Dangers of Supplements???

Dr. Shawn Talbott (Ph.D., CNS, LDN, FACSM, FACN, FAIS) has gone from triathlon struggler to gut-brain guru! With a Ph.D. in Nutritional Biochemistry, he's on a mission to boost everyday human performance through the power of natural solutions and the gut-brain axis.

A few months ago, you may remember having read some of the newspaper headlines or heard the spots on evening news that went something like, “Your Multivitamin May Be Killing You!” – or “Is This The End of Vitamins?”

Many of these (irresponsible) headlines were driven by an analysis of data from the Iowa Women’s Health Study (IWHS) published in the Archives of Internal Medicine (October 2011). The IWHS is a long-running (19 years) study that asks more than 38,000 women about their diet and lifestyle habits – questions about what they eat, what supplements they take, etc.

You can read more of my comments about the IWHS analysis HERE.

From the newspaper headlines, you might have come away with the idea that swallowing vitamins was poisoning these women and that Iowa must be awash in dead bodies. What the analysis actually found was that older women, who supplemented with high levels of certain minerals (particularly copper and iron), when they didn’t need them (because they already had normal levels of these minerals in their diets), encountered health problems, including a very slight statistical increase in mortality (so small that many researchers think the result may be an error/artifact of the statistical analysis).

So, the newspaper headlines would have been more accurate if they said something along the lines of, “Older women with excellent diets should go easy on mega-dose minerals” – but, of course, headlines like that don’t sell newspapers.

Jumping on the “supplements are killing us” bandwagon is Consumer Reports magazine (September 2012) with their cover story, “10 Surprising Dangers of Vitamins & Supplements.” Again, scary cover stories sell more magazines than accurate portrayals of the outstanding safety profile of dietary supplements.

The Consumer Reports (CR) article listed the following “10 dangers” of supplements:

  1. 1.   Supplements are not risk-free

The CR article indicates that “more than 6,300 reports of serious adverse events” associated with dietary supplements “streamed into the FDA” between 2007 and 2012. Six years and a little more than 1,000 adverse reports – so about 1,000 per year. Sounds like a lot, until you put that number in context against the millions and millions of servings of supplements that are consumed every year – which puts the rate of “adverse events” below 1% of users (they can still happen, to be sure, but adverse events for dietary supplements is very very rare).

Another way to look at the “dangers” associated with dietary supplements is to look at incidents reported to poison control centers. According to 2009 data from the American Association of Poison Control Centers, there were about 2.5 million calls (2,479,355) to poison control centers for possible “substance” reactions. Of those 2.5 million calls, 1.5 million were for drugs (1,564,773 = 63%), while only about 100,000 (4%) were for vitamins (72,768) or dietary supplements (29,417).

This means that of all the calls to poison control centers in the United States, only about 4% are related to dietary supplements, while about 63% are related to pharmaceuticals. Of those 4% of calls related to supplements, about 75% were related to children under the age of 5 accidentally ingesting the supplement.

Among the 1.5 million calls related to pharmaceuticals, almost 500 resulted in death (497) and more than 7,000 were considered major reactions (7,395). In contrast, calls about supplements resulted in a single death and 41 major reactions. I wish we could say that dietary supplements are associated with ZERO risk of adverse events 100% of the time, but I think you’ll agree that toxicity or “danger” associated with dietary supplements is quite low.

  1. 2.   Some supplements are really prescription drugs

The FDA has stated that it considers dietary supplements that are spiked with prescription drugs to be “the largest threat” to consumer safety. I agree – but it’s important to note that such products are ILLEGAL and are NOT supplements. They are dangerous synthetic drugs that are being misbranded as safe natural dietary supplements. Earlier this month, Chinese authorities detained nearly 2,000 people as part of a nationwide crackdown on the sale of fake health products and counterfeit drugs – so the problem is certainly not confined just to the supplement industry. The best way to protect yourself from dangerous drugs masquerading as dietary supplements is to buy only from reputable supplement companies that adhere to good manufacturing practices (GMPs).

  1. 3.   You can overdose on vitamins and minerals

I completely agree with this “danger” – but that’s why all dietary supplements come with “recommended usage” instructions. Follow them! The idea that “more” of a certain supplement is “better” is wrong – so stick with the specific serving suggestions on every dietary supplement you decide to consume.

  1. 4.   You can’t depend on warning labels

This “danger” is based on CR’s finding that some supplements carry warning statements and others don’t – but with such a low risk of adverse events for dietary supplements, it’s unrealistic to ask safe products to carry warnings for risks that are highly unlikely to ever occur. If you’re concerned about a specific health risk for your personal health status, consult with your own healthcare provider.

  1. 5.   None are proven to cure major diseases

Agreed – but let’s also agree that the same “danger” applies to prescription drugs, which also don’t “cure” any major diseases.

  1. 6.   Buy with caution from botanicas

Botanicas are Hispanic herbal shops found in many major cities. Like Chinese herbalists, botanicas often sell raw herbs of questionable identity, purity, and potency. If we were back in the Middle Ages, you might turn to raw herbs to make medicinal teas to help treat diseases and improve health – but in today’s modern world, we can standardize the amount of active ingredients in our dietary supplements, thus ensuring potency, purity, and effectiveness.

  1. 7.   Heart and cancer protection: not proven

Isn’t this really the same “danger” as #5?

  1. 8.   Betcha can’t guess this commonly reported problem

This is a silly “danger” to let you know that CHOKING is the #1 cause of “adverse events” associated with dietary supplements. Over 5 years of data collection, reports of choking numbered about 900 incidents in the FDA database. If we remove choking and kid’s getting into unattended supplements from the FDA and poison control databases, then adverse events associated with supplements are almost non-existent.

  1. 9.   Some “natural” products are anything but

Correct – sometimes you will find “synthetic” ingredients in your dietary supplements. Sometimes this is because a criminal is trying to illegally sell an undeclared prescription drug or steroid. Sometimes it’s because a synthetic version of a vitamin is superior to a natural version (as occurs for B-complex vitamins, which have superior absorption). But, in the vast majority of cases, “natural” does indeed mean natural.

  1. 10.         You may not need supplements at all

Agreed. If you’re eating a perfect diet with 2-3 servings of fatty fish each week (for omega-3 fatty acids), and 10-12 servings of brightly colored fruits and vegetables every day (for antioxidants and phytonutrients), and a diet based predominantly on low-glycemic whole grains (for B-vitamins and fiber), and lean meats (for protein), then maybe you don’t need a dietary supplement. Wait, I hope you’re also getting at least 8 hours of deep restful sleep each night and have a very low exposure to stress in your life, because then you certainly don’t need a supplement.

If you’re like the vast majority of busy people that I know (myself included), you probably don’t eat a perfect diet, or get as much sleep as you know you should, and you’re probably exposed to stressful events on a fairly regular basis. Join the club – there are a lot of us out there – and dietary supplements can help us fill the gap between where we ARE and where we WANT to be in terms of how we feel, how we look, and how we perform on a daily basis.

Thanks for reading…

Shawn

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Shawn M. Talbott, Ph.D.

Nutritional Biochemist and Author

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The Health Professionals Guide to Dietary Supplements (Lippincott, Williams & Wilkens) – http://www.supplementwatch.com/

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About the Author

Exercise physiologist (MS, UMass Amherst) and Nutritional Biochemist (PhD, Rutgers) who studies how lifestyle influences our biochemistry, psychology and behavior - which kind of makes me a "Psycho-Nutritionist"?!?!

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