Get smart on supplements

Ingredients Insight: What are dietary supplements?

Dr Daniel Fabricant: Dietary supplements include vitamins, minerals and other less familiar substances such as herbals, botanicals, amino acids and enzymes. They are also marketed in forms such as tablets, capsules, softgels and gel caps. While some dietary supplements are fairly well understood, others warrant further study.

What are the benefits?

Some supplements may help to ensure that people get an adequate dietary intake of essential nutrients. However, supplements should not replace the variety of foods that are important to a healthful diet, so consumers must be sure that they eat a variety of foods as well.

Unlike drugs, supplements are not intended to treat, diagnose, prevent or cure diseases. That means they should not make claims such as 'reduces arthritic pain' or 'treats heart disease'. Claims like these can only legitimately be made for drugs.

Are there any risks in taking supplements?

Yes. Many supplements contain active ingredients that have strong biological effects in the body. This could make them unsafe in some situations, and hurt or complicate health. For example, the following actions could lead to harmful – even life-threatening – consequences:

• using supplements with medications (whether prescription or over-the-counter)
• substituting supplements for prescription medicines
• taking too much of some supplements, such as vitamin A, vitamin D and iron.

Some supplements can also have unwanted effects before, during and after surgery, so people must be sure to inform their healthcare provider, including their pharmacist, about any supplements they are taking, especially before surgery.

Who is responsible for the safety of dietary supplements?

Dietary supplements are not approved by the US government for safety and effectiveness before they are marketed. If the dietary supplement contains a new ingredient, that ingredient will be reviewed (not approved) by the FDA prior to marketing – but only for safety and not effectiveness.

The manufacturers and distributors of dietary supplements are responsible for making sure that their products are safe before they go to market. Manufacturers are required to produce dietary supplements to minimal quality standards, ensure that they do not contain contaminants or impurities, and that they are accurately labelled.

As of December 2007, manufacturers in the US are required to report all serious adverse events or illnesses related to dietary supplements to the US Food and Drug Administration (FDA).The FDA can take dietary supplements off the market if they are found to be unsafe, adulterated or if the claims on the products are false and misleading.

How can I find out more about the supplement I'm taking?

If you want to know more about the product you are taking, check with the manufacturer or distributor about:

• information to support the claims of the product
• information on the safety and effectiveness of the ingredients in the product
• any reports of adverse effects or events from consumers using the product.

How can I be a smart supplement shopper?

Although the benefits of some dietary supplements have been documented, the claims of others may be unproven. If something sounds too good to be true, it usually is.

Here's how to be a savvy supplement user:

• Watch out for false statements such as 'a quick and effective cure-all', 'can treat or cure diseases' and totally safe' or has 'no side effects'.
• Be aware that the term 'natural' doesn't always mean safe.
• Don't assume that even if a product may not help you, at least it won't hurt you.
• When searching for supplements on the internet, use the sites of respected organisations, rather than relying on blind searches.
• Ask your healthcare provider for help in distinguishing between reliable and questionable information.
• Always remember – safety first.

Before making decisions about whether to take a supplement, people are advised to see their healthcare provider and/or a registered dietitian. They can help consumers achieve a balance between the foods and nutrients they personally need.