoid the confusion by heading straight for the “silver” products marketed to seniors, think again: About a third of the CVS offerings targeted people in the 50-plus range, with formulations for men, women, and menopausal women, as well as the standard unisex formulas. And here’s a news flash: You may not even need them.
With all the choices, it’s no wonder half of multivitamin users in a new, nationally representative Consumer Reports telephone survey expressed some doubt that they were taking the right product for their needs. Our survey, which included 2,002 adults and took place in April 2010, uncovered some other concerns, too: Fifty-six percent of respondents who took a multivitamin worried that it contained harmful ingredients, for example, and 47 percent expressed concern that their multivitamin didn’t contain the levels of nutrients listed on the bottle.
Our tests of 21 multivitamins at two outside labs—including leading brands, five for seniors, and six for children—will allay some of those fears. All but one of the products we tested met their label claims for key essential vitamins and minerals, and none contained worrisome levels of contaminants such as arsenic or heavy metals. Most of the pills we tested also passed the U.S. Pharmacopeia’s dissolution test, which involves immersing them in a simulated stomach-acid solution to determine whether they’ll dissolve properly in your body. (The USP is an independent standards-setting authority for the drug and dietary supplement industries.)
What’s more, we found that store brands did just as well in our tests as national brands, at a lower price. The biggest winner: Costco’s Kirkland Signature, whose regular, “mature,” and children’s multis cost a nickel or less a day.
But many people taking the pills don’t need to. Despite their popularity—Americans spent almost $4.7 billion on multivitamins in 2008, up from $3.7 billion in 2003—there’s virtually no evidence that they improve the average person’s health.
As a result, the supplement marketplace is not as safe as it should be.
- We have identified a dozen supplement ingredients that we think consumers should avoid because of health risks, including cardiovascular, liver, and kidney problems. We found products with those ingredients readily available in stores and online.
- Because of inadequate quality control and inspection, supplements contaminated with heavy metals, pesticides, or prescription drugs have been sold to unsuspecting consumers. And FDA rules covering manufacturing quality don’t apply to the companies that supply herbs, vitamins, and other raw ingredients.
- China, which has repeatedly been caught exporting contaminated products, is a major supplier of raw supplement ingredients. The FDA has yet to inspect a single factory there.
The lack of oversight leaves consumers like John Coolidge, 55, of Signal Mountain, Tenn., vulnerable. He started taking a supplement called Total Body Formula to improve his general health. But instead, he says, beginning in February 2008, he experienced one symptom after another: diarrhea, joint pain, hair loss, lung problems, and fingernails and toenails that fell off. “It just tore me up,” he said.
Eventually, hundreds of other reports of adverse reactions to the product came to the attention of the FDA, which inspected the manufacturer’s facilities and tested the contents of the products. Most of the samples contained more than 200 times the labeled amount of selenium and up to 17 times the recommended intake of chromium, according to the FDA.
In March 2008 the distributor voluntarily recalled the products involved. Coolidge is suing multiple companies for compensatory damages; they have denied the claims in court papers. His nails and hair have grown back, but he said he still suffers from serious breathing problems.
The Dirty Dozen
Working with experts from the Natural Medicines Comprehensive Database, an independent research group, we identified a group of ingredients (out of nearly 1,100 in the database) linked to serious adverse events by clinical research or case reports. To come up with our dozen finalists, we also considered factors such as whether the ingredients were effective for their purported uses and how readily available they were to consumers. We then shopped for them online and in stores near our Yonkers, N.Y., headquarters and easily found all of them for sale in June 2010.
The dozen are aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe. The FDA has warned about at least eight of them, some as long ago as 1993.
Why are they still for sale? Two national retailers we contacted about specific supplements said they carried them because the FDA has not banned them. The agency has “the authority to immediately remove them from the market, and we would follow the FDA recommendation,” said a spokeswoman for the Vitamin Shoppe chain.
Most of the products we bought had warning labels, but not all did. A bottle of silver we purchased was labeled “perfectly safe,” with an asterisked note that said the FDA had not evaluated the claim. In fact, the FDA issued a consumer advisory about silver (including colloidal silver) in 2009, with good reason: Sold for its supposed immune system “support,” it can permanently turn skin bluish-gray.
Janis Dowd, 56, of Bartlesville, Okla., says she started taking colloidal silver in 2000 after reading online that it would keep her Lyme disease from returning. She says her skin changed color so gradually that she didn’t notice, but others did. “They kept saying, ‘You look a little blue.’”
Laser treatments have erased almost all the discoloration from Dowd’s face and neck, but she said it’s not feasible to treat the rest of her body.
Under the DSHEA, it is difficult for the FDA to put together strong enough evidence to order products off the market. To date, it has banned only one ingredient, ephedrine alkaloids. That effort dragged on for a decade, during which ephedra weight-loss products were implicated in thousands of adverse events, including deaths. Instead of attempting any more outright bans, the agency issued warnings, detained imported products, and asked companies to recall products it considered unsafe.
(Sumber : Yahoohealth)