Health News / February 2007
Nature Lovers at Risk
Women turn to nutritional supplements for many reasons, including compensating for an inadequate diet, desire for “natural” products or treatments, or hope when medical science has not been successful. However, natural supplements lack many of the safeguards of prescription or over-the-counter drugs. The FDA requires supplements to bear an ingredient label, but the agency doesn’t verify the information or monitor the manufacturing process. Tests by Consumer Reports and others have found that bottles don’t always contain what their labels say they do or in the dosage stated. Some supplements have been contaminated with heavy metals, pesticides, bacteria or prescription drugs. And, even potentially helpful supplements can pose risks.
According to Consumer Reports, a few dietary supplements, like the herbs kava and yohimbe or the hormone DHEA, are potentially so dangerous, sources say the products shouldn’t be sold at all. Since the FDA doesn’t require dietary supplements to be proved safe and effective before going on the market, consumers must do their homework and learn all they can.
Labels that sound too good to be true, “boundless energy”, “quick weight loss”, “cancer cure”, almost certainly are not accurate. Even those that seem plausible, like “supports the immune system”, are of dubious value. Manufacturers can make those claims without submitting proof to the FDA as long as they describe how the product affects the body’s “structure or function” rather than promise to treat or prevent any disease. Consumers must choose supplements based on their own research, not label claims.
Most importantly, even for “natural” products, more is not better. It’s possible to overdose even on vitamins and minerals, which are by far the safest and best supplements available. Just twice the Daily Value of vitamin A (from retinol) increases the risk of birth defects and liver damage. For herbal and other supplements it’s often difficult to know what the optimal dose should be, but women should avoid any product that boasts of extra-high amounts.
Herbal and ‘natural’ supplements may not have the hoped for results, but it doesn’t mean they are inert. Women must know to watch for interactions. Supplements can interfere with some medications and make side effects of others more likely. St. John’s wort, for instance, may undermine drugs used to treat HIV/AIDS, asthma, high-cholesterol levels and hypertension. Anyone with a chronic disease or who takes medication (or birth control) and is considering a supplement, should talk to a doctor and a pharmacist first. Check other sources too, since doctors may not be familiar with these nonprescription products. Websites and publications like the Consumer Reports Medical Guide can search the interaction between specific supplements and drugs and identify the diseases that each supplement may worsen.
Look for “USP Verified” on labels. The United States Pharmacopeia is a nonprofit, nongovernmental group that sets the standards for pharmaceuticals in the United States. Supplement manufacturers voluntarily ask USP to test their products for identity, purity, and potency, as well as review their manufacturing process and their package inserts. The USP Verified Mark assures that the product contains the listed ingredients, is free of harmful levels of contaminants, will break down and release ingredients in time to work and was made under good manufacturing practices. The notation means the product was tested for identity, purity, and potency, and the manufacturing process was reviewed along with the brand’s package inserts. If there is no “USP Verified” label, it’s generally best to stick with a well-known brand over “dollar-store” deals. Consumer Report’s tests found the well known brand names usually have the amount stated on the bottle’s label and dissolve adequately, even if they haven’t yet undergone USP testing, while “dollar-store” brands don’t.
Consumer Reports Medical Guide, is an independent, subscription-based online service with continuously updated content for non-subscribers as well, that provides information and treatments ratings on over 150 common and chronic health conditions, over 1000 drug monographs, and more than 14,000 vitamins, herbs, and nutritional supplements.
For more information about USP and its standards-setting activities, visit usp.org/aboutUSP/media.
For more information about Consumer Reports Medical Guide, visit consumerreportsmedicalguide.org.
Recommended allowances and tolerable upper limits for vitamins and minerals can be found on the Institute of Medicine’s Web site, www.iom.edu.
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