By
Roy M. Arnold MD
21st Century Healthcare
445 Cross Pointe Blvd.
Suite 140
812-402-2003
It seems like we are constantly bombarded with advertising for various dietary supplements and herbal remedies – through TV ads, email spam and internet ads. Which ones really work and what can they offer you? The answers aren’t as simple as one might think nor are they easy to ferret out from the advertisements.
First and foremost, just because a supplement or over-the-counter remedy is available doesn’t mean that it is either effective, or safe. According to an article published on Med Page Today’s website April 15, 2013, over half of all class 1 (most serious) recalls in the US over the last 9 years involved dietary supplements. Most of those supplements were sexual-enhancement, body-building, or weight-loss aids, the article reported.
A branch of the National Institutes of Health, the National Center for Complementary and Alternative Medicine (NICCAM) has published some key points about dietary supplements on its website (www.nccam.nih.gov) These include:
• Dietary supplements contain a variety of ingredients, such as vitamins, minerals, amino acids, and herbs or other botanicals. Research has confirmed health benefits of some dietary supplements but not others.
• To use dietary supplements safely, read and follow the label instructions, and recognize that “natural†does not always mean “safe.†Be aware that an herbal supplement may contain dozens of compounds and that all of its ingredients may not be known.
• Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.
• The U.S. Food and Drug Administration (FDA) regulates dietary supplements, but the regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
• Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
So – which supplements are worthwhile and which ones are wastes of money? WebMD published an analysis a few years ago. The following is an excerpt:
Multivitamins – There is no harm in taking a multivitamin daily, but a better choice would be to eat a more nutritionally complete diet. Make certain that your multivitamin contains at least 100% of the recommended minimum daily requirement of all vitamins. Women who have undergone menopause and men do not need iron supplements. There is no benefit to taking megadoses of B vitamins or Vitamin C. Women who are in their reproductive years should take 0.5 mg of Folic acid daily according to the Centers for Disease Control and Prevention. Folic acid can protect against a rare type of nervous system birth defect in the unborn.
Meal replacements like Slim Fast® and Ensure® can supplement the diet for those who are elderly, ill or trying to lose weight. A better alternative for weight loss would be a nutritionally complete, calorie-restricted diet.
Sports nutrition – This broad category includes pills, powders and drinks. Among the ingredients are creatine, amino acids, protein formulas, and fat burners. Most experts believe that they can provide a small edge in muscle building and fitness if used over the long term. One should not expect dramatic results.
Calcium and Vitamin D – These elements are vital to bone health and are lacking in most US diets. Dairy is the best source of calcium but if you can’t tolerate dairy, a calcium supplement in the form of lactate or citrate can be helpful. Vitamin D is produced in the body in response to exposure to sunlight, but with the recognized cancer risk of sun exposure, a supplement is probably a good idea. Women should consume 1200-1400 mg of calcium daily either in the diet or as a supplement. Adults of all ages should consider taking 1000 International Units of vitamin D daily.
Glucosamine and Chondroitin – These are most often taken for arthritis and joint pain. A multi-center study published in The New England Journal of Medicine found no advantage in patients with knee pain; however a small subset of patients did find some relief. There are no known harmful effects of taking Glucosamine Chondroitin.
Fish oil – Omega-3 fatty acids found in fish are cardio-protective and the basis for the American Heart Association’s recommendations to consume fatty fish twice weekly. For those who cannot consume this amount of fish, fish oil supplements are a good alternative. Be certain that the capsules contain 1000mg of DHA and EPA, the two important omega-3 fatty acids.
The listed products are the only ones which have been shown to have scientific validity. Other products like ginko-biloboa, Echinacea, elderberry, cider vinegar or any other of the many products found on the shelves at health food stores have either not been rigorously tested or have not shown favorable results in tests.
Almost all supplements contain the following statement: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.†These words merit your attention before purchasing or using any supplement. Always consult your primary healthcare provider before adding a supplement particularly if you are taking prescription medications.
