Dietary Supplements, Low Regulation, Buyer Beware

IMG_6832Dietary supplements are causing an estimated 23,000 emergency room visits in the United States every year according to new research conducted by the federal government and published in this month’s New England Journal of Medicine. Everyone from GNC, Vitamin Shoppe, Wal-Mart to your local grocery store carry these products but their regulation is low making it a buyer beware purchase.

The Damage

Researchers reviewed 63 emergency room departments for a ten-year period, from 2004 to 2013. The main complaints related to dietary supplement use included:

  • Allergic reactions
  • Heart trouble
  • Nausea and vomiting

More than nine percent of these emergency room visits were severe enough that the individual had to be admitted to the hospital for further treatment.

The Victims

  • 28% were young adults between the ages of 20-34 years
  • 21% were unsupervised children
  • 37% of the complaints by older adults were related to choking, the feeling that the pill was still lodged or difficulty in swallowing after use.

Among young adults, half of these cases were caused by supplements marketed to help with weight loss or increase energy.   They were rushed to the emergency room with symptoms of chest pain, heart palpitations and irregular heart rhythms. While the law would require that many of these products carry warning labels of these very potential side effects had they been prescription drugs, dietary supplements have no such requirement.

Emergency room visits related to children were often related to unsupervised access to multivitamins, iron supplements, or those designed to enhance sleep or reduce anxiety. This suggests a need for dietary supplement manufacturers to improve their childproof packaging and for parents to store them in more secure locations.

The other group of victims were older adults. One-third of the emergency room visits were caused by allergic reactions or choking on pills. By issuing an advisory to the industry on capsule sizes, the FDA could easily reduce risk and associated health care costs related to this problem.

Consumers need to know that products don’t need FDA approval before being placed on the shelf for purchase. While The Dietary Supplement and Health Education Act (DSHEA) doesn’t allow supplements to be marketed as being able to cure disease it also doesn’t require safety testing. The FDA only has the power to remove them from your shelf if they are proven to be unsafe or an ingredient has been proven to cause harm.  In other words, after the damage has been done.

The Recommendations

Dietary supplements are a $32 billion industry that continues to grow. It’s important for you to:

  1. Understand that dietary supplements are currently under regulated.
  2. Share your use of all over the counter medications including vitamin, mineral, and herbal and weight loss supplements with your physician before having medical procedures or at your annual physicals and whenever you have a concern.

If you do choose to use a dietary supplement, find a store that has medically credentialed pharmacists on staff. Review your selection with these licensed and trained individuals before making your purchase and after sharing current medical conditions and medication usage. I never recommend the use of stimulants or weight loss pills.

You will no doubt read contradictory articles where manufactures counter that the number of adverse events from supplements are very low given their widespread use. However if you were one of the family, friends or victim who wound up in an emergency room, you know these products aren’t always safe.

Resources

http://www.nejm.org/doi/full/10.1056/NEJMsa1504267

http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine54118?xid=nl_mpt_DHE_2015-10-16&eun=g462514d0r



Categories: Nutrition & Wellness

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