For many people, the diet they take does not contain all the nutrients they need for healthy living and therefore, they may take dietary supplements to correct for that. According to the US FDA, a dietary supplement ‘contains a “dietary ingredient” intended to supplement the diet’. It includes vitamins and minerals, herbs and other botanicals, amino acids and dietary substances ‘that are part of the food supply such as enzymes and live microbes (probiotics), concentrates, metabolites, constituents, extracts or combinations of dietary ingredients’.

The common supplements include:

• Vitamins: multivitamins or individual vitamins e.g. Vit D or Biotin
• Minerals: Calcium, Magnesium, Iron
• Botanicals or Herbs: Ginger, Ashwagandha
• Botanical compounds: Caffeine and Curcumin
• Amino acids: Tryptophan and Glutamine
• Live microbials: Probiotics

As we can see, the term dietary supplement covers a very wide range of supplements to the diet. These supplements must be ingested, in particular, they must be swallowed to be considered dietary supplements. They can take the form of pills, tablets, capsules, liquid, gummies, softgels, cookies, bars and powders. They are required to be labelled as a dietary supplements and cannot make claims about curing diseases.

Herbal supplements are usually taken by people to manage a specific health concern such as inflammation or sleep problems whereas food supplements (multivitamins, omega 3) are taken to bridge the nutritional gap in the diet.

Herbal supplements may be dried, chopped, powdered or be in a capsule or liquid form. They can be ingested as pills or brewed as a tea or taken as a liquid. The FDA considers herbal supplements to be foods so they are not as tightly regulated as medicines are.

However, some medicines also come from plants. Therefore, it is the classification of a plant-based product as cosmetic, food, medicine or food supplement that determines which legal standards and laws are applied to it.

Case Study: Ashwagandha

Take the case of Ashwagandha. The Food Safety and Standards Authority of India (FSSAI) recently issued an advisory which prohibits the use of Ashwagandha leaves and their extracts in any way. Scientific studies have indicated that its leaves contain significantly higher levels of withanolides and these compounds have been linked to adverse effects such as liver toxicity and gastrointestinal distress. Some research also suggests potential neurotoxic effects from concentrated leaf extracts.

Case Study: Turmeric and Curcumin

Another example is turmeric which contains curcumin. Curcumin has anti-oxidant and anti-inflammatory properties and is a popular dietary supplement for health conditions such as arthritis, digestive disorders, depression and allergies, but though curcumin in its natural form as turmeric is safe, turmeric supplements taken in high dosages can cause liver damage.

Using herbal supplements for non-traditional indications such as athletic performance or weight loss may also cause toxicity. Using these products for prolonged periods may cause toxicity or taking excessive dosages to meet some target can cause toxicity. Apart from these, some herbs may have pronounced pharmacological effects.

Kidney health is influenced by what we consume, including medicines, supplements and traditional medicine. Though Ayurveda is an ancient system, how it is practiced in the modern day and the formulations, quality control and self-usage can pose risks. Therefore, its ancient roots and natural tag alone cannot deem it to be safe and effective for self-dosing.

Sometimes herbal medicines may also be adulterated with modern pharmaceuticals such as steroids so that the products can claim fast relief.

From all the examples above it should be apparent that herbal is not an automatic safe cure all and that a healthy diet should be the first line of defense. Taking food supplements comes next.

Non herbal food supplements do not have the same drawbacks as the herbal supplements mentioned above but even they can vary in their quality and other substances they contain such as fillers etc. so all are not equal.

It is always advisable to discuss your health with your health care provider before taking supplements to ensure that you take the right ones and that they don’t interact with any other medication or supplements you may be taking.