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HPRC Fitness Arena: Dietary Supplements
Dietary supplements and medications (prescription or over-the-counter) can be a risky combination. That’s because many dietary supplement ingredients, especially herbs and botanicals, can interact with drugs (such as ones to treat blood pressure, diabetes, depression, and anxiety) or even other dietary supplements. Interactions between drugs and supplements can result in either an increase or decrease in the effectiveness of your medications. In other words, you could be getting too much or too little of the medications that you need, which can be dangerous to your health. If you’re taking or plan to take a dietary supplement, inform your healthcare provider to make sure it’s safe to use with your medications.
Learn more about how supplements can change the effectiveness of your medications and know when drug-supplement interactions are especially important by using this interactive web resource from the National Center for Complementary and Integrative Health (NCCIH). And for information about many known interactions between dietary supplement ingredients and medications, as well as other dietary supplement ingredients, visit the Natural Medicines Comprehensive Database (NMCD).
When it comes to the topic of dietary supplements, a good rule of thumb is not to believe everything you hear or read from someone trying to sell you a product. Operation Supplement Safety (OPSS) recently received Ask the Expert questions about products that were recommended by staff at stores, whether or not they were safe to take, and whether they would cause a positive result on a urinalysis test. In fact, two products were “high risk.”
If you’re considering a dietary supplement product, be sure to consult your healthcare provider first. Service dietitians can be another good resource to determine if you really need to supplement your diet. It’s important to know how to spot potential high-risk supplements. Find out too if there is reliable scientific evidence that the ingredients in a product actually work. For more information, OPSS has a comprehensive “Frequently Asked Questions” (FAQs) section with subcategories about general and miscellaneous topics, dietary supplement ingredients, performance, and weight loss. Or, to watch some videos or short PSAs, click on “Tools for Warfighters,” and then the “Video” tab.
Before you take a dietary supplement, look at the Supplement Facts panel on the label and check to see if any of the ingredients are contained in a “proprietary blend.” Proprietary blends aren’t always called “proprietary blends” on the label (they might be described as “complexes,” “matrixes,” “formulas,” or other descriptive names), but you can tell if your product contains one if you see a list of ingredients without the amounts of each one next to them. Although the absence of a proprietary blend doesn’t automatically make a product safe, the presence of one is something to think twice about. To learn more, read the OPSS FAQ about proprietary blends.
DMAA has been illegal for use as an ingredient in dietary supplements for more than 3 years. It still is, but just when you think it would be disappearing from the market, it seems to be on a slight rise again. Our online search of available dietary supplements with DMAA turned up 11 products we had never encountered before, in addition to 34 products still on the list since before DMAA became illegal. We also found 50 discontinued products with DMAA still being sold by third-party retail outlets.
Unfortunately, illegal substances of all kinds are readily available on the Internet. For example, ephedra has been illegal since 2004, when FDA acted on growing reports of severe adverse events, including deaths, associated with the popular weight-loss supplement ingredient. However, products containing ephedra are commonly marketed online. Even substances on the Drug Enforcement Agency’s list of controlled substances can be purchased online. Worse, laboratory testing of dietary supplement products sometimes reveals the presence of illegal ingredients even when they aren’t listed on the products’ labels.
Ingredients such as DMAA are not allowed in dietary supplements because, according to FDA, “they can be a health risk to consumers.” Stay informed, starting with the OPSS FAQ about DMAA and updated list of Dietary Supplements/Products Containing DMAA.
Dietary supplements don’t require approval by the Food and Drug Administration (FDA) before being put on the market. That means unless a product has been tested in a laboratory, there’s no way to know its true contents, including potentially problematic ingredients and possibly even ones not listed on the label. So how can you tell if a product really contains what it says on the Supplement Facts panel? Check the product label to see if it carries a seal from an independent, third-party organization. For more information and examples of third-party organizations, visit the OPSS FAQ about third-party certification.
Drug testing can happen at any time in the military. If you’re taking or considering dietary supplements—especially ones considered “high risk”—you’ll want to make sure your product won’t affect your test results. High-risk supplements are among those marketed for bodybuilding, performance enhancement, sexual enhancement, and weight loss. They sometimes contain ingredients (listed on the label or not) that could cause a positive test result. If you have a product that you think might cause a problem with a drug test, contact one of the DoD Drug Testing Centers on the OPSS infosheet “Dietary supplements and drug testing.”
An adverse event from a dietary supplement is any undesirable health effect you might experience. It could be mild or life threatening. It’s important to know how to recognize symptoms that might impact readiness. To learn how, read the Operation Supplement Safety (OPSS) FAQ on adverse events, which also has a link to a form for reporting adverse events to the Natural Medicines Comprehensive Database. All forms are then sent to FDA. Documenting adverse events is an essential part of how the FDA evaluates potentially dangerous dietary supplements.
Manufacturers and distributors also are required to notify FDA of adverse events by calling the 800 telephone number located on product labels.
Operation Supplement Safety (OPSS) has a new infographic about caffeine and performance. Caffeine, which is a stimulant, is found in various beverages, dietary supplements, and even your ration items. While it can help boost your mental and physical performance, it’s important to use it strategically. Otherwise, you could experience some unwanted side effects. So if you choose to use caffeine, check out our new infographic with information about how and when to use it and where you’ll find it. And for more information about caffeine, please visit the OPSS FAQs about caffeine and hidden sources of caffeine.
“Explosive workouts.” “Extreme pumps.” “Enhanced endurance.” These are just some of the marketing claims used to promote nitric oxide (NO) supplements. Interestingly though, NO supplements don’t actually contain any nitric oxide, which is a gas. Instead, these types of supplements usually contain amino acids plus various other ingredients. So will these supplements fulfill their promises of improving your performance or are they just “full of hot air”? Read the Operation Supplement Safety (OPSS) FAQ on nitric oxide supplements to find out.
Since July 2016, the Food and Drug Administration (FDA) has released over 25 Public Notifications about individual supplement products marketed for sexual enhancement and weight loss that contain hidden active ingredients. Through laboratory testing, these products were found to contain drugs and controlled substances—ingredients that pose health and readiness risks. For a list of these Public Notifications, visit FDA’s Tainted Sexual Enhancement Products and Tainted Weight Loss Products.
The most common types of products found to contain “undeclared” ingredients (that is, substances not listed on the label) are those marketed for weight loss, sexual enhancement, and bodybuilding. Dietary supplements don’t require FDA approval before being put on the market, and there is no way to know the contents of a product without laboratory testing. So if you’re considering a dietary supplement, check the label to see if the product has been evaluated by an independent third-party organization.