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Default Are Dietary Supplements Safe?

Hi, this has been on my mind for sometime now, and I wanted to ask you
all a few questions. I have read an article at 'Are Dietary
Supplements Safe?'
Which says?
'Always tell your health professional if you are using a dietary
supplement or if you are thinking about combining a dietary supplement
with your conventional medical treatment. It may not be safe to forgo
your conventional medical treatment and rely only on a dietary
supplement. This is especially important for women who are pregnant or
breast-feeding.'
At:
http://www.medical-health-care-infor...upplements.asp
While it must be true, I wonder what you have to say about it. Do let
me know!
Regards,
Sherry

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Default Are Dietary Supplements Safe?

sherry wrote:
>
> Hi, this has been on my mind for sometime now, and I wanted
> to ask you all a few questions. I have read an article at
> 'Are Dietary Supplements Safe?'


Quoting from:
http://www.iht.com/articles/1993/03/08/topi_10.php

Pills containing iron supplements for pregnant women
could be fatal for small children, the U.S. Centers for
Disease Control and Prevention have warned. The agency
said iron poisoning is now the most common cause
of child poisoning deaths in the United States.
As few as six pills - usually with a glossy red or
green sugar coating - could be fatal to a child
weighing 22 pounds (10 kilograms) or less.

Quoting from:
http://www.fda.gov/bbs/topics/CONSUMER/CON00259.html

Some known risks of nutrients consumed at excessive potencies a
- Folic acid: Intakes higher than 1 milligram a day may mask
symptoms of vitamin B12 deficiency while pernicious anemia caused by
the deficiency progresses undetected.
- Iron: As few as six high-potency iron tablets could seriously injure
a child weighing 22 pounds or less. Iron is the most common cause of
U.S. child poisoning deaths, causing about 2,000 poisonings a year,
mainly in young children taking their mothers' prenatal supplements.
- Niacin: High intakes can damage the liver and cause severe
gastrointestinal problems.
- Selenium: High intakes can damage tissue, especially in tissues or
organs where selenium concentrates. Toxicity depends on the chemical
form and the selenium content of the foods eaten and has occurred with
high intakes after a few weeks.
- Vitamin A: Continuous high intakes can cause headaches, liver
damage (including cirrhosis), bone damage, diarrhea, and, during
pregnancy, birth defects.
- Vitamin B6: High intakes can cause bone pain, muscle weakness,
numbness, or other symptoms of nerve disorder.
- Vitamin C: Very high intakes can cause diarrhea and may cause
urinary tract problems.
- Vitamin D: Continuous high intakes can cause kidney damage and
bone deformity.

Quoting from:
http://www.nutriwatch.org/05Guidelines/mvm.pdf

Use of MVMs [multivitamin/mineral supplements]
has grown rapidly over the past several decades,
and dietary supplements are now used by more than
half of the adult population in the United States.
In general, MVMs are used by individuals who
practice healthier lifestyles, thus making
observational studies of the overall relationship
between MVM use and general health outcomes
difficult to interpret. Despite the widespread use
of MVMs, we still have insufficient knowledge
about the actual amount of total nutrients that
Americans consume from diet and supplements.
This is at least in part due to the fortification
of foods with these nutrients, which adds to the
effects of MVMs or single-vitamin or single-mineral
supplements. Historically, fortification of foods
has led to the remediation of vitamin and mineral
deficits, but the cumulative effects of
supplementation and fortification have also raised
safety concerns about exceeding upper levels.
Thus, there is a national need to improve the
methods of obtaining accurate and current data
on the public’s total intake of these nutrients
in foods and dietary supplements.

In systematically evaluating the effectiveness
and safety of MVMs in relation to chronic disease
prevention, we found few rigorous studies on which
to base clear conclusions and recommendations.
Most of the studies we examined do not provide
strong evidence for beneficial health-related
effects of supplements taken singly, in pairs,
or in combinations of 3 or more. Within some
studies or subgroups of the study populations,
there is encouraging evidence of health benefits,
such as increased bone mineral density and
decreased fractures in postmenopausal women
who use calcium and vitamin D supplements.
However, several other studies also provide
disturbing evidence of risk, such as increased
lung cancer risk with beta-carotene use among
smokers.

The current level of public assurance of the
safety and quality of MVMs is inadequate, given
the fact that manufacturers of these products
are not required to report adverse events and
the FDA has no regulatory authority to require
labeling changes or to help inform the public
of these issues and concerns. It is important
that the FDA’s purview over these products be
authorized and implemented.

Finally, the present evidence is insufficient
to recommend either for or against the use of
MVMs by the American public to prevent chronic
disease. The resolution of this important issue
will require advances in research and improved
communication and collaboration among scientists,
health care providers, patients, the
pharmaceutical and supplement industries,
and the public.
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Default Are Dietary Supplements Safe?

In article .com>,
"sherry" > wrote:

> Hi, this has been on my mind for sometime now, and I wanted to ask you
> all a few questions. I have read an article at 'Are Dietary
> Supplements Safe?'
> Which says?
> 'Always tell your health professional if you are using a dietary
> supplement or if you are thinking about combining a dietary supplement
> with your conventional medical treatment. It may not be safe to forgo
> your conventional medical treatment and rely only on a dietary
> supplement. This is especially important for women who are pregnant or
> breast-feeding.'


It depends on the supplement and your medical profile. Some medications
and supplements can cause an adverse reaction when taken together. In my
case, I can't eat anything containing grapefruit because it would render
the blood pressure medication I take ineffective.
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Default Are Dietary Supplements Safe?

Stan Horwitz wrote:

> It depends on the supplement and your medical profile. Some medications
> and supplements can cause an adverse reaction when taken together. In my
> case, I can't eat anything containing grapefruit because it would render
> the blood pressure medication I take ineffective.


Actually what it usually does it potentiate it and make it more potent.
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Default Are Dietary Supplements Safe?


"Mark Thorson" > wrote

> Quoting from:
> http://www.nutriwatch.org/05Guidelines/mvm.pdf


> Finally, the present evidence is insufficient
> to recommend either for or against the use of
> MVMs by the American public to prevent chronic
> disease. The resolution of this important issue
> will require advances in research and improved
> communication and collaboration among scientists,
> health care providers, patients, the
> pharmaceutical and supplement industries,
> and the public.


And since there is no financial incentive for anyone to do this
research, it ain't gonna happen. I take a multivitamin and a
couple of other supplements. It's probably wise to avoid
exceeding the RDA by a whole lot. Other than that, you have
to research before taking anything just because it is an herb.
Some of those herbs can kill you.

But then, so can Tylenol.

nancy




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Default Are Dietary Supplements Safe?

In article .com>,
"sherry" > wrote:

> Hi, this has been on my mind for sometime now, and I wanted to ask you
> all a few questions. I have read an article at 'Are Dietary
> Supplements Safe?'



You hear so many different claims on supplements that I find it very
difficult to tell what is meaningful information or not. Only last week
I heard a podcast about an alleged series of Johns Hopkins studies that
show that most supplements are either unnecessary or dangerous.
Exceptions were noted and there was an involved discussion of the theory
that pills simply cannot reproduce the quality and complexity of
nutritional substances found in real foods. Has anyone else heard about
that?

And then, only a few days later, I heard that there is a strong
correlation between vitamin D3 deficiency and breast cancer.

Emma
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Default Are Dietary Supplements Safe?

Emma Thackery wrote:

> You hear so many different claims on supplements that I find it very
> difficult to tell what is meaningful information or not. Only last week
> I heard a podcast about an alleged series of Johns Hopkins studies that
> show that most supplements are either unnecessary or dangerous.
> Exceptions were noted and there was an involved discussion of the theory
> that pills simply cannot reproduce the quality and complexity of
> nutritional substances found in real foods. Has anyone else heard about
> that?
>
> And then, only a few days later, I heard that there is a strong
> correlation between vitamin D3 deficiency and breast cancer.



You're going to hear a lot of conflicting information because they're
talking about a lot of different nutrients. There's nothing I can say
here that will clear up all the confusion, but keep in mind:


There's a difference between vitamins taken as supplements (extra, over
what one would normally get in a good diet) and deficiencies (when the
diet isn't enough).


All manner of illnesses and medicines, especially those associated with
aging, can interfere with the absorption of nutrients. For example,
B-12 deficiency is almost common with the elderly, even if they're
eating well. Vitamin shots might be in order.


Alcohol and smoking can interfere with the ability to absorb nutrients
so supplements might be in order for people who drink and smoke.


While it is practically impossible to get toxic amounts of vitamins and
minerals from food, it is possible, even easy, to get too much from
swallowing pills.


I take for granted that pills cannot reproduce the quality and
complexity of the nutrition found in food. For one thing, fiber is
missing, but that's only the most obvious. On the other hand, the
number of people trying to get all their nutrition from pills is
blessedly small.


When you say that you heard a podcast about an alleged series of Johns
Hopkins studies, are you suggesting that the studies weren't done, or
weren't done at Johns Hopkins? If that's the case, I suggest that you
not listen to those podcasts.


--Lia




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Default Are Dietary Supplements Safe?

In article >,
Julia Altshuler > wrote:

> Emma Thackery wrote:
>
> > You hear so many different claims on supplements that I find it very
> > difficult to tell what is meaningful information or not. Only last week
> > I heard a podcast about an alleged series of Johns Hopkins studies that
> > show that most supplements are either unnecessary or dangerous.
> > Exceptions were noted and there was an involved discussion of the theory
> > that pills simply cannot reproduce the quality and complexity of
> > nutritional substances found in real foods. Has anyone else heard about
> > that?
> >
> > And then, only a few days later, I heard that there is a strong
> > correlation between vitamin D3 deficiency and breast cancer.

>
>
> You're going to hear a lot of conflicting information because they're
> talking about a lot of different nutrients. There's nothing I can say
> here that will clear up all the confusion...


I'm hearing conflicting information because there is conflicting
information (on the same nutrients). But you're certainly right about
the other thing.

[...]

> When you say that you heard a podcast about an alleged series of Johns
> Hopkins studies, are you suggesting that the studies weren't done, or
> weren't done at Johns Hopkins?


No. I am suggesting that an unusual claim from a third party (podcast)
with no cite is an allegation until it has been documented.

> If that's the case, I suggest that you not listen to those podcasts.


Post hoc, ergo propter hoc.

Emma
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Default Are Dietary Supplements Safe?

Quoting from
http://jama.ama-assn.org/cgi/content/abstract/297/8/842

Mortality in Randomized Trials of Antioxidant Supplements
for Primary and Secondary Prevention
Goran Bjelakovic, MD, DrMedSci; Dimitrinka Nikolova, MA;
Lise Lotte Gluud, MD, DrMedSci; Rosa G. Simonetti, MD;
Christian Gluud, MD, DrMedSci
JAMA. 2007;297:842-857.

Context: Antioxidant supplements are used for prevention
of several diseases.

Objective: To assess the effect of antioxidant supplements
on mortality in randomized primary and secondary prevention
trials.

Data Sources and Trial Selection: We searched electronic
databases and bibliographies published by October 2005.
All randomized trials involving adults comparing beta
carotene, vitamin A, vitamin C (ascorbic acid), vitamin E,
and selenium either singly or combined vs placebo or vs
no intervention were included in our analysis. Randomization,
blinding, and follow-up were considered markers of bias
in the included trials. The effect of antioxidant
supplements on all-cause mortality was analyzed with
random-effects meta-analyses and reported as relative
risk (RR) with 95% confidence intervals (CIs).
Meta-regression was used to assess the effect of covariates
across the trials.

Data Extraction: We included 68 randomized trials with
232606 participants (385 publications).

Data Synthesis: When all low- and high-bias risk trials
of antioxidant supplements were pooled together there
was no significant effect on mortality (RR, 1.02; 95% CI,
0.98-1.06). Multivariate meta-regression analyses
showed that low-bias risk trials (RR, 1.16; 95% CI,
1.05-1.29) and selenium (RR, 0.998; 95% CI, 0.997-0.9995)
were significantly associated with mortality. In 47 low-bias
trials with 180 938 participants, the antioxidant
supplements significantly increased mortality (RR, 1.05;
95% CI, 1.02-1.08). In low-bias risk trials, after exclusion
of selenium trials, beta carotene (RR, 1.07; 95% CI,
1.02-1.11), vitamin A (RR, 1.16; 95% CI, 1.10-1.24), and
vitamin E (RR, 1.04; 95% CI, 1.01-1.07), singly or combined,
significantly increased mortality. Vitamin C and selenium
had no significant effect on mortality.

Conclusions: Treatment with beta carotene, vitamin A, and
vitamin E may increase mortality. The potential roles of
vitamin C and selenium on mortality need further study.
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Default Are Dietary Supplements Safe?

In article >,
Mark Thorson > wrote:

> Quoting from
> http://jama.ama-assn.org/cgi/content/abstract/297/8/842
>
> Mortality in Randomized Trials of Antioxidant Supplements
> for Primary and Secondary Prevention
> Goran Bjelakovic, MD, DrMedSci; Dimitrinka Nikolova, MA;
> Lise Lotte Gluud, MD, DrMedSci; Rosa G. Simonetti, MD;
> Christian Gluud, MD, DrMedSci
> JAMA. 2007;297:842-857.
>
> Context: Antioxidant supplements are used for prevention
> of several diseases.
>
> Objective: To assess the effect of antioxidant supplements
> on mortality in randomized primary and secondary prevention
> trials.
>
> Data Sources and Trial Selection: We searched electronic
> databases and bibliographies published by October 2005.
> All randomized trials involving adults comparing beta
> carotene, vitamin A, vitamin C (ascorbic acid), vitamin E,
> and selenium either singly or combined vs placebo or vs
> no intervention were included in our analysis. Randomization,
> blinding, and follow-up were considered markers of bias
> in the included trials. The effect of antioxidant
> supplements on all-cause mortality was analyzed with
> random-effects meta-analyses and reported as relative
> risk (RR) with 95% confidence intervals (CIs).
> Meta-regression was used to assess the effect of covariates
> across the trials.
>
> Data Extraction: We included 68 randomized trials with
> 232606 participants (385 publications).
>
> Data Synthesis: When all low- and high-bias risk trials
> of antioxidant supplements were pooled together there
> was no significant effect on mortality (RR, 1.02; 95% CI,
> 0.98-1.06). Multivariate meta-regression analyses
> showed that low-bias risk trials (RR, 1.16; 95% CI,
> 1.05-1.29) and selenium (RR, 0.998; 95% CI, 0.997-0.9995)
> were significantly associated with mortality. In 47 low-bias
> trials with 180 938 participants, the antioxidant
> supplements significantly increased mortality (RR, 1.05;
> 95% CI, 1.02-1.08). In low-bias risk trials, after exclusion
> of selenium trials, beta carotene (RR, 1.07; 95% CI,
> 1.02-1.11), vitamin A (RR, 1.16; 95% CI, 1.10-1.24), and
> vitamin E (RR, 1.04; 95% CI, 1.01-1.07), singly or combined,
> significantly increased mortality. Vitamin C and selenium
> had no significant effect on mortality.
>
> Conclusions: Treatment with beta carotene, vitamin A, and
> vitamin E may increase mortality. The potential roles of
> vitamin C and selenium on mortality need further study.


I cringe every time a study like this comes out because the media does
not do a good job of explaining statistics. Relative risk means just
that: how much more likely you are to have an event (death, heart
attack, cancer, etc.) if you do something compared to if you don't do
it. Although these relative risks are statistically significant, the
real-life significance is dicey. The highest RR was 1.16. That means a
16% increased likelihood of death. In contrast, the RR for smoking and
lung cancer is between 12 and 20. That means you're up to 20 TIMES more
likely to die of lung cancer if you smoke.

That said, vitamin A supplements in the US are unnecessary for most
people. Most of us get more than enough vitamin A in our diets. In
addition, the liver stores extra vitamin A quite efficiently. In some
cases, TOO efficiently. Megadoses of vitamin A supplements over a long
period of time can be detrimental to bone health and can cause liver
damage.

Bottom line: Cook and eat food containing naturally-occurring
nutrients. Do not rely on supplements or to save you from yourself.

Cindy

--
C.J. Fuller

Delete the obvious to email me
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