Question

How would you explain the safety and risk of dietary supplements to your patients?

Answer 1

You are most likely to have side effects from dietary supplements if you take them at high doses or instead of prescribed medicines, or if you take many different supplements. Some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia.
Some dietary supplements can improve overall health and help manage some health conditions. For example: Calcium and vitamin D help keep bones strong and reduce bone loss. Folic acid decreases the risk of certain birth defects.Omega-3 fatty acids from fish oils might help some people with heart disease. A combination of vitamins C and E, zinc, copper, lutein, and zeaxanthin (known as AREDS) may slow down further vision loss in people with age-related macular degeneration (AMD). Many other supplements need more study to determine if they have value.The U.S. Food and Drug Administration (FDA) does not determine whether dietary supplements are effective before they are marketed.

Safety and Risk
Many supplements contain active ingredients that can have strong effects in the body. Always be alert to the possibility of a bad reaction, especially when taking a new product.You are most likely to have side effects from dietary supplements if you take them at high doses or instead of prescribed medicines, or if you take many different supplements. Some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia. Supplements can also interact with some medicines in ways that might cause problems. Here are a few examples:Vitamin K can reduce the ability of the blood thinner warfarin to prevent blood from clotting.St. John’s wort can speed the breakdown of many medicines and reduce their effectiveness(including some antidepressants, birth control pills, heart medications, anti-HIV medications,and transplantdrugs).Antioxidant supplements, such as vitamins C and E, might reduce the effectiveness of some types of cancer chemotherapy.Manufacturers may add vitamins, minerals, and other supplement ingredients to foods you eat, especially breakfast cereals and beverages. As a result, you may get more of these ingredients than you think, and more might not be better. Taking more than you need costs more and might also raise your risk of side effects. For example, too much vitamin A can cause headaches and liver damage, reduce bone strength, and cause birth defects. Excess iron causes nausea and vomiting and may damage the liver and other organs.Be cautious about taking dietary supplements if you are pregnant or nursing. Also, be careful about giving supplements to a child, unless recommended by their healthcare provider.Many supplements have not been well tested for safety in pregnant women, nursing mothers, or children.If you think that you have had a bad reaction to a dietary supplement, let your healthcare provider know. He or she may report your experience to the FDA.You should also report your reaction to the manufacturer by using the contact information on the product label.