Do Supplements Work? What Supplements Work?

Faculty members at the Harvard School of Public Health have created a revised version of the Healthy Eating Pyramid that rectifies the mistakes of the USDA’s Food Guide Pyramid.

Consuming a variety of healthy foods can be sufficient to obtain the daily needs of nutrients (check out the best food options here) Supplements can be useful for compensating for the anticipated deficiency of certain nutrients.

Many supplements have not been tested on all groups of people, particularly children and pregnant women.  It is important to discuss with a certified medical professional when considering taking dietary supplements.

In most countries including the United States, supplement is considered food rather than a drug, so no regulation proves the effectiveness or safety.  Besides, supplements aren’t always safe or beneficial, especially when a medical condition occurs before or after surgery.

In one of the recent researches, some supplements, including herbal supplements such as St. John’s wort, can interact with antidepressants and birth control pills, reducing the effectiveness.

Fruits and vegetables contain many biologically active ingredients that may help prevent cancer in ways that vitamins and minerals alone do not.

Fish oil probably has the most scientific evidence.

WHO SHOULD TAKE WHAT SUPPLEMENTS?

Pregnancy

Folate deficiency in mothers, for example, leads to neural tube defects, but folate supplements only protect against defects if taken in the first few weeks after conception.

Iron

According to recent reports, the global prevalence of anemia in pregnancy is approximately 41.8%. The World Health Organization recommends a dose of 60mg per day for pregnant women.  In a study, for every 10mg dosage per day, up to 66mg per day can reduce the risk of maternal anemia by 12% and a baby with low birth weight by 3%.

Vitamin D supplements

Many pieces of evidence support the use of Vitamin D. It reduces the risks of many diseases, helps manage depression, and aids weight loss. In pregnancy, it helps to reduce the risk of low birth weight.

HOW EFFECTIVE ARE SUPPLEMENTS?

In most cases, supplement research begins with basic observational studies. Researchers compare people health who take a specific supplement to those who don’t take the supplement. However, antioxidant supplements may interact with some medicines, check out the article that includes concerns related to antioxidant supplements. 

CAUTIONS OF CERTAIN SUPPLEMENTS

According to the FDA (US), supplements most likely to be contaminated with pharmaceutical ingredients are herbal remedies promoted for weight loss, for sexual or athletic performance enhancement.

• Vitamin K can reduce the ability of blood thinners to work.
• Ginkgo can increase blood thinning.
• St John’s wort can reduce the effect of birth control pills – see below for more extensive elaboration.
• Vitamin E may not be protective of certain cancers. A study has shown that excessive vitamin E can promote the risk of prostate cancer in men.
• Vitamin A toxicity also can cause severe congenital disabilities and may increase the risk for hip fractures. The Tolerable Upper Intake Level (UL) of vitamin A for adults is 3,000 mcg RAE.  Some multivitamin supplements contain high doses of vitamin A; check the label to ensure the majority of vitamin A provided is in the form of beta-carotene, which appears to be safe.
• Meanwhile, beta-carotene is associated with a 24% higher risk of lung cancer in current and former smokers. 1mg per day is associated with an increased risk of tobacco-related cancers.

CONTROVERSIAL INGREDIENTS TO AVOID

The ingredients below had caused severe damage to the body or deaths; beware of the ingredients when choosing any supplement.  https://cdn1.sph.harvard.edu/wp-content/uploads/sites/1267/2015/09/The-Dangers-of-Dietary-Supplements1.pdf

• Dimethylamylamine (DMAA), a stimulant found in muscle-building supplements, caused deaths.
• Dinitrophenol, or DNP, a highly toxic industrial chemical, caused deaths.
• Concentrated green tea extract is promoted as a “fat-burning” supplement for the severely damaged liver.
• Jack3d, dimethylamylamine (DMAA). Muscle-building – brands that caused health problems or deaths
• OxyElite Pro.
• T5 (caffeine equivalent to 300 cups of coffee). Weight control – brands that caused health problems or death.

CONCERNS WHEN CHOOSING SUPPLEMENTS

• Exceeding the Recommended Dietary Allowance (RDA) is not essentially a medical problem until the Tolerable Upper Intake Level (UL) is reached, and then it can become harmful.
• Before taking a dietary supplement, it’s important to verify the sources of scientific research findings which are neutral and not biased or funded by parties of conflicting interests.
• Since certain supplements can render undesirable effects on one’s lifestyle (former or current smoking habit) or medication condition, it is important to read through the supplement label carefully and consult with health care providers before consumption, particularly when certain medical conditions are present or any hereditary disease is possible.
• Interaction with medications. Some dietary supplements can interact with a medication affecting their effectiveness. For example, St John’s Wort interacts with many medications, such as increasing side effects and decreasing medication effectiveness.
• Risk of surgery, Certain supplements can increase the risk of bleeding or affect the response to anesthesia.
• Medical condition. Supplements can aggravate certain medical conditions—for example, iron deficiency.
• Pregnancy and lactation. Most supplements have not been tested for pregnant, breastfeeding women nor for children.

Focus on the evidence and effect rather than marketing or selling terms

• Many supplements contain ingredients of natural sources; “natural” doesn’t mean “safe” by default.  For example, The herbs comfrey and kava can cause serious harm to the liver.
• Intake directly affects your body. Since what we consume can profoundly affect our genes and health, it is important to focus on the exact ingredients and the amount of consumption.  Many supplements come with multiple ingredients, which can mean you may consume too much or too little of certain ingredients.

Increasing side effects…

• St John’s Wort interacts with many medications: 

1. Antidepressants: SSRIs: Citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft).
2. Tricyclics: Amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil).
3. Monoamine oxidase inhibitors (MAOIs): Phenelzine (Nardil), tranylcypromine (Parnate), Nefazodone (Serzone).
4. Dextromethorphan (cough medicine).
5. Triptans (treating migraines): Naratriptan (Amerge), Rizatriptan (Maxalt), Sumatriptan (Imitrex), Zolmitriptan (Zomig).

Decreasing the effectiveness of medication…

1. Allergy drugs (antihistamines): Loratadine (Claritin), Cetirizine (Zyrtec), Fexofenadine (Allegra)
2. Digoxin.

Suppressing the immune system…

• Adalimumab (Humira), Azathioprine (Imuran), Cyclosporine, Etanercept (Enbrel), Methotrexate, Mycophenolate mofetil (CellCept), Tacrolimus (Prograf).

• Drugs to fight HIV
• Birth control pills (resulting in unplanned pregnancies)
• Reserpine (treating high blood pressure)

Increasing the effects…

• Sedatives
  1. Anticonvulsants such as phenytoin (Dilantin) and valproic acid (Depakote), Barbiturates, Benzodiazepines such as alprazolam (Xanax) and diazepam (Valium)
  2. Drugs to treat insomnia, such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem)
  3. Tricyclic antidepressants such as amitriptyline (Elavil)
  4. Alcohol

Reducing the level of medication…

1. 1. 1. Theophylline (opening airways in case of asthma, emphysema, or chronic bronchitis)
      2. Warfarin (anticoagulant, blood thinner)
      3. Antifungal drugs, such as ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan)
      4. Statins (drugs taken to lower cholesterol)
      5. Some calcium channel blockers (taken to lower blood pressure)

Source / Credit: Dietary Supplement Ingredient Database https://dietarysupplementdatabase.usda.nih.gov/Conversions.php

Disclaimer: DSID estimates for ingredient levels claimed on dietary supplement labels are based on analytical research results and are not guarantee product content or an endorsement of products by the USDA-ARS Nutrient Data Laboratory or its research partners.

Whether you use dietary supplements or not, maintaining a healthy lifestyle is essential. Stick to a nutritious diet, exercise frequently, keep your mind busy, quit smoking, and see your doctor regularly. Find out more on how to be fit.