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Dietary Supplements Harmful or Helpful

Cummings School of Veterinary Medicine Tufts University

Currently, over half of all Americans take dietary supplements on a regular basis, accounting for 15 billion dollars in sales per year. In one study of pet owners, approximately 10% of all dogs and cats were receiving dietary supplements. In magazines for pet owners and veterinarians alike, advertisements for dietary supplements abound. While it is tempting to believe the claims of disease prevention, treatment, or cure that are supposed to come from giving a few pills, knowing the real facts about supplements can help to determine which ones might be useful, which ones are useless, and which ones actually can be harmful.

First, it is important to understand that dietary supplements are regulated very differently from drugs. Under the Dietary Supplement Health and Education Act (DSHEA) of 1994, dietary supplements do not require proof of safety or efficacy before marketing. In addition, only going into effect in 2008 (2009 for smaller companies) are FDA regulations regarding good manufacturing practices. The current regulations can result in uncertain quality control and raise questions regarding issues of safety, efficacy, appropriate dose, and pharmacologic properties, such as bioavailability and dissolvability. In fact, while drug manufacturers must prove the drug to be safe and effective, the FDA must prove that a supplement is unsafe. It is easy to imagine that with the thousands of supplements on the market today, this is an unrealistic task for the FDA. Therefore, the safety, quality control, and effectiveness of dietary supplements can be questionable. Although dietary supplements are thought to be safe because they are “natural,†this is not necessarily so. Every year, many people have significant side effects or even die as a result of dietary supplement use so safety is not a given. What safety data is known is often known only for people. Even if the supplement by itself is safe, its use in combination with medications an animal may be taking can cause problems by decreasing the effectiveness of the medication or by increasing its toxicity. In addition, numerous studies have shown little consistency in quality control (ie, a tablet that is supposed to contain 500 mg may contain 500 mg but also may contain more or less than that amount). Some supplements may be contaminated (eg, fish oil supplements may contain high levels of mercury) and other issues, such as bioavailability and dissolution, can have a huge impact on the efficacy of the supplement.

Another major problem is that even if the safety and quality control issues were not an issue, there are few dietary supplements for which efficacy has been proven. Most supplements in veterinary medicine are used based on theory, on anecdote, or on data from other species. Properly conducted studies are few and far between for dietary supplements. Clearly, more research is needed in this area to determine which of the supplements have beneficial effects and which are a waste of money. In veterinary medicine, an additional difficulty is that the optimal (or even safe) dose is often not known and doses are empirically based on the amount given to a person. Therefore, a patient may be receiving either too high a dose and is at risk for toxicity or may be receiving too low a dose to have any potential benefits.

General supplementation of pets is unnecessary because the majority are eating a nutritionally balanced commercial pet food. Animals on unbalanced homemade diets are at high risk for nutritional imbalances but a general multivitamin supplement will not solve this problem. Owners who wish to feed homemade diets to their pets should contact a veterinary nutritionist who can formulate an individualized, nutritionally balanced diet.

Dietary supplements often are administered in various health conditions. However, the concerns about supplements mentioned above are as important, if not moreso, than in healthy animals. Because the use of dietary supplements is becoming more common, it is important if you are giving them to your pets. Owners often do not consider dietary supplements to be either a part of the diet or a medication so may not offer the information unless specifically asked. Once you find out what owners are giving their pets, you may then need to gather additional information. Since there is little governmental regulation over dietary supplements, pet owners should consider selecting dietary supplements for their pets (and themselves) that have the Dietary Supplement Verification Program (DSVP), which tests supplements for ingredients, concentrations, dissolvability, and contaminants.

For general information on dietary supplements and to determine which supplements are safe, what doses might be appropriate, and which have been tested for quality control, you might find the following websites/resources useful.

www.aafco.org

www.nas.edu/nrc/


www.consumerlab.com
http://vm.cfsan.fda.gov/~dms/supplmnt.html


http://www.mayoclinic.com/health/druginformation/DrugHerbIndex
http://nccam.nih.gov


http://dietarysupplements.info.nih.gov
www.quackwatch.org


http://www.nal.usda.gov/fnic/etext/000015.html