Leena Watts
Dietary supplements are big business, with many people taking them to improve their health. While some supplements are made under careful conditions and labelled correctly, others are not. The FDA does not approve dietary supplements for safety and effectiveness before they are sold to the public, and it is the responsibility of the supplement companies to ensure their products meet safety standards. Dietary supplements can be beneficial to health, but they can also have risks. Some supplements can cause problems if taken with certain medicines, and some have been found to contain harmful chemicals or incorrect doses. It is important to talk to a healthcare professional before taking supplements to ensure they are right for you.
| Characteristics | Values |
|---|---|
| Safety | Dietary supplements can be beneficial to health but are not totally safe and can have risks, especially for people receiving cancer treatment. |
| Side effects | Dietary supplements, herbal preparations, and homeopathic treatments caused almost 70,000 calls to US poison control centers in 2019. More than 7,000 people needed treatment at healthcare facilities, and more than 800 of these cases led to moderate to severe outcomes. |
| FDA approval | The FDA does not approve dietary supplements for safety and effectiveness before they are sold to the public. |
| FDA monitoring | The FDA monitors adverse event reports submitted by dietary supplement companies, healthcare professionals, and consumers, and can work with companies, ask for a voluntary recall, or take action to remove a dangerous product from the market. |
| Safe consumption | Consumers should be aware of potential health risks and keep in mind practices for safe consumption, such as not substituting a dietary supplement for prescription medicine or a healthy diet. |
| Doctor consultation | It is important to talk with a healthcare professional to decide if a supplement is right for you. |
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What You'll Learn
Dietary supplements and surgery
While some dietary supplements can be safe for consumption, they are not totally safe and can have risks, especially when taken with other medications. The use of supplements is particularly important to consider when preparing for surgery.
Some supplements may react with medicines used during and after surgery, increasing the risk of side effects such as bleeding and infection. They can also affect the way the heart and brain work, which could lead to complications during and after surgery. For example, cannabinoids can cause impaired temperature regulation and airway irritability in marijuana smokers, and they can interact with anaesthetic drugs. It is recommended that elective surgery should not occur within 3 days of cannabinoid use, and ideally, a period of abstinence of 2 weeks is recommended to reduce airway irritability.
Additionally, some supplements can interfere with how the body breaks down certain drugs, making them less effective or increasing side effects. For example, some supplements can increase the risk of bleeding, which could be dangerous for certain surgical procedures. This is why it is important to be transparent with your doctor about any supplements you are taking, so that they can advise on whether to stop taking them before surgery, and for how long.
However, adequate nutrition is essential for optimal health and plays a crucial role in the healing process after surgery. A balanced and nutrient-rich diet, along with targeted supplement use, can help support the body's healing process, reduce the risk of complications, and optimise overall surgical outcomes. For example, vitamin A is important for wound healing and immune function, while vitamin D and calcium are crucial for bone health.
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FDA's role in regulating supplements
The FDA's role in regulating supplements is primarily focused on ensuring the safety of human consumption through the oversight, management, and regulation of dietary supplements in the market. The FDA does not have the authority to approve dietary supplements before they are marketed, and it does not examine their effectiveness or actual content. Instead, the FDA's responsibilities include:
- Inspecting dietary supplement manufacturing establishments
- Reviewing new dietary ingredient (NDI) notifications and other regulatory submissions for dietary supplements
- Investigating complaints and monitoring the dietary supplement marketplace
- Examining dietary supplements and ingredients offered for import to determine compliance with US requirements
- Reviewing adverse event reports from firms, consumers, and healthcare providers to identify unsafe products
- Regulating the manufacturing processes and labelling standards for supplements, including prohibiting the marketing of adulterated or misbranded products
- Defining and regulating dietary supplements and good manufacturing practices (GMP) to ensure public safety
The FDA's work in dietary supplement oversight is coordinated by the Human Foods Program's Office of Food Chemical Safety, Dietary Supplements, and Innovation. It shares responsibility for the oversight of dietary supplements with the Federal Trade Commission (FTC), which regulates advertising, including infomercials. The FDA generally focuses on safety, quality, and labelling, and it has the authority to take enforcement actions against dietary supplements and firms if violations are identified.
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Supplements vs prescription medicine
Dietary supplements are not entirely safe and can pose risks, especially for those undergoing cancer treatment. Supplements, herbal preparations, and homeopathic treatments were responsible for almost 70,000 calls to US poison control centres in 2019, with over 7,000 people requiring treatment. Side effects from supplements are most common when high doses are taken or when they are used in place of prescribed medication. They can also cause adverse reactions when taken alongside certain medicines.
Supplements are regulated post-market, meaning they are sold to consumers without prior evaluation of their contents or safety. This is in contrast to prescription medication, which undergoes rigorous testing and evaluation by regulatory bodies like the FDA before being made available to the public. Prescription medication is also intended to target specific ailments or body parts, while supplements are used to enhance one's diet and reinforce nutrient supply.
Prescription medication is a set of drugs or medicines that require a prescription from a physician and are typically taken according to a schedule. They are formulated to treat and cure diseases or manage symptoms like acute pain and high blood pressure. On the other hand, supplements do not require a prescription and are not considered medicines. They are not meant to cure any illness but rather to supplement dietary needs.
While supplements can be beneficial, it is important to recognise that they should not be used as a replacement for prescription medication. Consulting a healthcare professional is crucial before taking any supplements or medication, as they can advise on potential side effects and interactions with other substances.
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Supplements and cancer treatment
Dietary supplements are widely used by cancer patients who believe them to be anticancer and antitoxicity agents. However, it is important to note that there is no reliable evidence that dietary or nutritional supplements can prevent, cure, or control the growth of cancer. In fact, some supplements, such as beta-carotene and vitamin E, have been found to increase the risk of certain cancers and overall mortality.
Some cancer treatments, such as hormone treatments for breast and prostate cancer, can lead to low levels of certain nutrients, which may cause you to feel unwell. In such cases, your doctor may prescribe a daily multivitamin and mineral supplement, or supplements like calcium and vitamin D to protect your bones.
It is important to note that supplements can have side effects, especially if taken in high doses or used instead of prescribed medicines. Some supplements can also cause problems if taken along with certain medications, including cancer drugs. For example, some supplements can interfere with how the body breaks down cancer drugs, making them less effective or increasing side effects. People getting chemotherapy may be at higher risk for side effects if they take certain dietary supplements. Due to these concerns, many cancer experts advise against taking dietary supplements during cancer treatment.
If you are considering taking supplements during cancer treatment, it is crucial to discuss this with your doctor or cancer care team. They can help you understand whether a particular product is safe for you and advise on potential interactions with your treatment. Additionally, it is important to remember that a balanced and varied diet is the best way to get a healthy supply of vitamins and minerals, and supplements should only be used under the supervision of your medical team and a dietitian.
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Safe consumption practices
While dietary supplements can be beneficial to your health, they can also have health risks. It is important to follow safe consumption practices to minimize these risks. Here are some guidelines to ensure safe consumption of dietary supplements:
- Consult a healthcare professional: Before taking any dietary supplements, it is important to talk to your doctor or a healthcare professional. They can help you understand if a particular supplement is safe for you and advise you on potential side effects or interactions with any medications you are currently taking. This is especially important if you are undergoing surgery or cancer treatment, as some supplements may interfere with your medications or increase the risk of side effects.
- Read the label carefully: Always read the label on the supplement bottle or package. Check the serving size, number of servings per container, and the list of ingredients. Look for the Supplement Facts label, which provides detailed information about the dietary ingredients and their amounts. Be cautious of false or misleading claims on the label, and remember that the term "natural" does not always mean safer.
- Follow dosage instructions: Take dietary supplements only as described on the label. Do not exceed the recommended serving size or take multiple supplements with overlapping ingredients, as this can lead to an overdose or adverse effects.
- Be aware of potential side effects: Keep yourself informed about potential side effects associated with the specific supplements you are taking. Report any adverse events or side effects to your healthcare provider and the FDA. This helps identify potentially dangerous products and protects other consumers.
- Purchase from reputable sources: Buy dietary supplements from reputable manufacturers who follow good manufacturing practices and comply with FDA regulations. Check if the manufacturer has submitted safety information to the FDA, as required for supplements containing new dietary ingredients.
- Do not substitute for prescription medication: Dietary supplements are not meant to replace prescription medicines or a healthy diet. Do not use supplements to treat, cure, or prevent any disease without consulting your healthcare provider.
- Be cautious with herbal supplements: Herbal supplements may be marketed as "natural," but they can still pose risks. Some herbal supplements have been found to contain little to none of the listed ingredients, harmful chemicals, or incorrect dosage information.
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Frequently asked questions
Dietary supplements can be beneficial to your health, but they can also involve health risks. Most people can use dietary supplements safely as long as they do not take too much. It is important to talk with a healthcare professional to decide if a supplement is right for you.
Dietary supplements can cause side effects, especially if taken in high doses or instead of prescribed medicines. Some supplements can also cause problems if taken with certain medicines, such as those used during and after surgery, or chemotherapy drugs. It is important to note that the term "natural" does not always mean safe, and some natural products can be harmful even when used as directed.
It is important to talk to a healthcare professional before taking any dietary supplement to ensure it is right for you. The FDA also monitors adverse event reports submitted by supplement companies, healthcare professionals, and consumers to ensure the safety of products on the market. If a product is found to be unsafe, the FDA can work with the company to bring the product into compliance, ask for a voluntary recall, or take action to remove the product from the market.
