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Are Supplements Safe?

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:
bulletCalcium and heart medicine (e.g., Digoxin), thiazide diuretics (Thiazide), and aluminum and magnesium-containing antacids.
bulletMagnesium and thiazide and loop diuretics (e.g., Lasix®, etc.), some cancer drugs (e.g., Cisplatin, etc.), and magnesium-containing antacids.
bulletVitamin K and a blood thinner (e.g., Coumadin).
bulletSt. John's Wort and selective serotonin reuptake inhibitor (SSRI) drugs (i.e., anti-depressant drugs and birth control pills).

What Should I Know Before Using Dietary Supplements?

Be savvy! Follow these tips before buying a dietary supplement:
bulletRemember: Safety First. Some supplement ingredients, including nutrients and plant components, can be toxic based on their activity in your body. Do not substitute a dietary supplement for a prescription medicine or therapy.
bulletThink twice about chasing the latest headline. Sound health advice is generally based on research over time, not a single study touted by the media. Be wary of results claiming a "quick fix" that depart from scientific research and established dietary guidance.
bulletLearn to Spot False Claims. Remember: "If something sounds too good to be true, it probably is." Some examples of false claims on product labels:
bulletQuick and effective "cure-all."
bulletCan treat or cure disease.
bullet"Totally safe," "all natural," and has "definitely no side effects."
bulletLimited availability, "no-risk, money-back guarantees," or requires advance payment.
bulletMore may not be better. Some products can be harmful when consumed in high amounts, for a long time, or in combination with certain other substances.
bulletThe term "natural" doesn't always mean safe. Do not assume that this term ensures wholesomeness or safety. For some supplements, "natural" ingredients may interact with medicines, be dangerous for people with certain health conditions, or be harmful in high doses. For example, tea made from peppermint leaves is generally considered safe to drink, but peppermint oil (extracted from the leaves) is much more concentrated and can be toxic if used incorrectly.
bulletIs the product worth the money? Resist the pressure to buy a product or treatment "on the spot." Some supplement products may be expensive or may not provide the benefit you expect. For example, excessive amounts of water-soluble vitamins, like vitamin C and B vitamins, are not used by the body and are eliminated in the urine.
bulletLearn about the optimum level of intake your body needs. Your body will use what it needs and discard the rest. Not everyone has the same level of need of each vitamin or mineral. It is important to supply your body with access to these and allow it to take what it needs.

How do I know if the supplement that I purchased contains the ingredients that it claims on the label or if it is contaminated?

You should be aware that the U.S. Food and Drug Administration (FDA) does not analyze the content of dietary supplements. At this time, supplement manufacturers must meet the requirements of the FDA’s Good Manufacturing Practices (GMPs) for foods. GMPs describe conditions under which products must be prepared, packed, and stored. Food GMPs do not always cover all issues of supplement quality. Some manufacturers voluntarily follow the FDA's GMPs for drugs, which are stricter. (Read about the differences between these two standards..)

Some manufacturers use the term "standardized" to describe efforts to make their products consistent. However, U.S. law does not define standardization. Therefore, the use of this term (or similar terms such as "verified" or "certified") does not guarantee product quality or consistency.

So the answer is you don't know if the supplement you just purchased contains what the label says or if contaminated products were used in the manufacture.

Contact the Manufacturer

If you have questions about a specific brand of dietary supplements, you can contact the manufacturer for more information. Ask to speak to someone who can address your questions, some of which may include:

  1. What information does the firm have to substantiate the claims made for the product? Be aware that sometimes firms supply so-called "proof" of their claims by citing undocumented reports from satisfied consumers, or graphs and charts that could be mistaken for well conducted scientific research.
  2. Does the firm have information to share about tests it has conducted on the safety or efficacy of the ingredients in the product?
  3. Does the firm follow good manufacturing practices and have a quality control system in place to determine if the product actually contains what is stated on the label and is free of contaminants?
  4. Has the firm received any adverse events reports from consumers using their products?
 

Seals of Approval

There are a few independent organizations that offer “seals of approval” that may be displayed on certain dietary supplement products. These indicate that the product has passed the organization’s quality tests for things such as potency and contaminants. These “seals of approval” do not mean that the product is safe or effective; they provide assurance that the product was properly manufactured, that it contains the ingredients listed on the label and that it does not contain harmful levels of contaminants.

Links to Seals of Approval

The following is a list of several organizations offering these programs:
bulletConsumerlab.com approved quality product seal: http://www.consumerlab.com/seal.asp
bulletNSF International dietary supplement certification: http://www.nsf.org/business/dietary_supplements/index.asp?program=DietarySups
bulletU.S. Pharmacopeia dietary supplement verification program: http://www.usp.org/USPVerified/dietarySupplements/

  Sources of information:
bulletOffice of Dietary Supplements
National Institutes of Health
Bethesda, Maryland 20892 USA
Web: http://ods.od.nih.gov

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These statements have not been evaluated by the Food and Drug Administration. This web page or any products found here are not intended to diagnose, treat, cure, or prevent any disease. If you find information here that is of interest to you, take it to your medical doctor for conversation and evaluation. Do not stop taking any prescription drugs without consulting with your medical doctor.

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