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The majority of side effects of dietary supplements are benign.
Moreover, virtually all negative effects of dietary supplements, what some people (especially fear-mongers) call the “dangers of supplements”, can be entirely avoided by following some practical guidelines on how to properly use these valuable natural health products.
This pro-active approach elevates dietary supplement safety and ensures that you will experience primarily health benefits from your nutritional supplements. Side effects, if present at all, will only be minor that way.
Last but not least...
One of the prime facts about vitamins is that the health risks of dietary supplements are low. A fortunate consequence thereof is that the majority of side effects of dietary supplements are reversible and disappear, usually within a short time, once you stop taking the product or set of products.
Here are the Top 10 Tips to avoid “vitamin mistakes” –that is, the negative side effects of dietary supplements...
When you buy dietary supplements you want to be in a situation where the benefits of supplements are as large as possible -and, respectively, the risks as low as possible.
The supplement market is flooded with low-quality, ineffective products due to an inadequate regulatory setting (see the 3-part article on "Exploring The Shady World Of Dietary Supplement Regulation" -PART 1: Dietary Supplement Regulation –Is Supplement Quality Assured?)
A substantial number of nutritional supplements are tainted with impurities and contaminants, such as heavy metals, pesticides, bacteria, fungi, prescription drugs, and other compounds (Cohen, 2009; News & Events –Press Announcements, Dec. 15, 2010, from Official US Government FDA website, accessed Feb. 2011), making them potentially harmful dietary supplements.
These unwanted substances can be a source, or a contributing factor, for side effects of dietary supplements –especially over the long run because many contaminants add to your toxic load. (To learn more about nutritional supplements and and the threats from contaminants review the article Health Risks From Dietary Supplements –Contaminated Supplements)
Stick to high-quality pure vitamins and health supplements to eliminate this danger. By the way, taking pure vitamins, to avoid side effects of dietary supplements, also means taking GMO (genetically engineered organisms) free supplements (see L-Tryptophan: The Truth About The FDA Tryptophan Recall Of 1989).
Low-dose nutritional supplements, unlike high dose science-based supplements (a.k.a "medicinal supplements"), have other "side effects of supplements" or rather non-desired results: small or no health benefits (and they may even be injurious to your health).
Research experiments (e.g., Prasad & Kumar, 1996) demonstrated, for example, that low doses of vitamin C promoted the growth of certain cancer cells, while high doses inhibited the cancerous progression.
In a research paper the authors clearly stated:
“[...] there is a distinct difference between low-dose and high-dose effects of certain antioxidants […].” (Prasad, et al., 2001)
Historically, small-dose –i.e., flawed– food supplements are usually products whose nutrient values are based on the issued proclamations of corporate government bodies, such as the "Recommended Daily Allowances" (RDAs) or the "Dietary Reference Intakes" (DRIs) in the US, or the daily "Nutrient Reference Values" (NRVs) in Australia and New Zealand.
Since high-quality nutritional supplements are exceptionally safe, even at science-based high doses, and since both in vitro and in vivo experiments found that high-dose supplements (multivitamins) inhibit the growth of many different types of human cancer cells (Prasad, et al., 2001), the research evidence rather strongly suggests that it would be advisable to adhere to that mode of supplementation. Particularly also since science-based high doses of nutritional supplements neither stimulate cell proliferation nor inhibit cell growth in healthy cells (Prasad, et al., 2001).
The selection and consumption of science-based, top-quality, high-dose nutritional supplements on a long-term basis are critical to obtain maximum health gains, and to avoid the great side effect of NOT receiving those benefits (and to prevent the possibility of potential harm).
As with any substance, whether natural or man-made, if it is used improperly it raises the risk for adverse events or side effects. For instance, everything has negative side effects if consumed at toxic levels, or for long enough.
Generally, the toxicity of a substance is dose/time-dependent. Excessive doses, for instance, are more likely to result in side effects of nutritional supplements. This is analogous to experiencing adverse events from a deficiency of certain vital nutrients.
If there is a deficiency of a particular nutrient it can directly lead to cellular dysfunction, with systemic detrimental ramifications, such as impaired immunity (Chandra, 1988).
The most common reasons for nutrient deficiencies are a lack of nutrient intake by way of a poor diet, and factors that damage and drain vital nutrients (e.g., pollutants, pesticides, toxins, drugs).
Nutritional deficiencies are not just created by a lack of nutrition or the exposure to poisons. Nutrient deficiencies (e.g., mineral deficiencies, vitamin deficiencies) are one of the possible negative side effects of food supplements.
The culprit? Adverse physiological dietary supplement interactions.
For instance, an excess of certain vitamins or minerals can invoke a deficiency of other essential nutrients (Watts, 1990) which can result in cellular dysfunction and in vitamin side effects. And certain nutrient deficiencies can promote excessive levels of other nutrients which also could contribute to adverse physiological events (Watts, 1990).
To quote David L. Watts, PhD, noting about minerals:
“[...] a deficient intake of an element can allow toxic accumulation of another element.” (Watts, 1990)
Here are a few examples that demonstrate the interrelationship of various nutrients, and the potential hazard from biological dietary supplement interactions.
High calcium intake depresses zinc, while high zinc levels can decrease copper levels (Watts, 1990). Low copper utilization leads to an accumulation of iron stores (Prasad, 1978; Watts, 1991). To correct an iron-deficiency anemia it may require more than just supplemental iron, but also calls for additional vitamin A, C, and B6 (Watts, 1990 & 1991).
High vitamin D levels, by increasing calcium utilization, can depress magnesium and potassium absorption (Hathaway, 1962).
High levels of vitamin E may induce a deficiency of vitamin A because of an interference with the absorption of beta carotene –a vitamin A precursor, a.k.a provitamin A (Watts, 1991).
This leads us to another area of potential problems with supplements...
Essential nutrients, such as vitamins, minerals, enzymes, and hormones, work synergistically or cooperatively with each other. That means that they interact with each other in a symbiotic, complimentary, mutually enhancing, "orchestra-like" fashion if they are within certain ranges of ratios (Nègre-Salvayre, et al., 1991; Niki, et al., 1995; Pal, et al., 2009; Yeum, et al., 2009; Johansson, et al., 2010).
This means that some of the best dietary supplements are multivitamin-mineral supplements (“multivitamins”).
The piecemeal fashion approach to supplementation increases the possibility that deleterious antagonistic relationships form among substances, which can lead to experiencing side effects of dietary supplements.
A study showed that the consumption of one or a two single-nutrient supplements can stimulate the growth of cancer cells while the use of a multivitamin, at the same doses, inhibited the growth (Prasad & Kumar, 1996).
To give a specific example, the (longterm) use of tryptophan supplements can invoke various types of disturbing health problems, as I described in Tryptophan Side Effects: L-Tryptophan Is Far From Harmless.
Generally, the risk of multivitamin side effects is smaller compared to the risk of adverse events from single element supplements.
Another study (Prasad, et al., 1994) documented and indicated that the use of a multiple-nutrient supplement (multivitamin) is more effective in the inhibition of human skin cancer growth than the use of a few single-element supplements (the nutrients individually had not effect on the growth of the cancer cells).
Conceivably the strongest argument for the intake of a comprehensive multivitamin supplement is the fact that different nutrients (e.g., vitamins, minerals) have different mechanisms of action and function at different biological targets within the organism (Prasad, et al., 2001).
Unsurprisingly, Kedar N. Prasad, PhD, and his collaborators declared that:
“[...] use of individual antioxidants alone for any health benefit on a long-term basis has no scientific rationale.” (Prasad, et al., 2001)
Human cells must have many essential nutrients, at sufficient amounts and at physiological beneficial ratios to each other, to function properly.
It follows that, generally, it is biologically reasonable not to take just one or a few single element nutritional supplements in isolation. For example, your supplementation regimen should probably not consist of only a vitamin D and a calcium supplement.
The human body needs a host of nutrients which work in combination with each other.
The discoverer of vitamin B5, Roger J. Williams, PhD, (1893–1988) coined the term “the orchestra principle” to reflect this biological reality (Gerras, et al., 1977).
Therefore, to get most health benefits and to avoid side effects of supplements...
Respect what your body's nutritional requirements are. Give it what it needs.
Use multivitamin supplements, especially high potency multi vitamins. They are safer and also more beneficial than taking one (or a few) single element nutritional supplement (Hoffer & Pauling, 1993). They are among the best health supplements you can take, period!
A comprehensive, high-quality multivitamin-mineral supplement ought to be the foundation of any nutritional supplement regimen. Add single ingredient supplements as your particular health situation demands it.
This basic supplement approach, reflecting your physiological needs, reduces the risk of experiencing negative side effects of dietary supplements, and, at the same time, it enlarges vitamin benefits.
Because lots of people have heard many times about a slew of vitamin C health benefits and, therefore, may have formed the conclusion that there is no such thing as “too much vitamin C”, relatively few people are aware that chewable vitamin C supplements, in the form of L-ascorbic acid, pose a real risk.
One of the facts about vitamin C, or ascorbic acid, is that it is a weak acid. Despite its low corrosion profile, taking chewable forms of vitamin C can, over time, lead to the erosion of tooth enamel, a hardy mineral layer protecting the integrity of your teeth (Hausman, 1989).
Analogously, after drinking orange juice (one of the foods high in vitamin C) or after having a drink made with ascorbic acid powder and water, it would make sense to rinse your mouth with plain water to wash away any of the remaining acid from vitamin C to avoid tooth demineralization.
For the most part nutrients and ingredients used in formulas or compositions of vitamins and health supplements are elements or substances commonly found in food.
What does this mean for you?
Take your supplements when you eat food. Either with a meal or right after a meal.
Supplement ingredients are usually micronutrients, such as vitamins, minerals, enzymes, and so forth. Thus, they're needed in relatively small doses. Food consists primarily of macronutrients, fats, proteins, carbohydrates, and water, requiring larger intakes.
In order for macronutrients to fully work and benefit the cells of the human organism they require micronutrients which act kind of like catalysts or activators of physiological processes that involve macronutrients (Mindell, 1991). By taking nutritional supplements with food you improve the digestion and absorption of both macro-, and micronutrients (Rosenbaum & Bosco, 1989).
Again, respect your body's needs. Obey how your body is used to, or ideally needs to, receive its nutrients. As a whole array or plethora of nutrients, both macro-, and micronutrients.
If you take food supplements on an empty stomach you are more likely to experience certain common side effects of dietary supplements, such as an upset stomach, diarrhea, bloating, and nausea.
Taking your supplements with food minimizes, or prevents, the experience of a number of dietary supplement side effects (Domrongkitchaiporn, et al., 2004).
There are a few exceptions to this guideline but in almost all instances of supplementation this principle is valid. (For more detailed information on how to take vitamins review the article "What's The Best Time To Take Vitamins & Nutritional Supplements?").
To prevent potential adverse side effects of nutritional supplements adhere to the recommended intake as stated on the product label. Generally, do not exceed product recommendations.
However, under certain circumstances and depending on your individual health status higher dosages are called for to achieve a desired result.
When you start out with a dietary supplement regimen, or when you introduce a new product to your existing supplementation program, start with a lower daily dose than what is recommended on the product label.
Stay at a lower dose, maybe at half or at a third of the total recommended dosage, and stay with it for a few days. Then, gradually, increase the dose until you are at the full recommended daily dose according to the supplement product label.
This is another precautionary step which helps you to avoid potential negative effects of dietary supplements. After all, certain substances in supplements (e.g. vitamin C or magnesium), especially at certain intake levels, exert a detoxifying action in the body which could lead to transient, usually minor, adverse reactions. By starting a nutritional supplement program slowly, and building it up gradually, you can minimize or avoid such unwanted events.
Ironically, one of the side effects of the improper use of nutritional supplements is not receiving benefits.
The body can only experience benefits from supplements if it is allowed to or given a chance to do so. That is, if you respect and adhere to your body's nature of remodeling and maintaining itself.
The human body is getting continuously renewed or “rebuilt” from essential nutrients. A continuous supply of these vital elements is critical for optimal physiological functioning and performance (e.g., the heart doesn't take a “vacation” from beating regularly and consistently). This calls for continuous (daily) supplementation, not a haphazard routine.
Although the human organism is in a constant “state” of change it does require a certain time span (a few to many months) for a significant or complete regeneration of its physiology. The remodeling requires both macro-, and micro-nutrients.
One-time or occasional intakes of nutritional supplements violates this principle of duration and the nature of regeneration and may even hamper the body's intent for regeneration.
Because the body needs both time, energy, and adequate nutritive resources to rebuild itself, health gains, generally, do not become apparent overnight.
Long-term, consistent supplementation is the biologically-sound approach to avoiding the surrender of health gains.
Experimental studies, for instance, have demonstrated that the one-time application of low-dose antioxidants protect cancer cells from subsequent treatment with radiation therapy while the daily intake of high doses of the same antioxidants over an extended time frame enhances, in conjunction with the therapy, the killing of cancer cells (but not of healthy cells) and reduces the radiation damage on healthy cells (Prasad, 2004).
If you review the numerous studies showing outstanding vitamin benefits, such as a reduced risk of cancer and mortality, discussed in another article of mine at 2 Big Lies: No Vitamin Benefits & Supplements Are Very Dangerous, some core principles of supplement use become evident:
This will greatly assist you in avoiding one of the greatest "side effects of dietary supplements": no benefits.
If you're under medical care tell your doctor about all the nutritional supplements you're taking. Certain types of supplement ingredients, particularly herbs and other botanicals, can interact deleteriously with a number of prescription drugs. Some nutrients, because of their specific physiological effects, could lead to complications during or after surgery. (More details at Facts About Dietary Supplements: Supplement-Drug Interactions).
This particular guideline should really be named how to avoid side effects of prescription drugs, rather than how to avoid side effects of dietary supplements. But I'm including it here because a lot of people are on prescription drugs and routinely take over-the-counter (OTC) medications and are not aware of this significant danger.
Pharmaceutical drugs are inherently toxic to the human organism largely because they are not biologically-innate substances. That is, drugs are not elements your body needs for health and life –unlike vitamins, minerals, and amino acids, for example.
A lack of health is not because of a lack, or deficiency, of drugs floating through your body.
As a matter of fact, drugs tend to deplete or destroy essential nutrients inside your body. This creates nutritional deficiencies which leads to adverse events or side effects.
On the other hand...
The majority of supplement ingredients are inherently safe because they are innate substances essential to keep your body healthy and alive.
A lack of health, especially the affliction of chronic diseases, more often than not is because of a lack, or deficiency, of essential nutrients.
It follows that the magnitude of damage, both in frequency and severity, caused by drugs with their destructive impact on vital nutrients of the body, is multiple times larger than the harm inflicted by supplement ingredients on pharmaceutical drugs.
The difference is like night and day.
Therefore, the crux of research data suggests (for more in-depth information about drug-induced nutrient depletion review the aforecited piece "Facts About Dietary Supplements: Supplement-Drug Interactions") it would be very prudent to take certain nutritional supplements while taking pharmaceutical medications or OTC drugs. Specifically, those types of supplements that provide essential innate nutrients, such as vitamins, minerals, and amino acids.
This minimizes or prevents drug-inflicted side effects and other health issues while at the same time assists in regaining your health. This plan of action is particularly pressing when your medical situation demands hospitalization.
But... don't be surprised if your doctor doesn't agree to this.
In my article What Are Nutritional Supplements? Information You MUST Know! I provided research documentation showing that medical doctors are poorly educated about nutritional supplements. And things we don't know about, things we are unfamiliar with, we tend to reject.
One of the central facts about nutritional supplements and side effects is that the majority of all adverse events, both minor and major, are the result of unintentional overexposures by infants and very young children up to about six years of age (American Association of Poison Control Centers, 1983-2008; Bronstein, 2009 & 2010).
Although there are very few cases of major injury every year (American Association of Poison Control Centers, 1983-2008; Bronstein, 2009 & 2010), keeping nutritional supplements inaccessible to infants will practically fully eliminate this health risk with dietary supplements.
preservation of health is a duty. Few seem conscious that there is
such a thing as physical morality." (Herbert Spencer, 1820-1903,
Numerous scientific papers have documented that people justify to themselves, rationalize, or give themselves permission to engage in a “bad” deed after they've done a “good” deed. Scientists call this “the licensing effect”.
In regards to nutritional supplements it has been found that people who take vitamins and health supplements perceive themselves as invulnerable to health challenges and, as an ironic consequence, neglect to engage in other health-promoting behaviors (Chiou, et al., 2011). This could mean, for example, that (some) supplement takers may exercise less or eat poorly.
Yet, keep in mind that “the licensing effect” is also common in many other instances, such as with people who take prescription medications. For instance, some people on cholesterol-lowering drugs (CLDs) may "justify" their choice of more frequently eating a slice of a triple-layer cake on the basis that their cholesterol-lowering medications will "undo" or "negate" the potential harm of the "forbidden" food.
In fact, such a trend has been registered in the medical literature with people who were taking cholesterol-lowering statin medications (“statins”). Statin drug users indulged in more gluttony –they consumed more calories and fat, and gained weight– than non-statin users (Sugiyama, et al., 2014), presumably because they mistakenly believed that they could practically eat whatever they wanted since they were “protected” by taking these medications. (Topping negligence with irony, the real evidence on statins shows that they do little good but lots of harm –see my article Do Garcinia Cambogia Side Effects Boost Diabetes?).
The licensing effect creates a trap. A self-constructed “trap of misconception”. The errors of the delusion are that just because you're doing one thing right health-wise doesn't means you're “bullet-proof” against ailments or health issues, and that you can now disregard other health-promoting habits, or that it doesn't matter whether you now engage in health-destructive activities.
The potential undesirable ramifications from the licensing effect suggest that, apart from consuming nutritional supplements, it takes a conscious effort not to neglect other activities and behaviors that support good health (as Spencer said: "The preservation of health is a duty.").
After all, many factors significantly influence whether you have good health or not. Taking nutritional supplements is only one part of the health equation, albeit it is an exceedingly important pillar of wellness.
So, the irony is that taking nutritional supplements can cause you to mistreat your health in other important ways, which, of course, could lead to a deterioration of your overall health. The smooth-sailing illusion of the licensing effect does make taking these health products, by association, another one of the potential side effects of dietary supplements.
(Originally published: ca. July-2012 | This is an updated version)
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