Dietary Supplements: What You Should Know

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Dietary supplements are ubiquitous in our time. More than 150 million Americans take dietary supplements as part of their ongoing health and wellness regimen.

A visit to any health food store or pharmacy presents a dizzying array of bottles with exotic-sounding ingredients on the labels. Nearly every day in the media one can find the results of new studies about dietary supplements and nutrients. Information about supplements abounds on the internet, but it is often inaccurate, incomplete or misleading.

WellWise.org hopes to become a source for you to find the latest correct information about many of the nutrients that supplements now provide. Below you will find information, constantly updated, on numerous healthy supplements.

But first, let’s clear up a few misconceptions.

Myth 1: Dietary supplements don’t work, or are unsafe

Quite often one will see articles in newspapers and other media that making such sweeping statements, supposedly backed up by clinical research. Bear in mind that clinical trials for supplements are complicated. Some are designed well, others poorly. Some are testing a specific herb, vitamin or other nutrient, while many people – including reporters – might mistakenly think that an entire category is being proven or disproven to be effective.  

Lending to the confusion, reporters covering health often are reading the studies very superficially, looking for the most compelling headline to attract a reader, while missing the very good news that may be buried deeper in the study. For some enlightening responses to such headlines, and explanations about how studies are misinterpreted, visit the Council for Responsible Nutrition site.

So, are supplements safe? Certainly compared to the millions of deaths and serious health complications caused by approved pharmaceuticals, the supplement industry comes off like a veritable saint. One anti-inflammatory drug alone, Vioxx, is estimated by the FDA to have caused between 89,000 and 140,000 deaths in the United States. Worldwide, the estimates run to 200,000.³

In January, 2010, the U.S. National Poison Data System published a report saying that, in 2008, there was not a single report of someone being killed by vitamins, minerals, amino acids or herbal supplements, including such popular supplements as blue cohosh, echinacea, ginkgo biloba, ginseng, kava kava, St. John's wort, valerian, yohimbe, Asian medicines, ayurvedic medicines, creatine, blue-green algae, glucosamine, chondroitin, melatonin, or any homeopathic remedies. Not one. On the other hand, some 100,000 Americans die each year from taking FDA-approved pharmaceuticals.

In addition, The American Journal of Medicine wrote in July 1998: "Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications⁴, and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone."  Common brand names for NSAIDS include Advil, Aleve and Celebrex.

That being said, the FDA is becoming more active in pursuing dietary supplement retailers and manufacturers whose products are "tainted" with hidden drugs and chemicals. Almost exclusively these are products promoted for sexual enhancement, weight loss, bodybuilding and diabetes. Many of these are laced with "potentially dangerous" ingredients, including prescription drug ingredients, banned drugs, anabolic steroids and stimulants, and untested or unstudied active drug ingredients.  

Our best advice: stick with proven strategies for weight loss (diet, exercise, fewer meats and more vegetables), bodybuilding (ingesting whey or soy protein after workouts), sexual enhancement (Viagra, Cialis, etc., and a few herbs with centuries of traditional use such as Horny Goat Weed).  

Myth #2: Health professionals scoff at dietary supplements

A surprising number of people believe this, but as a 2009 survey of nurses and doctors conducted by the Council for Responsible Nutrition revealed, a whopping 89 percent of nurses and 72 percent of physicians take dietary supplements, even more than the 68 percent of Americans who say they take supplements! On top of that, of the doctors who reported taking supplements themselves, some 85 percent recommend them to their patients. Even among the physicians who said they don’t take supplements, 62 percent reported that they recommended them to their patients.   

Another survey in 2011 – this one by Holistic Primary Care News for Health & Healing, a trade publication for physicians – found that the vast majority of mainstream primary-care physicians are using some type of supplement themselves, and nearly 100 ppercent are recommending some types of supplements to patients.

Myth #3: Dietary supplements are not regulated

This has been mistakenly repeated enough in the popular press that many people it is true, that no government agency has oversight, and therefore that supplements might be dangerous. While it is certainly true that a few supplements over the years have been found to have bogus ingredients in them, or different amounts than appear on their labels, the vast majority of supplements, especially those from reputable manufacturers, are quite safe.

As well, the dietary-supplements industry is doing a much better job nowadays of producing quality, and policing its own. Since passage of the Dietary Supplement Health and Education Act (known as DSHEA) in 1994, the supplement industry has exploded into a multibillion-dollar industry. DSHEA created a new framework for the safety of labeling of supplements. Under this law, a supplement firm must determine that the product it manufactures is safe, and that health claims made are not misleading or are substantiated by approved research. The Food and Drug Administration (FDA) is responsible to take action against any unsafe or mislabeled dietary supplement product on the market, or against those making unsubstantiated health claims.

Furthermore, as of 2010 the dietary-supplement industry is in the final phase of ensuring compliance with a set of FDA regulations called Good Manufacturing Practices⁵ (GMPs), which require companies to ensure through extensive documentation the identity, purity, quality, strength and composition of their dietary supplements. Most supplement-industry organizations expect that this will eliminate some of the fly-by-night and “me, too” companies that have turned out poor products in the past. So the FDA actually plays a substantial role in regulating dietary supplements.

Myth #4: Supplements are unnecessary if you simply eat well

 While this may have been true in our grandmothers’ time (providing you were eating lots of fresh fruits and vegetables and not so much meat), our ever-increasing reliance on petrochemical fertilizers, pesticides and herbicides, and other methods of modern industrial agriculture has significantly reduced¹ the amount and quality of nutrients in our food. (Note: organically grown foods² are mostly more nutrient dense than conventionally grown food)

Add to this the tendency, particularly in developed nations, to eat many more processed and fast foods than natural foods, and you have a real problem. In fact, most food and nutrition researchers now say that the “First World” is suffering from the same thing the “Third World” suffers from: malnutrition. Our food and our eating habits are literally starving us of the healthy nutrients our bodies need to thrive.

When you drive down a major street in nearly any American city, you would be hard-pressed to keep count of all the fast-food chains there, and fast foods are typically calorie laden, rich in unhealthy fats, and poor in healthy nutrients. This is particularly a problem for children.

The next time you’re in a grocery store, pay attention to what “foods” are most accessible to you, those at eye level in every aisle. These are the “value-added” food-like products – the snacks, the soft drinks, the ready-to-serve meals, the baked and packaged goods, etc. Manufacturers make far more profit on these foods than the ones that might have some actual nutritional value to them (which typically are around the edges of the store, and slightly out of reach). Therefore, they are able to pay more to occupy the prime real estate in supermarkets, i.e., everything at eye level in the center aisles. They are counting on impulse buying by the uneducated consumer, or the parent who is in a hurry and who trusts the food industry to provide good nutrition.

An excellent source for information on this and the politics of our food supply is Marion Nestle, an author of numerous books on the subject and a tireless campaigner for a better food system. Also, we recommend the books of bestselling author and journalism professor Michael Pollan, who has written extensively on our agricultural and food systems which, he says, has wrought havoc upon the diets, nutrition and health of Americans.

The consequences of poor nutrition for our health are appalling: heart disease, obesity, and diabetes, to name just a few. As you will read elsewhere on this site, diets in developed countries are overloaded with omega-6s, which has serious consequences for our ability even to think clearly. Coupled with the fact that we eat far too few foods that are loaded with omega-3s, the need for an omega-3 supplement such as krill oil or fish oil, or flax oil, for instance, becomes apparent.

Also, you probably have heard that it is important to eat 5-8 servings of antioxidant-rich fruits and vegetables a day. Realistically, though, how many people do you know who can boast that kind of discipline?

What do supplements do?

A better question might be “what don’t they do?”

Well, unless you have a pronounced deficiency in some nutrient, they don’t usually work quickly. Most nutritionists suggest that taking a supplement for a minimum of thirty days is necessary before one notices its effect. Sometimes people report that they didn’t realize what the supplement was doing for them until they stopped taking it.

Good nutrition is one of the main ways our bodies maintain and repair themselves. Because of the past success of Western medicine, we often have the expectation that by taking a pill, such as an antibiotic, we will get immediate results. However, optimal health requires time and commitment to nourish ourselves correctly. And, as we’re beginning to discover, our overuse of antibiotics has led us to a crisis in public health. One of the most important things we can do to protect ourselves from major health problems now is to get enough of the right kinds of nutrients and exercise. 

Some health professionals say that, while every body is unique and responds slightly differently to what is ingested, a general rule of thumb is one may not notice significant signs of  improvement before three months. Of course, some people experience immediate results, while others might feel nothing at all. Even this latter doesn’t mean that the supplement isn’t working, however. One may not be able to discern a change – a dramatic drop in bad cholesterol levels, for instance – without blood tests and other measures. 

What supplements should you take?

We at WellWise.org recognize the tendency to want to take everything we’ve read good news about (and there are so many). After all, when you begin to discover the amazing healing and disease prevention properties of nutrients, and the positive results of the thousands of studies and clinical trials that are being conducted with dietary supplements around the world, you want to fill your cheeks with these pills every day.

However, a saner and less-expensive approach would be to find a doctor or nutritionist who is knowledgeable about nutrition and supplements (note: most Western medical schools require almost no courses on this), and devise a deliberate and careful program. Organizations such as the American Dietetic Association, the largest organization of dietitians, are cautious about taking a position on dietary supplements, and recommends consulting a dietitian to determine what supplements may be best for your particular needs. 

In lieu of this, it is advisable to begin with a few supplements that have been widely proven effective for general health, such as vitamin D3, essential fatty acids like those found in krill oil and fish oil, and some form of antioxidants, such as vitamin E and/or C, and astaxanthin (also found in krill oil). Many doctors recommend taking a high-quality multivitamin (not the highly advertised brands).

Then one can begin adding supplements targeting specific areas of concern, such as eye health or joint problems, and noting how your body reacts to these additions and adjusting accordingly.

Elsewhere on this site you will find lots of information about various health conditions and what supplements or techniques are being used to correct them, from scientific research to physicians’ experiences. Also, you can download a pdf brochure on supplements from the Food and Drug Administration here.

Now, take a look at some of the supplements and their applications.

References: 

1. http://www.jacn.org/cgi/content/full/23/6/669

2. http://www.organic-center.org/reportfiles/Nutrient_Content_SSR_Executive_Summary_FINAL.pdf

3. http://www.adrugrecall.com/vioxx/death.html

4. http://www.amjmed.com/article/S0002-9343%2898%2900072-2/abstract

5. http://www.fda.gov/Food/DietarySupplements/GuidanceComplianceRegulatoryInformation/RegulationsLaws/ucm079496.htm