Vitamins, Minerals and Botanicals

By David M. Matson

Every day we see patients who take supplements in some form. Over the years these have been gaining a lot of traction and it just seems like more and more people are using them nowadays. I just read a great article in the American Dental Association News about vitamins, minerals and botanicals. I am going to try to summarize it in my own words but if I plagiarize a bit – sorry ADA.

The article really focused on whether or not we actually need such supplements in our diets and also on their safety and effectiveness. They all sound safe enough and there is much hype about what they do and how well they do it but patients should be careful and know that many supplements can interact with other medications. Some supplements have side effects if taken before surgery or with other medicines. They can also cause problems if you have certain health conditions and many have not been tested in children, pregnant women and other groups.

“It is possible to get all of the nutrients you need by eating a variety of healthy foods, so you don’t have to take one,” said Carol Haggans, a registered dietitian and consultant to the National Institute of Health. “But supplements can be useful for filling in the gaps in your diet.”

Supplements are regulated by the Food and Drug Administration as foods and not drugs. The label may claim certain health benefits but unlike medicines, supplements cannot claim to cure, treat or prevent a disease. “There is little evidence that any supplement can reverse the course of any chronic disease,” said Craig Hopp, Ph.D., an expert in botanicals (herbal products) research at NIH.

Some supplements can enhance health in different ways. The most popular are multivitamins, calcium and vitamins B, C and D. Calcium supports bone health, and vitamin D helps the body absorb calcium. Vitamin C and E are antioxidants which are molecules that prevent cell damage and help maintain health. Vitamin B12 which comes from meat, fish and dairy products helps with nerve and blood cell health. Vegans may consider this as a supplement. I had recently seen an article that told us fish oil wasn’t all that it was cracked up to be in terms of the claims that were out there. Fish oil probably has the most scientific evidence to support it and many studies suggest that it can promote heart health.

There are other supplements that need more study and those include glucosamine which is touted for joint pain and Echinacea (immune health) and flaxseed oil (digestion). Many supplements have mild effects with few risks. Vitamin K will reduce the ability of blood thinners to work. Ginkgo can increase blood thinning. And just because it says “natural” it doesn’t mean it is safe. Herbs comfrey and kava, for example, can seriously damage the liver.

Vitamin E had been thought to lower a man’s risk for prostate cancer but there is a recent NIH study of 29,000 men that found that taking supplements of vitamin E can actually raise and not reduce the risk of this disease. This just shows the importance of continuing study of these supplements. It is also interesting to note that there are no regulatory agencies that make sure that labels match what is in the bottles. You risk getting less, or sometimes more, of the listed ingredients. All of the ingredients may not even be listed. “Products sold nationally in the stores and online where you usually shop should be fine,” says Paul M. Coates, Ph.D., director of NIH’s Office of Dietary Supplements. According to the FDA, supplement products most likely to be contaminated with pharmaceutical ingredients are herbal remedies promoted for weight loss and for sexual or athletic performance. Bottom line – be careful. I think this is definitely an area where ‘if it seems too good to be true it probably is’. Make sure your doctor knows what you are taking.

NIH has fact sheets on dietary supplements if you would like more information on them. Go to http://ods.od.nih.gov/factsheets/list-all/. They also have an online database at www.dsld.nlm.nih.gov which will let you look up the ingredients of thousands of dietary supplements. It includes information from the label on dosage, health claims and cautions.

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