Vitamins Can Be Helpful In Moderate Doses
It is not unusual that dietitian Elizabeth Ward discusses nutritional supplements with her clients many times in a day. What’s less expected is how often she advises them to cut back.
“We see people who are taking massive doses of beta carotene, vitamin C and vitamin E but don’t really have a rationale for it,” said Ward, a nutritionist at Harvard Pilgrim Health Care in Boston.
Ward recommends taking vitamins and minerals in amounts matching 100 percent of the federal government’s Recommended Daily Allowances. “Chances are, most people could use a multiple vitamin, even if it’s best to get your nutrients in a balanced diet,” she said. “Few people have the perfect diet.”
Any additional supplements, Ward said, should come at the suggestion of a doctor or nutritionist.
The potential benefits of some substances are real and exciting. Antioxidants like vitamin E can protect against heart disease and there is growing evidence that saw palmetto berries fight prostate cancer.
But millions of Americans overdo it, taking high doses of everything from multiple vitamins to herbal tonics. With some substances oversupplementation doesn’t matter; the body will take what it needs and flush out the rest. But other products can be harmful.
“The very term ‘nutritional supplements’ denotes they are beneficial compounds,” said Michael Murray, a naturopathic physician at Bastyr University in Seattle and author of “Encyclopedia of Nutritional Supplements” (Prima, $19.95). “But the benefit only goes so far. A person cannot make up for poor dietary habits by taking either drugs or supplements.”
Murray’s specialty is natural medicine, which avoids synthetic drugs and surgery whenever possible. Yet he recommends starting a nutritional supplement program with close supervision from a physician or other qualified health professional such as a nutritionist. The risk of developing a regimen that doesn’t address specific deficiencies, or even one that threatens your health, is simply too high, he said.
Fat-soluble vitamins like A and E can be stored in the body, for instance, and some herbal remedies can jeopardize a pregnancy. Some ingredients can cause allergy symptoms.
Finding out which nutrients might be worthwhile for you is only part of the puzzle. You also have to determine the quality of any purchase and the truth of any claims it makes. That can be a challenge.
“There is currently no federal review of the safety or efficacy of dietary supplements,” said Judith Foulke, spokeswoman for the Food and Drug Administration. “A company can make claims on packaging and advertising for what we call ‘structural functions,’ but it cannot make specific medical claims that a certain vitamin or herb prevents a disease without the appropriate research documentation.”
For example, a manufacturer of liver pills can boast about its ability to “tonify the liver,” but not make promises about “preventing liver cancer.”
The FDA can investigate any claim that seems to have no merit, if it is brought to the agency’s attention. But other undertakings have higher priorities.
The federal Dietary Supplement Health and Education Act of 1994 eased fears in the natural-medicine field that the FDA might ban all vitamins, minerals, amino acids, herbs and other supplements until they passed the same rigorous standards applied to drugs entering the U.S. market. But the act does allow the FDA to consider more stringent regulation of manufacturing.
Larger supplement makers and leaders in the alternative medicine community have called for self-regulation in the last few years to build more credibility with consumers.
For its part, the FDA is conducting a public comment period through May about standards for nutritional supplements. The agency wants to gather information from manufacturers and consumers before deciding whether to set up federal regulations, Foulke said.