Jennifer Barrickman, PhD StudentWalden University
PUBH 8165-10Instructor: Howard Rubin, PhD
Winter, 2010
DefinitionBackgroundIssuesTools
Objectives
Background
Miller , M.F ., Bellizzi, K.M., Sufian, M., Ambs, A.H., Goldstein, M.S., &Ballard-Barbash, R. (2008). Dietary supplement use in individuals living with cancer and other chronic conditions: a population-based study. Journal of the American Dietary Association, 108(3), 483-494.
Definition
National Center for Complementary and Alternative Medicine [NCCAM]. (2009). Using dietary supplements wisely. (NCCAM Publication No. D426). Bethesda, MD.
Regulation
FDA. (2009). Overview of dietary supplements. Retrieved January 20, 2010, from http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ ucm110417.htm#what
NCCAM. (2009). Using dietary supplements wisely. (NCCAM Publication No. D426). Bethesda, MD.
1963 1994 2005 2008-2010
The Market$23.7 billion industry (Gorski, 2008)Approximately 80% use supplements
(Werneke et al., 2004)
Consumer Healthcare Product Association. (2010). Dietary supplement facts and figures. Retrieved January 24, 2010, from http://www.chpa-info.org/pressroom/DS_ FactsFigures.aspx
Gorski, D. (2008). The Dietary Supplement Safety Act of 2010: A long overdue correction to the DSHEA of 1994. Retrieved January 16, 2011, from http://www.sciencebasedmedicine.org/?p=3772
Werneke, U., Earl, J., Seydel, C., Horn, O., Crichton, P., & Fannon, D. (2004). Potential health risks of complementary alternative medicines in cancer patients. British Journal of Cancer, 90, 408-413.
IssuesGeneral Public HealthCancer Patients
American Cancer Society. (2010). Dietary supplements: How to know what is safe. Retrieved January 17, 2011, from http://www.cancer.org/acs/groups/cid/documents/webcontent/002385-pdf.pdf
FDA. (2010). Dietary supplements. Retrieved January 15, 2010, from http://www.fda.gov/Food/DietarySupplements/
Gardiner, P., Phillips, R., & Shaughnessy, A. P. (2008). Herbal and dietary supplement-drug interactions in patients with chronic illness. American Family Physician, 77 (1), 73-78.
NCCAM. (2010). Herbs at a glance: Ephedra. Retrieved February 5, 2011, from http://nccam.nih.gov/health/ephedra/#cautions.
van der Voet, G. B., Sarafanov, A., Todorov, T. I., Centeno, J. A., Jonas, W. B., Ives, J. A., & Mullick, F. G. (2008). Clinical and analytical toxicology of dietary supplements: A case study and a review of the literature. Biology Trace Element Research. 125, 1-12. doi: 10.1007/s12011-008-8157-0
Impact of Weak Regulation
RisksNatural ≠ safe (NCCAM,
2009)Examples of interactions
FDA. (2009). Overview of dietary supplements. Retrieved January 20, 2010, from http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ ucm110417.htm#what
National Library of Medicine. (2010). Dietary supplements labels database. Retrieved January 18, 2011, from http://dietarysupplements.nlm.nih.gov/dietary/
Potential Adverse Effects Supplement Warning
St. John’s Wort Can interfere with many medications
Ginkgo Increased bleeding risk
Mistletoe Safety during cancer treatment unknown; should only be used in clinical trial
Black Cohosh Hepatitis, liver failure, possibly contraindicated for hormone-sensitive conditions
Astragalus May interact with immune suppressors, affects blood sugar and blood pressure
NCCAM. (2011). Herbs at a glance. Retrieved February 5, 2011, from http://nccam.nih.gov/health/herbsataglance.htm
False claims
Office of Dietary Supplements. (n.d.). Dietary Supplements: Background information. Retrieved January 15, 2011, from http://ods.od.nih.gov/factsheets/dietarysupplements/
Oh, V. (1998). The powerful placebo: From ancient priest to modern physician/complementary medicine: A research perspective. British Medical Journal. 316, 1397.
Lack of DialogueAwarenessEmbarrassmentReliable informationTime
Gardiner, P., Phillips, R., & Shaughnessy, A. P. (2008). Herbal and dietary supplement-drug interactions in patients with chronic illness. American Family Physician, 77 (1), 73-78.
Progress
American Cancer Society. (2010). Dietary supplements: How to know what is safe. Retrieved January 17, 2011, from http://www.cancer.org/acs/groups/cid/documents/webcontent/002385-pdf.pdf
U.S. Pharmacopeia. (2011). About USP. Retrieved January 17, 2011, from http://www.usp.org/aboutUSP/
Tools“Time to Talk”RSS feedEducationSupport groupsMentorsValid websites
FDA. (2010). Dietary supplements. Retrieved January 15, 2010, from http://www.fda.gov/Food/DietarySupplements/
National Center for Complementary and Alternative Medicine. (2009). Using dietary supplements wisely. (NCCAM Publication No. D426). Bethesda, MD.
Call to ActionTalkListenUse tools
ReferencesAmerican Cancer Society. (2010). Dietary supplements: How to know what is safe. Retrieved January 17, 2011, from
http://www.cancer.org/acs/groups/cid/documents/webcontent/002385-pdf.pdf
Consumer Healthcare Product Association. (2010). Dietary supplement facts and figures. Retrieved January 24, 2010, from http://www.chpa-info.org/pressroom/DS_ FactsFigures.aspx
FDA. (2009). Overview of dietary supplements. Retrieved January 20, 2010, from http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ ucm110417.htm#what
FDA. (2010). Dietary supplements. Retrieved January 15, 2010, from http://www.fda.gov/Food/DietarySupplements/
Gardiner, P., Phillips, R., & Shaughnessy, A. P. (2008). Herbal and dietary supplement-drug interactions in patients with chronic illness. American Family Physician, 77 (1), 73-78.
Gorski, D. (2008). The Dietary Supplement Safety Act of 2010: A long overdue correction to the DSHEA of 1994. Retrieved January 16, 2011, from http://www.sciencebasedmedicine.org/?p=3772
Miejerman, I., Beijnan, J. H., Schellens, J. H. M. (2006). Herb-drug interactions in oncology: Focus on mechanisms of induction. The Oncologist, 11(7), 742-752.. Retrieved January 18, 2011, from http://theoncologist.alphamedpress.org/cgi/content/full/11/7/742
Miller , M.F ., Bellizzi, K.M., Sufian, M., Ambs, A.H., Goldstein, M.S., &Ballard-Barbash, R. (2008). Dietary supplement use in individuals living with cancer and other chronic conditions: a population-based study. Journal of the American Dietary Association, 108(3), 483-494.
National Center for Complementary and Alternative Medicine. (2009). Using dietary supplements wisely. (NCCAM Publication No. D426). Bethesda, MD.
National Institutes of Health, Office of Dietary Supplements. (2010). About dietary supplements. Retrieved from http://dietary-supplements.info.nih.gov/pubs/ partnersbrochure.asp
National Library of Medicine. (2010). Dietary supplements labels database. Retrieved January 18, 2011, from http://dietarysupplements.nlm.nih.gov/dietary/
Office of Dietary Supplements. (n.d.). Dietary Supplements: Background information. Retrieved January 15, 2011, from http://ods.od.nih.gov/factsheets/dietarysupplements/
Oh, V. (1998). The powerful placebo: From ancient priest to modern physician/complementary medicine: A research perspective. British Medical Journal. 316, 1397.
U.S. Pharmacopeia. (2011). About USP. Retrieved January 17, 2011, from http://www.usp.org/aboutUSP/
van der Voet, G. B., Sarafanov, A., Todorov, T. I., Centeno, J. A., Jonas, W. B., Ives, J. A., & Mullick, F. G. (2008). Clinical and analytical toxicology of dietary supplements: A case study and a review of the literature. Biology Trace Element Research. 125, 1-12. doi: 10.1007/s12011-008-8157-0
Werneke, U., Earl, J., Seydel, C., Horn, O., Crichton, P., & Fannon, D. (2004). Potential health risks of complementary alternative medicines in cancer patients. British Journal of Cancer, 90, 408-413.
References (cont.)
For Further Information…http://nccam.nih.gov/timetotalk/http://www.fda.gov/food/dietarysupplements/default.htmhttp://www.cancer.gov/ncicancerbulletin/081109/page6http://dietarysupplements.nlm.nih.gov/dietary/http://www.fda.gov/Food/DietarySupplements/Alerts/default.htmwww.nci.govwww.cancer.orgwww.asco.orghttp://www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds/TDS/
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