Health Blog: Does Dose Size Matter with Dietary Supplements?

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Yes, dose sizes can be beneficial or detrimental

We’re a pill-loving society.  And we’ve come to expect one tablet, capsule, gel-tab, etc. to equal one dose.  So entrenched is this belief we are led to think it true when it’s not.  Go ask Alice – was it one pill that made her larger in Wonderland or a portion of cake?

But, as Paracelsus warned, “the right dose differentiates a poison and a remedy.”

The Alice example may be a bit cute, but the point is we do not often consider the “dose” a critical detail.  We tend to expect that somebody else has determined the proper amount of a substance for us to take.

This may seem convenient, but losing sight of how much of anything we are taking, including supplements, might not be wise.  

Can supplements really be dangerous?

Not typically.  Some supplements can be toxic if taken in large amounts, like vitamin A.  Yet safety isn’t usually an issue because most supplement ingredients have a history of human use.  They’re also required to be “generally recognized as safe” (GRAS) to be sold.  Beware of assuming this is true, however.

Effects can vary amongst people.  An individual may be sensitive to a particular ingredient when a friend is not. Supplements may also interact with some drugs, causing side effects.  So it’s always a good idea to discuss what supplements you take, or plan to take, with your healthcare provider, especially a naturopath or holistic health provider who is up on supplements. Health blogs can be a good source of information, as well, but be aware that some blogs, though not these at WellWise, are all about selling you a certain product or brand.

Does supplement dose influence efficacy?

Yes.  The tricky part with supplements, though, is that they may have beneficial effects on different areas of the body. Effective doses for each use may differ. For example, a typical daily dose range of S-adenosyl-L-methionine (SAMe) for osteoarthritis is 200-600mg, while for depression it is 400-1600mg. Sometimes there may be even less overlap.

This means that the “serving size” found on a product label may not be accurate for every intended use.  Listed serving sizes can also be based on other unrelated factors such as ingredient costs, liability concerns, contaminant levels and capsule/tablet size restrictions.

Recommended Daily Allowances (RDAs) may not be sufficient either as dosage guidelines since they are set mainly to avoid deficiency conditions. For example, 90mg/day of vitamin C (100% of the RDA) may be enough to prevent scurvy, but it isn’t likely sufficient for other effects of vitamin C.

How much is enough then?

If product labels and RDAs are not definitive answers to this question, then what is?  Probably not news articles, which proclaim things like “Passion Flower May Boost Sleep Quality,” but often do not mention dose.

News articles, though, can be a good place to start.  Look for references to the original research study.  Then look it up.  Here’s how: 

The National Institutes of Health (NIH) maintains a database called PubMed that allows keyword searching of published scientific and medical literature.  There is also a subset of this database that is devoted to supplements.  You can even find all federally funded supplement research using CARDS.

If you’re not into reading original research, there are still other resources out there to help you determine dosage.  The University of Maryland Medical Center maintains an excellent index on supplements and herbs. They even have an iPhone app for help on the go.

The Office of Dietary Supplements of the National Institutes of Health is also increasingly creating more useful resources for consumers.  They also have an iPhone app called My Dietary Supplements, which can help track and manage your supplements and dosages.

Ultimately, it is up to the dietary-supplement user to do their homework.  Unless like Alice, you wish to blindly leave it to others whether you become large or small … or perhaps, whether you’ll feel anything at all.

Brad Douglass can be reached at about.healththink@gmail.com.

You can read more of Brad Douglas' blogs here.

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About HealthThink

In HealthThink on WellWise.org, I ruminate on all thoughts health especially as they intersect with dietary supplements.  How do we really think about health [when we’re healthy]?  And what does our behavior belie about how we think about health?  Aside from the general rule that applies to the entire blogosphere – never believe what you read in a blog – here are two tenets for this blog: 1) spending your good time reading entitles you to comment/complain about HealthThink and 2) if you complain/comment do not be surprised to see your ideas or words appear in said blog.  If you complain/comment using words in the spirit of this wordsmithing hit, you’ll get extra credit.  A blog with rules and extra credit: fantasatic.