Safety and risk You are more likely to have side effects from dietary supplements if you take them in high doses or instead of prescription drugs, or if you take many different supplements. Some supplements may increase the risk of bleeding or, if taken before surgery, may change the response to anesthesia. A Look at Vitamins, Minerals, Botanical Ingredients, and More When you're looking for that bottle of vitamin C pills or fish oil, you might be wondering how well they'll work and if they're safe. The first thing to ask yourself is if you need them in the first place.
More than half of Americans take one or more dietary supplements daily or from time to time. Supplements are available without a prescription and usually come in pill, powder, or liquid form. Common supplements include vitamins, minerals, and herbal products, also known as botanicals. People take these supplements to ensure they're getting enough essential nutrients and to maintain or improve their health.
But not everyone needs to take supplements. Some supplements can have side effects, especially if taken before surgery or with other medications. Supplements can also cause problems if you have certain health conditions. And the effects of many supplements haven't been tested on children, pregnant women, and other groups.
So, talk to your healthcare provider if you're thinking about taking dietary supplements. Dietary supplements are regulated by the U.S. UU. The Food and Drug Administration (FDA) as food, not as drugs.
The label may indicate certain health benefits. However, unlike medications, supplements cannot claim to cure, treat, or prevent an illness. Evidence suggests that some supplements may improve health in different ways. The most popular nutritional supplements are multivitamins, calcium, and vitamins B, C, and D.
Calcium supports bone health and vitamin D helps the body absorb calcium. Vitamins C and E are antioxidant molecules that prevent cell damage and help maintain health. Women need iron during pregnancy and breastfed babies need vitamin D. Folic acid (400 micrograms daily), whether in the form of supplements or fortified foods, is important for all women of child-bearing age.
Vitamin B12 keeps nerves and blood cells healthy. Research suggests that fish oil may promote heart health. Of the supplements that aren't derived from vitamins and minerals, Hopp says, “fish oil is probably the one with the most scientific evidence to support its use. The health effects of some other common supplements need further study.
These include glucosamine (for joint pain) and herbal supplements such as echinacea (immune health) and flaxseed oil (digestion). Many supplements have mild effects with few risks. Vitamin K, for example, will reduce the ability of anticoagulants to work. St.
John's wort is sometimes used to relieve depression, anxiety, or nerve pain, but it can also accelerate the breakdown of many medications, such as antidepressants and birth control pills, and make them less effective. Just because a supplement is promoted as “natural” doesn't necessarily mean it's safe. The herbs comfrey and kava, for example, can seriously damage the liver. As for vitamins and minerals, check the% of the Daily Value (DV) of each nutrient to make sure you're not getting too much.
Too much of certain supplements can be harmful. Scientists still have a lot to learn, including about common vitamins. A recent study found unexpected evidence about vitamin E. Previous research suggested that men who took vitamin E supplements may have a lower risk of developing prostate cancer.
Coates, director of the NIH Office of Dietary Supplements. That's why it's important to conduct clinical studies of supplements to confirm their effects. Because supplements are regulated as foods, not as drugs, the FDA does not evaluate the quality of supplements or evaluate their effects on the body. If a product is found to be unsafe after it hits the market, the FDA may restrict or prohibit its use.
Manufacturers are also responsible for the purity of the product and must precisely list the ingredients and their quantities. But there's no regulatory agency to ensure that the labels match what's on the bottles. You risk consuming less, or sometimes more, of the ingredients listed. All the ingredients may not even be on the list.
Some independent organizations carry out quality testing of supplements and offer stamps of approval. This does not guarantee that the product works or is safe; it only guarantees that the product has been manufactured correctly and that it contains the ingredients listed. The MyDS app provides the latest information on supplements and allows you to keep track of the vitamins, minerals, herbs and other products you take. You can even keep track of the supplements your parents, spouse, or children take.
For more consumer health news and information, visit health, nih, gov. National Institutes of Health 9000 Rockville Pike, Bethesda, Maryland 20892 USA. Department of Health and Human Services. For one thing, dietary supplements can sometimes interact with each other, as well as with over-the-counter (OTC) and prescription drugs.
In addition, unlike drugs, the U.S. The Food and Drug Administration (FDA) is not authorized to review the safety and effectiveness of dietary supplements before they are marketed. It is the responsibility of manufacturers to ensure that their products do not contain contaminants or impurities, are properly labeled and contain what they claim. In other words, the regulation of dietary supplements is much less stringent than that of prescription or over-the-counter drugs.
If used correctly, some supplements can improve your health, but others can be ineffective or even harmful. For example, a systematic review looking at the potential effects of nutritional supplements on cardiovascular health, mainly in heart attacks and strokes, suggests that few supplements help prevent heart disease, only omega-3 fatty acids and folic acid were effective. The same thing happened with dietary changes, with the exception of a low-salt diet. Other research on dietary habits reported by a group of Americans linked daily doses of more than 1000 milligrams (mg) of calcium to an increased risk of death from cancer (although other studies, as noted by the National Cancer Institute, suggest otherwise).
In addition, the data showed that people who consumed adequate amounts of magnesium, zinc, and vitamins A and K had a lower risk of death, but only if they got those nutrients from food rather than from supplements. Confused? National Institutes of Health (NIH) fact sheets can provide detailed information about the benefits and risks of individual vitamins and minerals, as well as herbal supplements. And if you're managing an underlying health condition (especially if you're taking medication) or are pregnant or breastfeeding, play it safe and talk to your healthcare team before adding any new supplements to your regimen. While supplement trends come and go, here are seven supplements that have historically been popular, and in all cases, experts recommend taking them with care, if at all.
Vitamin D promotes the absorption of calcium in the body, and having enough of it is critical to health and well-being, and offers the promise of protecting bones and preventing bone diseases such as osteoporosis, according to the NIH. Vitamin D supplements are popular because it's difficult (if not impossible for some) to get enough from food. In addition, as the Centers for Disease Control and Prevention points out, our body produces vitamin D when bare skin is exposed to direct sunlight, but the increase in time spent indoors and the widespread use of sunscreen, as a necessary way to prevent skin aging and skin cancer, have minimized the amount of vitamin D that many of us get from sun exposure. But vitamin D supplements are a sensitive topic.
Sometimes, it can seem like guidelines and research are contradicting each other. The truth is that the enthusiasm for vitamin D supplements is outpacing the evidence. And taking high doses isn't a good option. In healthy people, blood levels of vitamin D greater than 100 nanograms per milliliter can cause additional calcium absorption and cause muscle pain, mood disorders, abdominal pain and kidney stones, notes the Cleveland Clinic.
It can also increase the risk of heart attack and stroke. That said, vitamin D supplements may benefit certain people, including those at risk of deficiency, such as people with darker skin, living with certain health conditions, and older adults, according to MedlinePlus. The most recent consensus statement from the American Geriatrics Society specifically suggests that people over 65 can help reduce the risk of fractures and falls by supplementing their diet with at least 1000 IU of vitamin D per day, in addition to taking calcium supplements and eating foods rich in vitamin D. Keep in mind that vitamin D supplements and medications can interact with each other.
Medications that don't mix well with vitamin D include the weight-loss drug orlistat (Xenical, Alli), several statins such as atorvastatin (Lipitor), thiazide diuretics (such as Hygroton, Lozol, and Microzide), and corticosteroids such as prednisone (Deltasone, Rayos, Strapred), according to the NIH. John's wort is a plant used as tea or in capsules, with purported benefits for depression, attention deficit hyperactivity disorder, menopausal symptoms, insomnia, kidney and lung problems, obsessive-compulsive disorder, wound healing and more, notes the NIH. John's wort will be effective in treating mild depression. For example, a review of short-term studies looked at 27 clinical trials involving about 3,800 patients and suggested that the herbal remedy worked as well as certain antidepressants in reducing symptoms of mild to moderate depression.
However, according to Dr. Denise Millstine, an internist in the integrative medicine department at Mayo Clinic in Phoenix, Arizona, “the biggest problem with St. John's wort and its drug interactions. Taking St.
According to the NIH, St. John's wort may also reduce the effectiveness of other medications, such as birth control pills, chemotherapy, drugs for HIV or AIDS, and drugs to prevent organ rejection after a transplant. John's Wort, read about possible drug interactions and ask your doctor about the risks and benefits of this supplement, as well as how it compares to your other options. Calcium is essential for a strong skeleton, but as with all nutrients, too much of this mineral can be harmful.
As noted by the NIH, more than 2500 mg a day for adults ages 19 to 50 and more than 2000 mg a day for people aged 51 and over can cause problems. With calcium supplements, hardening of the arteries or atherosclerosis and an increased risk of heart disease are risks, although research is conflicting, according to the Cleveland Clinic. The NIH recommends 1,000 mg of calcium a day for women ages 19 to 50 and 1,200 mg a day for women ages 51 and older. The recommendation for men aged 19 to 70 years is 1000 mg a day and 1200 mg a day for men aged 71 and over.
According to the Dietary Guidelines for Americans, there are several food sources of calcium, such as low-fat plain yogurt, tofu, skim milk, cheese, and fortified cereals and juices. Calcium deficiency, or hypocalcemia, can be detected through routine blood tests. If you have low blood calcium levels despite having an adequate dietary intake, your doctor may prescribe a calcium supplement. Do you think that a healthy lifestyle requires not only eating good-for-you foods, exercising and getting enough sleep, but also taking a daily multivitamin and multimineral supplement? Considering that, according to the NIH, roughly a third of adults in the United States and a quarter of young people take them, you'll be surprised to learn that the jury is still out on whether they're useful.
A study published in the journal JAMA Internal Medicine, which examined data from nearly 40,000 women over the age of 19 who participated in the Iowa Women's Health Study, found that, on average, women who took supplements had a higher risk of dying compared to women who didn't take them. Multivitamins did little or nothing to protect against common cancers, cardiovascular disease, or death. However, other research has found benefits from taking multivitamins. For example, one study concluded that frequent use of multivitamin and mineral supplements helped prevent micronutrient shortages that could otherwise cause health problems.
For women of reproductive age, the American College of Obstetricians and Gynecologists recommends taking prenatal vitamins with folic acid to help prevent birth defects. Your doctor may prescribe you multivitamins if you have malabsorption syndrome, a condition in which your body doesn't absorb vitamins and minerals properly. However, in general, Manson says, “a supplement can never replace a healthy diet. Rich in omega-3 fatty acids, fish oil has been touted as a means to reduce heart disease and other ailments.
However, there is increasing evidence to suggest that fish oil supplements have questionable benefits. However, there is currently not enough positive evidence for doctors to prescribe fish oil supplements to all patients. In addition to conflicting research results, omega-3 deficiency is very rare in the United States, according to the NIH. An important drug interaction with omega-3 supplements is coumadine (warfarin).
However, many people don't get enough omega-3s in their diet for optimal health. According to the Chan School of Public Health, omega-3s play a critical role in the formation of hormones that relax artery walls, reduce inflammation and help blood clotting. Tofu, tempeh and soy milk are good plant-based sources of protein, fiber and other key nutrients, according to the Cleveland Clinic. Some women also take soy in supplement form because the plant contains estrogen-like compounds called isoflavones that are thought to help relieve menopausal symptoms.
However, some health experts have expressed concern that isoflavones in soy supplements may contribute to an increased risk of breast cancer. However, there hasn't been enough research done on soy protein isolate (SPI), the dust that forms when protein is removed from the rest of the plant, to know its true effect on breast cancer risk, Millstine says. According to the Mayo Clinic, women with a family history of breast cancer or thyroid health problems may be more vulnerable to these effects. But again, this is theoretical and more studies are needed.
In addition to supplements, SPI is often found in energy bars, veggie burgers, and some soups, sauces, smoothies, and breakfast cereals. A new world report shows that, despite heavy spending, the United States lags behind other rich countries. Estrone, estradiol, and estriol are the three main types of estrogen. A draft opinion from the United States,.
The Supreme Court overturns the federal right to abortion guaranteed by the 1973 decision in Roe v. Research finds that female pattern hair loss is common and associated with lower self-esteem. New research found that women taking estrogen were less likely to die from COVID-19 than women with natural estrogen levels. While supplements are not allowed to be sold as if they prevent or treat diseases, with a change in language, these companies can easily make claims such as “boost the immune system” or “maintain a healthy immune system.”.
These statements are 100% legal and may imply for consumers that the supplement can protect them from COVID-19, but that is not the case, Dra. Getting our nutrients straight from a pill seems easy, but supplements don't necessarily deliver on the promise of better health. Some can even be dangerous, especially when taken in larger than recommended amounts. More than half of American adults take vitamins, minerals, herbs, or other nutritional supplements.
Some of these products aren't especially useful, readers told us in a recent survey, but other than that, don't assume they're safe because they're all natural. They may not be either of them. These are 10 dangers that we have extracted from interviews with experts, published research, and our own analysis of serious adverse event reports submitted to the Food and Drug Administration, which we obtained through a Freedom of Information Act request. Reports described more than 10,300 serious outcomes (some included more than one), including 115 deaths and more than 2,100 hospitalizations, 1,000 serious injuries or illnesses, 900 emergency room visits, and another 4,000 major medical events.
Unless your healthcare provider tells you that you need more than 100 percent of the recommended daily intake for a particular nutrient, you probably don't. It's surprisingly easy to overdo it. For example, a 50-year-old woman concerned about her bones could have a breakfast of Whole Grain Total cereal, which contains about 1000 milligrams of calcium per serving, with half a cup of skim milk (150 milligrams of calcium) and take a calcium supplement (500 milligrams) in addition to her One-A-Day Menopause Formula multivitamin, which includes 300 milligrams of calcium. It would already be approaching the maximum tolerable daily calcium limit of 2000 milligrams.
Of the 233 labels we examined, most included only general warnings, such as those about not using the product while pregnant or breastfeeding, or about potential unspecified drug interactions. Forty percent of the labels warned people not to take the supplement if they had a medical condition, but only some mentioned an ailment, such as a bleeding disorder; 36 percent warned of possible adverse reactions; but only 13 percent warned of possible interactions with a specific medication or type of medication. Five of our 20 samples of 5-HTP, a mood and sleep supplement, contained warnings about a possible drug interaction for Parkinson's disease. John's wort may reduce the effectiveness of certain prescription medications, including birth control pills and blood thinners, such as warfarin (Coumadin).
Only two of the 17 samples we purchased explicitly warned of these dangers. Ginkgo biloba can also interfere with blood thinners, but we saw a warning about that possible interaction in a single bottle of ginkgo. Over the past decade, the FDA's regulatory partner, the Federal Trade Commission, which oversees the advertising of dietary supplements, has filed more than 100 legal challenges against claims about the effectiveness of supplements. Our reporter asked for advice on how to treat type 2 diabetes, high blood pressure and impotence, conditions that have effective conventional drug treatments.
The healers offered a variety of instructions and herbs, but none voluntarily offered relevant data about possible side effects or risky interactions that can occur when taking an herb with a medication. And when we returned the herbs to the office and checked the scientific evidence, we found that there was a lack of conclusive research on their effectiveness and safety. Omega-3 pills and antioxidants are widely believed to reduce the risk of heart disease and cancer, respectively, and millions of women take calcium to protect their bones. However, recent evidence casts doubt on whether those supplements are as safe or effective as supposed.
Most people can get enough omega-3s by eating fatty fish at least twice a week. The American Heart Association says that people with coronary artery disease may want to talk to their doctor about omega-3 supplementation. The researchers cautioned that the implications of their findings were worrisome, given that more than half of people aged 60 and over take supplements containing vitamin E. In addition, 23 percent of them take at least 400 IU per day, despite a recommended daily allowance of just 22 IU for adult men.
Most people get enough through their diet. Exceptions include vegetarians, who may need more vitamin B12, which is found in animal foods; approximately 10 to 30 percent of people over 50 who don't have enough stomach acid to extract vitamin B12 from food; and women who are pregnant or trying to become pregnant, who must take 400 micrograms of additional folic acid daily to help prevent birth defects. There is some evidence that 200 milligrams or more of vitamin C a day may improve cold symptoms in smokers and older people, although it won't prevent colds. Vitamin C can improve iron absorption, so avoid high doses if you have hemochromatosis, a condition in which your body absorbs and stores too much iron.
Two analyses have linked as little as 400 IU per day to a small but statistically significant increase in mortality. In addition, vitamin E can inhibit blood clotting, so it should not be taken with anticoagulants. Large clinical trials have repeatedly demonstrated that multivitamins do not improve the health of the average person. People who may need a multivitamin include women who are pregnant, breastfeeding, or trying to conceive; people who diet and consume fewer than 1,200 calories a day or who eliminate an entire food group (carbohydrates, for example); and those with medical conditions that affect digestion and absorption of food.
Manufacturers of nutritional supplements have no legal obligation to place warnings about possible drug interactions in their products, but nothing stops them if they want to. John's wort is especially prone to drug interactions, and most of the 17. The labels of the St. John's Wort products we reviewed contained a general warning or mentioned specific drugs or drug classes. One of the most comprehensive warnings we saw was on a bottle of Vitamin Shoppe.
The warning (shown) does a good job of alerting users to the herb's important interactions with anti-HIV drugs, anticoagulants, oral contraceptives, prescription antidepressants, and transplant medications. If you decide to take vitamins, botanicals, or other supplements, look for those that have the USP Verified mark, meaning they meet the quality, purity, and potency standards set by the nonprofit organization U. Some supplements that, with more rigorous testing, have been shown to be beneficial to health in observational studies are not only ineffective but also risky. The latest blow to calcium supplements was a report by German and Swiss researchers who followed nearly 24,000 adults for an average of 11 years.
Cohen said during an episode of the “AMA Moving Medicine” video series about dietary supplements and regulations. They found that people who got their calcium from food had a lower risk of atherosclerosis, while calcium supplements were associated with a higher risk of atherosclerosis. The FDA does not require that supplements undergo rigorous safety and efficacy testing, as drugs are tested. If you're browsing the internet looking for dietary supplements and find a site that claims their products can diagnose, cure, mitigate, treat, or prevent a disease, navigate directly to another site.
Two AMA members took time to talk about what doctors would like patients to know about vitamins and nutritional supplements. Research supplements at trustworthy government sites, such as the Food and Drug Administration, the Office of Dietary Supplements at the National Institutes of Health, and the National Center for Complementary and Alternative Medicine. Make sure your doctor or pharmacist knows what supplements and prescription medications you are taking or plan to take. .
