As I have become more involved in using functional nutritional therapy in my practice, I have come to realize that many people are still confused about
safety and effectiveness of various dietary supplements. Because these products are “natural”, many feel they are always safe to use. Although supplements and herbs can be safer than pharmaceutical drugs, they can still function as drugs in
body and should be used with caution and respect.It is estimated that over 80% of
world’s population and 60 million Americans use some form of complementary and alternative medicine (CAM). However, although many believe CAM compliments their current traditional healthcare, most do not inform their physicians that they are taking these products. And, many providers don’t ask or discuss CAM use with their patients, although one survey of 181 cardiologists found that half of them took antioxidant vitamins, themselves.
What many people don’t realize is that there is no regulatory agency in charge of
supplement industry. Herbal products are not tested for purity, effectiveness and safety as drugs are. In 1994,
Dietary Supplement Health and Education Act (DSHEA) was enacted that requires
FDA to prove beyond any doubt that a supplement is unsafe before removing it from
market. Other than regulating what can be included on
label, they are unable to enforce any other regulation.
There is no incentive for supplement companies to conduct research because they are unable to patent ‘natural’ products. Those marketing herbs and other supplements save millions of dollars not spent on research, or worse, yet, conduct their own “research”, which often does not include rigorous controls. Although there are many excellent and reputable supplement companies on
market,
typical consumer is unlikely to know who
credible ones are. Many independent sales representatives only know what
company tells them, and are as unaware as
consumer.
Even if
supplements are pure and not harmful by themselves, problems arise when combined with drugs. Dietary supplements may compete with drugs, leading to toxicity or treatment failure of that drug. An estimated 4 million people are at risk for herbal-prescription drug interactions. Here is a list of
most common interactions between supplements and drugs: * Warfarin (Coumadin) is used to prevent blood clotting for those at risk for deep vein thrombosis, stroke, or heart attack. Supplements that can change bleeding time controlled by this drug include flaxseed oil and fish oil supplements, goldenseal, saw palmetto, feverfew, garlic, ginseng, and willow bark, just to name a few.
* Digoxin is another heart medication. Ginseng has been noted to falsely elevate blood digoxin levels. Some herbs that will affect drug effectiveness include senna, licorice, aloe, cascara, hawthorne, foxglove, goldenseal and guar gum.