Straight talk about supplements

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Think all those natural remedies will help keep you and your family healthy this winter? Maybe you should read the opinion piece by Dr. Paul A. Offit, chief of the division of infectious diseases at the Children s Hospital of Philadelphia (and ACSH Trustee), and Dr. Sarah Erush, the clinical manager in the pharmacy department.

These experts inform us that the the Joint Commission, which reviews and accredits US hospitals, requires that dietary supplements (vitamins, minerals, botanicals) be treated like drugs which, in fact they are. This is, of course contrary to common usage, as dietary supplements on the consumer market are treated more like foods although this is completely without logic. The sales of these products may occur without prior research to prove they are effective, or even that they are labeled accurately. Obviously, this can lead to serious issues, as Dr. Offit and Ms.Erush describe.

They cite FDA finding that some of facilities where some supplements are produced were contaminated with rodent urine and feces. They also found that 20 percent of ayurvedic medicines purchased in Boston contained high levels of lead, mercury or arsenic. In 2008 two products were found to contain 200 fold greater levels of selenium than described on their labels. Although some believe that selenium can help prevent cancer without any evidence to support such a theory the element is quite toxic. The recommendation for selenium is 20 micrograms per day (7 billionths of an ounce roughly the weight of 1 thousandth the amount of a grain of salt). At excessive doses (and it doesn t take much), it can cause hair and nail loss, muscle cramps, joint pain and other problems.

Other issues include mislabeling. Some herbal products, such as St. John s Wort and gingko biloba, contained different herbs or contaminants, according to a recent finding in Ontario.

The authors noted that parents of children admitted to the hospital often ask that their kids continue to take the supplements they ve been given at home even though there s evidence of neither safety nor efficacy.

Fortunately for their patients, the hospital has instituted the following policy: No longer will we administer dietary supplements unless the manufacturer provides a third-party written guarantee that the product is made under the F.D.A. s good manufacturing practice (G.M.P.) conditions, as well as a Certificate of Analysis (C.O.A.) assuring that what is written on the label is what s in the bottle.

Not surprisingly, most of the supplements they ve been asked to use don t meet those criteria. Further, when the hospital contacted the manufacturers to determine their products eligibility, the great majority of them never responded. While lack of response doesn t prove lack of oversight, it does make one wonder, doesn t it?

ACSH s Dr. Ruth Kava opined, Clearly the experience of Drs Offit and Erush underscores the unreliability of the dietary supplement market today. Not only can consumers not be buying what they think they re buying, but they may also be getting too much of what might otherwise be a good thing. And it s scary to think that in spite of scientifically valid advice, some parents still want their children to continue to take such supplements. We have written extensively about the problems associated with the dietary supplement market.