How to know if dietary supplements can help or harm

Taking vitamins, minerals, botanicals, microbials? Tell your primary care provider

How to know if dietary supplements can help or harm

A lot of advertising for vitamins, supplements and over-the-counter medications will make robust claims about how these products can change lives. There are accompanying testimonials from those who are healthier than they have ever been before.

Collectively they are often referred to as “dietary supplements.” In the marketing of these products, we often learn they do not need a doctor’s approval, which means you can just go buy the stuff and start taking it.

Your doctor should still be involved, however. In some instances, a supplement or vitamin can alter the effects of prescribed treatment of existing health conditions. Your provider needs to know what you’re consuming to deliver accurate medical advice.

The Food and Drug Administration lists common supplements this way:

  • Vitamins (such as multivitamins or individual vitamins like vitamin D and biotin)
  • Minerals (such as calcium, magnesium, and iron)
  • Botanicals or herbs (such as echinacea and ginger)
  • Botanical compounds (such as caffeine and curcumin)
  • Amino acids (such as tryptophan and glutamine)
  • Live microbials (commonly referred to as “probiotics”)

“You need to be upfront,” said Amy Dwight, APRN, CNP, a family medicine provider at the Sanford Aberdeen Clinic. “One of the big things we see is that people don’t always think of those things as important to tell your doctor. Just because it says ‘natural’ on the label does not always mean it’s safe.”

A recent survey conducted by the Council for Responsible Nutrition indicated 75% of Americans use dietary supplements. In another national survey conducted by the Centers for Disease Control and Prevention, it was estimated that dietary supplement sales reached $55.7 billion in 2020.

We asked Dwight to help us get a handle on how to make safe decisions about dietary supplement use:

There are lots of dietary supplements out there. What basic tips do you have when considering taking a new dietary supplement?

Often, patients who have seen the advertising will ask providers if they should be taking what their TV or phone is telling them to take. They will offer a brand name and expect a thumbs-up or thumbs-down answer.

Unfortunately, being safe with supplements can be more complex.

“You will see something that tells you a product is good for fruit and vegetable support and you need to take it,” Dwight said. “But when you flip the bottle around and see what’s actually in the ingredients and how much of each ingredient is in the bottle, you realize you should be bringing these bottles or their labels with you to your next visit to your provider.”

The first step when contemplating a supplement is to ask your provider. They can cut through advertisers’ claims and tell you if there are any risks involved in putting this into your system.

“We’re here to answer questions,” Dwight said. “I don’t want people to be afraid of asking. We’re all open to having a conversation because taking a supplement or a vitamin is not a one-size-fits-all situation.”

Are there some popular dietary supplements in particular that we should use with caution?

Even widely recommended supplements as simple as calcium and vitamin D should involve consulting with a provider. Popular supplements containing ginkgo biloba are widely marketed, as are garlic supplements and St. John’s Wort. A Google search of any of the three will return pages of results. Shelves in the health sections at local department and grocery stores are filled with the same.

“They come in different strengths and sometimes more isn’t always better,” she said. “For instance, with ginkgo biloba or garlic, they can increase bleeding. If you’re elderly and already on a blood thinner, your provider needs to know that.”

Are vitamins and supplements different?

Vitamins are substances that occur naturally in your own body. If you have a well-balanced diet and you are getting plenty of lean proteins, whole grains, fruits and vegetables, you often don’t need extra vitamins.

“We get a lot of questions about vitamin D,” Dwight said. “It’s one of the vitamins where we can check the level in your body. Exposure to sunshine affects your level of vitamin D. If you live in the Midwest, you may be deficient in the winter months but during the summer you might not need to supplement your intake of vitamin D.

“Supplements do not occur naturally in the body,” Dwight continued. “If you’re taking a supplement you are looking to add something that is not naturally occurring in your body.”

How do I determine which supplements and vitamins are best for me?

To start with, it is important to remember that while the FDA has some oversight over both vitamins and supplements, the level of scrutiny falls well short of the standards applied to prescription medications.

“I advise my patients to look for a USP (United States Pharmacopeia) label,” Dwight said. “It means this product meets a federally recognized public standard for quality. It means an independent company reviewed it to make sure what it says is in the bottle is what you’re actually getting. It’s a third-party verification.”

Even an effective supplement can have a negative impact on your health if not taken correctly.

“Take vitamin C – people can get to almost toxic levels if they’re not careful,” Dwight said. “It’s popular during the winter because people don’t want to get the flu or COVID and they think taking more is going to be better, but that kind of thinking can backfire.”

Are there other providers – dentists, chiropractors, optometrists, for instance – who should also know if you’re taking a dietary supplement?

The short answer? Yes, you should tell them if you’re taking a dietary supplement.

“Different vitamins can affect your blood and how you bleed,” Dwight said. “If you’re going in for a root canal, that’s something that your dentist and your primary provider need to know about.”

Vitamins and supplements can affect several varieties of procedures. Foremost is anything that can change your blood or the speed of your digestion.

What should we know about children’s supplement intake?

A lot of parents seek out melatonin for their child as a sleep aid. It is a hormone the body makes to regulate sleep and can offer support for re-setting sleep routines in children and adults.

“There are a lot of different dosages of melatonin on the shelves,” Dwight said. “Consult with a provider to see if that interacts with any other medication the child might be taking. You also need to remember that the dose a child gets should not be the same as an adult would get.”

Pregnancy and breastfeeding are also factors to consider in supplement usage because what you’re taking can be passed along and cause harm to the baby.

Can supplement usage alter lab tests?

There are many supplements that can affect blood tests and urine tests. Telling your provider about the supplements you’re taking helps them to better understand test results and make decisions on how to best care for you.

“People will see a label and see that it improves blood pressure or digestion or something like that and think it’s automatically going to help,” Dwight said. “I’ll see a change in their blood work over six months and I’ll ask them if they’re doing anything differently. My first question will often be about whether they’re taking a supplement.”

Dwight will have them write down any supplements they’re taking and then ask them to stop taking them. They will come back later and see if the numbers get better.

“They’re taking these supplements for the right reasons, but they aren’t always informed about the consequences,” Dwight said. “We watch the kidneys and the liver and anything that can thin your blood. These are things that can have life-altering consequences and can make our job of caring for you a lot harder.”

If you are looking to start taking a dietary supplement or have questions about a supplement you’re currently taking, talk to your primary care provider. You can schedule an appointment at Sanford through My Sanford Chart or by calling your local clinic.

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Posted In Aberdeen, Family Medicine, Healthy Living, Nutrition