(Websites in English:) • • • • • • • • • • • Partners in Health - Working with Your Health Care Providers Dietary Supplements - More Than Vitamins ... How To Recognize a Dietary Supplement Using Potential Risks of Dietary Supplements What Should I Know Before Using Dietary Supplements Bottom Line Examples of Products Marketed as Dietary Supplements FDA MedWatch T ools 1. Nutrition Assessment 2. Dietary Supplement Diary 3. Medication Diary Hea lth Professional's Contact List Dietary Supplement Resources Partners in Health - Work with your doctors Potential Risks in Using Supplements With the abundance of information While some supplements may be contradicted on supplements, it is more beneficial for certain people, can important than ever t o talk to your doctor be circumstances where these products and other specialist s (nurses, may expose them to risks. pharmaceutical, etc..) to help organize Man y supplements contain active ingredients that can have strong effects on reliabl e information of the matter. the body. Take a combination supplement - More Than Vitamins ... supplements, use of medicines, or medicines replace it rather than supplements prescribed today are not only could bring fatal results. vitamins a nd minerals. Also included Also, some supplements may have other substances such as herbs, botanicals, unwanted effects before, during, and after an operation. It is important amino acids, and enzymes. Supplements come in various forms such as pills, powde rs, bars, or drinks. let your doctor know of vitamins, minerals, botanicals and other products that y ou are taking, especially before the operation. If you do not consume a variety of foods, some supplements can help here are som e examples of supplements that you are taking to ensure minimal affect certain d rugs (pharmaceuticals): some essentials. However, supplements are not intended t o treat, • Calcium and heart medicine to diagnose, prevent, or cure (eg, Digoxin ), thiazide diuretics diseases made, manufacturers (Thiazide) and antacids that can make those arguments . In some contain aluminum and magnesium. cases, supple ments may have effects • Magnesium and thiazide and loop negative side, especial ly if diuretics (eg, Lasix ®, etc..) shots before an operation or take some drog ras for cancer (eg, other medications, or if you have certain Cisplatin, etc.), and antacids medical conditions. containing magnesium. • Vitamin K and thinning drugs Unlike drugs, but as blood (eg, Coumadin). regular food supplements are no t • St. John's Wort and SSRI drugs covered for the Food and Drug (ie, contracept ive drugs). Administration (FDA) for its effectiveness. It is the responsibility of manufacturers that you should know before using supplements / distributors i nsure a supplement? products are healthy and what they say on the label is truth ful. A Ten Caution: Once a product enters the market, the FDA has the authority to take action • Remember: safety first against a supplement that presents a who le. Some ingredients in risk. supplements, including nutrients and plant compone nts, can be evidence that supports scientific activity based on their toxic acti vity in the benefits of some supplements, such as body. You must not replace a v itamin and mineral supplements is well established for a drug prescribed for cer tain conditions or therapy. health, but others need more • Think twice before fo r research. Whatever your decision, believe everything you read. supplements sho uld not replace Reliable is based prescription drugs or a variety of research-Th rough of an important health food. time, not a single medical study. Beware of c laims as made Recognize A Supplement. Learn To Recognize Arguments • Sometimes, you can see the difference confuse False. Remember: "If something sounds from a supplement, a food, or spectacular to be real medicine. An easy way it can be. " Some recognize a charge is to look at the Supplement Facts Panel (Supplement Facts Pa nel). • • • examples of false claims made by supplement manufacturers: o "cure all" or treat or cure diseases. or "completely healthy", "all natural", not "has no side effe cts." or limited portions. 'Mas' does not necessarily mean 'better'.Some produc ts may be harmful when taken high doses for a long time, or in combination with certain substances. The term "natural" Does not Mean Healthy. Do not assume that this term ensures that it is healthy. For some supplements, "natural" ingredien ts can affect medicines, be dangerous for people with certain medical conditions , or harmful in large quantities. For example, the tea derived from the leaves o f mint is considered healthy, but peppermint oil (extracted from the leaves) is much more concentrated and can be toxic if its used incorrectly. Worth spending my money on this product? Resist the pressure to buy a product or treatment "on the fly." Some supplements can be very expensive without providing any benefit. For example, high amounts of vitamins, like vitamin B and C, are used by the bod y and are excreted in the urine. After all: • • Never self-diagnose. Work with your doctor to determine what is the best way to manage your health. Check with your doctor before taking any supplements, especi ally when • • with or substituting them with other foods or medicines. Some supplements can he lp consume some nutrients, but others may cause health problems. Supplements are not intended to treat, diagnose, prevent, or cure disease, or replace a diet co mposed of a variety of healthy foods. Examples of Products Marketed as Supplements Vitamins, Minerals, Nutrients Vitamin / Mineral Multiple Vitamin B Complex Vitam in C Vitamin D Vitamin E Beta Carotene Calcium Acids Omega-3 Fat Folic Acid Zinc Iron botany and other substances Acidophilus Black Cohosh Echinacea Ginger Fiba Primorosa Oils of Garlic Oil Ginkgo Biloba Pes Glucosamine and / or Chrondroiti n Sulfate St. John's Wort Saw Palmetto * Adapted from A Healthcare Professional' s Guide to Evaluating Dietary Supplements, the American Dietetic Association & A merican Pharmaceutical Association Special Report (2000). Because of that many p roducts are marketed as supplements, it is important to know that supplements in clude vitamins, minerals, botanicals and other substances. * The list gives some examples of products that you see on the market as supplements. Unable to enlis t them all here. FDA MedWatch If you suspect that you have suffered a serious backlash for taking a certain su pplement, you and your doctor should report it to FDA Medwatch: • • Telephone: 1-800-FDA-1088 Fax: 1-800-FDA-0178 • Internet: www.fda.gov / medwatch / how.htm Below are three tools to help you and your doctor manage their intake of supplem ents and prescription drugs (on the web sites in English): 1. Nutrition Assessme nt 2. Dietary Supplement Diary 3. Medication Diary First Tool: appraisal of Nutrition Think upon the following sentences and use this list to talk to your doctor abou t your nutritional status and whether taking a supplement is right for you. Curr ently Nutrition Examination supplement use (s). Since less than two meals a day. My diet is quite strict (I do not drink milk, eat meat, etc..). As a single (a) most of the time. Unintentionally, I've lost or gained over 10 pounds in the la st six months. Volume 3 or more daily medications. Volume 3 alcoholic drinks or more per day. Source: adapted from the Nutrition Screening Initiative. General Q uestions Regarding the Use of supplements is to take a necessary supplement to m y daily diet? There are some precautions or warnings you should know (as the max imum dose)? There are some side effects? There are some supplements I should avo id while taking additional supplements or prescription drugs? Yes / No Yes / No Other issues to consider ... • • • Why is this product? What are its supposed benefits? How, when, and how long wil l take? According Tool: Journal Supplement To have an accurate record for your doctor to use it, put all the supplements yo u use and how often. If you are not sure whether certain material is considered as a supplement, check with the nutritional label found on the package. Fill, pr int, and share this table with your doctor so they can talk about what is best f or your health. It is very important that you consider the combined intake of di fferent supplements, including fortified foods, like some cereals and beverages. This could cause several problems with his health. Supplement No. When Reason E xample: Once a pill supplement my vitamin-mineral Multi Once a day diet bones Ho ld Example: 8 oz / 350 mg calcium orange juice hard day It refers to "Examples of Products Marketed as Dietary Supplements" to help comp lete this table. Third Tool: Medical records Please complete / complete information on all prescription and nonprescription m edicines you take regularly. Provide this information to your doctor to have you r medical records to date and better able to answer any questions you have. Quan tity When Reason Recipe Counter List of my doctors Name Doctors Doctors Doctors Doctors Hospital Pharmacists Nurses Specialty Nurse Other Phone # Government guidelines (English) Federal Government Agencies: • • • • • • Administration on Aging, DHHS Food and Drug Administration, DHHS, Center for Foo d Safety and Applied Nutrition: Dietary Supplements and Tips or for the Savvy Su pplement User: Making Informed Decisions and Evaluating Information and Food Lab eling and Nutrition National Institutes of Health, DHHS: o Office of Dietary Sup plements and National Center for Complementary and Alternative Medicine and Clea ringhouse (1-888-624-6226) Office on Women's Health, DHHS or 1-800-994-WOMAN U.S . Federal Trade Commission Department of Agriculture, Food and Nutrition Informa tion Center Others: • • • • • American Association of Retired Persons (AARP) American Pharmacists Association American Dietetic Association Food Marketing Institute National Council on Patie nt Information and Education (NCPIE)