Dietary
supplements: Safer than food - much safer than drugs
May 1999
Dietary
supplements enjoy a stellar safety record. They stand head-and-shoulders
above the other three categories of consumables as distinguished
by U.S. law: food, over-the-counter drugs, and prescription drugs.
Food
consumption is quite safe in the United States. Some dry foods like
spices are about as safe as dietary supplements. Yet other foods,
particularly perishables, cause thousands of deaths every year from
food poisoning. More die from allergic reactions. Over-the-counter
drugs, still generally safe, also cause thousands of deaths every
year.
At
the opposite end of the safety spectrum, prescription drugs are
the most dangerous. While they are vitally important, they kill
more than 100,000 people every year. In contrast, an average of
only about 2 people die every year from consumption of a dietary
supplement.
Given
their relatively benign effect, why are there so many stories in
the news about the dangers of dietary supplements? The FDA and other
organizations interested in expanding government regulation regularly
issue alarming reports of harm caused by dietary supplements. Well-intended
as they may be, these stories frequently turn out to be misleading.
Yet vindication of the implicated products is often sorely missing.
For
example, media reports that received national attention claimed
that a California teenager died from taking ma huang, or ephedra.
The coroner's report, however, later revealed that there was no
trace of this dietary supplement in her blood at the time of her
death. It turned out that she died from a congenital heart defect.
If
a proportionate amount of press coverage were given to actual harm
caused by prescription drugs, newspapers would be chock full of
tragedies resulting from drug side effects, errors in administration,
and experimental use. We have a real opportunity to save lives by
exercising greater caution in the use of prescription drugs. In
contrast, dietary supplements have low toxicity and their rate of
contamination is a non-problem.
Some
have suggested that dietary supplements, sometimes called "nutraceuticals",
be government-regulated at a level that lies between food and drugs:
more restrictive than foods but less restrictive than drugs. This
is illogical. As noted, dietary supplements are much safer than
food. If regulation is needed to protect consumers from unsafe substances,
then supplements should be less government-regulated than food,
not more so.
Legislation
was passed in 1994 (the Dietary Supplement Health and Education
Act or DSHEA) to ensure that regulations remain as lenient for dietary
supplements as for food. It is imperative that this standard be
upheld. If anything, it should be relaxed. (DSHEA defined the term
dietary supplement to include a vitamin, mineral, herb or
other botanical, amino acid -- or a concentrate, metabolite, constituent,
extract or combination of any of these ingredients intended to supplement
the diet, other than tobacco.)
Should
producers of dietary supplements regulate themselves to ensure their
products are safe? Of course they should - and they do. It is in
their best interest to maintain a reputation for delivering safe
products. The consequences of marketing an unsafe product are extremely
dire and likely to ruin a multi-million dollar investment overnight.
Is
there any safety issue with which consumers of dietary supplements
should be concerned? Yes, any substance can be toxic when taken
in excess -- even natural products and herbal remedies. Therefore
it is important to know what the appropriate dosage level is for
a given supplement and to observe it.
Furthermore,
individual responses to supplements vary just as they do with drugs
and should be adjusted accordingly. Like drugs, some supplements
provoke allergies, have exaggerated effects when taken simultaneously
with other substances, or are contraindicated for certain conditions
such as pregnancy. Certain supplements can cause undesirable side
effects. All these factors should be considered before taking a
supplement.
Because
incidents of contamination are extremely rare, the safety of any
particular brand of dietary supplement is of negligible concern.
However to ensure we maintain safety - and promote quality - it
always helps to buy from a reputable manufacturer. This doesn't
necessarily mean a large manufacturer since quality, and lack thereof,
comes in all sizes. But it does mean seeking those companies that
demonstrate a commitment to high levels of quality.
Safety
of any consumable product should never be ignored. Yet consumers
can take comfort in knowing that dietary supplements, when taken
as recommended, are exceptionally safe.
For
more information about safety, check out our safety
issues page.
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