Dietary Supplements: Questions and Answers
More than half of adults in the United States use dietary supplements, according to the Centers for Disease Control and Prevention. People take supplements for many reasons, including back- and neck-related problems such as spinal arthritis, osteoporosis, and joint pain. While some people find dietary supplements and herbs help relieve or reduce their pain, many questions remain about the safety and effectiveness of these products as a treatment for back and neck pain. It’s important to keep in mind that the term “natural” doesn’t always mean safe.
Q: Does the government ensure that dietary supplements are safe?
A: While drug manufacturers must conduct research studies in people to prove their products are safe and effective before they are marketed, dietary supplement makers do not. The supplement manufacturers/distributors are responsible for ensuring their products are safe, and the claims on their labels are accurate. The U.S. Food and Drug Administration can take action against a supplement manufacturer and/or distributor if it finds a supplement is unsafe once it is on the market. The action can include issuing a warning or requiring the product be removed from the marketplace. A recent study by the federal government found that injuries caused by dietary supplements lead to more than 20,000 emergency room visits a year.
Q: If a product is advertised as being effective for a particular reason, such as treating back pain, how do I know if it’s true?
A: Unfortunately, you may not be able to tell. Manufacturers do not have to prove supplements are effective. They can claim a product addresses a nutrient deficiency, supports health or reduces the risk of developing a health problem. Such a claim must be followed by the statement, “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."
Q: Should I check with my health care provider before I start using a dietary supplement?
A: There are many reasons you should discuss your use of supplements with your doctor or health care provider. Some supplements can interact with prescription and over-the-counter medicines you are already taking. Under certain circumstances, this could cause adverse and even potentially life-threatening effects. For example, if you are taking the blood thinner warfarin (Coumadin) while taking the herbal supplement ginkgo biloba, which also thins the blood—it can cause internal bleeding. St. John’s Wort can reduce the effectiveness of prescription drugs for heart disease, depression, seizures, certain cancers or birth control pills. Also, be sure to inform your pharmacist of any supplements you are taking so they can be sure the medications you are taking will not cause an interaction.
Q: Why should I tell my health care provider about supplements and herbs before having surgery?
A: It is very important to inform your doctor about any herbs or other supplements you are taking. Your doctor may tell you to stop taking these products several weeks before an operation to avoid potentially dangerous interactions with medications administered during and after surgery, including anesthesia. Interactions may include changes in heart rate, blood pressure and increased bleeding.
Supplements that may increase the risk of bleeding include:
- Dong Quai
- Fish Oil
- St. John’s Wort
- Vitamin E
Q: I’ve been told that supplements and herbs are better for pregnant women and people with chronic disease, like diabetes. Is that true?
A: It is vital that you check with your health care provider before taking supplements if you are pregnant, nursing a baby or have a chronic medical condition (such as diabetes, hypertension or heart disease).
Q: How can I know if the supplement I bought has the ingredients listed on the label?
A: The U.S. Food and Drug Administration doesn’t analyze the content of dietary supplements; therefore, you are relying on the manufacturer to be truthful when you purchase one of their products. The FDA has issued Good Manufacturing Practices for supplements, which specify rules for the products’ identity, purity, strength and composition.
Q: Where can I find reliable information on supplements?
A: A good place to start is the National Institutes of Health Office of Dietary Supplements website, which has fact sheets on many supplements (https://ods.od.nih.gov/factsheets/list-all/). The site also has a lot of general information about supplements.