According to the Food and Drug Association, more than half of Americans take dietary/nutritional supplements on a daily basis. On a global scale, about 63.8% of women use supplements, while 50.8% of men use them.
Grandview Research indicates that in 2021, the dietary/nutritional supplement market was valued at $151.9 billion worldwide. So, if something is so widely consumed, how can consumers know that what they are buying is actually working. Or in fact if you really need them?
Why Aren’t Supplements Evaluated or Regulated?
With well over 90 000 different supplements on the market, it can be quite confusing to understand what is safe and what isn’t. This is where most would go onto the FDA’s website to make an informed decision. However, this isn’t possible with these unevaluated supplements.
Why is this the case though?
Dr. Michael Roizen, M.D., explains that “the FDA has very little authority to mess with nutritional supplement companies because they’re not drug manufacturers, they’re selling foodstuffs or nutraceuticals,” further adding that they “can’t even inspect the company’s manufacturing process unless it has reasonable evidence that its products are harming people.”
What Do Doctors Say About Supplements?
Dr. Fatima Cody Stanford, M.D., M.P.H., M.P.A., physician-scientist at Massachusetts General Hospital and Harvard Medical School, explains that “with regards to vitamins, most of us are able to get our required nutrition via our diet.” She explains that most people don’t need to be taking these supplements, as they obtain all healthy vitamins and minerals from a healthy, balanced diet.
However, if you’re not following a diet that helps you obtain all the vitamins and minerals which are essential for bodily functions, supplements may be a good option for you.
Overconsumption of Vitamins and Minerals
Many people choose to take supplements even though they obtain their required daily intake of vitamins through their diet. According to the Department of Health and Social Care, supplements are only recommended to people who are at risk of deficiency or need a mineral or vitamin boost to help manage some health conditions.
Overconsumption of these vitamins and minerals that our body needs in small amounts to function can potentially be harmful to our bodies. Dr. Roizen adds that “this lack of regulation can lead to wildly inconsistent quality – and there’s… no guarantee that the ingredients touted on a bottle’s label will be in the supplement at all.”
Dr. Peter Cohen, M.D. from Harvard Medical School, explains that while supplements are not allowed to be sold with the misleading intention of preventing or treating a disease, with tweaks to the language that these companies use, they can make claims like “promoting and maintaining a healthy immune system.”
These statements can make consumers believe that these supplements can protect them from illnesses, which is something we saw at the height of the COVID-19 pandemic, specifically with supposed “immune boosting” supplements.
While there are many supplements available that provide various vitamins and minerals, there are two which are extremely common, and quite dangerous if over consumed. These include:
1. Fish Oil Supplements
Fish oil is rich in omega-3 fatty acids, essential lipids which the body cannot naturally produce. According to the Office of Dietary Supplements (ODS), the recommended daily intake for omega-3 fatty acids is 1100 mg for women, and 1600 mg for men.
While it is often suggested that we consume this to reduce heart disease and other ailments, a study published in The New England Journal of Medicine found that these supplements did nothing to reduce heart attacks, strokes, or risk of death from heart disease in those without any known factors for cardiovascular disease.
While it may be beneficial, having too much fish oil (which can arise from receiving enough from your diet but still taking supplements) can have adverse side effects, including:
- Gastrointestinal Trouble: Causes digestive issues, specifically heartburn, indigestion, nausea, flatulence, and diarrhea
- Vitamin A Toxicity: Many types of supplements with omega-3 fatty acids tend to be high in vitamin A, which is harmful if consumed in large quantities. For example, just one tablespoon (14 grams) of cod liver oil can provide up to 270% of your daily vitamin A needs in a single serving. This can cause dizziness, nausea, skin irritation, and joint pain.
- Bleeding: Consuming excess amounts of fish oil has been linked to nose and gum bleeding. In healthy people, high doses of omega-3 fatty acids have been reported to decrease the ability of blood coagulation. This can lead to recurring bleeding.
2. Iron Supplements
Mostly used by red blood cells, iron is an important part of hemoglobin, a protein found in the blood cells. Hemoglobin is responsible for delivering oxygen to all the cells in the body, making it an essential mineral.
Iron deficiency is the world’s most common mineral deficiency, which has led to an increase in the number of iron supplements. Unless you’re affected by this deficiency, you aren’t advised to take iron supplements, as this can lead to iron toxicity.
Consuming iron in amounts below 20 mg is usually safe, but may cause mild digestive symptoms. Consuming amounts between 20-60 mg are mild and moderately toxic. However, doses higher than 60 mg can cause circulatory collapse, bringing serious symptoms. Early symptoms of iron poisoning include:
- Shortness of breath
- Fluid in the lungs
According to the Office of Dietary Supplements, symptoms of iron poisoning can begin by consuming as little as 20 mg per kg (of body weight) of iron at one time. With the popularity of these supplements in gummy or chewable form, the risk of accidental poisoning is even higher. If not treated or attended to, iron poisoning can cause more severe issues, including:
- Liver Failure
- Persistent low blood pressure
More Isn’t More Beneficial
Johanna Dwyer, R.D. is a senior research scientist with the National Institutes of Health’s Office of Dietary Supplements. She says that it’s pretty hard to overdo it from food alone.
She then adds that “most people don’t realize there’s no real advantage to taking more than recommended.”
If you do decide to take a supplement but aren’t impacted by any deficiency, opt for a basic multivitamin. Andrew Shao, Ph.D. is the senior vice president of scientific and regulatory affairs for the Council for Responsible Nutrition. He explains that most multivitamins have such a wide margin of safety that even when you combine them with fortified foods, they’re still not going to cause you to overconsume them.
MAIN IMAGE CREDIT: Photo by Artem Podrez
- White, C.M., 2022. Continued risk of dietary supplements adulterated with approved and unapproved drugs: assessment of the US Food and Drug Administration’s tainted supplements database 2007 through 2021. The Journal of Clinical Pharmacology, 62(8), pp.928-934.
- Hao, J., Jin, R., Zeng, J., Hua, Y., Yorek, M.S., Liu, L., Mandal, A., Li, J., Zheng, H., Sun, Y. and Yi, Y., 2022. Consumption of fish oil high-fat diet induces murine hair loss via epidermal fatty acid binding protein in skin macrophages. Cell Reports, 41(11), p.111804.