Concerns About Dietary Supplements

In recent years, many people have incorporated supplements like vitamin D, magnesium, and collagen into their daily routines. They’ve become virtually common among a wide audience. However, experts have begun to express concerns: even products that are thought to be “natural” come with potential risks. A survey by the British consumer group Which? found that 76% of participants regularly use at least one dietary supplement, with nearly 20% of them taking four or more each day.

Doctors and nutritionists worldwide, as reported by the BBC, are witnessing an increase in cases of organ damage—particularly the liver, kidneys, and digestive system—often tied to the intake of dietary supplements. This appears to be especially true when individuals take multiple supplements concurrently or in high doses. It seems a lot of people are influenced by social media, opting for supplements even when they may not have a nutritional deficiency. Experts caution that while these supplements can be beneficial in some cases, they shouldn’t replace a balanced diet or professional medical advice.

Professor Ziv Ben Ari, who leads the Center of Excellence for Liver Medicine at Assuta, highlights that the potentially harmful effects of dietary supplements and medicinal herbs are becoming more recognized. She notes how the popularity of these products has soared, with individuals often reaching for them to enhance overall health or address issues such as fatigue or joint pain. Surprisingly, recent studies suggest that about 20% of liver injury cases related to medications are actually tied to dietary supplements and herbal remedies.

Meanwhile, Michal Sukman, a clinical dietitian at Maccabi Healthcare Services, emphasizes the importance of cautious supplement use. While they can effectively address nutritional deficiencies, uncontrolled usage might lead to side effects, especially because these products can interact negatively with medications or cause harm to vital organs. “A supplement can indeed be beneficial when it’s used correctly,” she explains, advocating for a personalized and evidence-based approach when considering supplementation.

A significant study published in the New England Journal of Medicine in 2015 revealed that in the U.S., around 23,000 emergency visits and 2,000 hospitalizations annually are related to adverse effects from dietary supplements. Most of these incidents involved weight-loss, energy, and performance-enhancing products. Among older adults, high doses of vitamins and the misuse of supplements commonly led to complications.

Sukman notes these findings suggest not necessarily that supplements are more dangerous, but rather that they’re being widely used without proper guidance. Many people tend to start taking supplements after seeing social media recommendations or peers’ advice, without confirming a genuine need.

Concerns over dietary products are particularly focused on weight-loss, energy, and bodybuilding supplements sourced from unregulated outlets. A common belief is that “natural” equates to safety, but Sukman warns this isn’t always the case. In a recent study, millions were found to use herbal supplements that could potentially damage the liver. Substances such as high-dose green tea extract and red yeast rice have appeared in liver injury reports.

The LiverTox database from the National Institutes of Health has documented numerous cases linking liver damage to dietary supplements. Substances like vitamin A and green tea extract have been singled out for causing harm, especially with prolonged usage or in large doses.

Sukman explains that excessive vitamin D can lead to increased calcium levels and potentially damage the kidneys, while high doses of certain minerals can further complicate existing kidney issues. There’s also a concern regarding the unexpected contents found in some dietary supplements, which sometimes include unlisted substances or contaminants, as noted by Professor Ben Ari.

She adds that while dietary supplements are classified as foods rather than medications, they don’t require the rigorous efficacy testing that pharmaceuticals do, leaving much responsibility in the hands of manufacturers. Also, many popular supplements lack substantial scientific backing. For instance, a study in Nature Microbiology raised doubts about the composition of widely-used probiotic products, noting inconsistencies and a limited understanding of their health benefits.

It’s common for people to mix a variety of supplements without realizing that this, too, can lead to excess intake or harmful interactions. For example, simultaneously taking a multivitamin with a vitamin B6 supplement could result in nerve damage. Furthermore, certain vitamins are fat-soluble and can accumulate over time, suggesting they don’t need to be taken daily.

Interactions between supplements and medications pose additional risks. For instance, vitamin K can interfere with blood thinners, while substances like St. John’s wort might reduce medication effectiveness. Therefore, Sukman insists on the importance of disclosing supplement usage to doctors, alongside prescribed medications.

While the risks are real, Sukman points out that dietary supplements can be essential under specific conditions, like confirmed deficiencies revealed through blood tests or during pregnancy. It’s crucial to investigate the root cause of any deficiency before proceeding with supplementation. For instance, folic acid is advised in early pregnancy, and certain medications can affect nutrient absorption, emphasizing the necessity for professional support.

Experts advise against taking supplements without a clear and validated need, particularly for vulnerable populations such as older adults, pregnant women, children, and those with health conditions. Anyone taking supplements should consult a doctor if they experience unusual symptoms, as there could be risks involved.

Sukman underscores that blood tests are valuable for personalizing supplementation. Rather than relying on ads or social media buzz, it’s better to confirm if there’s indeed a deficiency needing attention.

For generally healthy individuals, the benefits of supplements are not as compelling as commonly believed. A review by the U.S. Preventive Services Task Force published in JAMA indicated that there isn’t enough evidence to support the use of vitamin and mineral supplements for preventing heart disease, cancer, or overall mortality.

In closing, Professor Ben Ari advises exercising caution when considering any dietary supplement, weighing the potential benefits against the risks. Consulting with a healthcare provider before beginning any regimen is strongly recommended. Sukman’s guidance is straightforward: regularly evaluate the necessity of any supplement, ensuring the dose is appropriate and be aware of potential interactions with medications.