Dietary supplements side effects

Tests showed that although side effects of red rice products are not more common or more severe than those of competitor medications, safety issnes must be considered very carefully. Red rice has been tested under controlled conditions on fewer people that the pure active substances in medicines. Another cause for caution is that the known side effects of drags have to be registered by authorities, whereas no similar obligation exists for dietary supplements. Side effects may very easily remain hidden or totally unrecognized, especially if they only develop in the long term, which makes establishing causahty difficult. 

Several different niacin formulations are available niacin immediate-release (IR), niacin sustained-release (SR), and niacin extended-release (ER).28,29 These formulations differ in terms of dissolution and absorption rates, metabolism, efficacy, and side effects. Limitations of niacin IR and SR are flushing and hepatotoxicity, respectively. These differences appear related to the dissolution and absorption rates of niacin formulations and its subsequent metabolism. Niacin IR is available by prescription (Niacor ) as well as a dietary supplement which is not regulated by the FDA.28 Currently, there are no FDA-approved niacin SR products, thus, all SR products are available only as dietary supplements. 

Obtain a thorough medication use history, including present and past drugs prescription and nonprescription drugs the patient s self-assessment of response and side-effect problems use of alcohol, tobacco, caffeine, and illicit substances and use of herbal products and dietary supplements, as well as any allergies and adherence difficulties. 

Some precautions are based on the dietary supplement s side effect profile. St. John s wort may induce photosensitivity therefore, fair-skinned persons should be cautioned about exposure to bright sunlight while taking the herb. 

A dietary supplement may be safe when taken in the recommended doses but may become dangerous in higher doses. However, patients may develop side effects even when ingesting recommended doses. Adverse reactions may be due to allergic reactions, dietary supplements containing toxic substances, mis-identification of plant, mislabeling of plant, natural toxic substances such as pyrrolizidine alkaloids in comfrey, unnatural toxic substances such as heavy metals, or pesticides. 

Figure 6.1 Anna Nicole Smith, a famous actress and model, reports that she used the dietary supplement TrimSpa to achieve her recent weight loss. Advertisements like these encourage consumers to believe they will achieve miraculous weight loss results, i.e., look like a runway model, if they use this product. These advertisements never even hint at the potential side effects associated with this diet pill.

Unlike with drugs, manufacturers of dietary supplements do not have to disclose potential side effects of their products to consumers. The label of the supplement may contain a cautionary statement, but the lack of such a statement does not mean that no adverse effects are associated with the product. Dietary supplements may also interfere with the activity of other medicines (drugs or other supplements) an individual is taking. Also unlike with drugs, the manufacturer is not required to disclose these interactions to the consumer. 

In February 2004, the FDA withdrew ephedra, one of the most popular dietary supplements, from the market because it finally had enough information to prove that ephedra presented an unreasonable risk of illness or injury under the conditions of use recommended on the product labeling. This withdrawal did not happen until many people suffered from the terrible potential side effects of this supplement (see Chapter 4). 

A newer therapeutic approach is the administration of betaine (6-12 g daily), which lowers homocysteine levels by favoring remethylation [33], A theoretical hazard of betaine treatment is increasing the blood methionine, sometimes to an extravagant degree ( 1 mmol/1). Experience to date indicates that betaine administration is safe, with no major side effects except for a fishy odor to the urine. Other therapeutic approaches have included the administration of salicylate to ameliorate the thromboembolic diathesis. Patients also have been treated with dietary supplements of L-cystine, since the block of the transsulfura-tion pathway in theory could diminish the synthesis of this amino acid. 

Clinicians should be aware that many of their patients may be taking alternative treatments either via self-care or prescribed by CAM practitioners. Inquiring about this should be routine because of potential side effects and drug interactions. A working knowledge of CAM treatments will allow child psychiatrists to give parents and patients advice about safety and effectiveness. Use of St. John s wort in children with unipolar depression may at times be appropriate, particularly in cases where more standard treatments are contraindicated or have failed. However, it should be used cautiously and with an appropriate explanation of its risks and benefits, as a competent clinician would do for any treatment. Use of St. John s wort for other conditions is not currently recommended given the lack of evidence for efficacy. Kava extracts may be used for anxiety, with similar provisos. There are much fewer data about the efficacy and safety of other dietary supplements and their use cannot be supported at this point. 

There are also many drugs and dietary supplements that may have diuretic action as a side effect, but have a different primary purpose. For example, the supplement creatine is an ergogenic (energy-enhancer), but it also promotes fluid loss with regular use. 

Manufacturers of dietary supplements take a different stance when it comes to adverse events reporting. They claim that adverse events are anecdotal records and do not prove that ephedra caused the side effect or... 

Because melatonin is found in certain foods, the Food and Drug Administration considers it to be a dietary supplement instead of a drug. However, since melatonin has not been studied very extensively, it is still unknown if it causes long-term side effects. 

Banned substances must meet several criteria for anabolic steroids set up in the 1991 Controlled Substances Act. These dietary supplements have met all the criteria but one whether or not they build muscle. A variety of current studies are underway, particularly to determine if these supplements convert to sufficient testosterone to stimulate muscle growth. If research shows this to be true, the DEA is expected to add them to the list of banned substances, since substantial quantities would likely produce the same side effects as AASs. 

The purpose of a dietary supplement is to better one s health when in actuality it rarely does and the person remains in the average state of poor health. They are meant to enhance a healthy diet, not substitute it. With the use of several dietary supplements one could experience several side effects without gaining the possible benefits. 

Using a dietary supplement to lose weight may have dangerous side effects. 

---