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Don’t Take Supplements Without Doing This First

Supplements aren’t always safe—or even necessary. Follow these rules to help protect your health.

Think “all natural” means “perfectly safe”? That’s not always the case, at least when it comes to vitamins and supplements.

A study published by the Centers for Disease Control and Prevention (CDC) in 2015 estimated that about 23,000 Americans went to the emergency room each year between 2004 and 2013 due to problems related to supplements. About 10 percent of those cases even required a hospital stay.

While the number of people needing medical treatment is small compared to the total number taking vitamins and supplements—about 58 percent of Americans aged 20 and over, according to the CDC—supplements can pose certain health hazards. Learning more about them, including the best ways to purchase quality products, can help you prevent medical mishaps.

“There’s a lot of misinformation” surrounding supplements, says Keith Roach, MD, associate professor in clinical medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital. “A lot of people think if it’s natural it can’t hurt you, and that’s just not true.”

Who’s most at risk for health problems?
In the 2015 study, CDC researchers found that young adults between the ages of 20 and 34 were most likely to land in the ER due to supplements. Women ended up in the hospital more often than men, and children under age 4 were also at higher risk, mostly due to getting access to bottles and swallowing pills when their parents weren’t looking.

Weight-loss and energy-boosting supplements were the biggest offenders, accounting for about one-third of emergency room visits. They were responsible for nearly three-quarters of ER trips in which people complained of heart-related symptoms.

“Weight-loss and energy supplements have the potential to be scary,” says Dr. Roach. “With too much [of them], you’re going to start getting these kinds of toxicities.”

Taking supplements responsibly can start with a helpful change in mindset.

“Consumers need to think of supplements as drugs,” Roach says. “If you’re starting to have symptoms that look like the side effects of drugs, it could be the supplements. If it’s severe, go to the emergency room. If it’s not as severe, stop taking them and call your doctor.”

How to prevent problems
Supplements aren’t regulated by the U.S. Food and Drug Administration (FDA) in the way over-the-counter and prescription drugs are, so there’s comparatively little oversight. This means their safety and efficacy don’t have to be proven before they hit the market. It also means the actual content of any given supplement can differ greatly from what’s printed on the label.

“Because supplements are not regulated, most don’t have quality control, and you don’t know what you’re getting,” says Roach. That’s changing, he says, as more brands have their supplements independently tested and verified.

If you decide to take supplements, follow these guidelines to optimize your use and reduce the risk of health problems:

  • Look for supplements certified by organizations like NSF International, U.S. Pharmacopeia (USP) and ConsumerLab.com, which test and verify supplement content.
  • Buy products from reputable manufacturers or a good local store rather than an unfamiliar online vendor.
  • Speak with your healthcare provider (HCP) about potential drug interactions, since some supplements can affect how your prescriptions work. St. John’s wort may interfere with oral contraceptives or certain heart medications, for instance.
  • Read labels carefully and look for duplicate ingredients. For example, if you take a multivitamin in addition to a supplement with collagen plus B vitamins, you might be getting a lot more B vitamins than you intended.
  • Don’t take more than the recommended dose. Some products may be dangerous if you take too much or take them for too long.
  • Keep in mind that supplements are not intended to replace a nutritious, well-rounded diet or prescription medicine. Speak with an HCP about your health concerns.

Most of all, Roach says, remember that supplements are often unnecessary. Some might help people who can’t or won’t take over-the-counter or prescription drugs with certain medical conditions. They may also benefit people with a diagnosed vitamin deficiency.

But, he explains, “there is little to no value in taking supplements for a healthy person with a healthy diet. For most people, you’re wasting your money.”

Medically reviewed in March 2021.

Sources:

AI Geller, N Shehab, et al. “Emergency Department Visits for Adverse Events Related to Dietary Supplements.” New England Journal of Medicine. 2015; 373:1531-154.
Council for Responsible Nutrition. “Dietary Supplement Use Reaches All Time High.” 2021. Accessed March 18, 2021.
Liz Szabo. “Older Americans Are ‘Hooked’ on Vitamins.” The New York Times. April 3, 2018.
Art Swift. “Half of Americans Take Vitamins Regularly.” Gallup.com. December 19, 2013.
U.S. Food & Drug Administration. “FDA 101: Dietary Supplements.” July 15, 2015. Accessed March 18, 2021.
Kevin Loria. “How to Choose Supplements Wisely.” Consumer Reports. October 30, 2019.
National Center for Complementary and Integrative Health. “Herb-Drug Interactions.” September 2015. Accessed March 18, 2021.
Centers for Disease Control and Prevention. “Dietary Supplement Use Among Adults: United States, 2017–2018.” February 2021. Accessed March 29, 2021.
Mayo Clinic. “St. John’s wort.” February 13, 2021. Accessed March 29, 2021.

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