Beware of Supplement

Jun 21, 2024, 00:00 AM by Department of Pediatrics



Americans want to be healthy.  Who doesn’t?  Americans know that a significant part of being healthy is good nutrition.  Americans also know that good nutrition includes vitamins and numerous minerals such as iron.  More recently we have learned about probiotics, omega 3’s and 6’s, microbiomes, fish oil, herbal capsules, etc.  Numerous studies have been done to determine if all these ingredients improve health, how much is needed and how much is too much.  While many of the above ingredients are important for good health many may have side effects particularly if taking too much.

Information from the Eating Lab written by Anahad O’Conner in the Washington Post reports that Americans spend billions of dollars every year on dietary supplements that claim to promote almost every aspect of health.  . As they are not medicines they are not prescribed by physicians.  Many people take 4 or more supplements.  About 35% of children and adolescents use dietary supplements and nearly 10% of children between 2 and 5 years old get two or more dietary supplements.

This article goes on to explain that in the US companies sell an estimated 90,000 dietary supplements representing about $50 billion dollars.  With the potential of making so much money the buyer needs to beware.  Dietary supplements are regulated under the general umbrella of foods, not drugs.  Studies of melatonin, fish oil, probiotics, and ginkgo biloba have found that the doses and compounds on the labels are often not found in their bottles.   In one study in the journal, Pediatric Research, researchers tested 16 probiotic supplements and found that only one of them contained the specific bacterial strains listed on the label.  Sometimes they found the listed ingredient was missing or it contain unlisted ingredients.

Dietary supplements are not regulated as are the medicines sold either by prescriptions or over the counter. There are ways to determine that supplements you are buying are meeting high standards for purity and potency. The United States pharmacopeia (USP) has a voluntary program that companies can have their products tested.   If they meet the high standards of this testing, they are allowed to have a black and yellow “USP Verified” logo.  Another testing group has a blue and white ”NSF” logo.

Consumers of dietary products, children and adults, need to be aware of what and why they are taking dietary supplements.  Their physicians needs to know what they are taking also.  A lot of the supplements and medications use the same metabolic pathways and can cause dangerous side effects when they are combined.  For example Vitamin C can interact with statins, niacin, estrogen, warfarin and some chemotherapy drugs.  St. John’s wort can make birth control pills less effective.  Just because something is “natural” doesn’t make it safe.

It is probably wise to discuss dietary supplements with your health care provider and look for the label for UPS or NSF testing.  Remember Vitamin C is in citrus fruit and iron is in raisins and spinach.  Ask Popeye.

by Sally Robinson, MD Clinical Professor
Keeping Kids Healthy
Published 5/2023

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