Filed under: 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.
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.
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.
“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.
Two-a-day practices have started for teens in fall sports. One big issue is concussion education: learning the signs of a concussion and then what to do if you actually have one—or if someone you know does. Several dietary supplement manufacturers have promoted products to help with recovery from concussions and traumatic brain injuries (TBIs), but there isn’t enough scientific evidence to support these claims. If you suffer from a concussion or TBI, make sure you follow your doctor’s orders for recovery. And if you have children involved in sports, watch them for possible signs.
FDA warns consumers to avoid using products that claim to prevent or treat a concussion or TBI. For more information, read FDA’s Consumer Update on dietary supplements and concussions.
Caffeinated gum is a quick and efficient way for Warfighters to consume caffeine in order to improve physical performance and maintain cognitive capabilities temporarily during situations that demand vigilance. Because the caffeine is absorbed through tissues in the mouth, it enters the bloodstream faster than foods, beverages, and supplements do. In addition to the rapid absorption of caffeine, caffeinated gum offers other benefits such as being lightweight, compact, and providing caffeine in an appropriate amount when needed. However, caffeinated gum might not always be the best choice depending on your situation, needs, and preferences.
Aconitum kusnezoffii—one of several plants known as aconite—is being marketed in some dietary supplement products as a source of the stimulant 2-aminoisoheptane. All aconites naturally contain a toxin called “aconitine” and are considered poisonous. Although some types of aconite are used in traditional Chinese medicines, the plant must be properly processed, or it can be dangerous and lethal. Even when properly processed, it can still be dangerous.
There is no scientific evidence that 2-aminoisoheptane, also called octodrine or DMHA, occurs in aconite or anywhere else in nature. Octodrine is a nasal decongestant, first made in a laboratory in 1944. Without laboratory testing, there’s no way to know if a dietary supplement product labeled with this ingredient contains 2-aminoisoheptane or aconite (or both) or any of the other toxic chemicals found in aconite. Bottom line: If a product lists “2-aminoisoheptane (Aconitum kusnezoffii)” as an ingredient, it could be problematic.
Since May 2016, 43 dietary supplement products have been added to the Operation Supplement Safety (OPSS) High-Risk Supplement List, bringing the total number of products on the list to 247. Together with the U.S. Anti-Doping Agency (USADA), OPSS frequently updates the list to help you stay informed about current high-risk products. You can access the High-Risk Supplement List from the OPSS web page or download the app (from the Apps tab) to your phone or tablet and take it wherever you go. If you’re considering dietary supplements, be sure to check back often for more updates.