Complementary and Alternative Medicine is a govern-
ment organization within the National Institutes of
Health that investigates CAM treatments and runs rig-
orous clinical trials to determine safety and effectiveness.
Individuals interested in using dietary supple-
ments should consult their health care provider and
other reputable sources of information before taking
any new supplements. Pregnant or breastfeeding
women should be especially careful to discuss the sup-
plements they may want to take with their health care
provider. Many herbs and other dietary supplements
cross the placenta or are secreted into breast milk and
may affect the fetus or nursing baby. In addition, care
should be taken in giving children dietary supple-
ments. Few studies have been done specifically on
children and the recommended dosage for adults
may be harmful to children. As with any medication,
more is not necessarily better. Overdose is a common
cause of adverse side effects in dietary supplements. In
the event of side effects, the supplement should be
stopped immediately and the side effects reported to
a health care professional.Interactions
Dietary supplements may interact with both con-
ventional drugs and other herbs or dietary supple-
ments. Individuals should seek information about
specific interactions from their health care provider.
Many dietary supplements should be stopped several
days before surgery to reduce the risk of excess
bleeding.Complications
There is strong evidence that some dietary supple-
ments can cause serious harm or death. For example,
the weight-loss supplement ephedra was found to have
contributed to the death of the Baltimore Oriole’s
pitching prospect Steve Belcher in 2003. The FDA
later banned ephedra-containing supplements.
According to the American Association of Poison
Control Centers, there have been over 62,000 reports
of vitamin poisonings, over 23,000 cases linked to
minerals, and over 23,000 reports linked to herbs.
Twenty-seven deaths were attributed to dietary sup-
plements in 2005, of which 13 were attributed to herbs.
It should be remembered that ‘‘natural’’ does not
mean safe; for example, many wild mushrooms are
completely natural and cause death when eaten.
Complications may arise from dietary supple-
ments themselves or their misuse or poor regulation
of the manufacturing process. This is especially true of
those supplements imported into the United Statesfrom developing countries. Independent laboratory
analyses of dietary supplements have found:
Contamination with pesticides
Contamination with heavy metals
Presence of ingredients not listed on the label
Amount of dietary ingredient not the same as the
amount listed on the label
Some health professionals believe the number of
complications related to dietary supplements is
severely under-reported. This should improve withKEY TERMS
Alternative medicine—A system of healing that
rejects conventional, pharmaceutical-based medi-
cine and replaces it with the use of dietary supple-
ments and therapies such as herbs, vitamins,
minerals, massage, and cleansing diets. Alternative
medicine includes well-established treatment sys-
tems such as homeopathy, Traditional Chinese med-
icine, and Ayurvedic medicine.
Amino acid—Molecules that are the basic building
blocks of proteins.
Botanical—An herb; a dietary supplement derived
from a plant.
Complementary medicine—Includes many of the
same treatments used in alternative medicine, but
uses them to supplement conventional drug and
therapy treatments, rather than to replace conven-
tional medicine.
Conventional medicine—Mainstream or Western
pharmaceutical-based medicine practiced by med-
ical doctors, doctors of osteopathy, and other
licensed health care professionals.
Enzyme—Proteins that change the rate of a chem-
ical reaction within the body without themselves
being used up in the reaction
Herb—A plant used in cooking or for medical pur-
poses. Examples include Echinacea and ginseng.
Mineral—An inorganic substance found in the
earth that is necessary in small quantities for the
body to maintain a health. Examples include zinc,
copper, and iron.
Vitamin—A nutrient that the body needs in small
amounts to remain healthy but that the body cannot
adequately manufacture for itself and must acquire
through diet.Dietary supplements