Dietary supplements, draw the attention of doctors, are not “simple vitamins” or “only plants”, but can do a lot of harm when they are not administered according to the doctor's instructions and are not certified products.
Dietary supplements administered without indication can be a real danger PHOTO: Shutterstock
Food supplements, available in various stores, from supermarkets, grocery stores and pharmacies to online stores, and heavily promoted including on the Internet and on TV, seem to bring us only benefits. “What's wrong with taking vitamins?”or “They are herbal, not medicinal” are the phrases that worry doctors. We actually assume a number of risks, all the more so when it comes to products that do not need the accreditation of the National Medicines Agency.
“It is very difficult for us to recommend a dietary supplement without knowing that it has some studies behind it. Because besides vitamin C, let's say, there are other excipients and we don't know what they do in people with kidney disease, for example. Do not take any supplement. Or in people with cardiovascular diseases, who have to monitor the level of sodium, salt, and we don't know how much study they have, or if they have. There are other supplements that increase diuresis and may dehydrate some patients, that's why we recommend only those that have clinical studies”, explains the doctor specialized in diabetes and nutritional diseases Anca Roman. To know which products have clinical trials behind them requires the doctor to do his own research, because supplements, not being drugs, are not subject to the same rigors when placed on the market.
“I've had patients who completely gave up treatment”
The danger of supplements manifests itself in several ways. Patients convinced by advertisements that promise that certain products “cure diabetes” or “lower cholesterol” abandon the treatment of the underlying disease. Doctor Anca Roman gives the example of a patient who bought “herbal” products on the Internet, paying 700 lei, and later presented himself at the office. The analyzes showed that in the absence of the treatment prescribed by the doctor, serious imbalances occurred in the body.
“I've had patients who completely stopped treatment, took supplements and came back with a glycosylated hemoglobin of 10-11, which means blood sugars of 300-400. (…) It has reached such an extent that patients refuse drugs with clinical studies that actually have cardiovascular protection, that actually lower their cholesterol, have studies on lowering cholesterol plaque. And they don't want to take them anymore”draws the doctor's attention.
Often patients try the “miracle” products for a month or two, after which the results of the analyzes convince them to return to the treatment prescribed by the doctor.
“You don't play with vitamins A, D, E and K”
Family doctor Mihai Ungureanu says that most of the time his patients ask him before buying supplements. The majority are those who do not have a very good financial situation so that they can afford to buy the supplements which are not cheap at all. But he tells everyone that, not only that these supplements should not be administered without a recommendation, but, moreover, in the case of a deficiency, the cause must first be investigated and then determined which supplement would be needed and in what quantity.
Another warning that the family doctor has for patients is regarding the administration of certain vitamins. “Vitamins A, D, E and K are not to be trifled with. They are fat-soluble vitamins, they remain in the body and are eliminated rather difficult. Even though you may have low vitamin D in your blood test, go to your endocrinologist for a recommendation!”is the doctor's call.
The specialist, be it an endocrinologist, a gastroenterologist, etc., is the one who will indicate both the product that has proven its effectiveness, with studies, as well as the right dose and administration period. For insured patients, with a referral from the family doctor, investigations are the best solution to find out why they feel tired, feel weak, etc., by no means taking supplements without finding out the cause of the problems felt, he also says doctor Mihai Ungureanu.
Herbal products are not without risks
Things get complicated, in the case of the administration of various food supplements, in patients who have kidney problems and the kidneys are no longer able to eliminate certain substances in excess as well.
A category of supplements with risks for patients with kidney problems is represented by teas and extracts from certain plants. The nephrologist Emilian Postelnicu recalls in this regard the cases of kidney failure that occurred at a certain time in the Netherlands, due to the administration of some supplements.
“Historically, there was an epidemic of kidney failure in the Netherlands due to the use of Chinese herbal nutritional supplements that caused irreversible kidney damage in those who used them,” said the doctor. In Romania, too, certain products are marketed which, consumed in the long term, can affect kidney function. On the list of nephrologists, due to their nephrotoxic effect in case of long-term consumption, are those products based on the plant Aristolochia clematitis (wolf apple), used in prostate teas, a plant rich in aristolochic acid.
The worst thing about many dietary supplements is that they are not based on rigorous studies and there is no assurance that the ingredients on the label are the only ones found in the product. “You don't even know what's in them. No one controls them. I come as such and as such, they are congested with the population”, draws the attention of doctor Emilian Postelnicu.
Undesirable effects of supplement administration have also been reported, the nephrologist states, in the case of young people who frequently go to the gym and who consume protein supplements and creatine-based supplements. Young people go to the doctor when something unpleasant happens, such as problems urinating, or when, in the case of a random medical examination, they find elevated values of nitrogen retention. For this reason, in the case of young people who do sports, it is recommended to closely monitor the administration of various supplements, by a specialized doctor, especially since at the moment there are conflicting studies regarding creatine-based products, for example.
“Don't listen! It is a supplement and should be administered when you are deficient in something,” concludes the nephrologist.
