Dr. Mark Kestner: Natural supplements can create severe complications - Main Street Media of Tennessee

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Kestner

Natural supplements can sometimes be very beneficial for a wide range of health conditions.

They are called supplements because they are elements that would normally be in our diet, but for various reasons it can be a good idea to "supplement" or add to our diet. This leads to taking the isolated nutrient in a pill, capsule, powder or liquid form as an additional nutrient source for our body.

People sometimes misinterpret the concept of a natural dietary supplement. They read about the so-called benefits of a supplement in a popular information source such as a magazine, or more likely the internet.  Their thinking tends to include thoughts such as "It's all-natural so it can't hurt me" or "It looks like this will miraculously help my __________ problem."

Dietary supplements are not regulated like drugs. While this makes the products more accessible to the public, it can open doors to errors, abuse and misuse.

I often tell patients, "You and I could put sawdust in a capsule, label it and sell it as whatever we wanted to … and get away with it for a long time." That's because the industry is not watched closely enough.  We as consumers and professionals are totally dependent upon the manufacturers to accurately tell us exactly what is in their product.

While we might think that all manufacturers are competent and ethical enough to maintain a high level of accurate and complete labeling practices, research has demonstrated this just isn't the case.

One recent study completed by the U. S. Drug Induced Liver Injury Network performed chemical analysis of nutritional supplement products. It found that 51% of the 272 products tested contained chemicals not matching the labels.

Another study published in Journal of American Medical Association in July 2023 by Pieter A Cohen, MD et.al., found that a whopping 89% of the 57 "natural products" tested were not labeled accurately.  Some products contained only 0.02% of the labeled ingredient being tested, while others had up to 334%. 

Worse, several products illicitly contained chemicals that are illegal. Five substances banned by the FDA were discovered in the products and 12% of the products contained banned chemicals.

Other concerns arise when taking some natural supplements, even when the product label is accurate.

Some natural dietary products can be toxic when taken in amounts greater than recommended or in combination with other drugs or supplements.

I always consider the possibility of adverse effect of drugs and supplements when evaluating patients. I recently met with a patient who was having unrelenting back pain. He had tried chiropractic care, physical therapy and home exercises. He had tried drugs provided by his primary care provider.

His physical examination revealed excessive tautness and pain in the muscles of his back and legs. His flexibility was restricted for what would be normal for a man of his age and health status.

I began to question him about medications and dietary supplements he might be taking.

This revealed he was taking cholesterol medication and a drug for high blood pressure. This is concerning for this man as cholesterol medications can sometimes cause potentially serious muscle problems. As I reviewed his dietary supplements, I saw that he was also taking an iron supplement. Both the blood cholesterol medication and the iron supplement could be related to his muscle pain.

Iron supplements are sometimes essential for some patients but too much iron can cause problems. If needed, the usual recommended adult male dose of a supplement is only 8 mg. The highest normal safe dose is listed as 45 mg. However, for patients that have been tested and found to be anemic, doses of up to 65 mg three times daily may sometimes be prescribed by their doctor.

Taking these higher doses of iron can cause complications, however.  Iron supplements can cause indigestion, stomach pain, constipation, diarrhea, nausea, vomiting, back pain, muscle pain, chest pain, chills, lightheadedness and fainting, rapid heartbeat, fever, sweating, flushing, headache, metal taste, numbness or tingling in the hands and feet, rash and breathing problems.

Iron supplements can interfere with a range of drugs being taken for health conditions. Drugs include antibiotics, certain drugs for neurological conditions, thyroid medications, vitamins and others.

Iron can be toxic when taken above certain levels. This is especially a concern for young children. It is recommended to make sure iron supplements are out of reach of children at all times.

In 2015 an article appeared in the New England Journal of Medicine written by Andrew I. Geller, M.D. et. al. The article reported an estimated 23,000 emergency room visits per year are due to dietary supplements. This resulted in over 2,000 hospitalizations.

The top 10 herbal or dietary supplement products most often responsible for the emergency room visits are:

1. Weight loss

2.Energy

3.Sexual enhancement

4.Heart health

5.Sleep

6.Laxative

7.Bodybuilding

8.Immunity or infection

9.Pain or arthritis relief

10.Detoxification or cleansing

The top four vitamin related products included:

1.Multivitamin, or unspecified vitamin

2.Iron

3.Calcium

4.Potassium

Although nutritional supplements can be very valuable for a wide range of health issues, caution should be used when selecting and using them. Professional guidance is recommended.

It is also recommended to list all supplements as well as all medications taken before any healthcare visit.

Dr. Mark Kestner is a licensed chiropractic physician and acupuncturist with 30-plus years of experience focused primarily on treating complex and chronic spine, joint and neurological conditions in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.