Supplements: know what you are taking

Dietary and herbal supplements are widely used in the U.S. and poorly regulated. This poses some serious risks to consumers. As an herbalist with many years of training, I find that there are few in the general public, including MD’s, nurses and other health-care professional, that have even a fundamental understanding of what herbal medicine is; its potential and its dangers. The gamut of opinion seems to rest around two misguided extremes. One is that herbs are generally safe and can therefore be taken without professional guidance. The other is that herbs are completely unsafe because we don’t know how they work from a scientific point of view. Both opinions are wrong because research on herbs has been ongoing for many years, although the U.S. lags behind much of Europe in this respect. Also, herbs are therapeutically effective, so just like pharmaceuticals we should have at least some basic information available to all health care providers. With so many people consuming these supplements it is unacceptable that there is not at least a rudimentary course offered to all health care providers. So how did we end up with this problem and how can you as the consumer avoid its pitfalls?


Regulation History

First, just a brief history of regulation in the U.S. In 1938 the congress passed a law (the Federal Food, Drug and Cosmetic Act) that required animal testing for drugs, placed cosmetics and medical devices under FDA regulation and added many more layers of safety regulation to the U.S. food industry. Dietary supplements were defined under this act and were regulated as food. This meant that they could not be misleading in their labeling and that they had to meet standard safety requirements (FDA 2009 [1]). In 1994, a new law, the Dietary Supplement Health and Education Act was passed. This law took some small steps to “legitimize” the claims of dietary supplements and changed the safety regulations slightly. The manufacturers could now make general claims about the product’s affect on health if they are substantiated but could not make any claims that it could be used to “diagnose, prevent, mitigate, treat or cure a specific disease” (FDA 2009 [2]) This is the reason that we are in a sort of limbo when it comes to herbal and dietary supplements. It also explains the scarcity of good information that is available to us as consumers because there is little basic research being done on dietary supplements. There is little incentive to prove therapeutic value when no claims can be made.

How to be an Informed Consumer

As consumers we need to know some basic facts when taking dietary supplements or herbal medicines. These facts are the same as those for drugs; how much do we take, how often, what are the possible side effects, are there any dangers when taking the supplements while taking other supplements or drugs? Many of these questions are difficult to answer because the basic research that is needed to answer those questions has not been done. However, there are some good resources out there that can fill in some of the gaps. The following resources are intended to give you some idea of the potential benefits and hazards when taking supplements, so that you can some background information before discussing with your health care providers what supplements will work for you.


http://www.naturalherbsguide.com/

This web site offers good information on the individual herbs, the active compounds in the herbs, common ways of taking the herbs and standard dosages. I also like that it allows you to search through several different pathways, including Ayurvedic (traditional Indian medicine) and Chinese herbs.

http://altmedicine.about.com/

This is one of the best sites I have seen for information on supplements. It is moderated by Cathy Wong, an author and naturopathic doctor. This is the most extensive list of supplements that I have seen online. It offers good information on potential uses and potential dangers of using various supplements. The only downside is I wasn’t able to find much information on recommended dosages.

http://nccam.nih.gov/health/herbsataglance.htm

This site offers basic information on several herbs, including some background information on what research has been done. I found that this site is heavy on the side effects/caution side but doesn’t offer a lot of other relevant information.

http://www.nutrametrix.com/balanceaom

This is a link from my web site, balanceaom.com to nutraMetrix, a nutraceutical line that we carry in our clinic. I like this site as an information site because they offer extensive information about ingredients, dosage, what it used for, what are the risks and what scientific research has been done (both in the U.S. and Europe). It is also easy to find the type of supplement that you want because the products are listed by general categories (e.g. heart health).

I know many of my readers may have other valuable resources, if so please send a comment. Also, I would love to hear from readers if you have a specific herb or supplement that you want more information on. You can go to my website and submit a question, I will happily include it in my future blog posts on specific herbs/supplements.


Sources

1. U.S Food and Drug Administration (FDA). The Story of the Laws Behind the Labels. USFDA Center for Food Safety and Applied Nutrition web site. 2009. Available at: http://www.cfsan.fda.gov/~lrd/histor1a.html. Accessed April 14, 2009.
2. U.S Food and Drug Administration (FDA). Dietary Supplement Health and Education Act. USFDA Center for Food Safety and Applied Nutrition web site. 2009. Available at: http://www.cfsan.fda.gov/~dms/dietsupp.html. Accessed April 14, 2009.