Dietary Supplements — Choosing and Using Them Wisely

Betty Chaffee/ June 27, 2018/ Dietary Supplements, Medication Management, Medication Therapy Management/ 0 comments

Finding a non-prescription medicine for a cough or other minor ailment is pretty straightforward. You just go to the correct aisle in the pharmacy shelf and start reading labels. The label for each non-prescription medication will describe what symptoms it treats and the correct dose to use.
It’s not that simple with dietary supplements. Because they are regulated by the Food and Drug Administration (FDA) as nutritional products rather than drugs, it’s not likely you can get enough information from the label to pick the product that’s right for you. There are a couple of reasons for that.

Choosing the right supplement

First, dietary supplements don’t need to be proven effective for anything before they’re marketed. The manufacturer needs to ensure purity and safety of the product, but not efficacy. If the manufacturer makes a health claim on the label (such as “this product increases brain function”) it must be followed by a disclaimer. So in contrast to non-prescription medicines, which only have proven uses listed on the label, dietary supplements can make claims on the label without having clinical proof that they're true.

 

The supplement label on the right shows the health claim at the top of the label and the disclaimer required by the FDA labeling guidelines at the bottom. In contrast to non-prescription medicines, manufacturers of dietary supplements are not required to conduct research showing efficacy. Many products are marketed with unsubstantiated health claims, and so the label is required to state that efficacy is unproven.

Finding the right product for the health concern you want to treat or prevent can get complicated, too. It's easy to find a non-prescription medicine for a cough, for example. You just walk down the pharmacy aisle labeled "cough and cold" and you have an array of products. Looking through the supplement aisle is a whole different project. Here, items are shelved alphabetically rather than by indication. And many supplements are marketed for a variety of indications, making it that much harder to find the supplement that will help you stay healthy.

Choosing the right dose

Second, dietary supplements are labeled with serving size rather than dose. Many dietary supplements are used for a multitude of health reasons, with a different daily dose for each use. The label, however, doesn't make make that distinction. That makes it tough for consumers to know how much of a supplement to take.
Here is one example of what you can expect to find in a pharmacy or health food store. Many people take vitamin D. But how much vitamin D is the right amount?  Check out these four products, with dosages per capsule ranging from 400 units to 10,000 units. And they weren't the only dosages on the shelf!
But even more head-scratching occurs when you look at the dose labels on the back of the bottles.  Each one, regardless of the dose per capsule, shows that the "serving size" is one capsule.

Finding objective, reliable information about dietary supplements

Thought it may be hard to find reliable information about the best product to use and the effective dose, with a little homework before the shopping trip, sound decisions can be made!  There are several websites that can be counted on to provide objective information.

One of my favorites is RxList, which is free of charge and gives up-to-date reviews of supplements with research-supported information on efficacy, side effects, drug interactions, and dosage. The Office of Dietary Supplements provides similarly objective information at no charge. Other reliable sites include WebMD and MedScape, though those sites may require subscription fees. Be cautious when looking at other websites, as it's often hard to tell which ones are funded by manufacturers, marketers, or sellers of the products. Always confirm questionable information by reviewing the information in one of the objective databases listed above.

Dietary supplements are growing rapidly in popularity. A survey from 2005 indicated that about 56% of adults were using these products, while a survey in 2016 found supplement use in nearly 75% of US adults.  Be sure to choose products and doses that will benefit your health!

 

 

Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
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