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Understanding drug-supplement interactions

Do you take dietary supplements and medications? Read about the risks in a new resource from the National Center for Complementary and Integrative Health.

Many people take dietary supplements and medications together as a part of their daily health regimen, but few are aware of the potential for harmful interactions between prescription drugs, over-the-counter drugs, and dietary supplements. To help you learn more about these types of interactions, the National Center for Complementary and Integrative Health (NCCIH) created an interactive web resource that includes information about how supplements can change the effectiveness of your medications and how to work with your healthcare provide to make sure you’re taking them together safely. And for more information, please read HPRC’s Supplements and medications­ – What’s the problem?

Can SARMs do you harm?

SARMs can be found in some dietary supplement products, but are they legal and will they cause a positive drug test?

SARMs, or “selective androgen receptor modulators,” are experimental drugs that are illegal for use in dietary supplement products, but they still can be found in stores and on the Internet. SARMs are most often found in products advertised to have effects similar to those of anabolic steroids.

Read the Operation Supplement Safety (OPSS) FAQ about SARMs to learn more, including the ingredient names used for SARMs that may appear on dietary supplement labels. And remember: FDA does not approve dietary supplements prior to marketing. For more information on FDA’s role with regard to dietary supplements, visit FDA Basics.

Cannabidiol in dietary supplements

FDA says that products with the ingredient cannabidiol can’t be marketed as dietary supplements.

Cannabidiol (CBD) is a major chemical found in marijuana that may have beneficial effects on certain health conditions, but it’s still being tested as a new drug. However, FDA recently announced that products containing CBD cannot be sold as dietary supplements.

Read the Operation Supplement Safety (OPSS) FAQ for more information, which also includes a link to the OPSS FAQ on hemp. While you’re there, check out our other OPSS FAQs. Still can’t find the answer you’re looking for? Use our “Ask the Expert” button located on the OPSS home page.

DMAA is still around

HPRC’s list of dietary supplement products containing DMAA has been updated again, revealing some new products even though DMAA is an illegal ingredient.

DMAA has been illegal as a dietary supplement ingredient for more than 2 years, but products containing this substance continue to be available. Many are still being produced (or produced again), and some are even new. That means it’s very important to read dietary supplement product labels carefully to make sure yours doesn’t contain this potentially dangerous ingredient. Not only could it be dangerous to your health, it could also be dangerous to your military career. DoD follows federal policy with regard to the use and possession of substances and products considered illegal.

Keep in mind, though, that pre-workout, weight loss, and other performance dietary supplements without DMAA also may not be safe for your health. In fact, FDA has already declared two DMAA “replacement” ingredients unsuitable for use in dietary supplements: DMBA and BMPEA. For more information, please visit these Operation Supplement Safety (OPSS) FAQs:

And please visit the newest update of “Dietary Supplement Products Containing DMAA,” which lists DMAA-containing products past and present.


Energy drinks and teens don’t mix

Energy drinks have become increasingly popular among teens, but they provide no health benefit and can even be harmful.

It’s cause for concern: Approximately 30% of teens consume energy drinks on a regular basis. Energy drinks provide no nutritional benefit and can actually pose health risks to adolescents, including increased heart rate, high blood pressure, anxiety, digestive problems, sleep disturbances, dehydration, and even death. Teens who consume energy drinks are also more likely to engage in unhealthy behaviors such as drinking more sugar-sweetened beverages, smoking cigarettes, and using drugs and alcohol.

Many of the negative effects associated with energy drinks are due to the large amounts of stimulants in these beverages. Their caffeine content can range from 50 to more than 500 mg per can or bottle. The American Academy of Pediatrics recommends that children and teens:

  • consume no more than 100 mg of caffeine per day (equal to about 2 cans of caffeine-containing soda or one 8 oz. cup of coffee) and
  • avoid energy drinks altogether.

However, the amount of caffeine teens consume from energy drinks is trending upwards, in part due to heavy marketing with celebrity athletes. Be sure to talk to your teens about the potential problems associated with energy drinks, and make sure they don’t confuse them with sports drinks.

Are supplements the “whey” to protein?

Whey protein is often referred to as the “king of proteins.” But are whey protein supplements the best option for muscle growth and recovery?

Whole foods, not dietary supplements, should be your first choice for protein. Protein supports muscle growth and repair. People often turn to protein supplements (such as whey, casein, and soy) to optimize those effects, especially after a workout. Whole food protein sources such as lean meats, fish, dairy products, legumes, nuts, and seeds are just as effective (in some cases more effective) than protein supplements. Whey protein products can be an acceptable, convenient, and efficient way to deliver protein when your needs are greater or when normal dietary sources are not available. If you are using protein supplements, be sure to choose a product that has been third-party evaluated for its quality. Read more here.

FDA warns again about powdered caffeine

FDA issued warning letters to 5 distributors of powdered pure caffeine and continues to warn consumers against using these products.

The Food and Drug Administration (FDA) is again warning about the dangers of powdered pure caffeine. At least 2 deaths (both teenagers) were associated with it in 2014, yet it continues to be sold, primarily in bulk online. FDA recently sent warning letters to 5 distributors of pure powdered caffeine, warning about potential serious health effects. FDA notes that it’s difficult to determine the difference between a safe amount and a toxic amount but that one teaspoon is roughly equivalent to 28 cups of coffee. For more information, read FDA’s update and HPRC’s 2014 article.

Where to go for dietary supplement information

Visit OPSS—for the first time or again—for new FAQs, videos and PSAs, and print materials with information about dietary supplements.

Searching for reliable information about dietary supplements and don’t know where to go? Operation Supplement Safety (OPSS) has answers for you. OPSS has a comprehensive “Frequently Asked Questions (FAQs)” section with subcategories about general and miscellaneous topics, dietary supplement ingredients, performance, and weight loss. Or if you’re an educator and need some videos or short PSAs, click on “Tools for Warfighters,” and then search the “Video” tab. We also have materials that can be printed for distribution or ordered through the USAPHC Health Information Products e-catalog.

Didn’t find what you’re looking for while in OPSS? Use our Ask the Expert button located on the OPSS home page

Protein powders: Food or supplements?

Some protein powders have Nutrition Facts labels while others have Supplement Facts labels. Is this a case of mislabeling?

Conventional foods and dietary supplements follow different rules when it comes to labeling, but the difference between the two isn’t always black and white. Such is the case with protein powders. If you look closely at various protein powders, you may notice that some are labeled with Nutrition Facts (required for foods), while others have Supplement Facts (required for supplements). So are protein powders conventional foods or dietary supplements? Read more in our OPSS FAQ on protein powder labels.

For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety FAQs.

Products for concussions hit by FDA

Some dietary supplement products claim to prevent, treat, or cure a concussion. But FDA says to be on the lookout for these claims.

If you suffer from concussions or traumatic brain injuries (TBIs), don’t be tempted to turn to dietary supplements to help you get back on the field. Several dietary supplement manufacturers have promoted products to help with recovery from concussions and TBIs, but there isn’t enough scientific evidence to support these claims. The Food and Drug Administration (FDA) is monitoring this issue and contacting specific companies making claims that their products can prevent, treat, or cure concussions.

FDA warns consumers to avoid using products that claim to prevent or treat a concussion or TBI. For more information about these claims and FDA’s response, see this Consumer Update.


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