An FDA guide to dietary supplements

FDA Consumer, Sept-Oct, 1998 by Paula Kurtzweil

"The majority of supplement manufacturers are responsible and careful," FDA's Yetley says. "But, as with all products on the market, consumers need to be discriminating. FDA and industry have important roles to play, but consumers must take responsibility, too."

Supplements Associated With Illness and Injuries

NAME                          POSSIBLE HEALTH HAZARDS

Herbal Ingredients

Chaparral                     liver disease, possibly irreversible
(a traditional American
Indian medicine)

Comfrey                       obstruction of blood flow to liver,
                              possibly leading to death

Slimming/dieter's teas        nausea, diarrhea, vomiting, stomach
                              cramps, chronic constipation,
                              fainting, possibly death (see
                              "Dieter's Brews Make Tea Time a
                              Dangerous Affair" in the July-August
                              1997 FDA Consumer)

Ephedra                       ranges from high blood pressure,
(also known as Ma huang,      irregular heartbeat, nerve damage,
Chinese Ephedra and           injury, insomnia, tremors, and
epitonin)                     headaches to seizures, heart attack,
                              stroke, and death

Germander                     liver disease, possibly leading
                              to death

Lobelia                       range from breathing problems at
(also known as Indian         low doses to sweating, rapid
tobacco)                      heartbeat, low blood pressure, and
                              possibly comma and death at higher
                              doses

Magnolia-Stephania            kidney disease, possibly leading to
preparation                   permanent kidney failure

Willow bark                   Reye syndrome, a potentially fatal
                              disease associated with aspirin intake
                              in children with chickenpox or flu
                              symptoms; allergic reaction in adults.
                              (Willow bark is marketed as an
                              aspirin-free product, although it
                              actually contains an ingredient that
                              converts to the same active ingredient
                              in aspirin.)

Wormwood                      neurological symptoms, characterized
                              by numbness of legs and arms, loss
                              of intellect, delirium, and paralysis

Vitamins and Essential
  Minerals

Vitamin A                     birth defects, bone abnormalities,
in doses of 25,000 or         and severe liver disease
more International
Units a day

Vitamin [B.sub.6]             balance difficulties, nerve
in doses above 100            injury causing changes in touch
milligrams a day              sensation

Niacin                        range from stomach pain, vomiting,
in slow-released doses        bloating, nausea, cramping, and
of 500 mg or more a day       diarrhea to liver disease, muscle
or immediate-release doses    disease, eye damage, and heart
of 750 mg or more a day       injury

Selenium                      tissue damage
in doses of about 800
micrograms to 1,000 mcg
a day

Other Supplements

Germanium                     kidney damage, possibly death
(a nonessential mineral)

L-tryptophan                  eosinophilia myalgia syndrome,
(an amino acid)               a potentially fatal blood disorder
                              that can cause high fever, muscle
                              and joint pain, weakness, skin rash,
                              and swelling of the arms and legs