Heartlines Newsletter

A publication of Cardiovascular Consultants of South Florida
Howard Berlin, MD, FACC

Supplements: Are they Safe?

Patients frequently ask what supplemental vitamins they should take. This topic has become part of the medical landscape, and as a physician, I am concerned about what advice to give patients safely. Patients are bombarded by advertising, testimonial support, and peer pressure to take supplemental vitamins. The makers and sellers of these products also suggest that patients consult with their physician before taking vitamins or dietary supplements. This puts physician in a very uncomfortable position. Vitamins are organic compounds required in tiny amounts for essential metabolic reactions in a living organism. These do not include minerals, fatty acids, or amino acids, nor do they encompass the large number of other nutrients that promote health but are not essential for life.

Until 1900s, we obtained vitamins solely through food. Changes in diets could occur during a particular growing season that could alter the types and amounts of vitamins ingested. Vitamins have been produced as commodity chemicals and made widely available as inexpensive pills for several decades to allow supplementation of dietary intake. The U.S. Food and Drug Administration (FDA) is largely responsible for our current predicament, in part because of the way it regulates vitamins. If the FDA finds a supplement to be unsafe once it is on the market, only then can it take action against the manufacturer and/or distributer, such as by issuing a warning or requiring the product to be removed from the marketplace. So, Manufacturers do not have to prove that a supplement is effective but can claim that the product addresses a nutrient deficiency, supports health, or reduces the risk of developing a health problem—if true. In essence, the multibillion-dollar supplements industry has the legal right to market vitamins without proof of efficacy. Only if the product is found to be unsafe after it is one the market can action be taken.

Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease. Sometimes dietary supplements may have unwanted effects, especially if taken before surgery or with other dietary supplements or medicines or by people with certain conditions. Whatever your choice, supplements should not replace prescribe medications or the variety of food important to a healthful diets. There are many examples of scientific findings that contradict certain claims or assumptions about the value of vitamin supplementation. For example, the Agency for Healthcare Research and Quality has issued a consensus document that the effect of supplemental Antioxidants Vitamin C, Vitamin E, and Coenzyme Q10 has any benefit on cardiovascular disease. There is good evidence that Vitamin supplementation has no clinically important effect on lipid levels.

At this time, the totality of information indicates that there is no substitute for good eating habits and that a Mediterranean diet, aerobic exercise, weight loss, and smoking cessation are favorable steps to reduce the risk of cardiovascular disease.

 If you are interested in finding out about the studies that we are currently enrolling, please call your doctor or Becky Nembhard at 954-965-4900 x173 or, email her at rnembhard@infinityclinicalresearch.com.