Perhaps you’ve heard this a time or two? Eat right, exercise, get plenty of sleep and…take your vitamins. Americans believe in their vitamins. We have entire stores and quite big ones at that dedicated to the belief that we can protect our skin, our brains, our colons, our hearts, and our bones by taking supplements or vitamins to take the place of the dietary needs we are missing out on in our fast-paced world. We do so by handing over $28 billion each year to the U.S. Vitamin and Supplement Industry and we do so in droves.

The National Center for Health Statistics estimated in 2011 that 53 percent of American adults used some type of supplement in the years 2003 to 2006. And we did so with an almost childlike belief that those bottles of purified health will do as they claim or at the very least be safe. Neither of which is always the case as is pointed out in this New York Times opinion piece by two health care providers from Philadelphia’s Children’s Hospital.

The Food and Drug Administration (FDA) does not regulate dietary supplements as drugs. Those unregulated items do not have to prove safety or effectiveness but we do know that they aren’t necessarily safe. In 1962, the FDA attempted to require the following disclaimer on vitamin supplements: “Vitamins and minerals are supplied in abundant amounts by commonly available foods. Except for persons with special medical needs, there is no scientific basis for recommending routine use of dietary supplements.” by the 1970s, hearings, legal battles and the Proxmire Amendment virtually negated the FDA’s mission of protecting the American public from dangerous doses of vitamins and eliminated much of any warnings the FDA might have required on labels.

With or without the warnings, in trials, some supplements such as beta-carotene, vitamin E, and high doses of vitamin A were linked to increased risk of premature death. The FDA estimates that approximately 50,000 adverse reactions to dietary supplements occur each year. And now at least one study is more than suggesting, it’s stating emphatically that they aren’t effective either. “Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided,” say the study’s researchers. The study was published this month in the Annals of Internal Medicine under the heading “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” Here’s an article about two additional studies making the same claim.  Here’s a softer take but still holding that supplements may cause more harm than good.

Whether we want to see them as a drug or not…whether they get regulated as drugs or not, the authors of the opinion piece wrote, “until the FDA has the political backing and resources to regulate them like drugs, individuals should steer clear.”

The studies looked at people who took multivitamins or other supplements for long periods of time (in at least one study for 12 years) and found no difference between the supplements and placebos but there are exceptions. All of the studies looked at individuals without deficiencies. If you’ve gone to your doctor and had tests run and the tests come back that you are deficient in something, you should follow your doctor’s advice including taking supplements in the correct dosage. In addition, doctors still believe that pregnant women should take folic acid for preventing birth defects and the jury is still out for vitamin D which may actually prevent falls in older adults. You can find out more about the studies here.

Just as you shouldn’t self-diagnose for heart disease, you shouldn’t self-diagnose for vitamin C deficiency or choose to take ginkgo biloba without having a conversation with your physician. Even if you choose to stand back and wait to see if future studies will uphold these current studies, you should always let your doctor know of any supplements or vitamins you are taking so that your doctor can determine if they might interfere or react poorly with any prescription drugs you are taking.  And of course if you are going to take any drug or supplement, take the time to learn about it, about its side effects and effectiveness.  Your doctor is part of your health care team but it’s a partnership that requires you as well.

It can be difficult to know when a supplement is a supplement or if it is a food. Supplements must be labeled as such and contain one or more “dietary ingredients.” The “dietary ingredients” in these products may include

• vitamins
• minerals
• herbs or other botanicals
• amino acids
• other substances found in the human diet, such as enzymes

Conventional food items have a nutritional label. Dietary supplements have a supplement facts panel.