Pills and Protections

I have a friend here who is very into nature and natural solutions. That’s good, in some ways! I like that she’s environmentally conscious and she eats a lot of salads, which seems very healthy to me. But the other day, I was in here room and saw a lot of bottles (like a dozen or more) of all kinds of supplement pills and “natural” health pills. She’s taking a lot of pills every day, and I don’t really know if any of them are safe (I feel pretty sure that none of them are doing any good, so I’m mostly just wondering if any are doing anything bad). How dangerous is it to take all of these supplements? There were no prescriptions or “real” medicines in the whole bunch.

In the United States, the agency responsible for regulating the natural supplements your friend is taking is the same agency that regulates the food industry and the pharmaceutical industry. We’re talking about the FDA, of course: the Food and Drug Administration. They regulate a whole lot of things, but we’ll look more carefully at just a few in a moment.

The natural supplements that your friend is taking are not heavily regulated. To understand why, we should look briefly at some products that are heavily regulated: medicines and prescription drugs. The FDA has fairly stringent guidelines for pharmaceuticals, say the consultants at pharmaceutical product consulting firm Global Regulatory Partners. Companies that research and develop new drugs have to spend a little extra to get to the finish line, jumping through regulatory hoops along the way--and while companies and the FDA don’t always agree on exactly what’s necessary, the general idea is that we, as consumers, end up better protected. When a company makes a drug with potentially dangerous ingredients, or when a company wants to claim its product cures something, it has a lot of work to do to convince the FDA.

But that’s not true of all products. Foods don’t have to be proven this way--if you start a new company that makes cakes, you don’t have to put those cakes through clinical testing. The FDA just wants you to do basic things like be honest about what is in the cakes. On the scale between medicines and foods, your friend’s supplements fall somewhere in between--closer, perhaps, to food than to medicine in terms of the FDA’s regulatory reach.

Does this mean that supplements are dangerous? Not necessarily, say the pros behind Ephedra diet pills. If a company wants to use a new ingredient in a supplement, there’s an approval process for that--so natural supplements have to rely on things we already know are fairly safe.

Some supplements--like daily multi-vitamins--are clearly harmless and probably good for you. Others are less self-evidently useful. The danger in your friend’s routine is probably not found in any one supplement: it's found in the amount and combination she is taking. The FDA warns that combining supplements is dangerous, and your friend should absolutely speak to a medical professional about the pills she is taking.

“Let food be thy medicine and medicine be thy food.” -- Hippocrates