Frequently we are asked about the merits of taking food supplements to improve health and so we thought we'd share some information about the subject. As we have said before on this site, one of our goals is to make our readers better informed consumers because diabetes and the medications we take make this mandatory.
The boom in dietary supplements dates from 1994 when the Congress shielded producers from most government oversight. What you purchase has no prior certification or purity inspection. The 1994 law did mandate that supplement manufacturers desist from advertising their products as treatments or prevention for diseases. It did, however, allow them more vague claims of "supporting bodily functions." The FDA is mandated to intercede only in a product that is marketed as a drug or if it poses an unreasonable risk to the consumer. This leaves many gray areas. For example Willow bark, which has the same chemical makeup as aspirin, carries none of the warning that aspirin does to not give to children or teens who have the flu or chicken pox. Therefore, the unknowing consumer could cause deadly Reye's syndrome.
The Associated Press has analyzed the Food and Drug Administration records of side effects from supplements. They found the FDA has logged more than 2,500 reports of side effects and 70 deaths associated with dietary supplements. About 900 of the illnesses and 44 deaths were thought to be a result of taking products containing ephedrine-like stimulants. Millions of Americans take supplements especially herbs which are the fastest growing segment of the product lines. They spend about 3.2 billion dollars a year on these products.
There are some supplements that are positive additions to our diets. Folic acid can prevent birth defects, calcium impedes osteoporosis, and some researchers believe that garlic lowers cholesterol, ginger controls nausea, and St. John's wort is being studied as an anti-depressant.
The problem is that the myriad of products available have little or no data to support their claims, and that some experts feel that they are sold by exaggerating their benefits. The pills, teas, and tonics are sold with little information as to their benefits and more importantly, their risks.
Some in the industry, under the auspices of the New American Herbal Products Association have come out with a list of 700 herbs with suggested warning labels for the 200 member companies. This botanical council will publish a translation of Germany's "Commission E" safety and evaluations of 300 herbal products, 200 of which were approved as drugs in Germany. This is thought to be the best guide written on the subject to date.
Below is a list of supplements that the government warns can be risky:
- Ephedra: This can be bought under the names of ma huang, epitonin, and sida cordifolia, and contains the stimulant ephedrine which is currently banned in several states. Federal limitations on this supplement are now pending as it can cause heart palpitations, psychosis, heart attacks, and stroke.
- Chaparral: This is sold as both tea and pills to fight cancer; however, it has caused documented liver disease and deaths.
- Comfrey: When taken internally, this supplement is toxic to the liver and may be carcinogenic. It is banned in Canada and restricted in Germany.
- ADHEA: This hormone turns into estrogen and testosterone in the body. It is marketed as an anti-aging supplement; however, there is no evidence that this is realistic. It does cause liver damage in some people and may raise the risk for developing cancer.
- Dieter's Teas: These herbal blends contain ingredients such as senna, aloe, rhubarb root, buckthorn, cascara, and castor oil, all of which act as laxatives. When taken in excessive amounts thy can cause disruptions in potassium levels and disrupt the heart. They have caused excessive diarrhea, vomiting, constipation, and fainting, as well as death in at least 4 young women.
- Pennyroyal: This member of the mint family can induce miscarriage. One young woman is known to have died after using pennyroyal to induce an abortion.
- Sassafras: This was once used to flavor root beer, but the oil is banned as an additive in the U.S. It has been implicated in liver cancer in animals.
Supplements which interact with medications:
- Licorice root when eaten with laxatives hastens the loss of potassium.
- Flax seed can delay the absorption of medications.
- Kava kava can increase the effects of alcohol and some drugs for psychiatric disorders.
- High doses of Vitamin E can cause bleeding in people on blood thinners. The same is true of bromelin, a product sold as a digestive aid.
High doses of these vitamins and minerals can be risky:
- Vitamin A: High doses during pregnancy can cause birth defects. Doses for the general populations of over 25,000 International Units a day have been linked to liver disease, joint pain, and headaches.
- Vitamin D: Taking doses 10 times the daily requirements of 10 micrograms, for only a few months, can cause dangerously high levels of calcium and lead to kidney damage.
- Vitamin C: Doses higher than 1,000 milligrams a day can cause diarrhea and kidney stones.
- Selenium Supplements which contain 5 to 50 milligrams a day can cause nausea, loss of hair and nails, and nerve damage.
If you are considering taking any food or dietary supplement, vitamin, or mineral, check with your endocrinologist first. The study of drug interactions is a complicated subject, and only your doctor will be able to determine for sure the safety of any additions to your medical/dietary program.
