Wednesday, July 24, 2013

How Safe Are Supplements?

In recent years, there has been much controversy about the safety and efficacy of dietary supplements. Are they as safe as pharmaceutical medications? Should you be concerned that  they could make you sick? Interestingly, in the United States and Europe, regulatory agencies (FDA, EMEA, etc.) are trying to, or have succeeded in, restricting or blocking the sale of many dietary supplements to the general public. You might think that they are trying to regulate these supplements because they are trying to protect you from “dangerous” supplements that could harm you, but is this really the case?

Interestingly, a recent analysis of government statistics out of Britain finds that you should be far more concerned about over the counter medications than dietary supplements. Taking prescription or over the counter drugs exposes a person to one of the greatest preventable risks of dying. But even more surprising is that driving your car to a pharmacy is even far more risky than taking dietary supplements!

The results from the data shows that many very common daily activities put you at a higher risk of death than taking dietary supplements. You are over 1,700 times more likely to die riding your bike (even with a helmet on!) than from taking supplements. Taking a Tylenol is about 348 times riskier than a supplement. Step up to a prescription drug, and the risk jumps to 62,000 times that of taking supplements. For some perspective on these large numbers, you are just about as likely to be hit by lightning as you are to be harmed by taking dietary supplements.

We’ve discussed in previous articles that even the seemingly “safe” over the counter medications can cause serious side effects or even death. Acetaminophen (e.g. Tylenol or Paracetamol, as it is called in the UK) is the leading cause of calls to poison control (over 100,000 calls per year) and is responsible for many deaths every year. NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen are a major cause of gastrointestinal bleeding and can cause potentially cause severe muscle damage, which can are both lead to death. Obviously, not everyone who takes these medications gets ill, but the risk is still there.

The issue of supplements, with regard to safety and efficacy, is a hotly debated and highly political issue. There is a lot of money on both sides of this issue both from supplement makers and suppliers on one side and pharmaceutical companies on the other. While the issue of efficacy is something that research is continuing to shed light on, the issue of safety is directly addressed in these infographics.

The simple fact is, most “supplements” are things we should normally get in our diet. Unfortunately, the “Standard American Diet” (abbreviated SAD for obvious reasons) is lacking in...well almost everything that makes us healthy. Not only basic nutrients like vitamins, minerals, and amino acids, but also things like phytonutrients and antioxidants. These are nutrients which we now understand are fundamental to the prevention of disease and in promoting long term wellness. Supplements may be a potential solution for those unable to eat a healthy diet. Supplements may also be important for those individuals who may need extra nutrients supplemented to address their particular biochemical needs or disease states.

So what are the risks when it comes to supplements?  Obviously, some people may be allergic or sensitive to some substances (including the non-active ingredients or excipients), some supplements may not be manufactured with the best raw materials or tested properly to be pure and free from contamination, and there is some evidence that overdoing any one type of supplement (e.g. anti-oxidants) out of balance with the rest of a person’s physiology may be harmful. This is why it is always important to consult with a healthcare professional before taking any medication or supplement. Nevertheless, when compared to pharmaceutical medications, or even everyday activities, supplements as a whole seem to carry a very good safety profile.

The whole list of risky activities, as compared to taking dietary supplements, can be found here, with the relative risks ranked and compared. For a slightly better visualization of the data, there is a graph which can be found here. The data was taken from official UK and EU government sources and collated by an independent risk management consultant.

Researched and written by Dr. Rebecca Malamed, M.D. with assistance from Mr. Malcolm Potter.


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  2. Hello, I have browsed most of your posts. This post is probably where I got the most useful information for my research. Thanks for posting, maybe we can see more on this. Are you aware of any other websites on this subject. Justine Henderson

  3. I am glad you found the post helpful. Unfortunately, I am not aware of other websites on this subject. I would be very interested to learn about any that you might find. Please share if you do! Dr. Rebecca