Herbal Supplements - Are They for You?

By Helenkay Smith, MS, RD, LDN
Nutrition Specialist, Fitness and Wellness Center
Passavant Retirement Community

National surveys show that more than 50% of Americans take some type of herbal remedy, nutritional supplement or vitamin. The Food and Drug Administration (FDA) does not police this industry. Unlike prescription drug products that must be proven safe and effective for their intended use before marketing, there are no provisions in the law for the FDA to approve dietary supplements for safety or effectiveness before they reach the consumer.

But, these supplements are 'natural' so they must be safe, right? Wrong! Arsenic is 'natural' too, but it's not recommended for consumption!

Hand in hand with the safety issue is the variability of reported dosage or strength and bioavailability of the supplements. Often, herbal supplements have varying amounts of active ingredients that don't match what's advertised on the label and could even contain contaminates. Because of this, the supplements you take can negate or enhance the effects of the medicines that your doctor prescribes for you.

Some prescribed medications have what's called a narrow therapeutic window. This means the body cannot tolerate much variation in the medication dosing. One example of this is the anti-blood clotting medication warfarin (Coumadin). If you Coumadin level is too low, dangerous blood clotting can occur. On the other hand, if it is too high, you would be prone to excessive bleeding. Medications that control arrhythmias, seizures, suppress the immune system also have therapeutic windows. These medications cannot tolerate herbal interference and taking certain herbal remedies can place you at great danger.

It is also important to note that many herbal supplements should be stopped up to two weeks prior to surgical procedures. Some interfere with blood clotting, some increase the sedation effects of anesthesia and pain medications and some alter blood pressure. Your doctor needs to know that you are taking them before a procedure is scheduled.

So what about vitamins and minerals? They're safe, aren't they? You may not be aware that even vitamins and minerals can cause toxicity. Remember, these are meant only to supplement a balanced diet, not replace it and only when necessary for a specific health need. For instance, if you are unable to tolerate dairy products, it is essential for you to take a calcium supplement.

The National Academy of Sciences has established upper levels on intake (ULs) that should not be exceeded. Some fat soluble vitamins, such as vitamins A, D, E and K can have dangerous side effects when too much is ingested. Water soluble vitamins such as B-3, B-6, C and folic acid, even though excessive amounts are excreted through the urine, can also cause problems. Iron, when taken in excess can cause constipation, stomach cramps, nausea and vomiting.

It is important to realize that singling out a particular nutrient or herbal supplement will never have the combined effect that a healthy diet provides. If you are eating a balanced diet, there is no need to take additional supplements, however, a multi-vitamin will not likely hurt if you are not sure that you are eating as well as you should.

This is not to say that you should throw away all of your supplements. Rather, you should take a cautionary look at them, read the label and make sure that your physician is aware of every herb and dietary supplement that you take. Before you start taking a supplement, you should talk it over with your doctor.

Additional information can be found at www.dietary-supplements.info.nih.gov