| In the United States, dietary supplements that make structure/function claims must carry the following disclaimer:
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
The FDA's purpose in requiring the statement is to alert the buyer that the FDA has not reviewed or approved the claim and that the product should not be considered an approved drug. |
| Likewise, dietary supplements and herbal remedies are sold over the counter and should not be considered life-saving medical interventions. Instead, herbs and nutrients are often most effectively used to support and maintain health, to improve health and protect the body.
We must use common sense in decisions about conventional self-care with OTC drugs versus seeing a doctor. We know when we have a cold or a headache or motion sickness, and it is usually appropriate to self-medicate for such simple ailments. These conditions will go away anyway, with or without treatment. |
| We certainly shouldn't expect dietary supplements to substitute for qualified medical care, either. If you have any symptoms that could indicate serious illness, by all means seek professional help.
Too often people look to herbs as miracle cures when nothing else has worked. In some cases, herbs have provided striking results in conditions that seemed to be beyond conventional treatment, but this is rare. If we build up the expectation that herbs are miraculous, we may easily overlook the major role they can play in modern health care. |
| Trusting Natural Remedies
Whether we are considering drugs used to treat serious diseases or dietary supplements used to support and maintain health, we want assurance that all products used for health have the same attributes: safety, effectiveness, and quality. One of the most hotly debated issues on the subject of herbal medicines concerns proof of safety. For decades, medical authorities, regulators, and the media have warned that herbs are "un-proven" and "unregulated. |
Thomas J. Moore
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 He rejects meat, milk, sugar, oil, fruit, salads, and dietary supplements. Nine months later, the swollen lymph nodes are gone. Three years later, they recur, and this time he checks into a Mexican clinic that prescribes an herbal tonic but allows many more foods—except pork, tomatoes, and vinegar. Again he recovers.9
In 1952, four-year-old Ann O'Neil of Baltimore lay dying of leukemia. She had received the last rites. Her aunt had already made a yellow burial gown. |
Barrie R Cassileth, Ph.D.
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 One of the seventeen panels it developed was responsible for over-the-counter (OTC) drugs, a category that includes most dietary supplements and herbal products.
Because it was impossible to study and evaluate the hundreds of thousands of existing OTC drugs in short order, the FDA attempted to regulate them immediately by permitting their sale only if the label did not claim to prevent or treat disease. Eventually, some drugs were studied and reclassified when found to be unsafe or when their effectiveness was documented or disproved. |
Andrew L. Stoll
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 Taking food or other dietary supplements, which may improve fat absorption, could also reduce diarrhea. A patient of mine has successfully used daikon radish, an Asian vegetable, reported to improve digestion after a fatty meal. |
Gale Maleskey
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 This law allows certain substances to be sold for human consumption without FDA approval, as long as they are marketed as "dietary supplements" and not labeled for a particular use like prescription or over-the-counter drugs.
To make DHEA supplements, vitamin and pharmaceutical companies extract sterols, most commonly diosgenin, from wild yams. Some supplements, however, are extracts of wild yams that haven't been processed into DHEA. These are marketed as containing natural precursors for the body's production of DHEA, but they have not been found to boost DHEA levels.
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Carl C. Pfeiffer
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 For example, we know that many zinc-deficient teenagers have acne. Zinc dietary supplements benefit acne. Zinc is a natural nutrient, which is needed by the body. A broad-spectrum antibiotic also benefits acne. So what happened? A group of skin specialists tested, in a double-blind fashion, zinc against tetracycline in a fixed dose schedule. Under these circumstances, the tetracycline proved to be significantly better for acne. But the zinc is needed by the body, while the tetracycline is not. |
Stephen T., M.D. Sinatra
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 At this point, I suggested some dietary supplements. I placed her on a regime with coenzyme Q10, vitamin B-6, zinc, chromium picolinate, and a multivitamin and mineral complex. She was told to take these supplements after every meal. She persisted in her regimen and, to her surprise, lost five pounds in the following week. Perhaps she may have had a low metabolism and in addition a subtle deficiency of nutrients.
Clinical research has also revealed the beneficial effects of coenzyme Q10 in brain disorders, aging, and allergies. |
Tanya Harter Pierce
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 The form of aloe vera sold was found to have the ability to greatly stimulate the immune system and had proven to be very beneficial for both cancer and AIDS patients.) The cesium and aloe vera were obviously working for people because T-UP, Inc., had hundreds of testimonies on file from consumers who claimed life-changing beneficial results. T-UP also had never received a single consumer complaint.
Buf'big business" was not interested in whether cesium or aloe vera were beneficial to T-UP's ailing customers. |
Leo Galland
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 In the body, beta-carotene is converted to vitamin A, but the importance of carotenoids for human health extends far beyond beta-carotene's role as a precursor of vitamin A. dietary supplements of beta-carotene are ineffective in preventing cancer or heart disease, whereas food that is high in beta-carotene and other carotenoids does confer protection. Scientists have previously paid insufficient attention to these other carotenoids, like alpha-carotene, lutein, lycopene, and the xanthins. |
Barrie R Cassileth, Ph.D.
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| Literally hundreds of dietary supplements, nutritional aids, and similar products are widely promoted and generally available to the public. Their promises are rarely substantiated in fact.
A dietary supplement act passed in 1994 removed dietary and nutritional supplements from Food and Drug Administration (FDA) review. Therefore, supplements are not regulated. They are not evaluated for safety or purity, nor are they studied to see whether they live up to promoters' claims (see Chapter 7). |
Gale Maleskey
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| Since they are classified as dietary supplements, not drugs, they can be purchased without a prescription.
This policy raises doubts in the minds of many health practitioners. In Europe, where phytomedicines are common, people are accustomed to having herbs prescribed by doctors. In the United States, however, you can just walk into a health food store and buy them in quantity. Why should there be such a discrepancy in the way they're distributed? |
Barrie R Cassileth, Ph.D.
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| Acupuncture, hand and back yoga exercises, hydrotherapy, dietary supplements glucosamine and chondroitin. attention deficit disorder Biofeedback, B vitamin supplements. backache Chiropractic, valerian, massage, and other bodywork. bronchitis Zinc lozenges, inhale steam with oil of eucalyptus, drink elderberry tea. burns (minor) Aloe gel, cream of arnica.
Carpel Tunnel Syndrome Hydrotherapy, massage, ginger compress. cholesterol, high 1 to 5 cloves of fresh garlic or coated tablet with allicin yield of four grams of fresh garlic. |
Gale Maleskey
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| Certain vitamins, herbs, and emerging dietary supplements can be toxic in higher doses.
?If you are pregnant or nursing, avoid all supplements unless they have been prescribed or approved by your doctor. Also, check with your physician before using supplements if you are taking prescription medication. People who are taking anticoagulant (blood-thinning) medications, for example, should not take high doses of vitamin E, the herb red clover, or a number of other supplements that thin the blood.
There are exceptions. |
Barrie R Cassileth, Ph.D.
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| It was not always that way with pharmaceuticals, and it still is not that way with health-food products and dietary supplements sold in health-food stores, supermarkets, and pharmacies.
Despite continuing concern on the part of Food and Drug Administration (FDA) officials and others who work in the public interest, there are still no across-the-board standards or federal laws governing the quality of food supplements, herbs, and other products marketed with claims for improving health benefits. |
| There are important distinctions between dietary supplements in the form of the vitamin pill that many take each morning and products aimed at treating illness. A daily vitamin tablet is unnecessary if you eat a healthful, balanced diet, but it is good insurance against inadequate consumption of necessary nutrients in your food. A general daily supplement will help those whose diets do not provide the necessary nutrients or who have special needs, such as calcium to protect against osteoporosis. |
Cheryle R. Hart, M.D. Mary Kay Grossman, R.D.
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 Vitamin and Calcium Supplements
Let's start our discussion of dietary supplements with calcium. If you do not consistently eat enough dairy products, we strongly recommend you take a calcium supplement to prevent thinning of your bones. People under twenty-four years old need 1,200 to 1,500 milligrams each day. This is approximately equivalent to four to five servings of dairy products, including milk, cheese, yogurt, cottage cheese, or calcium-fortified orange juice. Each serving of these foods contains approximately 300 milligrams of calcium. |
| Your body has to naturally make them from scratch using either the food you eat or dietary supplements you take. Commonly prescribed antidepressant medications, such as Prozac, Paxil, Zoloft, Celexa, Effexor, and Well-butrin, work by using the dopamine or serotonin already in the brain. These medications do not work very well if you are already depleted of neurotransmitters. This depletion explains why these medication doses may have to be increased to work better.
The right amount of dopamine helps you feel energetic and less hungry. |
Dr. Gary Null
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 To prevent undesirable effects, women may want to combine exercise with sufficient amounts of antioxidants, in the diet and/or as dietary supplements. (See "Antioxidants," above.)
BREATHING EXERCISES. Breathing exercises combined with physical activity increase the action of lymphatic cleansing. Detoxification expert Susan Lombardi explains, "For lymphatic cleansing, you want to synchronize your breathing with the movement of your legs and arms. When you are walking or jumping on the trampoline, inhale four times, and exhale four times. |
| It should be noted, however, that any dietary supplements used should be low in vitamin A, niacin, copper, and iron, the levels of which tend to be elevated in pill users."
CHLAMYDIA. "Another reason the pill is bad for female infertility is that it promotes the growth of chlamydia. This condition has reached epidemic proportions in the United States, with over half a million new cases yearly. Chlamydia causes pelvic inflammatory disease, which can then cause sterility. Usually, the first time it strikes, chlamydia does not render a woman sterile. |
| Janson, the author of The Vitamin Revolution in Health Care—a practical guide detailing the most recent developments in medical approaches to health care and preventive medicine—has been in practice for twenty years, using nutrition and dietary supplements with his patients.
DR. DAVID KAUFMAN 425 West 59th Street, Suite 3A New York, NY 10019 (212)523-7754
Dr. Kaufman has been in practice for over seven years. His focus is on infertility, sexual dysfunction, and urinary problems.
DR. STEVEN RACHLIN 1510 Old Northern Boulevard Roslyn, NY 11576 (516) 625-6884
Dr. |
Barrie R Cassileth, Ph.D.
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| Caveat emptor—let the buyer beware—is the only rule governing the purchase of many products used as health foods or dietary supplements. What you think you are buying is not necessarily what you get.
Laws and regulations regarding the manufacture, promotion, and sale of foods and drugs were needed initially in the early years of this century, when profiteering and fraud were rampant. Food was often contaminated, adulterated with harmful chemicals, and packaged under unsanitary conditions. Worthless "medicines" were sold as cure-alls by pseudodoctors and traveling "snake oil" salesmen. |
Elaine Feuer
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 Both the Los Angeles Times and the New York Times reported that the number one issue in Washington in 1992 through 1994, as measured by congressional mail, was dietary supplements. Groups that asked Congress to redirect the FDA included Citizens For Health, Council For Responsible Nutrition, the Nutritional Health Alliance, the American Herbal Products Association, and the National Nutritional Foods Association.
Influenced more by political action committees (PACS) than by angry constituents, Congressmen Henry Waxman and John Dingell introduced the FDA's proposed legislation in Congress. |
Dr. Vern Cherewatenko and Paul Perry
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 Patented special dietray fiber complex nutrient drink fortified with
Canister antioxidant vitamins and other dietary supplements.
• Will I take the prescribed amount of HCA/chromium and not miss?
• Will 1 monitor my blood and see my doctor regularly for feedback?
If the answer to any of these questions is no, then your Diabetes Cure program will be compromised. Remember, medication alone won't stop the progress of diabetes.
Step 4: Exercise Daily, Actively and Passively
Exercise is the easiest way of making your body receptive to insulin. |
Michael Janson, M.D.
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 Last year the New York Times published an article supportive of the value ol dietary supplements, but a manufacturer cannot send that article, nor any supportive scientific article, to its customers without concern for potential FDA regulatory action.
FDA's spokesmen mislead by carefully selecting their words when testifying before Congress in order to avoid saying what they really intend, as evidenced by their position papers. They say the debate is not about vitamins and minerals when sold in what they call reasonable potencies. |
| What you need to know is that virtually all of the raw materials for dietary supplements are made in bulk by a few manufacturers. They are then purchased by supplement "manufacturers" who only tablet, encapsulate and affix their own label to the products before sending them to distributors or retail outlets.
Be Wary of Claims
What this means most of the time is that the hyperbolic claims for particular brands are exaggerated, even though the ingredients are what they claim to be and do what they are supposed to. |
| There was a time when there were more unscrupulous companies selling dietary supplements, but as the industry has matured they have formed trade groups to help monitor each other. Also, the consumer is becoming more sophisticated at evaluating supplements, because there are frequent articles in the newspapers and magazines on the topic. Companies now have to keep on their toes if they are to stay in business, and they have to sell effective, competitive products.
When to Take Supplements
Most of the time, it is a good idea to take supplements with food. |
| My Own Health Habits
Since my exposure to the importance of dietary supplements, I have been taking them myself and recommending them for my patients (and anyone else who wants to listen). I have also run marathons, played racquetball, done longdistance bicycling trips (and more recently, taken up in-line skating). I eat a whole foods diet (especially avoiding sugar and margarines), which is mostly vegetarian (no meat or chicken), and I try to keep my stress levels in control.
In the early 1980s, I went to see another cardiologist, Dr. |
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