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Top Ten Questions You Should Ask
Before Taking Vitamin Supplements

By Edward C. Geehr, MD - from LifeScript

More than half of all Americans take some form of supplement, spending more than $16 billion a year to help maintain good health and well-being. But how do consumers know that they’re spending their money on the right supplements and using them in the right dosages? 

According to Edward C. Geehr, M.D., a member of the Scientific and Medical Advisory Board of LifeScript, a premier provider of personalized, direct-to-consumer nutritional supplements, there are certain questions consumers should ask themselves before starting a supplement program. Although most individuals can benefit from a well-designed supplement program, there are important things to consider when making decisions about supplements, said Dr. Geehr. Dr. Geehr has put together a list of the top ten most important questions you should be asking before you begin taking supplements.

1. Do I need nutritional supplements?
There is no substitute for a well-rounded diet. Whole foods contain protein, energy and fiber that are difficult to obtain from supplements alone. Balance is the key. A good diet, coupled with a well-designed supplement program, can satisfy the dietary requirements of most people. For those on a restricted diet, however, such as vegans, athletes, body builders or dieters constantly trying to lose weight, supplements may be essential for good health. Restricted diets also diminish nutrients intake. Supplements can help fill in the nutrient gaps in diets such as these.

2. Am I Taking Supplements to Try to Treat a Disease or Illness? 
You should never treat yourself for a disease or illness with supplements. There is little or no conclusive evidence that supplements are beneficial for any of the following common conditions: memory loss, dementia, chronic pain, obesity, varicose veins, diabetes, hair loss, impaired hearing, impotence, infertility, infections, eczema or psoriasis, multiple sclerosis, strokes, snoring or sleep apnea, carpal tunnel syndrome, Parkinsons disease, and active cancer. Those with chronic diseases or taking prescribed medications will want to speak with their physician before taking supplements to avoid potential serious drug interactions and harmful side effects.
Having said that, it is important to note that there is an emerging body of evidence suggesting that some vitamins and herbal preparations may be useful for managing certain conditions, such as enlarged prostate, osteoporosis and heart disease. Talk to your doctor or dietician about the promising dietary supplements for these conditions. Keep in mind, however, that the FDA does not regulate, recommend or sanction the use of any supplements as treatments, except for soy proteins. According to the FDA, soy proteins may reduce the risk of heart disease when taken above certain minimum amounts per serving (6.25 grams). 

3. Are the supplements and the quantities I’m taking right for me? 
Its always best to consult with an expert before beginning a regimen of supplements. Registered Dieticians, Certified Nutritional Specialists and physicians are all well qualified to review your diet and make supplement recommendations. Today, you can find these qualified experts at natural health centers, specialty markets and even on-line. The Internet has spawned a revolution in personalized vitamins. Consumers can simply go online, fill out a personal health profile and instantly receive recommendations based on formulations by some of the nations leading nutritionists and physicians. These customized formulations can be purchased in daily dose packets and delivered directly to the home. 

4. Will Taking More of a Supplement Provide Me with Beneficial Results Faster?
More is not always better. Certain vitamins and minerals considered to be essential to maintaining normal health can be toxic in high doses. For example, too much vitamin A can cause liver toxicity, adversely affect bone growth, and cause yellowing of the skin and palms. In general, supplements should not be taken in amounts that exceed the daily RDI (Reference Daily Intake) unless directed by your dietician or physician. 

5. Can I mix my medications with my supplements? 
Some supplements may interfere with certain medications, resulting in serious side effects. The medications of greatest concern include blood pressure and heart medications, blood thinners (Coumadin or warfarin), certain antidepressants, immunosuppressant drugs, seizure medications, certain cancer therapies, and anti-arrhythmic drugs. If you are taking any medications, check with your physician or pharmacist before taking supplements.

6. Should I stop taking supplements if I’m scheduled to have surgery?
Recent reports note a higher incidence of bleeding problems (either hemorrhage or blood clots) during or after surgery in patients who were taking certain supplements. Some supplements may also interfere with anesthetics used in surgery. Its recommended that all supplements be stopped at least four weeks before surgery unless specifically permitted by your physician. 

7. Does it matter if my supplements are natural?
There appears to be little difference between synthetic and naturally occurring vitamins. Natural vitamins are no more effective at delivering nutrients than synthetic ones and may be much more expensive. Herbal preparations are usually naturally derived, although it may be difficult to determine the actual content or purity of the active ingredients. The most important factor is the quality and reputation of the manufacturer and whether or not assays are performed to verify the supplement ingredients.

8. How long will a supply of vitamins stay fresh?
Vitamin freshness and potency varies according to the vitamin, its purity, the way its manufactured and its date of manufacture. Most have a shelf life of several years, and all have an expiration date posted on the bottle or jar label. To ensure the freshest supplements, many consumers today are turning to monthly mail order programs that deliver fresh vitamins every month in personal daily dose packets. This helps prevent consumption of expired vitamins and reduces waste. 

9. How can I tell if my supplements are effective?
Vitamins effect different people in different ways. Many people believe they see direct benefits of using Vitamin C or echinachea to ward off a cold. Others believe their weight loss results are enhanced by using specific supplements in combination with exercise and dieting. A growing amount of scientific research has addressed the potential benefit of supplementing diets with vitamins or minerals, according to the American Dietetic Association. Large, randomized, double-blind supplementation trials have demonstrated positive health benefits of some supplements, uncertainty with respect to others and ineffectiveness or adverse effects of still others. The industry continues to learn more each year, as both advocates and detractors initiate a growing number of studies. 

10. Who regulates the supplement industry?
Supplements are considered food products and as such are not regulated as drugs or pharmaceuticals by the Food and Drug Administration (FDA). Under the 1994 Dietary Health and Supplement Education Act (DSHEA), manufacturers and marketers of supplements may not promote supplements as a remedy for any particular disease or illness. That same act exempted supplements from the testing and labeling requirements of pharmaceuticals. However, supplements are still required by DSHEA to clearly label their ingredients along with the percentages of the RDI. Although all manufacturers are required to follow good laboratory practices and safety procedures while preparing their products, consumers should realize that the burden of proof of safety of the product does not rest with the manufacturer. The FDA is required to prove that the product is not safe before it can take action to remove a product from the market. The FDA can order certain supplements removed from the market place if adverse incidence reports and an investigation indicate that there is a serious safety issue for consumers. If you believe a particular product is not safe, file a report at http://www.fda.gov/medwatch/report/consumer/instruct.htm

About the Author
Edward C. Geehr, MD, is a member of the National Scientific and Medical Advisory Board of LifeScript, a leading provider of personalized nutritional supplements. Dr. Geehr formerly was national Chief Medical Officer with Inpatient Consultants, and is a member of the American College of Sports Medicine, the Wilderness Medical Society (co-founder) and the National Association of Inpatient Physicians. He previously was Clinical Associate Professor of Medicine and Surgery at the University of California, San Francisco, and is a graduate of Yale University and Duke University Medical School.

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