Sunday, January 03, 2010

Drug reference guides and dietary supplements

Do you know how the FDA regulates dietary supplements like omega-3 fatty acids (http://www.omega3.org)? What drug reference guides provide this type of information? Can you rely on the FDA? Here's what the FDA currently says about dietary supplements:
Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.* Manufacturers must make sure that product label information is truthful and not misleading.
It's difficult to find reliable information about nutritional supplements and herbal products. Therefore, it's important to find reliable sources of information about specific agents. For example, there's a site called http://www.omega3.org and it contains information about omega-3 fatty acids. The topic of fish oil supplements and cardiovascular health has been explored at great depths. You'll see many published papers on this topic. As a result, we have stronger levels of evidence regarding certain nutritional supplements and alternative remedies. The evidence may be much weaker for other agents.

Epocrates Rx Pro and Epocrates Essentials includes information about Alternative (herbal) medicines. If you look up "fish oils" or "omega-3 fatty acids," the list of Reported Uses is very long. Then if you look at the Reported Doses section, it starts with:
Safety/efficacy may not be established; concentration of active ingredients may vary widely between products.
You can also find agents like fish oil in the PDR for Herbal Medicines (Physician's Desk Reference for Herbal Medicines). Skyscape offers the Drug Interaction Facts: Herbal Supplements & Food. As the interest in dietary supplements continues to grow, there will be an increased demand for medical apps and websites like http://www.omega3.org.

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