August 2, 2012 — Consumer Reports has published a critical investigation of dietary supplements. They identified ten hazards and warned consumers: “Don’t assume they’re safe because they’re ‘all natural.’” Dietary supplements (vitamins, minerals, herbs, or other supplements) are used by more than half of Americans. Although most people believe they have health benefits, this is not always the case, and some supplements can have life-threatening side effects.
The investigators obtained adverse event reports that were submitted to the U.S. Food and Drug Administration (FDA) from 2007 until April 2012. The reports came from manufacturers, consumers, and doctors, and because many are voluntarily submitted, they may under-estimate the actual number of adverse events. There were 6,300 reports that detailed 10,300 cases of serious outcomes, including:
- 115 deaths
- 2,100 hospitalizations
- 1,000 serious injuries
- 900 emergency-room visits
- 4,000 other serious medical events
The researchers noted that the reports do not prove a causal link between the supplement and the injury. However, they were concerned about the large number of adverse events.
Contrary to popular belief, the ingredients in dietary supplements are not always safe. Sometimes supplements contain prescription drugs, which is illegal, but difficult to test and enforce. Other times, supplements contain doses of vitamins or minerals that far exceed the recommended daily allowance. These mega-doses may interact with certain medications or cause other unintended side effects. Even “normal” vitamin or mineral supplements could be harmful, especially for people with digestive problems, or people who take blood-thinning medications.
The investigators also found that the labels on supplements are often unreliable and lack adequate warnings about the risk of side effects. The investigators reviewed the labels on 233 supplements, and found the warnings were often inconsistent or incomplete. Although all supplements containing iron carried an FDA-required warning, most of the other supplements did not warn about specific side effects. The labels on many products containing DMAA list the ingredient as “geranium oil” or “geranium extract,” though most experts agree that DMAA is a synthetic drug with no connection to the geranium plant.
Furthermore, supplements may not be as beneficial as most people believe. Although antioxidant vitamins are often promoted as a way to reduce the risk of cancer, a study published in the Journal of the National Cancer Institute in May found no evidence that vitamins A, C, E, selenium, or beta-carotene prevent cancer or improve outcomes. Another study found that vitamin E may actually increase the risk of prostate cancer, which is concerning, because more than half of Americans over the age of 60 take a vitamin E supplement.
Omega-3 (fish oil) is widely used to reduce the risk of cardiovascular disease. However, a study published in June in the New England Journal of Medicine looked at 12,500 diabetics who were at high risk of heart disease, and found that Omega-3 supplements did not reduce their risk of heart disease.
Calcium supplements are also very popular for improving bone health. However, a recent study found that people who take calcium supplements were 86% more likely to have a heart attack than the people who not using calcium supplements. People who got enough calcium from food (milk, yogurt, cheese, sardines, tofu, salmon, kale, turnip greens, etc) had a 30% lower risk of heart attack.
The FDA does not ban dietary supplements very often. Ephedra was the last supplement to be banned. Although DMAA supplements have been linked to dozens of injuries and several deaths, the FDA has not banned DMAA. They have sent warning letters to manufacturers. However, supplement stores such as GNC and Vitamin Shoppe continue to sell DMAA products.
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