“Safe and natural.” It’s a marketing phrase attached to dietary supplements that’s often accepted as self-evident. The marketing works. Supplements have a strong health halo. But evidence suggests that this reputation may be undeserved. Not only are there continued questions about whether most supplements have any health benefits whatsoever, there is also evidence that they can be harmful.

With the help of an expert panel of independent doctors and dietary-supplement researchers, Consumer Reports identified 15 supplement ingredients that are potentially harmful. The risks include organ damage, cancer, and cardiac arrest. The severity of these threats often depends on such factors as pre-existing medical conditions as well as the quantity of the ingredient taken and the length of time a person has been exposed to the substance.

Many of the ingredients on this list also have the potential to interact with prescription and over-the-counter medications, such as cholesterol-lowering statins and blood-thinning drugs like aspirin and warfarin (Coumadin and generic).

Reducing the risk
If you don’t look for it, you won’t find it. And if you set the system up to minimize the likelihood of finding harm, it should be no surprise that supplements are not associated with a lot of safety concerns or reports. Given the way this data was assembled, it’s not possible to estimate a relative risk of harm, or even assess the any change in incidence of liver damage associated with supplements. But it should put to rest any claims that supplements are without harm. Even more troubling, it doesn’t look like there’s any way to avoid the risk of supplement harms, unless you decide to avoid them completely. There’s no question that drugs can cause liver problems, and they do so with more frequency than supplements. But these harms are not related to widespread product contamination – a risk that is very real, and difficult to avoid, with any dietary supplements sold today. Until regulations are tightened, I don’t expect manufacturers to do much to improve the quality of their products. Which is unfortunate, because until we can consistently trust what’s on the label, it’s going to continue to be hard to accept dietary supplements as either safe or effective.

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