Dietary supplements comprise a variety of products
ranging from familiar multivitamins found in every
supermarket to exotic botanicals such as the South
African herb hoodia. Millions of Americans take dietary
supplements daily; their use has become increasingly
common since the 1990s.
The United States Food
and Drug Administration (FDA) estimates that in 1999
more than 12 million Americans were taking ephedra, a
weight-loss supplement that was later banned because it
can cause serious side effects. Due to the large number
of different supplements and their range of uses, testing
and regulation of these products is difficult and often
ineffective.
Dietary supplements in conventional medicine
Conventional medicine, also called Western or
mainstream medicine, is practiced by licensed medical
doctors (MD) and doctors of osteopathy (DO), dentists
(DDS orDMD), registered nurses (RN), licensed practical
nurses (LPN), pharmacists, and similar health care
professionals. Some dietary supplements are routinely
used as an accepted part of conventional medicine.
The
most common of these are vitamin and mineral supplements
taken in accordance with established dietary
reference intakes (DRIs). DRIs are a set of values for
different nutrients that indicate the daily amount of
that nutrient necessary to meet the needs of most individuals,
as well as the largest amount of the nutrient
that can be consumed daily without harmful effects.
Other supplements, such as folic acid, are prescribed
for pregnant women in order to decrease the risk of
neural tube defects in their offspring. Still other supplements,
such as enzymes, may be given when the body
fails to produce adequate amounts of the enzyme as the
result of a genetic disorder such as cystic fibrosis. When
taken under supervision of a conventional health care
professional, dietary supplements tend to be extremely
safe.
Dietary supplements in complementary and
alternative medicine
Most dietary supplements are used within a system
of complementary and alternative medicine (CAM).
Complementary medicine uses treatments that are not
part of conventional medicine to supplement conventional
medicine.
Alternative medicine uses treatments
that are not part of conventional medicine as a complete
replacement for conventional medicine.
Alternative medicine
includes well-established treatment systems such as
homeopathy, traditional Chinese medicine, and Ayurvedic,
or traditional Indian medicine, as well as newer faddriven
treatments. Many CAM treatments have their
roots in tradition and folklore.
Herbs are some of the most common dietary supplements
used in CAM. Many have been used for
hundreds of years and show evidence of effectiveness.
Others are ineffective or may harm the individual
either directly or when used as a replacement for conventional
drugs and treatments whose effectiveness
has been proven.
Vitamin and mineral supplements
used as part of conventional medicine become part of
the CAM system when they are used in mega-doses
that far exceed DRI values or when they are used to
prevent or treat a specific condition (e.g., vitamin C to
prevent colds).
Likewise, enzymes and amino acids
that have specific uses within conventional medicine
become part of the CAM system of dietary supplements
when they are used in non-conventional ways or
in non-standard doses. Some dietary supplements,
such as bee pollen, are used exclusively in CAM.
