Dietary Supplements 101: What you should know

The US supplement industry is a $30 billion dollar business.¹ The Council for Responsible Nutrition estimates that almost 70% of US adults use dietary supplements.² Before I continue, I must state that I do not have any conflicts of interest and rest assured, although I am a pharmacist, I do not support ‘Big Pharma’ when it comes patients unnecessarily being prescribed medication.

Personally, I use caution when it comes to dietary supplements for one simple reason – they are not regulated like prescription medications. The FDA is the administration that regulates the approval and use of prescription medication. What this means is that on a prescription bottle labeled with a specific amount of ingredients, you can be certain that the actual amount in a given tablet, capsule, cream, suppository, solution, etc. is between about 95% and 105% of what the label actually states. As an example, if you are prescribed to take a tablet that is 100mg in strength, then you can be certain that the amount is between 95mg and 105mg of that medication.

On the contrary, dietary supplements are regulated by the Dietary Supplement Health and Education Act of 1994. Since they are not regulated like drugs, companies that manufacture and produce dietary supplements are able to put whatever claims they want on their bottles. It is possible and highly likely that what is stated on the supplement label is not what is in the actual tablet or capsule. In fact, the New York Attorney General and the Federal Trade Commission have recently filed suit against Prevagen for their claims of memory boosting.

Moreover, many weight loss dietary supplements contain botanicals and plant-derived ingredients that can cause and make health problems worse. Sometimes, these supplements can interact with prescription medicines that you are prescribed. St. John’s wort, in particular, can negatively interact with a number of medications, including Statins (Crestor, Simvastatin), Warfarin (Coumadin), and Tricyclic antidepressants, like Elavil or Pamelor.

I believe there are great health benefits and medicinal properties of nutraceuticals, however there is a great need for credible research and evidence before I would be comfortable recommending these products to my patients. Throughout my years of practice, I have found that many patients do not consider dietary supplements, OTC products, and vitamins as medications. I would recommend that the next time you have an appointment with your doctor, inform him/her of everything you take, even those that you purchase in a store or online, just to ensure that they are safe for you and do not interact with your prescription medications.

The next time you think of taking a supplement, remember that right now you have no way of knowing for sure what’s really in your supplement bottle. And despite the promising on the labels, the pills probably won’t make you any healthier (unless you have a medically diagnosed deficiency), and they might even be hurting you.

References:

1. https://www.vox.com/2016/3/10/11179842/dietary-supplements-medical-evidence
2. https://www.crnusa.org/CRNPR14-CRNCCSurvey103014.html
3. https://annals.org/article.aspx?articleid=1789253
4. https://www.iflscience.com/health-and-medicine/23000-people-us-end-er-annually-because-supplements

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