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One of the reasons why dietary supplements are so popular is the perception that they are harmless.
But like all medications, taking vitamins and minerals has many potential dangers.
The problem is that, unlike conventional drugs, dietary supplements are not required to warn consumers of their potential risks.
They are also not required to submit full documentation of their risks to the Australian medicines regulatory authority, the Therapeutic Goods Administration (TGA), when cleared to market, leaving us all uninformed.
This week I published an article in Australian Prescriber identify six possible harms of taking vitamin and mineral supplements.
What do we mean by supplements?
Food supplements are natural health products such as vitamins, minerals, amino acids, enzymes, plant extracts, and seaweed that are used to increase people’s diets. rather than treating the disease.
Although these products are more commonly referred to as complementary medicines in Australia, particularly by the TGA, the term “dietary supplement†is used frequently by consumers and in the scientific literature.
Food supplements dominate the complementary medicine industry in Australia.
Sales reached AU $ 4.9 billion in 2017, after doubled in the last ten years.
Complementary medicines are widely used in Australia. A national survey published in 2018 showed that 63% of people use them regularly.
Supplements containing vitamins and minerals were the most popular type of complementary medicine, reportedly used by 47% of respondents. Examples include vitamin D, vitamin C, calcium, magnesium, and vitamin A.
Read more: Thinking of trying collagen supplements for your skin? Healthy food is better value for money
6 potential harms of food supplements
People often say that they have never heard of the harms of dietary supplements. This is not surprising, given that their marketing is largely benefit-based with little to no mention of the potential harm.
In addition, consumer information leaflets are never provided, and few products carry warnings on their packaging of potential serious effects.
Nevertheless, there is well recognized night from Ingredients food supplements, which would be familiar to anyone who has studied pharmacology, especially when these substances are consumed in large doses.
For these reasons, some high dose vitamin A and selenium products are legally regulated by the TGA as Schedule 2 (pharmacy only), Schedule 3 (pharmacist only) and Schedule 4 drugs. (prescription drugs only).
When considering the possible harm that could occur with dietary supplements, most people only think about side effects.
However, as with any medicine, at least six types of damage can occur. that I identified in my research:
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Side effects. Side effects of vitamins and minerals can occur with short or long term use. Usually, side effects occur at too high doses, but not always. They can also cause new diseases or disrupt existing conditions. Some supplements also pose risks during pregnancy and breastfeeding
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Drugs interactions. Interactions with other drugs, certain foods, and certain illnesses can make other drugs more toxic or less effective.
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Cost. The cost of dietary supplements can impact people’s finances and their ability to afford treatment or other essentials.
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Delay more effective treatment. Time spent taking ineffective products can delay more effective interventions, waste valuable time and allow disease to progress
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False hope or fraud. Falling for fraudulent claims offering false hope can be demoralizing and depressing, which for some can be the difference between continuing to deal with a health problem and giving up.
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Drug burden. As the number of drugs and supplements increases, so does the risk of something going wrong. This includes the risk of side effects, drug interactions or making a mistake.
The key to safety is the dose
Many dietary supplements are used safely for medical purposes. Women are prescribed folic acid and iodine during pregnancy, for example, or vitamin and mineral supplements are given for deficiencies, such as iron.
The key to using them safely is the dose, which is determined from research showing that the benefits outweigh the risks.
This is not the case when people self-heal with products bought on the open market. Consumers rarely consider the dosage effective or safe, and often just take the dosage recommended on the label – which might be unnecessary – or what they think is right.
Many people overlook the risk of overdosing on the same ingredient like vitamin B6 or vitamin A, which is more likely when taken through multiple products.
Read more: New study on vitamin supplements finds they can do more harm than good
In order for people to make informed decisions about using dietary supplements, the details of the pros and cons should be evidence-based and readily available. People need to know not only where to look for this information, but also how to criticize it.
Healthcare professionals can help people by openly discussing the risks and benefits of dietary supplements, explaining why dose is important for both effectiveness and safety, and directing them to good quality information that goes to the forefront. – beyond what appears on the manufacturer’s label.
Manufacturers should be required to make this information more easily accessible.
When evaluating the potential benefits and risks of supplements, it is essential to look beyond the main or well-known ingredient. Identify the exact product used, all of its ingredients, dose taken, and potential for cumulative overdose from repeated ingredients in multiple products.
As with all medicines, if you have any side effects or problems after taking food supplements, report them to the TGA.
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