Do Different Dietary Supplements Have Different Levels of Effectiveness?

Many adults and children in the United States take one or more vitamins or other dietary supplements. These products come in a variety of forms, such as tablets, capsules, gummies, powders, energy drinks and bars. Popular supplements include vitamins D and B12; minerals such as calcium and iron; herbs such as echinacea and garlic; and products such as glucosamine, probiotics and fish oils. Each product comes with a supplemental information label that lists the active ingredients, the amount per serving (dose), and other ingredients.

The manufacturer suggests the serving size, but your healthcare provider may decide that a different amount is more appropriate for you. Some dietary supplements can help you get adequate amounts of essential nutrients if you don't eat a variety of nutritious foods. However, supplements cannot replace the variety of foods that are important to a healthy eating routine. For more information on what constitutes a healthy eating routine, the Dietary Guidelines for Americans and MyPlate are good sources of information.

Many other supplements need more studies to determine if they have value. The Food and Drug Administration (FDA) does not determine if dietary supplements are effective before they are marketed. Many supplements contain active ingredients that can have strong effects on the body. Always be alert to the possibility of a bad reaction, especially when taking a new product.

Manufacturers can add vitamins, minerals and other supplement ingredients to the foods you eat, especially breakfast cereals and beverages. As a result, you might get more of these ingredients than you think, and more may not be better. Taking more than you need costs more and may also increase the risk of side effects. For example, too much vitamin A can cause headaches and liver damage, reduce bone strength, and cause birth defects.

Excess iron causes nausea and vomiting and can damage the liver and other organs. Be careful when taking dietary supplements, beyond a standard prenatal supplement, if you are pregnant or breastfeeding. Also, be careful when giving supplements to a child, unless recommended by their healthcare provider. The safety of many supplements has not been well evaluated in children and in people who are pregnant or breastfeeding.

If you think you've had an adverse reaction to a dietary supplement, tell your health care provider. They may report their experience to the FDA. You can also send a report directly to the FDA by calling 800-FDA-1088 or filling out an online form. You should also report your reaction to the manufacturer using the contact information on the product label.

The FDA has established good manufacturing practices (GMP) that companies must follow to help ensure the identity, purity, concentration and composition of their dietary supplements. These GMPs can prevent the wrong ingredient (or too much or too little of the right ingredient) from being added and reduce the chance of contamination or of incorrectly packaging and labeling a product. The FDA regularly inspects facilities that manufacture supplements. Tell your healthcare providers (including doctors, dentists, pharmacists, and dieticians) about any dietary supplements you are taking.

They can help you determine which supplements, if any, might be valuable to you. Keep a complete record of all dietary supplements and medications you take. The Office of Dietary Supplements website has a useful form, My Dietary Supplement and Medicine Record, which you can print and complete at home. For each product, write down the name, the dose you take, how often you take it, and the reason for using it.

You can share this record with your healthcare providers to discuss what is best for your overall health. Dietary supplements are products intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure diseases. The FDA is the federal agency that oversees both supplements and drugs but the FDA regulations for dietary supplements are different from those for prescription or over-the-counter drugs.

Drugs must be approved by the FDA before they can be sold or marketed while supplements do not require this approval. Supplement companies are responsible for having proof that their products are safe and that the claims on the label are truthful and not misleading. However, as long as the product does not contain a “new dietary ingredient” (one introduced since October 15th 1999), the company does not have to provide these safety tests to the FDA before the product is marketed. Dietary supplement labels may include certain types of health-related claims but manufacturers must follow good manufacturing practices (GMP) to ensure the identity, purity, strength and composition of their products. If the FDA believes that a dietary supplement is unsafe it can recall the product from the market or ask the manufacturer to voluntarily recall it. The FDA monitors the market for potential illegal products that may not be safe or make false or misleading claims.

The Federal Trade Commission which oversees product advertising also requires that information about a complementary product be truthful and not misleading. The federal government can take legal action against companies and websites that sell dietary supplements when companies make false or misleading statements about their products if they promote them as treatments or cures for diseases or if their products are not safe. NIH supports research and provides educational materials on dietary supplements while The FDA issues rules and regulations and oversees the labeling marketing and safety of dietary supplements. Recall notices are also posted on the FDA website or you can sign up for email notifications.

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