Dietary Supplements

What are dietary supplements?

Dietary supplements are a products that you may take by mouth to add nutrients to your diet. They are available as pills, tablets, capsules, liquids, and powders. Ingredients may include:

• vitamins
• minerals
• amino acids
• herbs
• probiotics
• enzymes.

Use of dietary supplements in the US is widespread. The dietary supplement business is a multi-billion dollar industry. Often there are misleading claims about the benefits.

The US Food and Drug Administration (FDA) does not regulate supplements and say which are OK for sales in the US. However, the FDA does have rules that must be followed when specific health claims are made. You should be quite wary of products that have general claims as a treatment or cure for disease. Also be cautious if they claim that they are a way to keep you from getting sick or to help you live longer. It is important to be an informed consumer when choosing supplements. Always discuss what you are taking or plan to take with your healthcare provider.

What about vitamins and minerals?

Vitamins and minerals occur naturally in food. We need them to stay healthy. However, the busier we are, the less likely it is that we will eat enough different foods to get all of the vitamins and minerals we need. Eating on the run often limits how much healthy food we eat, such as whole grains, fruits, vegetables and dairy products. You may want to add a daily multivitamin and mineral supplement to your diet. Dietary supplements should be viewed just as that—additions to your diet, not a substitute for a healthy diet.

You may need more nutrients if you are pregnant, older, or have a chronic illness. You may need to take supplements no matter what foods you are eating. For example:

• Women of child-bearing age should take a folic acid supplement.
• Adults and children who do not get out in the sun may need a vitamin D supplement.
• Adults age 50 and older should eat foods fortified with vitamin B12 or take a supplement that contains vitamin B12.
• Some medicines and the natural effects of aging may keep the body from absorbing certain nutrients.

If you decide to take vitamins and minerals, follow these guidelines:

• Check with your healthcare provider, pharmacist, or dietitian first, especially if you take prescription medicine or are being treated for a health problem.
• Choose a supplement that gives no more than 100% of the daily value for the vitamins and minerals. This helps you avoid taking too much. Don't take very large "megadoses." Having too much of some supplements, especially as you get older, can be poisonous.
• Store brands or generic brands can be as effective as brand names. Many different formulas are available. Ask your pharmacist, dietitian, or healthcare provider what is best for you.
• Look for stamps or seals of approval from USP (US Pharmacopeia), ConsumerLab.com, and NSF. These seals tell you that the product has passed quality tests for things like purity and active ingredient content. Remember that the stamp does not assure safety or effectiveness.

What about amino acids?

Amino acids are substances that form proteins. Some amino acids are made by the body, and others are obtained from the food we eat. Most people get more than enough amino acids from the proteins in their diet. However, some amino acids are sold as supplements, such as lysine, tryptophan, arginine, carnitine, and homocysteine. Do not take amino acids unless recommended by your healthcare provider. They can have unpleasant or dangerous effects.

What about herbal supplements?

Herbal supplements are made from plants. Ginkgo biloba, ginseng, echinacea, and black cohosh are examples of herbal supplements. Herbal supplements are advertised as "all natural," but:

• "Natural" does not always mean safe. Some herbs can cause serious side effects such as high blood pressure, diarrhea, heart attack, or stroke.
• When you use any herb for a health problem, you are using that supplement as a drug. Because they have an effect on your body, herbs can interfere with medicines you may already be taking. For example, St. John's wort can reduce the anticoagulant effect of the blood-thinning drug warfarin.

If you are thinking about taking an herbal supplement, ask your healthcare provider, pharmacist, or dietitian about it. Many resources are available to help your provider decide if an herbal would be helpful and safe for you.

What are probiotics?

Probiotic is a term used to describe the helpful bacteria that are normally in some parts of the body, such as the digestive system. The bacteria help digestion. They can also help keep you from having too many harmful bacteria.

If you take antibiotics, the medicine may kill the good bacteria. You may then have too many bad bacteria. This can cause diarrhea or vaginal yeast infection. Probiotic supplements contain concentrated doses of good bacteria. They can be used to help you not have too many bad bacteria.

Probiotics may also help:

• Treat Irritable bowel syndrome.
• Prevent and treat inflammation after colon surgery.
• Prevent eczema in children.

Lactobacillus acidophilus and Saccharomyces boulardii are 2 common probiotic supplements. They can be bought without a prescription. Probiotics can also be found in foods such as yogurt, miso, and some juices and soy drinks.

Probiotics do not help everyone who has problems with an overgrowth of harmful bacteria. Tell your healthcare provider if you plan to try a probiotic supplement.

What about supplemental enzymes?

Enzymes are proteins made by the body. They help your body in many important ways. For example, you need digestive enzymes to break down and use the food you eat. You may need digestive enzymes if your body cannot make enough of these enzymes. Lactase is an example of a digestive enzyme. Lactase helps if you have trouble digesting milk products.

There is no evidence that digestive enzymes are needed by the general population. If you have digestive problems, ask your healthcare provider if a digestive enzyme supplement might help you.

What's best for me?

The FDA oversees only certain labeling laws for dietary supplements. It can remove a supplement from the market only after it has been found to be unsafe. Supplements are not inspected or regulated the way that prescription medicines are. If you are thinking about using supplements, remember:

• Dietary supplements are not standardized. They may have different strengths and effects. Some may be contaminated. Be careful about which products you use.
• Do not self-diagnose any health condition. Talk to your healthcare provider, pharmacist, or dietitian before you buy something to try to treat yourself. Just because something worked for someone else does not mean it will work for you.
• Use only the supplement your provider or dietitian recommends. Don’t buy combinations that have ingredients you do not want or need.
• If your provider does not suggest a dietary supplement, but you decide to use one anyway, tell your provider. Then he or she can keep an eye on your health and adjust your other medicines if needed.

For more information contact:

National Institute of Health, Office of Dietary Supplements
Web site: http://www.ods.od.nih.gov/Health_Information/Information_About_Individual_Dietary_Supplements.aspx

U.S. Food and Drug Administration
Phone: 1-888-SAFEFOOD (888-723-3366)
Web site: http://www.fda.gov/Food/default.htm

Food and Nutrition Information Center, Department of Agriculture
Phone: 1-301-504-5414
Web site: http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=1