Dietary Supplements: Vitamins, Placebo Or Harm?

Why dietary supplements are not medicine? In Germany and France, garlic products are classified as medicinal and sold only in pharmacies, and in the Netherlands they are classified as nutritional supplements. The main risk groups for long-term and uncontrolled use of nutritional supplements: insufficient study of their effects.

It would seem that the hype around dietary supplements started to decline already 5-7 years ago. But no, it is only a false appearance. We understand why dietary supplements have nothing to do with evidence-based medicine.

Not so long ago, we witnessed a boom in the development of biotechnological products, first of foreign, and then of our production, and the phrase "dietary supplement - biologically active food additive" was not familiar to anyone. What is this - the same long-awaited progress in medicine, or another wave of fraud, which came "at the right place and at the right time"?

In the combination of nutritional supplements, the key word is food

Concentrates of natural natural substances isolated from food raw materials of animal (including marine), mineral, vegetable origin, or substances obtained by chemical synthesis, identical to natural analogues, are called dietary supplements. They also include eubiotics - enzyme and bacterial preparations that have a regulatory effect on the microflora of the gastrointestinal tract.

Regarding nutritional supplements, the term "food supplements" is widely used, but this is incorrect. Food additives are substances, usually synthetic, specially introduced into food products in order to give them certain properties. It would be better if the products did not contain them, but the modern food industry cannot do without flavorings, dyes, preservatives, and thickeners. Dietary supplements are not drugs, but there is no sharp line between them: as drugs, they have a targeted effect on specific systems of the human body.

As a result of the difference in the approach to the registration of medicinal products and dietary supplements, a situation has arisen where the same drug is registered as a medicinal product in some countries, and as a food supplement in others.

In Germany and France, garlic products are classified as medicinal and sold only in pharmacies, and in the Netherlands they are classified as nutritional supplements. The situation is similar with St. John's wort: in Germany, they are sold in pharmacies and are recommended for self-medication as antidepressants, and in Great Britain and the Netherlands they are classified as nutritional supplements.

 

Why dietary supplements are not medicines?

Unlike medicines that act quickly and strongly, dietary supplements help the body to "self-adjust" and eliminate disorders that lead to the development of one or another disease. Dietary supplements do not work "in place" of the body's regulatory systems, but eliminate the deficiency or excess of any compounds in the human body. Their use allows you to consistently restore the body without harming it, without the destructive side effects characteristic of many drugs.

The "legislator of fashion" in the production of dietary supplements is the USA, where the volume of their sales in 2000 amounted to 6 billion dollars, and in 2001 it may reach 12 billion dollars.

The growth of this branch of production is facilitated by the law adopted in 1994 by the US Congress (The Dietary Supplement Health And Education Act - DSHEA). The law allows supplement manufacturers to market almost anything as beneficial to the body, without any serious evidence of effectiveness, as long as the drugs are not being used for medical purposes as medicine. This law tied the hands of the FDA and led to the creation of an unregulated industry. As a result, the market is filled with drugs whose advertising may not correspond to reality, along with high-quality drugs.

The FDA - the US Food and Drug Administration - periodically reports on side effects and deaths caused by dietary supplements. So, around 1998, the Associated Press agency published data according to which more than 2,500 cases of side effects caused by nutritional supplements and 79 deaths related to them were officially registered in the US in just one year.

The use of bio-supplements with ephedrine caused about 900 complications and 44 deaths. It is appropriate to clarify that these statistics are official, so the true state of affairs is unknown.

 

Why are we discussing this far from us American situation? Because it is not so far away - both television and newspapers widely advertise "safe and proven health improvement products.

The main risk groups with long-term and uncontrolled use of dietary supplements 1. Insufficient study of their action. The appearance of nutritional supplements with unconfirmed effectiveness.

Great hopes were given by vitamins - antioxidants. It seemed that the results proving their effectiveness in preventing cancer and coronary heart disease were about to be obtained. However, these hopes were not destined to come true. Large-scale studies have shown that supplements with beta-carotene not only do not save from cancer and myocardial infarctions, but may contribute to their occurrence. The issue turned out to be so serious that even the WHO issued an appeal calling for the abandonment of such supplements.

2. Side effects caused by the components included in dietary supplements

Just a few examples:

• St. John's wort prolongs the effect of anesthetics, which means that it should be canceled in future anesthesia.
• Ginkgo biloba reduces blood clotting, so it is dangerous for pregnant women and those who have surgery.
• Mint when used by pregnant women threatens miscarriages. Senna - dehydration of the body and intestinal atony.
• Ginseng, which is part of a large number of nutritional supplements of the "tonic group", is contraindicated in hypertension and tachycardia.

3. Insufficient study of the compatibility of input components

Recently, preparations containing 40 or more components are increasingly appearing on the market. To understand how well they "rhyme", clinical trials are needed.

4. Risk of overdose

Overdose is possible due to unclear instructions for use or when using several nutritional supplements with the same active substances at the same time. For example, wormwood (Artemisia absinthium) contains active narcotic derivatives that can cause disruption of the central nervous system and worsen the mental state of the body.

 

Wormwood can appear under more than a dozen names: wormwood, absinth, mugwort, warmot, magenkraut, herba absinthi, etc.

5. Content of powerful medicinal components in dietary supplements

For example, Sleeping Buddah (made in China) contains the active substance estazol (benzodiazepines), which can cause serious side effects. Extremely dangerous for pregnant women.

6. Unpredictable interaction of dietary supplements with other medicines taken by a person

The fact is that dietary supplements are rarely bought by completely healthy people. They are usually used during periods of exacerbation of chronic diseases, before and after surgical intervention, during pregnancy, that is, when other drugs are also taken. How they interact with each other is unknown.

7. Adverse effects of dietary supplements on the fetus during pregnancy

Pregnant women should be classified as a high-risk group: the effect of dietary supplement components on the fetus and a woman's health has not been studied much. For example, the calcium preparations of the Chinese corporation Tianshi, being a sample of high-tech products with assimilation up to 95% (according to the manufacturers), which are offered, in particular, to pregnant women - we repeat, in the absence of clinical trials!

By the way, a very important point regarding the products of this corporation is unclear - the threat of prion diseases. The fact is that, unlike many calcium preparations of other companies, the source of which is mollusk shells, eggshell, etc., the calcium of this product is of animal origin. Namely, it is produced from the bones of young calves. Mass cases of "mad cow disease" have not been registered in China, but given the possibility of spontaneous cases of these diseases among animals, can this very unsymbolic danger be discounted?

8. Vague recommendations of the doctor regarding the use of nutritional supplements

Sometimes dietary supplements are prescribed either not to those who need them, or to those who no longer need them. The use of nutritional supplements can replace tried and tested methods of treatment, as a result, patients lose precious time and come to doctors already in the late stages of the disease - such cases are known to oncologists.

 

The most popular active "beginnings" of dietary supplements

• seaweed;
• concentrates of polyunsaturated fatty acids;
• dietary fiber in cereal bran;
• garlic preparations;
• bacterial products from acidophilic lactic acid bacteria;
• dietary supplements containing phospholipids;
• many mixtures, the active principle of which are various medicinal plants.

Note that only high-quality products should be used.