Dietary supplements are not medicines. Registration and control of their turnover is not handled by the Ministry of Health, but by Rospotrebnadzor, for which this is part of the food market. The clinical studies required for drugs are not required for supplements. These products are usually recommended to their clients by nutritionists and nutritionists, often without medical education. Dietary supplements include all vitamins, trace elements and sports nutrition.
Their opponents say that our grandparents did not take anything like this and lived healthy up to 80-90 years. But the deteriorating environmental situation, new standards for food, and stress weaken the immune system. Therefore, healthy or near-healthy people take applied nutrition creatine supplements to improve their quality of life.
Manufacturers claim that the use of dietary supplements often gives results, although not as fast as in the case of synthetic drugs. They may be unavailable to the patient, or prohibited due to contraindications. It is stated that in the recommended doses, the supplements have no side effects and, unlike homeopathic remedies, contain tangible amounts of the active substance. But the opinions of doctors about the use of dietary supplements in the treatment of patients differ.
“There is no benefit in therapy from dietary supplements, and their demand is due to the extremely low medical literacy of the population,” says a therapist at a Moscow clinic. “This is a huge market worth tens of billions of dollars. I guess over time the supplements will go out of use.
The pursuit of profit is also due to the fact that these complexes require long-term continuous use. If dietary supplements really help, for example, against hypertension, there is no doubt that there is an active medicinal substance there.
What is the possible catch
In order for the consumer to feel the benefits of the supplement and continue to spend money, undeclared ingredients may be added to it. In dietary supplements for erectile dysfunction, they put sildenafil, in other words, Viagra; from excess weight – means that enhance the feeling of satiety. “Harmless” muscle building supplements may contain synthetic anabolics. In the US, this problem has already caused a lot of lawsuits.
But the presence of the active substance and its dosage are not indicated in the instructions, otherwise the drug is subject to registration as a medicine. This threatens with an overdose: daily intake of the same sildenafil will result in more serious problems than with potency.
“The evaluation of the drug by the patient is extremely subjective,” recalls the therapist. – The placebo effect in control groups sometimes reaches 30% of the effectiveness of a real drug. The patient can explain the good state of health by the action of dietary supplements and continue taking it.
Although the same or even more useful substances may be produced endogenously – by the body itself. Apart from vitamins, the only supplement whose benefits can be seriously discussed are omega-3 fatty acids. But even in this case, there is no reliable evidence of effectiveness.
Summarizing 28 studies on the possible beneficial effects of various dietary supplements on the brain activity of older people, researchers from the Cochrane Society, the world’s main subject of evidence-based medicine, did not find evidence of their effectiveness.
When to take
Dietitians were the first doctors to use dietary supplements. After 35 years, a quarter of people in Russia are obese, and after 55 – more than a third of men and half of women. Many people do sports, but less than 1% of the adult population eats properly, hence the need to adjust the diet.
According to the gastroenterologist and nutritionist, magnesium and chromium supplements are used in nutrition: they significantly affect the metabolism. As well as probiotics – live microorganisms taken to improve the functioning of the intestines and stimulate the immune system, which also belong to dietary supplements. The doctor emphasizes that it makes sense to drink vitamins only according to direct indications, if a blood test indicates their deficiency.
Many people take pre- and probiotics under the influence of advertising, not doctors. But some complexes combine different microorganisms, which sometimes leads to poor health.
“Probiotics are used according to indications, having previously made a coprogram and checked the intestines for dysbacteriosis and digestibility of muscle fibers,” the endocrinologist warns. – Taking vitamins and microelements, you need to know exactly how they work, where exactly, and with whom in the company.
For example, iodine binds heavy metals. All this is excreted in a complex by the liver and kidneys, which may not be able to cope if, moreover, they eat improperly and sleep poorly. The problem manifests itself as an allergy: swelling, rash, headache, etc. And the patient believes that the iodine supplement is to blame.”
What might be the benefit
Doctors sometimes recommend supplements as an accompaniment to primary therapy when the body needs support.
“Dietary supplements sometimes help in treatment,” says Grigory Bashkirtsev, a neurologist and rehabilitation specialist at GMS Clinic. – Protein shakes, for example, are taken not only by bodybuilders, but also by older people with cachexia – a severe deficiency of muscle mass. Of course, along with the main testosterone treatment.
From what can be attributed to dietary supplements, colleagues most often prescribe chondroprotective drugs for joints. Their effectiveness has not been proven, but clinical practice shows that there is a small positive effect.”
Supplements partly compensate for the lack of vitamins, amino acids and trace elements that are not synthesized in the body or are present in insufficient quantities. For example, essential amino acids can only be obtained from food.
“Sometimes, according to tests for muscle tone, one can understand that one of them needs one or another microelement more than others,” adds Grigory Bashkirtsev. – Most often, sports doctors and neurologists prescribe magnesium and B vitamins – they nourish the nerves.
In the treatment of polyneuropathy – damage to the peripheral nerves, leading to paralysis – vitamin B12 and thioctic, also known as alpha-lipoic acid, are indispensable. This is especially important in the complication of diabetes. B12 is also included in combination therapy for diseases of the stomach, for example, atrophic gastritis.
What to fear
There are more than 2,100 different supplements on the Russian market, and this is precisely the reason why doctors do not trust them – it is difficult to distinguish the wheat from the chaff in the absence of research.
“Dietary supplements can be beneficial, but you need to understand in detail not only the compositions, but also the manufacturers,” explains Grigory Bashkirtsev. “There are thousands of supplements on the market, and few of them are of high quality.”
In the US, where the number of dietary supplements reaches 80,000, the situation is even more alarming. The concentration of toxic impurities in some “garbage” additives sometimes rolls over. Every year, 20,000 ambulance calls are due to poisoning with dietary supplements.
“Some nutritional supplements combine substances that are incompatible with each other,” warns a doctor at an outside clinic. – Even a complex of different B vitamins, useful individually, can cause severe allergies. Vitamin D in some dietary supplements is contained in the amount of 10 thousand units per capsule.
When an elderly person “to maintain strength and vitality” begins to take such a dietary supplement several times a day, he will experience aching joints, and possibly leg cramps during sleep. There are many questions about stabilizers in dietary supplements, which sometimes contain such an amount of sugar and starch that they can make any weight loss supplement high-calorie.”
Dietary supplements can be useful only if the doctor, following the results of the diagnosis, decides that the body lacks vitamins, minerals or amino acids. It is impossible to treat diseases with supplements, especially on your own – the lost time for taking really helping drugs will cost more.
