The Dangers of Dietary Supplements
Every day, most American adults swallow some kind of dietary supplement, according to the National Institutes of Health. It might be a multivitamin, a weight-loss pill, or another product taken with the hope that a tiny tablet will conveniently and safely provide significant health benefits.
But, the reality is that dietary supplements carry plenty of potential risks, notes Jenna Rosenfeld, RD, CDN, CNSC, a registered dietitian at Weill Cornell. “The most serious risks occur when supplements contain doses stronger than advertised or contain ingredients that aren’t listed on the label,” she explains. “For example, many weight-loss pills have been taken off the market because they contain dangerous active ingredients. Additionally, an ‘all-natural’ male enhancement pill was recalled because it contained sildenafil, the active ingredient in Viagra. The ingredients in supplements can also interact with current prescription medications or be administered in a dose that is unsafe.”
Lack of Oversight
Unlike prescription medications, which undergo testing and regulation standards imposed by the U.S. Food and Drug Administration (FDA), dietary supplements are not subject to the same level of scrutiny. Supplements can be sold without receiving any sort of approval, although the FDA can recall supplements if they’re proven to be unsafe.
“Studies have shown that the vast majority of supplements contain more or less of the ingredient advertised, as well as markedly different doses than labeled,” Rosenfeld says. And, some supplements contain ingredients that do not appear on the label. For example, some supplements have been found to contain heavy metals such as lead, mercury, or arsenic.
Risks Are Real
Dietary supplements have been linked to many adverse health events. For example, a study published in the New England Journal of Medicine revealed that, on average, 23,000 emergency room visits per year from 2004 to 2013 were due to adverse side effects from supplement use. Nearly three-quarters of the ER visits were associated with weight-loss pills and muscle-building supplements that triggered heart palpitations, chest pain, or other symptoms.
Liver damage is also a serious risk. Research reported in the journal Hepatology showed that one in five cases of hepatotoxicity (chemical-induced liver damage) is caused by a dietary supplement.
Supplement Safety
Carefully read the label on any supplement before purchasing it. If you’d like some help, there are organizations that routinely analyze supplements.
Two non-profit groups that study supplements include NSF International and the United States Pharmacopeia (USP). Two independent laboratories—Consumer Lab and Labdoor—also research and review supplements.
“These organizations test for purity and accuracy of labeling ingredients and doses,” Rosenfeld says. “If the supplement passes their tests, they provide their own stamp of verification on the supplement. However, be aware that some unscrupulous companies may print labels with a near-identical image of these seals of approval.” You can get information on a variety of supplements from the organizations’ websites (see What You Can Do).
Start with Your Doctor
Your health depends on your being honest with your healthcare providers about supplement use. For your safety, tell your doctor about all of the medications you take, including supplements as well as over-the-counter medications. Some supplements can interact with other medications and cause real harm. For example, some supplements can interact with warfarin, a drug commonly prescribed to reduce the risk of blood clots; some supplements can inhibit its action, while others can magnify its effect.
“It is always recommended that you check with your doctor before starting a supplement, as they may interact with your prescription or over-the-counter medications. Also, certain supplements may be contraindicated for some patients, depending on their medical history,” Rosenfeld says. “Also, it’s advisable to have your doctor on board to have a discussion regarding any side effects to look out for, which can help you prevent potential serious adverse reactions.”
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