The Scoop on Supplements

by Molly M. Ginty

Whatever stage of life you’re in, and whether you’re physically fit or living with chronic illness, you can find ways to be a wise steward of your health and well-being. Our health and wholeness are important keys to responding to God’s call for us and acting boldly on that call. That’s why Women of the ELCA have embarked on a new health initiative: Raising up Healthy Women and Girls. This ongoing column represents our commitment to the issue of women’s health.

When Jaime Hunt heard the bad news about her anti-depressant, she didn’t let it get her down. "I take an herbal supplement called St. John’s wort for depression," says Hunt, a public relations coordinator in Bloomington, Minnesota. "New research questions whether it works. But regardless of what the studies say, this herb does the job for me. Even if it’s a placebo effect, I’m getting the results I want and plan to continue using it."

Like an estimated one–third of Americans, Hunt takes over-the-counter supplements that promise to promote good health. And like other supplement users, she’s working to make sense of a flurry of recent studies that question these products’ efficacy.

In the past year, landmark research has challenged the claims of some of the most popular herbs and supplements: glucosamine and chondroitin to ease arthritis, saw palmetto to treat enlarged prostate glands, echinacea to ward off colds, and St. John’s wort for depression.

"Partially as a result of these studies, sales were down 3 percent in 2005 for the $20 billion mass market for supplements," says Mark Blumenthal, director of the American Botanical Council, a non–profit research organization in Austin, Texas. "But those who are committed to the natural lifestyle are sticking by their trusted supplements."

As they continue popping valerian to relieve anxiety, ginkgo to boost brainpower, and ginseng for physical stamina, herb users cite older research — much of it conducted in Europe — and their own positive experiences.

Herb enthusiasts say the St. John’s wort study (done at Vanderbilt University) tested subjects with more severe depression than the herb is intended to treat. They note that the glucosamine/ chondroitin study (funded by the National Institutes of Health) helped arthritis sufferers who took both supplements together, though taking them individually had little effect. They argue that the echinacea study (sponsored by the National Center for Complementary and Alternative Medicine) used one-third of the recommended dosage. And they say the saw palmetto study (at the San Francisco VA Medical Center) employed a different extraction method than the one typically used.

Who is correct in their claims — the supplement supporters or the scientists?

Consumers will get no answers from the Food and Drug Administration (FDA), the government agency that regulates over-the–counter supplements. The FDA doesn’t investigate a supplement until someone gets sick; it has stricter standards for toothpaste. Since the passage of the 1994 Dietary Supplement Health and Education Act, which places supplements in a regulatory gray area somewhere between food and drugs, supplement labels are not allowed to make medical claims, but supplements may be sold over the counter in any amount and any form.

Because herbs and supplements aren’t as carefully regulated as prescription drugs — and because some consumers take these potent substances irresponsibly — tragedy can result. More than 150 deaths have been linked to ephedra, which the FDA banned in 2003. Unscrupulous supplement makers have sold products laced with lead, mercury, and other contaminants, prompting the FDA to call for stricter production standards and clearer labeling changes that health advocates welcome but say are still not enough to protect consumers.

Complicating the picture is the fact that herbal remedies, though some have been used for thousands of years, have not been subjected to the rigorous controlled studies that most drugs undergo.

While the world waits for more studies and the FDA continues its hands–off approach, how can you take supplements, enjoy their benefits, and stay safe?

Experts say you should start by researching any herbs you plan to try through the American Botanical Council (www.herbalgram.org), the Herb Research Foundation (www.herbs.org), or the National Center for Complementary and Alternative Medicine (http://nccam.nih.gov).

"Learn what you can about an herb’s toxic effects and what it doesn’t mix with," recommends Harold Bloomfield, author of Healing Anxiety with Herbs. "Some people have the mistaken notion that if something is natural, it’s safe in any dose. But people can have allergic reactions to herbs, and using them incorrectly can be fatal."

Health advocates say you should buy herbs and supplements only from companies with good track records such as Enzymatic Therapy, Nature’s Way, and Nature’s Herbs. "It’s important to find a high–quality product," says Fredi Kronenberg, director of the Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine at Columbia University in New York. "Looking for the least expensive brand is probably not the best approach until the industry cleans itself up."

The most important precaution? Keep your doctor informed. "Self-diagnosis and self–treatment can lead to self–malpractice," says Gregory A. Plotnikoff, an associate professor of clinical medicine at the University of Minnesota in Minneapolis. "The best decisions are made in partnership with a physician, and periodic re–evaluation is wise."

By doing their homework — and getting medical supervision — thousands of Americans are using herbal remedies and supplements successfully and safely.

"Without treatment, my osteoarthritis is so severe that I can hardly walk, sit, or stand," says Fern–Marie Crawford, a retired administrative assistant in Spring Valley, California. "Prescription medications upset my stomach, disturb my sleep, and trigger mood swings. But glucosamine and chondroitin eliminate my pain with virtually no side effects. That’s why these supplements, for me, are the only choice that works."

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

Article published in Lutheran Woman Today, September 2006