Dietary Supplements: Buyer Beware

There’s new reason to think twice before doling out your hard-earned cash on vitamin and herbal supplements. While the health benefits of taking supplements have long been a topic of debate, a study in this week’s New England Journal of Medicine says they’re to blame for an estimated 23,000 trips to the emergency department in the U.S. every year. Key culprits are products that claim to aid weight loss or boost energy. UR Medicine Pharmacy Director Curtis Haas explains why supplements may not be a wise investment—for your health or your finances.

Vitamins, minerals and supplements have never been more popular. In 2013, Americans spent about $25 billion on these products, despite growing evidence that few will benefit from taking them, since their essential needs are met by their diet.

Multiple large studies have concluded that widespread, untargeted use of vitamin and mineral supplements does not improve health or prevent chronic diseases. While there are specific, valuable uses for vitamins for pregnant women, small children, and people with specific vitamin deficiencies, there is no evidence that general use of multivitamins and minerals is beneficial. The belief that a daily multivitamin is a healthy habit is more a product of marketing genius than scientific evidence.

The value of herbal supplements is even more concerning. This industry is relatively unregulated, most of their product claims are not supported by scientific evidence, and it is sometimes unclear what these products actually contain. New York State’s Attorney General recently ordered major retailers to remove some herbal supplements from their shelves due to inaccurate labeling. Some products didn’t even contain the herbal described on the label. It’s the latest in a long history of problems with herbal product quality and reliability. Potentially dangerous drugs or other banned substances have been found in some herbal supplements.

Many herbals, such as Echinacea, glucosamine, and gingko biloba, failed to achieve their claimed benefits when evaluated in systematic, unbiased studies. “All natural” remedies advertise the power to increase your energy, improve your sex life, lead to miraculous weight loss, thicken your hair, improve your memory, restore your hearing, and even make you smarter. The ads rarely tell you what ingredients are in these miracle supplements, and often make unenforceable guarantees. It’s the modern-day version of the “snake oil” salesman, except today’s version promotes unproven herbal or natural supplements rather than alcoholic elixirs containing cocaine and opiates. They also promote the notion that substances from a “natural” source are inherently safe and healthy, which may or may not be true. Herbal supplements may also interact with prescription drugs that could lead to side effects or ineffective treatment.

While vitamin and mineral supplements can have important health benefits for a small group of people with a defined need, for most consumers the evidence of benefit is lacking and the potential for harm is real.

Curtis E. Haas, Pharm.D., FCCP, BCPS, is Director of Pharmacy for the University of Rochester Medical Center.