Many adults and children in the United States take one or more\u00a0vitamins\u00a0or other\u00a0dietary supplements. In addition to vitamins, dietary\u00a0supplements\u00a0can contain\u00a0minerals,\u00a0herbs\u00a0or other\u00a0botanicals,\u00a0amino acids,\u00a0enzymes, and many other\u00a0ingredients. Dietary supplements come in a variety of forms, including tablets,\u00a0capsules, gummies, and powders, as well as drinks and energy bars. Popular supplements include vitamins D and B12; minerals like\u00a0calcium\u00a0and\u00a0iron; herbs such as\u00a0echinacea\u00a0and garlic; and products like\u00a0glucosamine, probiotics, and fish oils.<\/p>\n\n\n\n
Products sold as dietary supplements come with a Supplement Facts\u00a0label\u00a0that lists the active ingredients, the amount per serving (dose), as well as other ingredients, such as\u00a0fillers,\u00a0binders, and flavorings. The manufacturer suggests the serving size, but your\u00a0healthcare provider\u00a0might decide a different amount is more appropriate for you.<\/p>\n\n\n\n
Some dietary supplements can help you get adequate amounts of\u00a0essential\u00a0nutrients\u00a0if you don\u2019t eat a nutritious variety of foods. However, supplements can\u2019t take the place of the variety of foods that are important to a healthy diet. To learn more about what makes a healthy diet, the\u00a0Dietary Guidelines for Americans\u00a0is a good source of information.<\/p>\n\n\n\n
Some dietary supplements can improve overall health and help manage some health conditions. For example:\u00a0<\/p>\n\n\n\n
A combination of vitamins C and E,\u00a0zinc,\u00a0copper,\u00a0lutein, and\u00a0zeaxanthin\u00a0(known as AREDS) may slow down further vision loss in people with\u00a0age-related macular degeneration\u00a0(AMD).\u00a0<\/p>\n\n\n\n
Many other supplements need more study to determine if they have value. The U.S. Food and Drug Administration (FDA) does not determine whether dietary supplements are effective before they are marketed.<\/p>\n\n\n\n
Many supplements contain active ingredients that can have strong effects on the body. Always be alert to the possibility of a bad reaction, especially when taking a new product.<\/p>\n\n\n\n
You are most likely to have side effects from dietary supplements if you take them at high doses or instead of prescribed medicines, or if you take many different supplements. Some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia. Supplements can also\u00a0interact\u00a0with some medicines in ways that might cause problems. Here are a few examples:<\/p>\n\n\n\n
Manufacturers may add vitamins, minerals, and other supplement ingredients to foods you eat, especially breakfast cereals and beverages. As a result, you may get more of these ingredients than you think, and more might not be better. Taking more than you need costs more and might also raise your risk of side effects. For example, too much\u00a0vitamin A\u00a0can cause headaches and\u00a0liver\u00a0damage, reduce bone strength, and cause birth defects. Excess iron causes\u00a0nausea\u00a0and vomiting and may damage the liver and other organs.<\/p>\n\n\n\n
Be cautious about taking dietary supplements if you are pregnant or\u00a0nursing. Also, be careful about giving supplements to a child, unless recommended by their healthcare provider. Many supplements have not been well tested for safety in pregnant women, nursing mothers, or children.<\/p>\n\n\n\n
If you think that you have had a bad reaction to\u00a0a dietary supplement, let your healthcare provider know. He or she may report your experience to the FDA. You may also submit a report directly to the FDA by calling 800-FDA-1088 or\u00a0completing an online form. You should also report your reaction to the manufacturer by using the contact information on the product label.<\/p>\n\n\n\n
The FDA has established good manufacturing practices (GMPs) that companies must follow to help ensure the identity, purity, strength, and composition of their dietary supplements. These GMPs can prevent adding the wrong ingredient (or too much or too little of the correct ingredient) and reduce the chance of contamination or improper packaging and labeling of a product. The FDA periodically inspects facilities that manufacture supplements.<\/p>\n\n\n\n
Several independent organizations offer quality testing and allow products that pass these tests to display a seal of quality assurance that indicates the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants. These seals do not guarantee that a product is safe or effective. Organizations that offer quality testing include:*<\/p>\n\n\n\n
Tell your healthcare providers (including doctors, dentists,\u00a0pharmacists, and dietitians) about any dietary supplements you\u2019re taking. They can help you determine which supplements, if any, might be valuable for you.<\/p>\n\n\n\n
Keep a complete record of any dietary supplements and medicines you take. The Office of Dietary Supplements website has\u00a0a useful form, \u201dMy Dietary Supplement and Medicine Record,\u201d that you can print and fill out at home. For each product, note the name, the dose you take, how often you take it, and the reason for use. You can share this record with your healthcare providers to discuss what\u2019s best for your overall health.\u00a0<\/p>\n\n\n\n
Consult your healthcare provider before taking dietary supplements to\u00a0treat\u00a0a health condition.<\/p>\n\n\n\n
Keep in mind the term \u201cnatural\u201d doesn\u2019t always mean safe. Some all-natural botanical products, for example, like comfrey and\u00a0kava, can harm the liver. A dietary supplement\u2019s safety depends on many things, such as its chemical makeup, how it works in the body, how it is prepared, and the amount you take.\u00a0<\/p>\n\n\n\n
Dietary supplements are products intended to supplement the diet. They are not medicines and are not intended to treat,\u00a0diagnose,\u00a0mitigate, prevent, or\u00a0cure\u00a0diseases. The FDA is the federal agency that oversees both supplements and medicines, but the FDA regulations for dietary supplements are different from those for\u00a0prescription\u00a0or over-the-counter medicines.<\/p>\n\n\n\n
Medicines must be approved by the FDA before they can be sold or marketed. Supplements do not require this approval. Supplement companies are responsible for having\u00a0evidence\u00a0that their products are safe and that the label claims are truthful and not misleading. However, as long as the product does not contain a \u201cnew dietary ingredient\u201d (one introduced on October 15, 1994), the company does not have to provide this safety evidence to the FDA before the product is marketed.<\/p>\n\n\n\n
Dietary supplement labels may include certain types of health-related claims. Manufacturers are permitted to say, for example, that a supplement promotes health or supports a body function (like\u00a0immunity\u00a0or heart health). These claims must be followed by the words, \u201cThis statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.\u201d<\/p>\n\n\n\n
Manufacturers must follow good manufacturing practices (GMPs) to ensure the identity, purity, strength, and composition of their products. If the FDA finds a dietary supplement to be unsafe, it may remove the product from the marketplace or ask the manufacturer to voluntarily recall the product.<\/p>\n\n\n\n
The FDA monitors the marketplace for potential illegal products that may be unsafe or make false or misleading claims. The Federal Trade Commission, which monitors product advertising, also requires information about a supplement product to be truthful and not misleading.<\/p>\n\n\n\n
The federal government can take legal action against companies and websites that sell dietary supplements when the companies make false or deceptive statements about their products, if they promote them as treatments or cures for diseases, or if their products are unsafe.<\/p>\n\n\n\n
NIH supports research and provides educational materials on dietary supplements.<\/p>\n\n\n\n
FDA<\/a><\/a>\u00a0issues rules and regulations and oversees dietary supplement labeling, marketing, and safety. Recall notices are also posted on the FDA webpage or you can\u00a0subscribe to receive FDA notices of recalls, market withdrawals, and safety alerts<\/a>.<\/p>\n\n\n\n FTC<\/a><\/a>\u00a0regulates<\/a>\u00a0health and safety claims made in advertising for dietary supplements.<\/p>\n\n\n\n USDA<\/a><\/a>\u00a0provides information on a\u00a0variety of food and nutrition topics<\/a><\/a>.<\/p>\n\n\n\n HHS provides\u00a0wellness information, personal health tools, and health news<\/a><\/a>.<\/p>\n\n\n\n A Look at Vitamins, Minerals, Botanicals.<\/p>\n\n\n\n When you reach for that bottle of vitamin C or fish oil pills, you might wonder how well they\u2019ll work and if they\u2019re safe. The first thing to ask yourself is whether you need them in the first place.<\/p>\n\n\n\n More than half of all Americans take one or more dietary supplements daily or on occasion. Supplements are available without a prescription and usually come in pill, powder, or liquid form. Common supplements include vitamins, minerals, and herbal products, also known as botanicals.<\/p>\n\n\n\n People take these supplements to make sure they get enough essential nutrients and to maintain or improve their health. But not everyone needs to take supplements.<\/p>\n\n\n\n \u201cIt\u2019s possible to get all of the nutrients you need by eating a variety of healthy foods, so you don\u2019t have to take one,\u201d says Carol Haggans, a registered dietitian and consultant to NIH. \u201cBut supplements can be useful for filling in gaps in your diet.\u201d<\/p>\n\n\n\n Some supplements may have side effects, especially if taken before surgery or with other medicines. Supplements can also cause problems if you have certain health conditions. The effects of many supplements haven\u2019t been tested in children, pregnant women, and other groups. So talk with your health care provider if you\u2019re thinking about taking dietary supplements.<\/p>\n\n\n\n \u201cYou should discuss with your doctor what supplements you\u2019re taking so your care can be integrated and managed,\u201d advises Dr. Craig Hopp, an expert in botanicals research at NIH.<\/p>\n\n\n\n Dietary supplements are regulated by the U.S. Food and Drug Administration (FDA) as foods, not as drugs. The label may claim certain health benefits. But unlike medicines, supplements can\u2019t claim to cure, treat, or prevent a disease.<\/p>\n\n\n\n \u201cThere\u2019s little evidence that any supplement can reverse the course of any chronic disease,\u201d says Hopp. \u201cDon\u2019t take supplements with that expectation.\u201d<\/p>\n\n\n\n Evidence does suggest that some supplements can enhance health in different ways. The most popular nutrient supplements are multivitamins, calcium, and vitamins B, C and D. Calcium supports bone health, and vitamin D helps the body absorb calcium. Vitamins C and E are antioxidants\u2014molecules that prevent cell damage and help to maintain health.<\/p>\n\n\n\n Women need iron during pregnancy, and breastfed infants need vitamin D. Folic acid\u2014400 micrograms daily, whether from supplements or fortified food\u2014is important for all women of childbearing age.<\/p>\n\n\n\n Vitamin B12 keeps nerve and blood cells healthy. \u201cVitamin B12 mostly comes from meat, fish, and dairy foods, so vegans may consider taking a supplement to be sure to get enough of it,\u201d Haggans says.<\/p>\n\n\n\n Research suggests that fish oil can promote heart health. Of the supplements not derived from vitamins and minerals, Hopp says, \u201cFish oil probably has the most scientific evidence to support its use.\u201d<\/p>\n\n\n\n The health effects of some other common supplements need more study. These include glucosamine (for joint pain) and herbal supplements such as echinacea (immune health) and flaxseed oil (digestion).<\/p>\n\n\n\n Many supplements have mild effects with few risks. But use caution. Vitamin K, for example, will reduce the ability of blood thinners to work. Ginkgo can increase blood thinning. The herb St. John\u2019s wort is sometimes used to ease depression, anxiety, or nerve pain, but it can also speed the breakdown of many drugs\u2014such as antidepressants and birth control pills\u2014and make them less effective.<\/p>\n\n\n\n Just because a supplement is promoted as \u201cnatural\u201d doesn\u2019t necessarily mean it\u2019s safe. The herbs comfrey and kava, for example, can seriously damage the liver.<\/p>\n\n\n\n \u201cIt\u2019s important to know the chemical makeup, how it\u2019s prepared, and how it works in the body\u2014especially for herbs, but also for nutrients,\u201d says Haggans. \u201cTalk to a health care provider for advice on whether you need a supplement in the first place, the dose, and possible interactions with medicine you\u2019re already taking.\u201d<\/p>\n\n\n\n For vitamins and minerals, check the % Daily Value (DV) for each nutrient to make sure you\u2019re not getting too much. \u201cIt\u2019s important to consider the DV and upper limit,\u201d says Haggans. Too much of certain supplements can be harmful.<\/p>\n\n\n\n Scientists still have much to learn even about common vitamins. One recent study found unexpected evidence about vitamin E. Earlier research suggested that men who took vitamin E supplements might have a lower risk of developing prostate cancer. \u201cBut much to our surprise, a large NIH-funded clinical trial of more than 29,000 men found that taking supplements of vitamin E raised\u2014not reduced\u2014their risk of this disease,\u201d says Dr. Paul M. Coates, director of NIH\u2019s Office of Dietary Supplements. That\u2019s why it\u2019s important to conduct clinical studies of supplements to confirm their effects.<\/p>\n\n\n\n Because supplements are regulated as foods, not as drugs, the FDA doesn\u2019t evaluate the quality of supplements or assess their effects on the body. If a product is found to be unsafe after it reaches the market, the FDA can restrict or ban its use.<\/p>\n\n\n\n Manufacturers are also responsible for the product\u2019s purity, and they must accurately list ingredients and their amounts. But there\u2019s no regulatory agency that makes sure that labels match what\u2019s in the bottles. You risk getting less, or sometimes more, of the listed ingredients. All of the ingredients may not even be listed.<\/p>\n\n\n\n A few independent organizations conduct quality tests of supplements and offer seals of approval. This doesn\u2019t guarantee the product works or is safe; it just assures the product was properly made and contains the listed ingredients.<\/p>\n\n\n\n \u201cProducts sold nationally in the stores and online where you usually shop should be fine,\u201d Coates says. \u201cAccording to the FDA, supplement products most likely to be contaminated with pharmaceutical ingredients are herbal remedies promoted for weight loss and sexual or athletic performance enhancement.\u201d<\/p>\n\n\n\nFEDERAL TRADE COMMISSION<\/h3>\n\n\n\n
U.S. DEPARTMENT OF AGRICULTURE<\/h3>\n\n\n\n
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES<\/h3>\n\n\n\n
Should You Take Dietary Supplements?<\/h2>\n\n\n\n