This information is excerpted from the Consumer Dietary Supplement Information segment of the US Food and Drug Administration's public information website (www.fda.gov). The FDA works to safeguard public health. A large part of its job is to ensure that consumers are provided with food and drugs that are safe, unadulterated, and honestly presented. The FDA is also concerned with the safety and accuracy of statements about non-drug, dietary supplement products once they are on the market.
Tips for Older Dietary Supplement Users
Can Dietary Supplements Help Older Consumers?
Even if you eat a wide variety of foods, how can you be sure that you are getting all the vitamins, minerals, and other nutrients you need as you get older? If you are over 50, your nutritional needs may change.
• Informed food choices are the first place to start, making sure you get a variety of foods while watching your calorie intake.
• Supplements and fortified foods may also help you get appropriate amounts of nutrients.
To help you make informed decisions, talk to your doctor and/or registered dietitian.
They can work together with you to determine if your intake of a specific nutrient might be too low or too high and then decide how you can achieve a balance between the foods and nutrients you personally need.
[Ed note: In the US, the Academy of Nutrition and Dietetics provides a nutritionist/dietitian search map (http://www.eatright.org/programs/rdfinder/). Type in a postal code or other area identifier, and the locator will provide full contact information on any licensed professionals in your area. These professionals often specialize in the nutritional needs of older adults and those with chronic illnesses such as diabetes or arthritis. Physicians more likely to be informed about nutrition and preventive healthcare may be located, for example, via the American Holistic Medical Association website (www.holisticmedicine.org) or the world wide directory of Functional Medicine Doctors (www.functionalmedicinedoctors.com). These and other groups represent licensed physicians trained to address the underlying causes of disease.]
What Are Dietary Supplements?
Today's dietary supplements are not only vitamins and minerals. They also include other less-familiar substances, such as herbals, botanicals, amino acids, enzymes, and animal extracts. Some dietary supplements are well understood and established, but others need further study.
Whatever your choice, supplements should not replace the variety of foods important to a healthful diet.
Unlike drugs, dietary supplements are not pre-approved by the government for safety or effectiveness before marketing. Also, unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases.
• But some supplements can help assure that you get an adequate dietary intake of essential nutrients;
• Others may help you reduce your risk of disease.
Some older people, for example, are tired due to low iron levels. In that case, their doctor may recommend an iron supplement.
At times, it can be confusing to tell the difference between a dietary supplement, a food, or over-the-counter (OTC) medicines.
This is because supplements, by law, come in a variety of forms that resemble these products, such as tablets, capsules, powders, energy bars, or drinks. One way to know if a product is a dietary supplement is to look for the "Supplement Facts" label on the product.
[Note: For example, click the "Label Info" tab (next to "Description") for any supplement listed in ProHealth's store. The Supplement Facts will include at least serving size (e.g., one softgel) and number of servings, amount of each active ingredient per serving, and % of daily value each ingredient provides per serving, if that has been established.]
Are There Any Risks, Especially to Older Consumers?
While certain products may be helpful to some older individuals, there may be circumstances when these products may not benefit your health, or when they may create unexpected risks. 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 your health.
1. Are you taking both medicines and supplements and/or substituting one for the other?
Taking a combination of supplements, using these products together with medications (whether prescription or over-the-counter), or substituting them in place of medicines your doctor prescribes could lead to harmful, even life-threatening results.
Be alert to any advisories about these products. For example, Coumadin (a prescription medicine), ginkgo biloba (an herbal supplement), aspirin (an over-the-counter drug), and vitamin E (a vitamin supplement) can each thin the blood. Taking any of these products alone or together can increase the potential for internal bleeding or stroke. Another example is St. John's wort that may reduce the effectiveness of prescription drugs for heart disease, depression, seizures, certain cancers, or HIV.
[Ed note: Though many physicians may have easy in-office access to databases with information about drug-drug and drug-supplement interactions, physician time is short. Be sure to share with your physician updated lists of all drugs and supplements you are taking (how much, how often, and reason). But also remember - if you've been prescribed a new drug or are concerned about the effects of drugs/supplements you're taking - you can always ask for a pharmacist consultation at your local pharmacy. It's the pharmacist's job to be up-to-date on the latest information, and it's often best to schedule these talks to ensure the pharmacist has time to give attention to your questions. Additionally, a number of excellent drug-supplement-herb interaction databases are available free online (e.g., MedlinePlus Herbs, Supplements & Drug interactions, Medscape Interaction Checker, or Drugs.com Interactions Checker.]
2. Are you planning surgery?
Some supplements can have unwanted effects before, during, and after surgery. It is important to fully inform your healthcare professional, including your pharmacist, about the vitamins, minerals, herbals, and any other supplements you are taking, especially before surgery. You may be asked to stop taking these products at least 2 to 3 weeks ahead of the procedure to avoid potentially dangerous supplement/drug interactions - such as changes in heart rate, blood pressure, or bleeding risk that could adversely affect the outcome of your surgery.
[Ed Note: For individuals diagnosed with chronic fatigue syndrome (ME/CFS), fibromyalgia, multiple chemical sensitivities, or restless leg syndrome, see "Advice for Those Facing Surgery" with recommendations from Drs. Charles Lapp, Daniel Clauw, Robert Bennett and others, and MCS America's advice on "Planning a Successful Hospital Stay or Surgery for Those with 'Invisible' Illness".]
3. Do you tend to think taking more of a good thing is better?
Some people might think that if a little is good, taking a lot is even better. But taking too much [more than the recommended dose, without your professional healthcare team's review and approval] of some nutrients, even vitamins and minerals, can also cause problems.
Depending on the supplement, your age, and the status of your health, taking more than 100% of the Daily Value (DV) (see the Supplements Facts panel) of certain vitamins and minerals (for example, vitamin A, vitamin D, and iron from supplements and food sources like vitamin-fortified cereals and drinks) may actually harm your health. Large amounts can also interfere with how your medicines work.
Remember: Your combined intake from all supplements (including multivitamins, single supplements, and combination products) plus fortified foods, like some cereals and drinks, could cause health problems.
How Will I Be Able to Spot False Claims?
Be savvy! 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 are some signs of a false claim:
• Statements that the product is a quick and effective "cure-all." For example: "Extremely beneficial in treatment of rheumatism, arthritis, infections, prostate problems, ulcers, cancer, heart trouble, hardening of the arteries, and more."
• Statements that suggest the product can treat or cure diseases. For example: "shrinks tumors" or "cures impotency." Actually, these are drug claims and should not be made for dietary supplements.
• Statements that claim the product is "totally safe," "all natural," or has "definitely no side effects."
• Promotions that use words like "miraculous cure," "scientific breakthrough," "exclusive product," "secret ingredient," or "ancient remedy." For example: "A scientific breakthrough formulated by using proven principles of natural health-based medical science."
• Text that uses overly impressive-sounding terms, like those for a weight-loss product: "hunger stimulation point" and "thermogenesis."
• Personal testimonials by consumers or doctors claiming amazing results. For example: "My husband has Alzheimer's. He began eating a teaspoonful of this product each day. And now in just 22 days, he mowed the grass, cleaned out the garage, and weeded the flower beds; we take our morning walk together again."
• Limited availability and advance payment required. For example: "Hurry. This offer will not last. Send us a check now to reserve your supply."
• Promises of no-risk "money-back guarantees." For example: "If after 30 days you have not lost at least 4 pounds each week, your uncashed check will be returned to you."
What Are The Key "Points to Ponder" Before I Buy?
• Think twice about chasing the latest headline. Sound health advice is generally based on research over time, not a single study. Be wary of results claiming a "quick fix" that depart from scientific research and established dietary guidance. Keep in mind that science does not generally proceed by dramatic breakthroughs, but rather by taking many small steps, slowly building towards scientific agreement.
• We may think, "Even if a product may not help me, it at least won't hurt me." It's best not to assume that this will always be true. Some product ingredients, including nutrients and plant components, can be toxic based on their activity in your body. Some products may become harmful when consumed in high enough amounts, for a long enough time, or in combination with certain other substances.
• The term 'natural' does not always mean safe. Do not assume this term assures wholesomeness or that these products have milder effects, making them safer to use than prescribed drugs. For example, many weight-loss products claim to be "natural" or "herbal" but this doesn't necessarily make them safe. The products' ingredients may interact with drugs or may be dangerous for people with certain medical conditions.
• Spend your money wisely. Some supplement products may be expensive and may not work, given your specific condition. Be wary of substituting a product or therapy for prescription medicines. Be sure to talk with your healthcare team to help you determine what is best for your overall health.
• Remember: Safety first. Resist the pressure to decide "on the spot" about trying an untested product or treatment. Ask for more information and consult your doctor, nurse, dietitian, pharmacist, and/or caregiver about whether the product is right for you and safe for you to use.
Who Is Responsible For Ensuring The Safety And Efficacy Of Dietary Supplements?
Unlike prescription and over-the-counter medicines, dietary supplement products are not reviewed by the government before they are marketed. Under the law, manufacturers of dietary supplements are responsible for making sure their products are safe before they go to market. If you want to know more about the product you are purchasing, check with the manufacturer to find out if the firm:
• Can supply information to support the claims for their products.
• Can share information on the safety or efficacy of the ingredients in the product.
• Has received any adverse event reports from consumers using their products.
What is FDA's Responsibility?
FDA has the responsibility to take action against unsafe dietary supplement products after they reach the market. The agency may also take legal action against dietary supplement manufacturers if FDA can prove that claims on marketed dietary supplements are false and misleading.
What If I Think I Have Had A Reaction To A Dietary Supplement?
• Adverse effects from the use of dietary supplements should be reported to the FDA's MedWatch Program. You, your healthcare provider, or anyone should report a serious adverse event or illness directly to FDA if you believe it is related to the use of any dietary supplement product by calling FDA at: 1-800-FDA-1088, by fax at: 1-800-FDA-0178 or reporting on-line15. FDA would like to know whenever you think a product caused you a serious problem, even if you are not sure that the product was the cause, and even if you do not visit a doctor or clinic.
What's The Bottom Line?
• Dietary supplements are intended to supplement the diet, not to cure, prevent, or treat diseases or replace the variety of foods important to a healthful diet.
• Supplements can help you meet daily requirements for certain nutrients, but when you combine drugs and foods, too much of some nutrients can also cause problems.
• Many factors play a role in deciding if a supplement is right for you, including possible drug interactions and side effects.
• Do not self-diagnose any health condition. Together, you and your healthcare team can make the best decision for optimal health.
Ask yourself the following questions and use the checklist below to talk to your doctor, nurse, dietitian, pharmacist, and/or caregiver about dietary supplements. [These questions apply equally to drugs.]
Questions to ask:
- What is this product [or drug] for? What are its intended benefits? How, when and for how long should I take it?
- Is taking a dietary supplement an important part of my total diet?
- Are there any precautions or warnings I should know about (e.g., is there an amount or 'upper limit' I should not go above)?
- Are there any known side effects (e.g., loss of appetite, nausea, headaches, etc.)? Do they apply to me?
- Are there any foods, medicines (prescription or over-the-counter) or other supplements I should avoid while taking this product?
- If I am scheduled for surgery, should I be concerned about the dietary supplements [drugs] I am taking?
For more information on this subject, see the FDA's Consumer Information on Dietary Supplements page at http://www.fda.gov.