An important analysis termed “Trends in Dietary Supplement Use Among US Adults From 1999-2012” by lead author Kantor was published in JAMA, October 11, 2016. An editorial was written by Dr P.A. Cohen.

Supplements may do more harm than good.

The main finding is that about 50% of adults in the United States used supplements within the last 30 days, and this proportion was unchanged from 1999-2000 compared to 2011-2012. This is despite the fact that multiple studies have yielded mainly disappointing results about potential health benefits, and there is more and more evidence of harm.

The Dietary Supplement Health and Education Act of 1994 is an important reason for continued widespread use. This act states that supplements are presumed to be safe until the FDA detects evidence of harm, which usually occurs only after extensive use and exposure to many consumers. For example, supplements containing Ephedra were linked to serious adverse effects, including myocardial infarctions, seizures, strokes, sudden deaths. Beta-carotene supplements were found to actually increase the risk of lung cancer among smokers. The National Institutes of Health has invested 250 to 300 million dollars per year in dietary supplement research. They found that echinacea does not treat the common cold, St. John’s wort does not treat major depression, vitamin E does not prevent prostate cancer, glucosamine and chondroitin do not treat arthritis, and that ginkgo biloba does not improve cognition.

Use of some supplements can be justified, including treatment of vitamin and mineral deficiencies, used for early age-related macular degeneration, vitamin D for multiple sclerosis, and perhaps probiotics for various disorders.

Why do consumers continue this widespread use given this knowledge? Perhaps they are not aware of these negative results. Perhaps they do not have faith in the scientific process and in fact believe there is a conspiracy by the “established” healthcare system. Most researchers believe that perceived benefits are largely placebo effects.

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