Dietary supplements may include vitamins, minerals, herbs, botanicals, amino acids, enzymes, organ tissues, extracts, glandulars or metabolites. The U.S. Food and Drug Administration, or FDA, states that manufacturing problems associated with dietary supplements have occurred. Supplements have been recalled by the FDA because of microbiological, pesticide, and heavy metal contamination, because they do not contain the ingredients they claim to contain, or they contain more or less than the amount of ingredient declared on the supplement label. Please consult a doctor before taking supplements.
Dietary Supplement Regulation
Supplement manufacturers have a legal responsibility to ensure the safety of their products prior to sale. Unlike drug products that are tested for safety and effectiveness prior to sale, the FDA has no legal provision to approve dietary supplements for safety or effectiveness before they reach consumers. Consequently, the FDA does not analyze dietary supplement contents before sale. Serving sizes and amounts of nutrients in dietary supplements also are decisions made by the manufacturer and do not require FDA review nor approval. Furthermore, the manufacturer, and not the FDA, maintains responsibility for the accuracy of the ingredient list and the supplement facts label, and should ensure that product contents match the amounts declared on supplement labels.
Quality Analysis
The United States Pharmacopeia, or USP, a non-governmental authority, sets strict standards for dietary supplements, food ingredients and prescription and over- the-counter medicines. Quality, purity, strength, and consistency standards are set by the USP to ensure public health. Dietary supplement manufacturers may voluntarily register their products with USP to verify the quality, purity, and potency of their dietary supplement products. Verification is not required by law and USP services are fee-based. Products and ingredients that pass strict USP verification requirements receive the USP mark on the label. If you take supplements, look for the USP-verified mark on product labels. The USP also tests for proper manufacturing practices and accuracy of ingredient labeling. The verification process includes lab testing of supplement samples, documentation reviews, manufacturing audits and testing of products from market shelves.
Medication and Supplement Interactions
Dietary supplements may cause serious side effects if combined with medications. For example, MedlinePlus advises never to take garlic within two weeks of surgery because the herb slows blood clotting and can prolong bleeding. Garlic can also slow the liver's process of breaking down medications such as acetaminophen, and surgical anesthetics, causing serious adverse effects. Moreover, drugs that slow blood clotting such as aspirin, ibuprofen, naproxen and warfarin can cause excessive bleeding if combined with garlic. For safety, MedlinePlus warns patients to consult their doctors before taking garlic if they take medications. As another of many examples, the hormone melatonin should never be combined with CNS depressants or sedatives because excessive sedation may occur. You should not take melatonin with certain medications to control hypertension because it elevates blood pressure and it also increases bleeding risk when mixed with aspirin, ibuprofen, warfarin and other drugs that slow blood clotting. Consult a doctor before taking any supplement, especially if you take medications.
Adverse Supplement Interactions
MedlinePlus warns that some herbal supplements can pose health risks if mixed with other herbs and supplements. For example, herbs with sedative properties such as St. John's wort, valerian, hops, 5HTP, kava, skullcap and others, when combined with melatonin, can increase the adverse side effects of melatonin, such as extreme drowsiness and dizziness. Melatonin may also increase the effect of herbs that slow blood clotting such as garlic, ginger, ginkgo, Panax ginseng, danshen and others, increasing the risk of bleeding.
Member Comments