Dietary Supplements — More Harmful Than Helpful?

According to information from the American Osteopathic Association, 88% of Americans aged 65 and older take dietary supplements in spite of only 24% having indications of nutritional deficiency.

Whether this discrepancy is due to unhappiness with the medical system or the hope of a shortcut to better health and longevity, scientists are sounding the alarm that improper supplementation can instead be damaging our health and shortening our lives. 

Although consumers overwhelmingly believe the supplements they take are benign, the U.S. Food & Drug Administration (FDA) regulates the products of this multi-billion dollar industry under the category of food, not drugs. 

"The FDA does not approve each dietary supplement for safety and effectiveness before it is marketed," explains Joan Salge Blake, nutrition professor and registered dietitian nutritionist at Boston University. "Determining the quality, effectiveness and safety of dietary supplements is the responsibility of the manufacturers."

This lack of oversight allows companies to make exaggerated or, worse, totally false claims about their products. Ryan Peterson, M.D., board-certified physician at NuView Treatment Center in Los Angeles says, "Many older adults take supplements without realizing the potential risks of megadosing, interactions and mislabeling issues."

"Most people who take an excess of multivitamins likely just have expensive urine because you excrete most of them out," says Hector Perez, M.D., bariatric surgeon at Renew Bariatrics. "However, vitamins A, D, E and K aren't water soluble and are stored in your body fat."

"A buildup of Vitamin A can cause nausea, vomiting, headaches, dizziness and blurred vision and reduce bone strength," Blake says. "Excessive amounts of Vitamin D may result in a loss of appetite, weight loss and irregular heartbeat."

"Most disturbingly," she adds, "taking Vitamin K without informing your physician can interfere with the anti-clotting medication Warfarin (also known as Coumadin) and increase the risk of heart attack and stroke."

With almost three-quarters of American adults either overweight or obese, losing weight has become a national focus. Instead of choosing injectables like Ozempic and Wegovy or the more extreme bariatric surgery, many turn to supplements for what they view as a safer alternative.

"People looking for quick weight loss solutions often take random herbal supplements such as detox teas and appetite suppressants that promise quick results, only to end up with GI distress," Perez says.

Some teas contain laxatives that can cause diarrhea, cramping and even dependency if used regularly. They often contain diuretics that induce loss of water instead of fat. Ironically, the resulting dehydration can potentially trigger the body to retain fluids which leads to bloating — the very issue the teas claim to combat. 

"A lot of people think, 'If a little is good, a lot must be better.' But with supplements, that's rarely true," says Taher Saifullah, M.D., founder of the Spine and Pain Institute Los Angeles.

Megadosing can result from people self-diagnosing themselves having a deficiency of a certain vitamin when in fact the opposite is true. "It's common for people with bone pain to think they need more vitamin D," Perez says. "What they don't understand is that Vitamin D toxicity can cause bone pain just like its deficiency, so they mistakenly double up on it and get stuck in a vicious cycle."

Heavy metal is more than a music genre. High levels of lead, mercury and even arsenic are often found in herbal remedies used in traditional Chinese and Indian medicine. Cases of poisoning from these ingredients have been reported in the United States, Europe and Asia.

"Just because something is labeled as 'natural' doesn't mean it's safe," Saifullah says. "Yohimbe, marketed for weight loss and energy, can cause dangerously high blood pressure and heart problems. Green tea extract sounds healthy, but in large doses, it can hurt your liver." 

Herbal supplements can interact with prescription medications in ways that aren't always obvious. "One example is St. John's wort, which reduces effectiveness of many medications, including antidepressants and  anticoagulants," says Laura O'Hara, registered dietician at Archwell Health in Nashville. "Ginkgo biloba can increase risk for spontaneous bleeding when taken with nonsteroidal anti-inflammatory drugs (NSAIDs) or anticoagulants such as Warfarin." 

The lack of oversight by the FDA opens the door for rampant mislabeling and adulteration within the supplement industry. Ingredients listed on the labels may not be present. Conversely, products could contain ingredients not listed. Actual dosage might not match what is shown on the label.

Weight loss benefits and promises of enhanced appearance or sexual performance are the most prevalent culprits of exaggerated claims. "It's like playing Russian roulette with your health," Perez says.

To feel confident about what you are ingesting, "purchase supplements that have been third-party tested," says Shelly Balls, registered dietitian nutritionist for Flawless Bloom. "Look for supplements that are USP Verified, or NSF Certified to ensure you're getting safe and pure products."

While they may not always deliver the glowing results promised on the label or in advertisements, "there's solid evidence that supplements are helpful in certain deficiencies," Perez says. "Vitamin D and calcium are essential for bone health, and iron supplements make sense for those at risk for anemia." 

"Up to 30% of folks over the age of 50 experience a decline in stomach acids, diminishing the body's ability to absorb the naturally occurring vitamin B12 found in animal foods," Blake says. "Because of this issue, it is recommended that older adults meet their vitamin B12 needs through supplements or fortified foods along with a well-balanced diet."

O'Hara adds, "Fiber supplements like Metamucil have been proven to be beneficial for various gastrointestinal conditions like ulcerative colitis and irritable bowel syndrome. They have the added benefit of lowering cholesterol and blood sugars." 

"Wellness isn't found in a bottle — it's about balanced nutrition, regular movement and stress management," Peterson says.

"Vitamin and mineral supplements are called supplements for a reason," Blake adds.  

Perez sums up the keys to optimum wellness, sharing, "I always encourage my patients to focus on whole foods, physical activity and mental well-being. Supplements can play a role, but they should complement a healthy lifestyle, not replace it."

Edd and Cynthia Staton are nationally recognized journalists who won Gold and Merit awards for two of their Next Avenue articles at the 2024 National Mature Media Awards. They are authors of three best-selling books and creators of Retirement Reimagined!, an online program to help people considering the retirement option of moving abroad. Visit them at www.eddandcynthia.com. Read More