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dietary supplement (nutraceutical, medicinal food)

Includes various preparations used as food supplements. Also see nutritional supplement for supplements without food value. Indications: - mostly used to improve or maintain overall health [4] Contraindications: - USPSTF does not recommend herbal supplements for prevention of cardiovascular disease or prevention of cancer [12] Epidemiology: - increased use of dietary supplements among elderly (52% to 64% 2005-2011) [9] - % of elderly at risk for major drug-drug interaction(s) increased from 8% to 15% (205-2011), mostly involving commonly used drugs & supplements [9] - ~50% of U.S. adults use dietary supplements despite lack of evidence for benefit [10] Clinical significance: - inquire about dietary supplements as a routine component of medical history [12] Complications: - 23,000 emergency visits annually in the U.S. related to dietary supplements [8] - iron, calcium, & potassium are most commonly implicated in older people, causing allergic reactions or dysphagia - weight-loss & energy products are most commonly implicated in younger people causing palpitations, tachycardia [8] - children ingest anything within reach - 20% of drug + supplement-related hepatoxicity associated with dietary supplements [5] - hepatotoxicity from dietary supplements required liver transplantation more often than injury from conventional drugs (13% vs. 3%) [5] - no body-building supplements required liver transplantation [5] Notes: - almost half of U.S. adults report using dietary supplements - 25% of elderly do not inform their physicians about the herbs & supplements they regularly take [9] - insufficient evidence to support benefit or identify harm from use of multivitamin & mineral supplements to prevent cancer & chronic disease. [1] - 2/3 of commercially available FDA-recalled supplements contain anabolic steroids, weight-loss stimulants, or erectile-dysfunction drugs months after the recall [6] - only 21% of store-brand herbal supplements contained DNA from the plants listed on the labels [7] - only 4% of Walmart brand supplements contained DNA from the plants listed on the labels [7] - health food store employees frequently recommend creatine & testosterone boosters for boy high school athletes - manufacturers are not required to demonstrate safety or efficacy unless the supplement includes ingredients introduced after 1994 [12]

Related

nutritional supplement pharmaceutical herb; medicinal herb; herbal supplement; botanical weight loss diet

Specific

alfalfa chewing gum cider vinegar condiment cornsilk Dexatrim Results dietary fiber diosmin fish oil fructooligosaccharide fructooligosaccharide/Saccharomyces boulardii glyceryl monolaurate green coffee extract hesperidin lipid injectable emulsion (Clinolipid) liver stomach concentrate Metabolife olive leaf extract plum preparation Prevagen protein supplement (ProMod) RNA oral Rosigen Royal jelly rutin; rutoside; quercetin-3-rutinoside; sophorin Saccharomyces boulardii lyo (Florastor) shark cartilage soy protein isolate soybean lecithin theanine (N5-ethyl-L-glutamine) triheptanoin; C7 oil (Dojolvi) venom HYPERDRIVE 3.0 vitamin B50 wheat germ Xanadrine

General

food

References

  1. NIH-State-of-the-Science Panel, National Institutes of Health state-of-the-science conference conference statement: Multivitamin/mineral supplements and chronic disease progression. Ann Intern Med 2006, 145:364 PMID: 16880454 - Huang H-Y et al, The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: A systematic review for a National Institutes of Health state-of-science conference Ann Intern Med 2006, 145:372 PMID: 16880453
  2. Prescriber's Letter 14(4): 2007 USP verified supplements Detail-Document#: 230410 (subscription needed) http://www.prescribersletter.com
  3. Mursu J et al. Dietary supplements and mortality rate in older women: The Iowa Women's Health Study. Arch Intern Med 2011 Oct 10; 171:1625. PMID: 21987192
  4. Bailey RL et al. Why US adults use dietary supplements. JAMA Intern Med. Feb 4, 2013 PMID: 23381623 http://archinte.jamanetwork.com/article.aspx?articleid=1568520
  5. Navarro VJ et al Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology. August 24, 2014 PMID: 25043597 http://onlinelibrary.wiley.com/doi/10.1002/hep.27317/abstract;jsessionid=7443A648D85532ADB7F3AA91FEAF564D.f04t02
  6. Cohen PA Presence of Banned Drugs in Dietary Supplements Following FDA Recalls. JAMA. 2014;312(16):1691-1693 PMID: 25335153 http://jama.jamanetwork.com/article.aspx?articleid=1917421
  7. New York Attorney General News Release. Feb 3, 2015 A.G. Schneiderman Asks Major Retailers To Halt Sales Of Certain Herbal Supplements As DNA Tests Fail To Detect Plant Materials Listed On Majority Of Products Tested. http://www.ag.ny.gov/press-release/ag-schneiderman-asks-major-retailers-halt-sales-certain-herbal-supplements-dna-tests
  8. Geller AI, Shehab N, Weidle NJ et al Emergency Department Visits for Adverse Events Related to Dietary Supplements. N Engl J Med 2015; 373:1531-1540. October 15, 2015 PMID: 26465986 http://www.nejm.org/doi/full/10.1056/NEJMsa1504267
  9. Qato DM et al Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med. Published online March 21, 2016 PMID: 26998708 http://archinte.jamanetwork.com/article.aspx?articleid=2500064 - Jou J, Johnson PJ Nondisclosure of Complementary and Alternative Medicine Use to Primary Care PhysiciansFindings From the 2012 National Health Interview Survey. JAMA Intern Med. Published online March 21, 2016 PMID: 26999670 http://archinte.jamanetwork.com/article.aspx?articleid=2500061 - Steinman MA Polypharmacy - Time to Get Beyond Numbers JAMA Intern Med. Published online March 21, 2016 PMID: 26999383 http://archinte.jamanetwork.com/article.aspx?articleid=2500058
  10. Kantor ED, Rehm CD, Du M et al Trends in Dietary Supplement Use Among US Adults From 1999- 2012. JAMA. 2016;316(14):1464-1474 PMID: 27727382 http://jamanetwork.com/journals/jama/article-abstract/2565748 - Cohen PA The Supplement Paradox. Negligible Benefits, Robust Consumption. JAMA. 2016;316(14):1453-1454 PMID: 27727369 http://jamanetwork.com/journals/jama/article-abstract/2565733
  11. Herriman M, Fletcher L, Tchaconas A, Adesman A, Milanaik R. Dietary supplements and young teens: Misinformation and access provided by retailers. Pediatrics 2017 Jan 2 PMID: 28044048 http://pediatrics.aappublications.org/content/early/2016/12/29/peds.2016-1257
  12. Medical Knowledge Self Assessment Program (MKSAP) 18, 19 American College of Physicians, Philadelphia 2018, 2022
  13. Dietary supplements: Medline Plus http://www.nlm.nih.gov/medlineplus/dietarysupplements.html
  14. Nutritional Supplements for the Athlete http://www.clevelandclinic.org/health/health-info/docs/1900/1901.asp?index=8419