Dietary Supplements Pose Real Dangers to Patients

White, C Michael

doi:10.1177/1060028019900504

Cited by 46 publications

(44 citation statements)

References 12 publications

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“…Despite the popular belief that natural supplements are safer, their use can be associated with important adverse effects and supplement/herb-drug interactions, which is only minimally regulated by the Food and Drug Administration (FDA). Additionally, excessive consumption of certain supplements may be harmful, under-reported in the consumer reports or media, and under-appreciated by patients and healthcare providers [10].…”

Section: Diet and Use Of Nutritional And Herbal Supplementsmentioning

confidence: 99%

Emerging Complementary and Integrative Therapies for Geriatric Mental Health

Nguyen

Lavretsky

2020

Curr Treat Options Psych

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Purpose The use of complementary and integrative medicine (CIM) is on the rise among diverse populations of older adults in the USA. CIM is commonly perceived as safer, less expensive, and more culturally acceptable. There is a growing body of evidence to support the use of CIM, especially mind-body therapies, diet and nutritional supplements used for mental disorders of aging. Recent findings We summarize the results of the recent clinical trials and meta-analyses that provide the evidence for the role of CIM in treating older adults with mood or cognitive disorders that includes the use of diet and supplements, and mind-body therapies. Summary Dietary and mind-body therapies have become increasingly popular and show the strongest evidence of efficacy for mood and cognitive disorders. Although the use of vitamins and supplements is the most popular CIM practice, only mixed evidence supports their use with additional concerns for herb (supplement)-drug interactions. Despite increasing use of CIM by the general population, information to guide clinicians providing care for older adults remains limited with variable scientific rigor of the available RCTs for a large number of commonly used CIM interventions for the mental health of older adults. Although the terms, "alternative," "complementary," and "integrative" are often used interchangeably, the National Center for Complementary and Integrative Health (NCCIH) defines these terms as follows: "alternative" medicine refers to a set of practices of medicine (e.g., traditional, oriental, mind-body, etc.) without sufficient evidence base that is used in place of conventional medicine, whereas "complementary" medicine refers to non-mainstream practice that is used together with conventional medicine. "Integrative" medicine refers to the use of conventional and complementary approaches in a coordinated way targeting specific disorders or underlying neurobiological processes (e.g., inflammation). CIM emphasizes a holistic, patient-focused approach to healthcare and wellness targeting the whole person rather than one organ system. Historically, these p r a c t i c e s a r e o r i e n t e d t o w a r d h a r m o n i o u s rebalancing of mind, body, and spirit. The NCCIH identified three categories for complementary and integrative approaches: (1) natural products (herbal medicines, botanicals, vitamins, minerals, probiotics, and other dietary supplements); (2) mind and body practices (massage therapy, meditation, yoga, acupuncture, chiropractic/osteopathic manipulation, hypnotherapy, tai chi, qigong, healing touch, and relaxation exercises); (3) other complementary approaches (indigenous healing practices, Chinese medicine, Ayurvedic medicine, homeopathy, and naturopathy). Unfortunately, CIM is rarely included in the healthcare systems on the large scale with the exception of a few modalities (i.e., acupuncture and chiropractic care) due to the lack of reimbursement by the US medical insurances, and remain unaffordable for many older adults living on a limited income [4]....

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Section: Diet and Use Of Nutritional And Herbal Supplementsmentioning

confidence: 99%

Emerging Complementary and Integrative Therapies for Geriatric Mental Health

Nguyen

Lavretsky

2020

Curr Treat Options Psych

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“…Since the FDA only removes products proven to be unsafe, many supplements may contain banned substances, heavy metals (arsenic, lead, aluminum, etc. ), and/or microbial material, such as toxigenic fungi, molds and yeast, and strains of salmonella [14]. Overuse of some supplements can have health consequences by themselves, and medications only increase the risks.…”

Section: Supplements and Drug Reactionsmentioning

confidence: 99%

Avoiding Food-Drug Interactions: A Proposal

Susan¹

2020

J Fam Med Dis Prev

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The treating physician has a great responsibility when prescribing medication. He must be aware of any situations that might interfere with his prescription. He checks current medications in order to avoid drug-drug interactions. However, other factors that may affect the effectiveness or clearance of the prescription are often overlooked, including food-drug and supplement-drug interactions. Even the healthiest and most desirable foods, such as leafy greens or fiber, can affect the medication, leading to treatment failure. Physicians rarely ask patients about eating habits, and patients do not know to offer such information. I therefore propose the use of a food frequency questionnaire during the first visit to the doctor, in order to have realistic basis for prescriptions and to allow physicians to advise patients about intake of various foods during treatment. In addition to opening communications between the physician and patient, this would result in more effective treatment strategies that have better adherence, since they would be adapted to the patient's current lifestyle. Physicians would be able to offer more inclusive instructions when prescribing, increasing patient confidence and treatment outcomes. Key Findings • Food-drug interaction can be an important factor in treatment effectiveness • Physicians are usually unaware of patient dietary patterns • A food frequency questionnaire at the time of the initial visit can improve treatment outcomes Patient Care Check for updates Some Unexpected Food-Drug Interactions While the effects of grapefruit on multiple medications is well known, there are several other foods, often considered healthy and therefore part of a normal diet, that can affect the absorption and excretion of important drugs. Some examples are listed below:

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“…However, the current regulation and monitoring systems of DS has been criticized for being weak and ineffective [11]. Indeed, the requirements for the quality control of food and drugs are not mandatory for DS [12].…”

Section: Introductionmentioning

confidence: 99%

Vaccinium macrocarpon (Cranberry)-Based Dietary Supplements: Variation in Mass Uniformity, Proanthocyanidin Dosage and Anthocyanin Profile Demonstrates Quality Control Standard Needed

et al. 2020

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Vaccinium macrocarpon (syn. American Cranberry) is employed in dietary supplements (DS) with the aim to improve urinary tract well-being. This property is linked to the antiadhesion-activity of proanthocyanidins (PACs) against uropathogenic-bacteria. However, the current European legislation has been criticized for being weak and ineffective. Indeed, recent scientific works report mislabeled, contaminated, and adulterated supplements containing dangerous or unknown compounds, or sold at toxic doses. In this work, we analysed 24 DS that claim to contain cranberry, and to have a specific dosage of PACs. Our tests included the control of the good manufacturing practice according to the European Pharmacopoeia, and the verification of the claimed dosage of PACs. Moreover, in order to confirm the real presence of cranberry in DS, chemical fingerprinting via HPLC-UV/Vis-MS/MS was employed. Our results showed that 17 DS did not comply with the uniformity test of dosage forms, and only five contained cranberry. Finally, 16 DS claimed an incorrect amount of PACs. These data suggest that several cranberry-based DS are present in the European market with insufficient quality controls. Considering that often DS are self-prescribed by consumer relying on their claim, the data obtained in this work should encourage more controls and stricter rules.

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Dietary Supplements Pose Real Dangers to Patients

Cited by 46 publications

References 12 publications

Emerging Complementary and Integrative Therapies for Geriatric Mental Health

Emerging Complementary and Integrative Therapies for Geriatric Mental Health

Avoiding Food-Drug Interactions: A Proposal

Vaccinium macrocarpon (Cranberry)-Based Dietary Supplements: Variation in Mass Uniformity, Proanthocyanidin Dosage and Anthocyanin Profile Demonstrates Quality Control Standard Needed

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