Are your patients taking safe supplements? According to a 2015 study, over 20,000 annual emergency room visits can be attributed to dietary supplements. Many of these visits involve young patients experiencing adverse side effects of weight loss or energy supplements and older adults experiencing a medical emergency due to swallowing problems from taking large supplements. (11)
Adulterated and tainted supplements are also a significant safety concern. According to the U.S. Food and Drug Administration (FDA), nearly 2,000 products marketed as dietary supplements have been reported for containing undeclared ingredients, featuring exaggerated health claims, and many other concerns. (15) Although there are government agencies responsible for protecting consumers, these entities can’t test every product for its safety, quality, and purity. (5) That’s why it’s essential for practitioners and consumers to scrutinize supplement brands.
But how can you tell if a supplement is safe or if you’re purchasing from a trusted brand? Read on to learn the basics of purchasing and recommending safe supplements and discover tips for keeping yourself and your patients safe.
5 tips for safe supplements
Outlined below are some tips you and your patients can use to ensure supplement safety.
1. Choose high-quality dietary supplements
The supplement brands you recommend to your patients matter. The FDA and Health Canada oversee the regulation of dietary supplements and natural health products in the United States and Canada, respectively. However, supplements are not as rigorously regulated as over-the-counter and prescription medications. (4)(12) As a result, many supplement manufacturers don’t have strict quality and safety standards in place, potentially putting consumers at risk.
There are four key components to consider when looking for high-quality, safe supplements:
- Testing: Does the manufacturer conduct routine testing of their products, and are those results available to consumers?
- Third-party certifications: Is the product evaluated by a third-party organization? Are there any third-party certification seals on the product’s label? If so, what are they?
- Current Good Manufacturing Practices (cGMPs): Does the manufacturer produce supplements that are in accordance with cGMPs, a registration program and set of standards enforced by the FDA and Health Canada?
- Audits: Does the manufacturer have an internal and external audit program to confirm that manufacturing, packaging, labeling, and storing practices are properly maintained?
If the answer to any of these questions is “no,” you may want to consider choosing or recommending a different brand.
2. Recommend purchasing from reputable sources
Where you source your favorite supplement brands matters too. It’s best to purchase safe supplements directly from trusted retailers that specialize in supplements. Advise your patients to avoid purchasing supplements from large retailers like Amazon, Ebay, and brick-and-mortar stores such as Target and Walmart, as many of these companies don’t have adequate quality assurance programs. In fact, recent reports demonstrate that it’s not uncommon for these large retailers to unknowingly sell counterfeit, expired, or incorrectly stored supplements. (1)(10)(13)
Learn more about Fullscript’s commitment to supplement quality on the blog.
3. Ask your patients about the dietary and herbal supplements they’re taking
Many supplements and herbs are known to interact with certain prescription drugs, potentially reducing or increasing their effects. (3) Regularly ask your patients about any medications and supplements they’re taking to ensure that the products can be taken safely together. Request that they inform you if they plan on taking a new supplement or medication. It’s also wise to chat with your patient about where they’re sourcing their supplements. Use this as an opportunity to stress the importance of purchasing supplements from trusted sources.
Learn more about nutrient-drug interactions and herb-drug interactions.
Did you know? Nearly 25% of U.S. adults take at least one supplement and prescription medication. (3) Vitamin D, fish oil, magnesium, probiotics, and CoQ10 are some of the most popular supplements taken by consumers. (9)
4. Keep your patients’ needs in mind
If your patients have trouble swallowing, opt for different supplement forms like liquids or powders. For children or patients who may be resistant to taking dietary supplements in capsule or pill form, consider chewable forms or suggest mixing powders into soft foods like yogurt.
Be aware of your patients’ medical history and any other factors that can influence their ability to take supplements safely. For example, pregnant and breastfeeding patients should avoid many herbal supplements and need to use caution with other types of dietary supplements. (2)(6) Furthermore, it’s essential to be aware of your patients’ allergies and sensitivities to ingredients, as some supplements contain allergens (e.g., eggs, gluten, nuts, and soy). (8)
Did you know? Third-party certifications and the supplement facts panel can help with identifying allergens. Health conditions common supplements
5. Report safety concerns
Many herbal and dietary supplements aren’t tested for safety before they hit shelves, meaning that consumers may be vulnerable to experiencing adverse effects. Reporting adverse reactions to supplements can help government agencies investigate safety concerns and identify potentially harmful products. (7)
If you or your patient experience a severe reaction or illness as a result of taking a dietary supplement, report your safety concerns through the U.S. Food & Drug Administration or Health Canada. You can also report safety or quality concerns directly to the supplement distributor.
Did you know? You may be more likely to experience an adverse effect of a supplement if you take high doses of a supplement, combine multiple supplement ingredients, or take supplements that may interfere with certain medications. (14)
The bottom line
Supplements are a central part of any integrative medicine protocol, but not all supplements are created equal. By recommending high-quality, safe supplements from trusted sources to your patients, understanding their unique needs, and informing them about the safety and efficacy of supplements, you can help ensure that they safely adhere to their treatment plan.
- A.G. Schneiderman Asks Major Retailers To Halt Sales Of Certain Herbal Supplements As DNA Tests Fail To Detect Plant Materials Listed On Majority Of Products Tested | New York State Attorney General. (n.d.). https://ag.ny.gov/press-release/2015/ag-schneiderman-asks-major-retailers-halt-sales-certain-herbal-supplements-dna
- American Pregnancy Association. (2022, June 9). Herbs and Pregnancy. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/herbs-and-pregnancy/
- Asher, G., Corbett, A. H., & Hawke, R. L. (2017). Common Herbal Dietary Supplement-Drug Interactions. American Family Physician, 96(2), 101–107.
- Center for Food Safety and Applied Nutrition. (2018, September 20). Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements. U.S. Food And Drug Administration. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/small-entity-compliance-guide-current-good-manufacturing-practice-manufacturing-packaging-labeling
- Bernstein, I. B. G. (2022, May 1). Is My Patient Taking an Unsafe Dietary Supplement? Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/my-patient-taking-unsafe-dietary-supplement/2022-05
- Budzynska, K., Gardner, Z. E., Dog, T. L., & Gardiner, P. (2013). Complementary, Holistic, and Integrative Medicine: Advice for Clinicians on Herbs and Breastfeeding. Pediatrics in Review, 34(8), 343–353. https://doi.org/10.1542/pir.34-8-343
- Center for Food Safety and Applied Nutrition. (2022a, October 26). Questions and Answers on Dietary Supplements. U.S. Food And Drug Administration. https://www.fda.gov/food/information-consumers-using-dietary-supplements/questions-and-answers-dietary-supplements
- Center for Food Safety and Applied Nutrition. (2022b, November 29). FDA Issues Guidances on Food Allergen Labeling Requirements. U.S. Food And Drug Administration. https://www.fda.gov/food/cfsan-constituent-updates/fda-issues-guidances-food-allergen-labeling-requirements
- ConsumerLab.com. (n.d.). Most Popular Supplements According to ConsumerLab Survey. https://www.consumerlab.com/news/most-popular-supplements-from-survey/02-29-2020/
- Felton, B. R. (2020, December 17). FDA Finds Hidden Drugs in Nearly 50 Dietary Supplements Sold on Amazon, eBay. Consumer Reports. https://www.consumerreports.org/dietary-supplements/fda-finds-hidden-drugs-in-weight-loss-sexual-enhancement-dietary-supplements-sold-on-amazon-ebay-a6199440119/
- Geller, A. I., Shehab, N., Weidle, N. J., Lovegrove, M. C., Wolpert, B. J., Timbo, B. B., Mozersky, R. P., & Budnitz, D. S. (2015). Emergency Department Visits for Adverse Events Related to Dietary Supplements. New England Journal of Medicine, 373(16), 1531–1540. https://doi.org/10.1056/nejmsa1504267
- Health Canada. (n.d.). Natural and Non-prescription Health Products Directorate – Canada.ca. https://www.canada.ca/en/health-canada/corporate/about-health-canada/branches-agencies/health-products-food-branch/natural-non-prescription-health-products-directorate.html
- Matsakis, L. (2019, July 19). Amazon Warns Customers: Those Supplements Might Be Fake. WIRED. https://www.wired.com/story/amazon-fake-supplements/
- Office of Dietary Supplements – Dietary Supplements: What You Need to Know. (n.d.). https://ods.od.nih.gov/factsheets/WYNTK-Consumer/
- Office of Regulatory Affairs. (2022, December 21). Health Fraud Product Database. U.S. Food And Drug Administration. https://www.fda.gov/consumers/health-fraud-scams/health-fraud-product-database