1. WHAT IS IMPORTANT TO REMEMBER WHEN USING OR CHOOSING TO USE DIETARY SUPPLEMENTS Ariel Clark Kaplan University

2. INTRODUCTION What is a dietary supplement? A dietary supplement can include herbs, minerals, vitamins, and many other things. (National Institutes of Health: Office of Dietary Supplements, n.d.). What we will be discussing:  Facts about supplements  Choosing a supplement  Sharing information with your doctor  Drug/supplement Interactions  Herb usage https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAYQj B0&url=http%3A%2F%2Fods.od.nih.gov%2FHealth_Information%2FODS_Frequently_Asked_Questions.aspx&e i=AtIQVaXkOcLvgwT5vYPICQ&bvm=bv.89184060,d.eXY&psig=AFQjCNGno_fGZAWuyHRrDA6FLLVkSBciMQ &ust=1427252086299865

3. DIETARY SUPPLEMENT FACTS  Not all supplements are created equal  There are different forms that supplements come in  Powders  Capsules  Tablets,  Drinks (teas, energy drinks, etc.) (National Institutes of Health: Office of Dietary Supplements, n.d.)  No dietary supplement can replace the benefits of a complete and nutritious diet. (National Institutes of Health: Office of Dietary Supplements, n.d.). http://sportsandfitness2.blogspot.com/2014/12/different-types-of-herbal-teas- and.html

4. FACTS CONTINUED…  Dietary Supplements are not managed by the FDA, which is a common misconception, since the DSHEA was signed. (National Institutes of Health: Office of Dietary Supplements, n.d.).  The FDA has set a standard of Good Manufacturing Practices, which means that quality standards and safety is more likely for a supplement that is produced following these standards. (National Institutes of Health: Office of Dietary Supplements, n.d.).  A USP stamp on a label means that it was manufactured with good manufacturing practices, does not contain contaminants, and contains exactly what is listed on the label. (National Institutes of Health: Office of Dietary Supplements, n.d.).  A consumer needs to do research on a supplement before deciding to take it. Look for any recalls, interactions, or reports of adverse events after someone taking a particular product.

5. WHEN IS IT RIGHT TO USE A SUPPLEMENT Supplementing your diet with a dietary supplement can be a big decision. Here is how you know when a supplement is appropriate.  Your doctor has recommended you begin taking a supplement  If you are over 50, a supplement of B12 would be recommended.  Women of childbearing age who may become pregnant would need to ensure they get enough folate  Those who do not get enough exposure to sunlight  A CAM practitioner can also suggest you begin with a dietary supplement  (USDA, 2015). http://www.naturopathic bynature.com/common- sense-approach-to- taking-health- supplements/

6. HOW TO CHOOSE A SUPPLEMENT  Ensure the supplement was creating using GMP’s  Look for a USP stamp  (National Institutes of Health: Office of Dietary Supplements, n.d.).  A simple test is to try dissolving your supplement in water and see how long it takes to break down (I personally use this method).  If you are using herbs, ask for assistance from a professional  Only take a supplement that you need, otherwise you are simply wasting your money or putting yourself at risk  Try to avoid supplements that contain mega-doses http://www.popsugar.com/fitness/Label-Able-USP- Verified-Supplement-Mark-638682

7. SHARING INFORMATION ABOUT SUPPLEMENTS WITH YOUR HEALTHCARE PROVIDER It is important to share any information about supplements that you are taking with your doctor or healthcare provider because..  Many people are unaware that supplement usage can pose serious side effects and are unaware of what the supplements are actually doing.  (Sekhri, Kaur, 2014).  some supplements are not safe for pregnant or nursing women  Some supplements are not safe to use with certain medical conditions  Supplements can interact with medications  Supplements can have negative effects during surgery.  (FDA, 2002). http://www.1stclassmed.com/blog/key-topics-to-cover-with-your- doctor-as-a-copd-patient

8. COMMON DRUG/SUPPLEMENT INTERACTIONS Using a Prescription blood thinner like Warfarin or Coumadin at the same time as Vitamin E, or ginkgo Biloba, which both thin blood can have disastrous effects. (FDA, 2002). St. Johns Wort can interact with prescription medications such as oral contraceptives, medications for seizures, and medications for the heart, making them less effective. (FDA, 2002). These are just two well-known examples that show how much of an impact an herb or supplement can have on a prescription medication. This leads back to the point of discussing dietary supplements with your doctor.

9. INFORMATION ON HERBS When deciding to use herbs there are several things that need to be considered.  Does science support the use of the herb for your purpose  How the herb is used  What are potential side effects  What are some precautions/contraindications Pregnancy breastfeeding interactions with medicines. (National Center for Complementary and Integrative Health, 2015) http://www.drrhondafine.com/blog/herbal-and- natural-supplements-to-enhance-sexual-passion/

10. WHERE YOU CAN FIND MORE INFORMATION FDA http://www.fda.gov/Food/DietarySupplements/default.htm National Institutes of Health: Office of Dietary Supplements http://ods.od.nih.gov/Health_Information/ODS_Frequently_Asked_Ques tions.aspx#Need National Center for Complementary and Integrative Health https://nccih.nih.gov/health/herbsataglance.htm I recommend these websites to further your knowledge on dietary and supplement use as they are reliable and are personal favorites of mine.

11. REFERENCES FDA. (2002). Tips for Dietary Supplement Users. Retrieved fromhttp://www.fda.gov/Food/DietarySupplements/UsingDietarySuppleme nts/ucm110567.htm National Center for Complementary and Integrative Health. (2015). Herbs at a Glance. Retrieved from https://nccih.nih.gov/health/herbsataglance.htm National Institutes of Health: Office of Dietary Supplements. (n.d.) Dietary Supplements: What You Need to Know. Retrieved from http://ods.od.nih.gov/ Sekhri, K., & Kaur, K. (2014). Public knowledge, use and attitude toward multivitamin supplementation: A cross-sectional study among general public. International Journal Of Applied & Basic Medical Research, 4(2), 77- 80. doi:10.4103/2229-516X.136780 USDA. (2015). Questions to ask before taking Vitamin and Mineral Supplements. Retrieved from http://www.nutrition.gov/dietary- supplements/questions-ask-taking-vitamin-and-mineral-supplements