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Approach Dietary Supplements with Caution

October 16, 2015
John S. Williamson, Ph.D.
John S. Williamson, Ph.D.

Branch Chief, Basic and Mechanistic Research, Division of Extramural Research
National Center for Complementary and Integrative Health

This week has been an active—and sobering—one for news about the safety of dietary supplements. One story receiving a lot of attention is a study published Wednesday in the New England Journal of Medicine in which researchers estimate that at least 23,000 emergency department (ED) visits per year in the United States from 2004-2013 were attributed to adverse events related to use of dietary supplements. 

The researchers, a team from the Centers for Disease Control and Prevention and the Food and Drug Administration (FDA), examined nationally representative data from 63 EDs. Strikingly, more than one-quarter of the ED visits in the study involved young adults ages 20 – 34. Weight loss products or energy products were involved in more than half the visits for this age group (mostly due to cardiac symptoms). In fact, nearly three-quarters of all ED visits involving cardiac symptoms (palpitations, chest pain, or tachychardia) were caused by weight loss or energy products.  Cardiac symptons were also commonly noted in visits due to body building products (49.8%), and sexual enhancement products (37.3%).

In past years, the FDA has warned of possible health risks from dietary supplements due to many reasons, such as interactions between supplements and prescription drugs; contamination of supplements by synthetic prescription drugs; and unknown  contaminants due to unknown production quality. 

NCCIH has had a longstanding commitment to build the base of objective evidence on the safety and efficacy of natural products, including supplements. We work hard to examine whether they work, and if so, how they work. We have stringent requirements to make sure that the supplements tested in our studies are the same from lot to lot, in where they are collected and how they are manufactured. NCCIH’s role is to conduct scientific research—this includes identifying the bioactive substances in supplements affecting human cells, organs, the immune system, and the brain as well as research on interactions.

We also provide objective, evidence-based information to help people make informed decisions about using complementary approaches, including supplements, such as our fact sheets and ebook on herbs; Web portals on dietary and herbal supplements and information about erectile dysfunction/sexual enhancement, weight control, and energy; and a newsletter and CME program for health professionals about herb-drug interactions.   

Remember, “natural” does not always mean safe, and if a product’s claims seem too good to be true, they probably are.


Comments are now closed for this post.

The issue is real and more research is needed on both adverse and synergistic effects of dietary supplements.  It is also important to discriminate as to what is  being aggregated under supplements as noted in the article above.  Finally, keeping some perspective is also useful 23,000 ED visits per year seems like a lot until it is contrasted to the ED visits involving adverse reactions to pharmaceuticals which increased between 2005 and 2009, from 1,250,377 to 2,287,273 visits.

I check all supplements that I use with Consumer Lab.  The only pharma I use is a thyroid supplement prescribed by my Naturopathic doctor.  I am a healthy 91 years and have never had a problem with supplements which I have counted on for preventive use.  

I appreciate all efforts by the NCCIH to advance CAM in a responsible manner.  However, one area much in need of improvement is the information pages provided for current research.  For example, the fact pages on lavender are outdated.  There is a huge difference between the use of lavender as a plant and use of lavender oil.  There is a lot of current research on lavender oil and its effect on anxiety.  Although the studies are limited in their rigor, they do have value.  Germany is actually allowing the use of lavender oils gel caps on a prescriptive basis for reducing anxiety.  My point is that outdated information is worse than no information at all.  If there is no time to update. then remove guidance that is greater than 5 years old unless there has not been more current research.  Place a caveat on all fact sheets that facts are changing rapidly!Thank you again for your continued support of responsible CAM growth in the US.

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