Vitamins and dietary supplements: Why pharmacists' recommendations matter

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As Americans increasingly turn to vitamins and herbal supplements as alternatives to prescription drug use, medical professionals and government leaders worry that few realize the implications.

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As Americans increasingly turn to vitamins and herbal supplements to prevent, augment, or replace their prescription drug use, medical professionals and government leaders worry that few realize the implications of taking what they perceive as innocuous, over-the-counter dietary aids.

Unbeknownst to many consumers, vitamins and dietary supplements can have toxic and life-threatening side effects when used in megadoses or combined incorrectly with prescription drugs. They also can contain significant levels of heavy metals or be spiked with prescription drugs. And manufacturers may make illegal claims about their drugs' effectiveness in treating, curing, or preventing disease.

A report released in May by the Government Accountability Office (GAO) and covered by The New York Times found pesticide residues that appeared above the allowable limit in 16 of 40 supplements tested as part of a Congressional investigation. This is a matter for concern, in light of the fact that the number of Americans taking vitamins and herbal supplements seems to be growing. Approximately 50% of adults regularly take vitamin supplements, and approximately 25% take herbal supplements at least occasionally - a figure that has gone up 8% since a 2007 national survey - with annual sales reaching approximately $25 billion, the report said. The dietary supplement industry is expected to continue to grow, along with the aging of the population and an increasing popular interest in personal health and wellness, according to a 2009 GAO report.

The loophole gives pharmacists, as frontline healthcare professionals, a unique opportunity to counsel patients on the correct use of vitamins and herbal supplements.

"People pick up [a magazine] and read about Gingko biloba, so they go out and buy Gingko, but they don't realize these kinds of herbal medications can be contraindicated with their own [prescription] medications," said Christine R. Jacobson, RPh, of Wasatch Health Mart, Wasatch, Utah. "Because of the economy, they're not going to the doctor. They read it and say, 'I've got that, I'm going to try it.' The public thinks it's smarter; they think they know their bodies more. They don't trust their doctors. But they trust their pharmacists."

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