Truth or Hype? The Real Story Behind Your Dietary Supplements

Dietary supplements have permeated modern lifestyles offering a convenient means to bridge nutritional gaps, enhance physical performance and address specific health concerns.

In the United States alone the expenditure on these products has reached staggering heights with Americans collectively spending billions annually.

This widespread usage underscores the significance attached to supplements in contemporary wellness practices. However, amidst their popularity, concerns persist regarding their safety, efficacy and regulation.

Torrance Memorial Medical Center Board Certified Geriatric Pharmacist Mei Tsai, PharmD, often fields questions about the safety and efficacy of dietary supplements. She reminds patients supplements are regulated by the Food and Drug Administration (FDA) much like food – not like pharmaceuticals.

“What this means is the FDA’s role comes after the product is marketed, unlike pharmaceuticals. The rigorous studies on effectiveness and safety medications must go through is not a standard for dietary supplements prior to launching on the market,” said Tsai, who strongly suggests patients thoroughly research supplement brands before purchasing them.

“This doesn’t mean supplements are entirely bad or dangerous,” she added. “A good manufacturer will do their own quality and safety studies without mislabeling a dietary supplement as something that can treat, prevent or cure a disease. Any supplement should be taken after a conversation with your physician or pharmacist to ensure it does not conflict with current medications or conditions.”

Instances of mislabeling, contamination and adverse reactions underscore the need for vigilant consumer scrutiny. Additionally, the potential for supplements to interact with medications or exceed safe dosage limits warrants caution.

Dr. Omer Deen, a Torrance Memorial hospitalist who is a fellow of the American College of Gastroenterology and the American Gastroenterological Assn., is concerned about the rising number of men taking testosterone.

Advertising the suggestion low testosterone levels are responsible for a variety of issues men may face, including decreased libido, fatigue weight gain and reduced muscle mass, plays off common insecurities among men. The prevalence of these ads during sports broadcasts and sports radio shows led the FDA to issue tough rules requiring companies distributing testosterone supplements revise the labels.  Clarity was needed showing the drugs are only for patients with diseases like hypogonadism or injuries that cause severely low levels of testosterone, and replacement therapy may raise the risk of cardiovascular problems.

“I would say probably only one-tenth of male patients who are taking testosterone truly need to be on it,” Deen said.

A danger of taking testosterone when it isn’t necessary is fooling the body into believing it has an abundance.  This could shut down natural production of it, and lead to testicular atrophy, a condition in which one or both testicles diminish in size and may have reduced function.

Supplements are available that can provide real health benefits without much concern about negative side effects. Deen, who specializes in internal medicine and clinical nutrition, and serves on the Board of Directors for the National Board of Physician Nutrition Specialists and fellowship trained in Clinical Nutrition at Cleveland Clinic, recommends vitamins D3 and K2. Taken together these supplements can help support your mood, boost brain function and improve your well-being.

“Many patients do have deficiencies in vitamins and minerals because the foods we eat are hyper-processed, stripping away all the good stuff in them,” he said.

For his patients, Deen does his best to impress upon them the importance of eating a balanced diet, rich in natural, whole foods. Doing so, along with maintaining a healthy gut to properly process what we eat, can eliminate the need for most supplements.

“The more advanced I become in my career,” he said, “the more I am reminded of what my mother used to say, ‘Eat foods as close to how God made them.’”

What are the most popular supplements?

Vitamin D continues to be the most popular dietary supplement purchased, according to a 2020 survey by ConsumerLab.com, followed by magnesium, and fish oil (Omega-3). Other popular supplements include turmeric, probiotics and vitamin C. Collagen and CBD are on the rise.

“Supplements are a workaround,” Deen said. “It’s easier to take supplements than to take better care of ourselves through what we eat. It’s not the right answer, but it’s why we end up doing it.”

Balancing the perceived benefits with potential risks remains a pivotal aspect of navigating the complex landscape of dietary supplements. Deen recommends consulting with a physician who has experience in clinical nutrition and functional medicine.

How Are Dietary Supplements Regulated?

The Federal Food, Drug and Cosmetic Act (FD&C Act) was amended in 1994 by the Dietary Supplement Health and Education Act (often referred to as DSHEA), which defined “dietary supplement” and set out FDA’s authority regarding such products.

Under existing law:

• The FDA does NOT have the authority to approve dietary supplements for safety and effectiveness, or approve their labeling, before sale to the public.
• Supplement companies are responsible to ensure their products meet the safety standards.
• Dietary supplement labels are required to have nutrition information in the form of a Supplement Facts label. They also must have a statement on the front of the product identifying it as a “dietary supplement” or similar descriptive term (e.g., “herbal supplement” or “calcium supplement”).

The FDA provides answers to many frequent questions people have about dietary supplements. You can view them by visiting www.FDA.gov.