May / 2001
Your Health

Dietary Supplements
by: Maureen McArthur

Natural remedies, herbs, formulas, and other dietary supplements are available in health food stores, drugstores, and even some grocery stores. The labels read "improve memory," "promote higher energy levels," or "maintain healthy digestion." And many consumers seem to believe the claims. According to the U.S. General Accounting Office, an investigative division of Congress, about $31 billion was spent on dietary supplements and related products in 1999.
But on these same labels is the disclaimer required by federal law: "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." So how much is really known about these dietary supplements?
"If the product is a dietary supplement, there is a lot we don't know," says Kelly Smith, Pharm.D., drug information specialist and assistant director, University of Kentucky Hospital Drug Information Center. "Dietary supplements are not tested in thousands of people before they are marketed like drugs are tested. This means that the evidence for the product's effectiveness is based mainly on historical use rather than scientific studies."
Limited scientific studies have been done for some products. The Office of Dietary Supplements (ODS) at the National Institutes of Health coordinates research and funding for research on the effectiveness of dietary supplements.
"If you are considering using a dietary supplement, choose one that references clinical studies rather than just testimonials," says Smith, who also is a clinical assistant professor, Pharmacy Practice and Science Division, UK College of Pharmacy.
Another unknown about these products is the potential side effects and interactions with prescribed or over-the-counter medications.
For example, the popular herbal remedy St. John's Wort, often taken for treatment of mild depression, has been shown to interact with drugs used to treat cancer and AIDS and with birth control pills. St. John's Wort makes these medications up to 50 percent less effective in certain people.
Other dietary supplements have been associated with liver damage, kidney failure, and even death. These serious side effects can occur rapidly or over time.
The quality of dietary supplements can also be uncertain. The FDA does not regulate the manufacturing of these products.
Consumers can try to find products of higher quality by looking for products labeled "USP" or "NF," which follow the standards set by the U.S. Pharmacopoeia, a non-governmental scientific organization that develops standards for medications and health care products.
If you are taking or considering taking a dietary supplement, Smith says, "Because so much is unknown about dietary supplements, it's important that consumers get all the information available by talking with their pharmacists or physicians about these products."

Maureen McArthur is a senior information specialist at the University of Kentucky Chandler Medical Center, Office of Public Relations.