Advertised throughout the media, displayed in grocery stores and pharmacies, and promoted widely on the Internet, dietary supplements look like just another consumer product on the shelf. But are they? Take this quiz to find out how much you know about using dietary supplements safely.

1. A supplement labeled "natural" means that it also is:

1. mild
2. without any risk of side effects
3. safe to use with other medications
4. none of the above

2. Since dietary supplements are so easily available - and don't require a doctor's prescription - they are much safer than drug products and can be used to self-treat illnesses without a health professional's advice or supervision.

True or False

3. Testimonials in dietary supplement promotions give a good idea of the supplement's benefits and safety because they're based on firsthand accounts.

True or False

4. Many supplements have proven health benefits.

True or False

5. Before you start taking a dietary supplement, talk it over with a knowledgeable person like:

1. your doctor or health professional
2. your pharmacist
3. a supplement salesperson
4. a friend who takes them

Answers

1. D. none of the above. The term "natural" may suggest to consumers that the supplement is safe, especially when compared with prescription drugs that are known to have side effects. But natural is not necessarily safe. Although many supplements can be used safely by most people, other supplements, including some herbal products, can be dangerous. Aristolochic acid, which has been found in some traditional Chinese herbal remedies, has been linked to severe kidney disease. And the herb comfrey contains certain alkaloids that, when ingested, have been linked to serious, even fatal, liver damage. Animal studies suggest that the herb may cause cancer, too. Even certain vitamins can be toxic at high doses. And certain supplements have been found to interact with other medications in ways that could cause injury.


2. False. Studies have shown that some herbal products interact with drugs and can have a wide range of effects. For example, St. John's Wort can lower the effects of indinavir, a protease inhibitor for treating HIV. St. John's Wort also may interfere with drugs used by organ transplant patients and drugs used to treat depression, seizures and certain cancers. In addition, there are concerns that it may reduce the effectiveness of oral contraceptives. Garlic, ginkgo, danshen and dong quai can cause blood to thin, which could cause serious problems for people on drugs like warfarin or aspirin. Dietary supplements are not required to go through the same pre-market government review for quality, safety and efficacy as drug products. But that doesn't mean they should be taken lightly - or without consulting your health care professional, especially if you have a medical condition or are taking other drugs. 


3. False. It's unwise to judge a product's efficacy or safety based only on testimonials. First, it is very difficult to verify the accuracy of the account: Some marketers may embellish or even make up testimonials to sell their product. Second, you can't generalize one person's experience to others. Anecdotes are not a substitute for valid science. 

 
4. True. Studies suggest that several popular supplements, including herbal products, may provide health benefits. For example, calcium can reduce the risk of osteoporosis, folic acid during pregnancy can prevent birth defects, and there is some evidence suggesting that St. John's Wort may be helpful for some people with mild depression. Check out any health claims with a reliable source, such as the National Institutes of Health's Office of Dietary Supplements, a public health or scientific organization like the American Cancer Society or the Arthritis Foundation, and your health provider. 

 
5. A or B. Talk to your doctor, pharmacist or other health provider about any medicines you take, as well as any dietary supplements you're using or thinking about using. Though some doctors have limited knowledge of herbal products and other supplements, they have access to the most current research and can help monitor your condition to ensure that no problems develop or serious interactions occur. Retailers or marketers can be good sources of information about their products and their ingredients, but bear in mind that they have a financial interest in their products. If your doctor or pharmacist has a financial interest in the product, get a second, independent opinion.