On Monday night, the ABC’s Four Corners program raised some serious concerns regarding the safety of dietary supplements. And I am really glad that they did. Supplement safety is an issue that needs to be discussed.

The safety issue

It is important to note that the investigation that was aired on the Four Corners program is based almost entirely on dietary supplements from the United States, which is overseen by the Food and Drug Administration (FDA). In Australia, therapeutic supplements are strictly regulated and monitored by the Therapeutic Goods Administration (TGA). For therapeutic supplements to be approved and listed by the TGA in Australia, they undergo rigorous safety assessments. The manufacturing facilities must also comply with strict standards and are required to hold a Good Manufacturing Practice (GMP) license.

Comparing the TGA to the FDA is like comparing apples to oranges, they are remarkably different. As highlighted in the Four Corners program, the FDA does not have strict regulatory standards for the quality and safety of supplements. Unfortunately, the program did not elaborate on the strict TGA standards for Australian therapeutic supplements. The majority of safety issues associated with American supplements, do not necessarily apply to products listed by the TGA. However, this conversation does not end here.

The world of online supplements

We literally have the world at our fingertips. From our laptops, desktops, smart phones and tablets, we can purchase products online, at any time of the day. Supplements and other health products included. And while it is more convenient (and often much more economical) to purchase supplements from overseas websites, if these products are not assessed by the TGA, then you cannot be assured of their quality, let alone their safety. If you are buying supplements online, look for an AUST-L number on the product. This means it is a TGA listed product.

The self-prescription nutritional, herbal and even hormonal supplements is another serious issue in the online supplement market. Particularly if those products are not at all regulated in terms of ingredients used, dosages used and manufacturing processes. If a substance (nutrient, herb, hormone or drug) is not available over-the-counter in Australia, then it is likely to be deemed unsafe or it requires professional prescription and supervision.

The dangers of supplements

There seems to be this idea that because something is natural, or naturally derived that is it completely harmless. This is simply NOT TRUE! The dose makes the poison. Medications, supplements, and even foods can also interact with one another. Medications are most commonly affected by interactions, and may become either more or less effective. This, in addition to issues mention above, is where supplements can become dangerous.

Most of what we ingest needs to be processed in some way by the liver. If we inundate our liver with substances it needs to breakdown, we run the risk of causing significant damage. Nutrients and herbal medicines are not exceptions, and in excessive dosages may cause damage to the liver and other organs.

What about antioxidants? Surely these antidotes to aging are safe? Well, not exactly. Research has shown that high supplemental doses of antioxidants can actually promote the growth and spread of cancer cells. It is also important to know that antioxidant supplements can interfere with chemotherapy drugs, reducing their efficacy. If you are undergoing treatment for cancer, please always check with your specialist that it is safe to take supplements. Antioxidant intake through whole foods is generally ok, however juicing may not be. Again, this is a conversation to have with your specialist.

Do we even need supplements?

It was not so subtly noted by some of the interviewees that according to the research, supplements don’t work and are a waste of money. I disagree.

There is definitely research to show that various nutritional and herbal supplements are effective in specific conditions. However, it is difficult to determine that a specific nutrient or herb is or isn’t effective in very large, controlled studies as we all have very individual biochemical and genetic makeups. Nutrients also have co-dependent relationships with one another, so a lack of one nutrient may impact on several others. There are just so many variables in nutrition research.

As a naturopath, I see the diet as the foundation for good nutrition. However, correcting the diet and nutritional deficiencies does take time. I find that the short-term and appropriate use of supplements can provide tremendous support for my patients. When prescribing for patients, I look at two things — the needs of the patient sitting in front of me and the research. The products that I do prescribe are TGA listed products and I generally spend a substantial amount of time sifting through the research to make sure that the prescription is safe and efficacious for that patient. This is probably not the best business model, but the safety of my patient and the general public is my main priority.

View references

Four Corners Episode – Supplements and Safety
http://iview.abc.net.au/programs/four-corners/NC1604H016S00

Using supplements? You need to keep these things in mind
http://www.abc.net.au/news/2016-05-16/supplements-what-you-need-to-know/7408972

What does TGA approval of medicines mean?
http://www.australianprescriber.com/magazine/27/6/156/8/

The TGA – Who we are & what we do
https://www.tga.gov.au/who-we-are-what-we-do

UT Southwestern Medical Center. “Antioxidant use may promote spread of cancer.” ScienceDaily. ScienceDaily, 14 October 2015.
<www.sciencedaily.com/releases/2015/10/151014134537.htm>

Antioxidants may make cancer worse
http://www.scientificamerican.com/article/antioxidants-may-make-cancer-worse/


 

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Sarah Woolner

I’m Sarah — a qualified naturopath and food enthusiast. I am currently practicing on Sydney's Northern Beaches, in Brookvale and Mosman. If you would like to make an appointment please send me an email via the contact page.

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