Natural Supplements Pharmacology in VA and MD
Explain how diet and nutrition, including the use of dietary, herbal, and over-the-counter supplements, can affect the efficacy and safety of prescribed medications. Examine data on the effect of dietary supplements and dietary interventions on mortality and cardiovascular outcomes in adults. Side effects of drugs in clinical practice, especially those related to nutrition, should be reported spontaneously, and particular attention should be paid to accounting for malnutrition, general nutritional status, and dietary supplements used (Peter et al., 2017). The impact of some medications on eating habits and nutritional status is well documented (Lappin et al., 2018; Little, 2018).
In particular, 75% of veterans, like the general population, have been shown to have taken vitamins and supplements, and 18% to have changed medications (US Food and Drug Administration, 2008). According to a website report (US Food and Drug Administration, 2008), many patients take vitamins and supplements in addition to or instead of prescription drugs (nearly one in five Americans). Although nutritional supplements are considered in polypharmacy malnutrition (Gaddey and Holder, 2014), another phenomenon that should not be underestimated is the trend towards the use of vitamins and nutritional supplements instead of prescription drugs. In the United States, especially among veterans, there is a tendency to use vitamins and supplements, which are the most common form of complementary and alternative medicine (CAM) currently used (Goldstein et al., 2014).
In Australia, most dietary supplements fall into the complementary medicine category, which includes vitamins, minerals, herbal, aromatherapy and homeopathic products, although some products may be considered specialty products and regulated by the Food Administration . Terms may include “nutritional supplements,” “herbal teas,” “natural products,” and “vitamins.” They apply only to supplements containing vitamins and/or minerals, provided that these products are regulated as foods and address the ingredients of the supplement, including their safety, purity, and bioavailability.
According to the U.S. Food and Drug Administration, a dietary supplement is any product that contains nutrients, such as vitamins, minerals, or herbs, and is intended to supplement the diet. Patients may find nutritional supplements natural and harmless. They may not mention their use to professionals involved in treatment.
The survey also collected respondents’ views on whether these nutritional supplements and complementary drugs should be more strictly regulated by the Food and Drug Administration (FDA). The survey collected information about the health status of the respondents, the different types of nutritional supplements or complementary medicines used, the effects tested, future use considerations, and possible recommendations for others to use these products. It should be noted that naturally occurring DHEAS and not additives were measured in the experiment. CGMP for dietary supplements will also help ensure the consumer that the supplement they are purchasing contains what is listed on the label, including the amounts of various ingredients and the purity of the products. Thus, with this provision available in the “current DSHEA, the FDA has requested CGMP Supplement Scheme in November 1995 by the dietary supplement industry contributions to these CGMPs such as the healthcare community and consumers.
The Dietary Supplements, Health and Education Act of 1994 allows claims to be placed on herbal products stating their intended effect on the body’s structure or function (e.g. reducing fatigue) or their effect in improving overall health (e.g. improving mood or cause). Analysis of some of the purported effects of herbal products shows that they are sometimes very similar to clinical efficacy claims for various diseases or conditions. To date, there is no generally accepted process for ensuring that supplements contain the directions on the label. It’s very risky to assume that because a supplement is “all natural” it won’t cause side effects.
In some cases, excessive intake of vitamins and minerals can be harmful or cause unwanted side effects; therefore, maximum levels are needed to ensure its safe use in dietary supplements”. All intakes of calcium from the diet and supplements should be taken into account to avoid overconsumption. A nutritional history assessing intake of calcium-rich vegetables and dairy products can provide useful information for supplementation guidance.
Other nutritional supplements such as vitamin B6, vitamin A, multivitamins, antioxidants, and iron, as well as dietary interventions such as reduced fat intake, did not significantly affect mortality or CVD outcomes (very low to moderate). One found little association between vitamin C intake and risk reduction, and the other found no effect from supplementation. A 2013 Cochrane review found no evidence that vitamin C supplements reduce the risk of lung cancer in healthy people or people at high risk of smoking or asbestos exposure. Regular supplementation trials have shown that vitamin C shortens the duration of the common cold, but this has not been confirmed in the few therapeutic studies that have been done. Given the consistent impact of vitamin C on cold duration and severity in regular supplementation studies, and the low cost and safety, it may be beneficial for patients with a cold to test on a case-by-case basis whether therapeutic vitamin C is good for them. Further research is needed to determine the tolerability of the effects of in vitro nutritional supplements in humans.