FROM THE EDITORS

Dietary supplements should be . . . supplemental

Mark Lee, M.D.
General Internal Medicine

The most common alternative therapy in use today is dietary supplements, which include herbs, vitamins and minerals. In this month's issue, we discuss herbal supplements and the risks they may pose to your health.

Since 1994, when the U.S. Congress passed the Dietary Supplement Health and Education Act, there's been a tremendous explosion of growth in the dietary supplement industry, with sales exceeding $20 billion annually, according to some estimates.

Most dietary supplements are derived from plants or herbs, though minerals, vitamins and even some hormones, such as DHEA and melatonin, are included in the category. People often take supplements because they believe that taking them is good for the prevention and treatment of many diseases, including arthritis, osteoporosis, infections and immune-related conditions. Supplements — especially herbal products — are also popular because of the perception that they're natural and, therefore, "good for you."

But natural doesn't always translate into being safe. Any product that's strong enough to provide a potential benefit to the body can also be strong enough to cause harm. Tobacco, for example, is a "natural" product, and it's clearly not safe. Some natural products, such as nightshade or hemlock, can be extremely toxic when ingested and can even cause death.

Vitamins have generally proved to be safe. However, marketing campaigns and the antioxidant craze of the past decade have spurred the concept that "if a little is good for you, then a lot must be great." Megadose vitamin therapies are publicized as effective strategies to cure colds and infections, prevent Alzheimer's disease, and even prevent or cure cancer. Unfortunately, there's little scientific evidence to support these claims and their side effects have resulted in more of a problem rather than a panacea.

Despite these concerns, there's growing evidence that certain supplements — when used in conjunction with modern medicine — can help you achieve and maintain good health. Supplements can be part of your overall wellness plan, provided you use them wisely. When reading supplement labels, ask yourself these questions: Does the product promise rapid improvement in health or performance? Does it seem too good to be true? Does the manufacturer use the results of a single study or series of anecdotes to support its use?

And remember, supplements are just that — supplemental. They can't replace a nutritious diet. To achieve and maintain good health, you need to build your "health pyramid" — don't smoke, eat nutritious foods, exercise every day, rest up and make sure to have meaning in your life. Once you've created and maintained this foundation, adding specific supplements may provide the added edge you're looking for.

Reprinted from "Mayo Clinic Book of Alternative Medicine."