When you reach for the vitamin C bottle or fish oil tablets, you might wonder how well they’re going to function and if they’re healthy. The first thing you have to ask yourself is if first you need them.
Around half of all Americans take one or more dietary supplements regularly or occasionally. Supplements are available without a prescription and typically come in a type of pill, powder, or liquid. Also known as botanicals, common supplements include vitamins, minerals, and herbal products.
People are taking these supplements to ensure they are getting enough vital nutrients and preserve or enhance their health. But not everyone have to take supplements.
“It’s possible to get all of the nutrients you need by eating a variety of healthy foods, so you don’t have to take one,” says Carol Haggans, a registered dietitian and consultant to NIH. “But supplements can be useful for filling in gaps in your diet.”
Some supplements may have side effects, particularly if taken with other medicines or before surgery. If you have other health issues, supplements can also cause problems. And the effects of several supplements on infants, pregnant women and other groups have not been checked. So if you are considering taking dietary supplements, talk to your health care provider.
“You should discuss with your doctor what supplements you’re taking so your care can be integrated and managed,” advises Dr. Craig Hopp, an expert in botanicals research at NIH.
Dietary supplements are governed by the United States. The regulation of foods and medications (FDA) as products, not as medicines. Some health benefits can be listed on the label. Yet, unlike pharmaceutical drugs, supplements cannot claim to cure, treat or prevent a disease.
“There’s little evidence that any supplement can reverse the course of any chronic disease,” says Hopp. “Don’t take supplements with that expectation.”
Evidence shows that certain supplements can do different things to improve safety. Multivitamins, calcium, and Vitamins B, C, and D are the most common nutrient supplements. Calcium enhances bone health, and vitamin D helps absorb calcium in the body. Vitamins C and E are antioxidants — molecules which prevent damage to the cells and help maintain health.
Women need iron during pregnancy, and vitamin D is required for breastfed infants. For all women of childbearing age, folic acid—400 micrograms per day, whether from supplements or fortified food — is essential.
Vitamin B12 protects healthy nerve and blood cells.“Vitamin B12 mostly comes from meat, fish and dairy foods, so vegans may consider taking a supplement to be sure to get enough of it,” Haggans says.
Research suggests fish oil may promote cardiac safety. Of certain supplements not derived from minerals and vitamins, Hopp says,“fish oil probably has the most scientific evidence to support its use.”
More research is required regarding the health effects of some other may supplements. Which include glucosamine and herbal supplements such as echinacea (immune health) and flaxseed oil (digestion) for joint pain?
Many additives have mild effects, with little risks. Still practice caution. For example, vitamin K can lessen the ability of blood thinners to function. Ginkgo will increase dilution of the blood. The herb St. John’s wort is often used to relieve stress, anxiety or nerve pain, but it can also intensify the degradation of other drugs — such as antidepressants and pills for birth control — and make them less efficient.
Only because it promotes a supplement as “natural” doesn’t automatically mean it’s healthy. For example, the herbs comfrey and kava may cause serious damage to the liver.
“It’s important to know the chemical makeup, how it’s prepared, and how it works in the body—especially for herbs, but also for nutrients,” says Haggans. “Talk to a health care provider for advice on whether you need a supplement in the first place, the dose and possible interactions with medicine you’re already taking.”
For vitamins and minerals, test each nutrient’s percent Daily Value (DV) to make sure you don’t get too much. “The DV and the upper limit are important to remember,” Haggans says. Too many of the additives can be harmful.
Also on popular vitamins, scientists still have a lot to know. One recent research showed surprising signs of vitamin E. Earlier studies indicated people who have taken supplements of vitamin E can have a lower chance of developing prostate cancer. “Much to our surprise, a major NIH-funded clinical trial involving more than 29,000 people found that taking vitamin E supplements significantly raised — not reduced — their risk of this disease,” says Dr. Paul M. Coates, director of the NIH Dietary Supplements Office. This is why clinical trials of supplements are critical for confirming their effects.
Due to the fact that supplements are licensed as products, not as medications, the FDA does not determine the consistency of supplements or their effects on the body. If a product is considered unsafe once it reaches the market, the FDA can limit or prohibit its use.
Manufacturers are also responsible for the purity of the drug, and they must list the ingredients and their quantities accurately. But there is no enforcement body that ensures labels suit what’s inside the bottles. You risk having fewer of the listed ingredients, or sometimes more. It cannot even mention all the ingredients.
A few independent organizations carry out additional standard checks and provide approval seals. This does not guarantee that the product works or is safe; it simply guarantees that the product has been properly produced and contains the ingredients specified.
“Products sold nationally in the stores and online where you usually shop should be fine,” Coates says. “According to the FDA, supplement products most likely to be contaminated with pharmaceutical ingredients are herbal remedies promoted for weight loss and for sexual or athletic performance enhancement.”
“Deciding whether to take dietary supplements and which ones to take is a serious matter,” says Coates. “Learn about their potential benefits and any risks they may pose first. Speak to your health care providers about products of interest and decide together what might be best for you to take, if anything, for your overall health.”