Apr 292012

All those pill bottles on your parent’s counter or kitchen table are seldom all prescription medications. Vitamins, minerals, herbs, botanicals, amino acids, enzymes, animal extracts and the magic fruit/vegetable/supplement of the month, the nutritional supplement industry has gotten ridiculous in the United States. Elderly people who fuss about taking medication will pop a handful of pills if they are vitamins, herbs, etc.

While some supplements are good for you and necessary, I am reminded of a point someone from another country once made, “Americans have the most expensive urine in the world.” This was said because excess vitamins and minerals are often excreted through the kidneys and Americans have made supplements into a multi-billion dollar industry. (Many of your prescription medications are also excreted through your kidneys as recent studies of our water have shown.) We literally flush those supplements down the toilet.

Having said that let me state that I take supplements, recommend them to others and have even given them to my pets (on the recommendation of my veterinarian). They are often necessary in a country where a majority of the food consumed is over processed and deficient in nutritional value. Add to that the added stress we live under, especially caregivers, our bodies may have need for additional supplements. There are scientific studies that verify some of these needs for supplementation. With the decrease in nutritional status that many in our elderly population suffer from, supplementation can be a necessity.

My problem is not with the taking of supplements but rather the ‘take a pill to fix it’ thinking that we seem to all suffer from. The pharmaceutical and supplement industries both encourage this mentality. Yet nutritional supplements are not without side effects and can interact negatively with many medications. Unfortunately many people, especially the elderly, believe that if it is a supplement or ‘natural’ it must be good for you.

Before you take or give any supplement or vitamin, please get the facts from an unbiased resource such as the National Institutes of Health Office of Dietary Supplements.

You should always talk with your pharmacist and physician because many vitamins and herbs interfere with prescription medications. You should also know that vitamins A, D, E, and K are stored in your fat and can build up to toxic levels. Even vitamins that are not stored can interfere with medical treatments, such as some forms of chemotherapy.

Of consideration for older adults is that many are on some form of blood thinner such as Coumadin or aspirin. This is a problem because some supplements also act as blood thinners which can lead to hemorrhage, or counteract the medication which can lead to clot formation, stroke or heart attack. (Even certain foods interfere with Coumadin.)

Also, be alert to the fact that some supplements can have unwanted effects before, during and after surgery. Please discuss this with your healthcare professional before scheduled surgeries. Pharmaceutical manufacturers list known supplement interactions but there honestly is no way to test all the supplements or foods available for potential interaction. Consider stopping all supplements two to three weeks before surgery unless your doctor and anesthetists gives you the okay.

Another consideration is the supplementation added to many of our foods such as milk, bread, cereals, sports drinks, vitamin waters, nutritional shakes, etc. You could end up getting more of a certain supplement than you realize or at least wasting money on something you do not need.

The Institute of Medicine of the National Academy of Sciences has developed recommended Dietary Reference Intakes (DRI) for vitamins and minerals. Dietary Reference Intakes is the general term for a set of reference values used for planning and assessing nutrient intake for healthy people. Three important types of reference values included in the DRIs are Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). Be careful not to go over the UL as toxicity can occur.

When buying supplements you should know that the Food and Drug Administration has established quality standards for identity, purity, strength and composition of dietary supplements.

You might want to look for quality seals of approval from independent companies such as U.S. Pharmacopeia (USP), Consumer Lab.com, and NSF International. These are voluntary testing and auditing programs to ensure the quality of production. This ensures you are getting what you are buying, in safe levels, manufactured according to FDA guidelines and that it is safe from contamination.

This is not to say that other supplements do not meet the same guidelines just that these have gone through the headache and expense of testing and verification. The FDA regulations have done much to reduce some of the problems that have occurred in the past.

Some other resources you might find helpful:
The United States Department of Agriculture’s Food and Nutrition Information Center

The USDA Nutritional Evidence Library

USDA Healthy Meals Resource System