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Are supplements really necessary for good health?

When you reach for that bottle of vitamin C or fish oil pills, you might wonder how well they'll work and if they're safe. Before that, the first thing you should be asking yourself is whether you actually need them in the first place.

More than half of all Americans take one or more dietary supplements daily or on occasion. Supplements are available without a prescription and usually come in pill, powder or liquid form. Common supplements include vitamins, minerals and herbal products, also known as botanicals. People take these supplements to make sure they get enough essential nutrients and to maintain or improve their health, but not everyone needs to take supplements.

For most people, it's feasible to get all the essential nutrients needed for a good diet by eating a variety of healthy foods on a regular basis, but supplements do serve the purpose of filling in gaps that some might find in their diet.

Unfortunately, some supplements may have side effects, especially if taken before surgery or with other medicines. Supplements can also cause problems for those with certain health conditions, and the effects of many supplements haven't been tested in children, pregnant women and other groups. For these reasons, it's important to talk with your health-care provider if you're thinking about taking dietary supplements.

The U.S. Food and Drug Administration (FDA) regulate dietary supplements as foods, not as drugs. What this means is that the label may claim certain health benefits, but unlike medicines, supplements can't claim to cure, treat or prevent a disease. Though there's minimal evidence that any supplements can reverse the course of chronic diseases, evidence does suggest that some supplements can enhance health in different ways. The most popular nutrient supplements are multivitamins, calcium and vitamins B, C and D. Calcium supports bone health, and vitamin D helps the body absorb calcium, while vitamins C and E are antioxidants-molecules that prevent cell damage and help to maintain health.

Women need iron during pregnancy, and breastfed infants need vitamin D. Folic acid-400 micrograms daily, whether from supplements or fortified food-is important for all women of childbearing age. Vitamin B12, which comes primarily from meat, fish and dairy, keeps nerve and blood cells healthy. Research also suggests that fish oil can promote heart health. Of the supplements not derived from vitamins and minerals, fish oil has been supported by scientific evidence more than any other supplements.

The health effects of some other common supplements need more study. These include glucosamine (for joint pain) and herbal supplements such as Echinacea (immune health) and flaxseed oil (digestion). Many other supplements have mild effects but with few risks, so they should be used with caution. Vitamin K, for example, will reduce the ability of blood thinners to work, while Ginkgo biloba can increase blood thinning. The herb St. John's wort is sometimes used to ease depression, anxiety or nerve pain, but it can also speed the breakdown of many drugs-such as antidepressants and birth control pills-and make them less effective.

Something else to keep in mind is the fact that just because a supplement is promoted as "natural" doesn't necessarily mean it's safe. The herbs comfrey and kava, for example, can seriously damage the liver. For vitamins and minerals, check the % Daily Value (DV) for each nutrient to make sure you're not getting too much.

Scientists still have much to learn even about common vitamins. One recent study found unexpected evidence about vitamin E. Earlier research suggested that men who took vitamin E supplements might have a lower risk of developing prostate cancer, but a recent large-scale study found that vitamin E actually increased risk for the disease instead of reducing it. That's why it's important to conduct clinical studies of supplements to confirm their effects.

Because supplements are regulated as foods, not as drugs, the FDA doesn't evaluate the quality of supplements or assess their effects on the body. If a product is found to be unsafe after it reaches the market, the FDA can restrict or ban its use. Manufacturers are also responsible for the product's purity, and they must accurately list ingredients and their amounts, but there's no regulatory agency that makes sure that labels match what's in the bottles. As a result, you risk getting less, or sometimes more, of the listed ingredients. Sometimes all of the ingredients may not even be listed.

A few independent organizations conduct quality tests of supplements and offer seals of approval. This doesn't guarantee the product works or is safe, but it does assure that the product was properly made and contains the listed ingredients.

Avoid any potential risks and play it safe by doing your research and consulting your health-care professional about any supplements you're taking now or thinking about taking before doing so. Remember that while certain supplements might claim to improve your body in one way or another, most times they should be taken with a grain of salt before solid evidence is found to support them.

Also keep in mind that the safest alternative to supplements for any bodily pain you might be experiencing is to see a physical therapist, who can create a personal program to help you improve upon any physical issues and live a more enjoyable life.

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