ACSH and ABC News: Twitter Q&A on Supplements

Related articles

Yesterday at 1 PM Eastern, the ABC News Medical Unit, headed by Dr. Richard Besser, created a social media event to talk about supplements. Along with the American Council on Science and Health, participants included the National Institutes of Health, Stanford University and others.

Why? Because there is a great deal of confusion about supplements. Much of the population in America grew up at a time when you were supposed to 'take your vitamins' and since vitamins are supplements, supplement marketers lump vitamin takers in as part of their effort to look mainstream. But someone who takes St. John's Wort might have very little in common with someone who takes Vitamin D because they don't drink milk.

Compounding the problem is that a law passed in 1994, the Dietary Supplement Health and Education Act (DSHEA), provides easy workarounds for supplement makers to imply medical benefit without actually adhering to anything we recognize as medical trials.

The Twitter event yesterday was broken into 12 topics, but rather than make you sift through the whole transcript, you can get right to the most precise answers - because we are here to be trusted guides and can get to the point, we don't have to worry about government or academic media training rules.

The answers are short, because they had to be cut down to 140 characters or less, and Dr. Lila Abassi, our Director of Medicine, was the expert, but it seemed too much to make her write this article about it also. Ask away in the comments if you have deeper questions.

1. What are dietary supplements? Are vitamins considered dietary supplements?
There is no clear answer to the first question because DSHEA leaves it intentionally vague. Vitamins are supplements except when they are taken in large doses to treat something. Then they are drugs. An example is vitamin b3 (niacin) used high dose to lower cholesterol.
2. How many Americans use dietary supplements? Which ones are the most popular?

Up to a third, but that is because vitamins are a supplement, so supplement becomes colloquial to the public.
3. How are dietary supplements currently regulated? Is it different than for drugs? Should regulations be more lenient? More strict?

Most supplements are drugs, since they treat or prevent something. They should be treated like drugs.

4. Do you take a multivitamin? Why or why not? If you do, do you find it helps? What does the science say?

Studies consistently show that people who take multivitamins either get no benefit, or die at the same times as those who don't.
5. Do you use supplements to prevent or treat a cold? If so, which ones? Do they work? What does the science say?

Nothing prevents a cold. And if something did, it would be a drug by definition, not a supplement.
6. Omega-3 fatty acids are often in the news. Do you use them? Why or why not? Do they help? What does the science say?

No clear answer, but no good evidence that they do anything either

7. Millions of U.S. adults suffer from #arthritis. Do you use dietary supps to manage #arthritis? Which ones? Do they help? What does the science say?
8. Do you take supplements to build muscles? If so, which ones? What does the science say?
Most deaths from supplements were people trying to build muscle. The only one that works is DHEA, a banned (in sports) anabolic steroid.
9. Some people use #melatonin as a sleep aid. Have you used melatonin to help you sleep? What does the science say?

It works, but no one knows the right dose or effects from long term use or high doses.
10. Many natural products have been studied for effects on menopausal symptoms. Have any shown benefit? What does the science say?
Soy works, but acts on the same estrogen receptor as HRT, which works better.
11. Only about one-quarter of supplement users talk to their healthcare providers about their use of these products. Do you? If not, why not?
They think they are not taking a drug, so they may not mention it. Doctors often use the same internet info that anyone else does.
12. What safety concerns should people be aware of if they take vitamins and supplements?
They are lab rats for untested drugs. And what the label says is in the bottle often is not.