Dietary Supplement Dangers

The current consensus in the global nutrition community is that more than 90% of negative incidents involving dietary supplements are not due to the naturally toxic ingredients of the supplements themselves, but are caused by three core reasons: "indiscriminate abuse, non-compliant product risks, and superimposed conflicts with existing diet/medication". Healthy people follow the trend of taking supplements without any evaluation, and the probability of health damage is 3.2 times higher than that of obtaining clear benefits - this data comes from the National Supplement Adverse Reaction Tracking Report released by the New England Journal of Medicine in 2023.

A while ago, when I was rotating in the clinical nutrition department of a tertiary tertiary hospital, I just received a 22-year-old girl. In order to whiten her skin quickly, she followed the formula of Xiaohongshu's "three-piece whitening set" and took 1000 mg of vitamin C, 2 grape seed extracts, and 3 tablets of vitamin C every day. After taking nicotinamide tablets for three months, she first felt pain when urinating. Later, she was found to have 2+ occult blood in her urine and a 2mm calcium oxalate stone in her kidney. The doctor asked her to stop all supplements, drink more water and jump for two weeks before the stone was passed. She was particularly aggrieved at the time, saying that bloggers all said, "These are antioxidants and there is no harm in eating them."

Interestingly, there have always been two completely different views in the nutrition community regarding the harm of supplements. They have been arguing for almost ten years and have not yet completely unified.

One group is the "supplement redundancy theory" led by the Harvard School of Public Health. They conducted a follow-up study spanning 20 years and covering 120,000 people. The conclusion is that in addition to four groups of people who clearly need additional supplements - women during pregnancy/pregnancy preparation, folic acid supplements, strict vegetarians supplement vitamins B12 and 6 Elderly people over 5 years old should take vitamin D3 supplements, and patients diagnosed with nutritional deficiencies should take corresponding nutrients. As long as the remaining healthy people can eat 1 pound of vegetables, half a pound of cereals and potatoes, 2 ounces of meat and 1 egg every day, the nutritional gain brought by supplements can be completely ignored. On the contrary, the risk of excessive supplementation is higher. For example, the commonly consumed vitamins A, D, E, and K are all fat-soluble. If they are taken in too much, they will not be excreted in the urine and will accumulate in the liver. Over time, toxic reactions will occur. I have seen people who took imported high-dose vitamin D for half a year and developed hypercalcemia. They suffered from nausea and vomiting every day and could not even walk.

The other group is the "accurate supplement group" in the field of functional medicine. Their views are also very practical: young people now eat takeout every day, stay up late, and are stressed. Many people actually have hidden nutritional deficiencies. For example, people who eat highly processed foods all year round are deficient in B complex, and people who do not get sunlight all year round are deficient in D3. In this case, it is indeed possible to supplement, but the prerequisite is that you must first do a serum nutrition test to supplement whatever is missing. Strictly limit the dosage. The more the better. A boy who works in the Internet came to me before and said that he socialized and drank every day and was afraid of liver problems. He bought a certain Australian online celebrity liver-protecting tablets and took 2 tablets a day. After taking it for half a year, he went for a physical examination. The transaminase was twice the normal value. He thought he had hepatitis. The result was that he had hepatitis. Circle, I found that the content of silibinin in a single pill of that liver-protecting tablet is 350mg, which is almost 70% higher than the recommended daily safe intake of 210mg. It was originally intended to protect the liver, but in the end it put a metabolic burden on the liver. I stopped for two months and then checked again, and the indicators were all normal.

There is another pitfall that many people have not noticed, which is superimposed risks. For example, if you are already taking multivitamins and buy additional vitamin C effervescent tablets and B-complex tablets, your daily vitamin C intake may exceed 2000mg. Long-term consumption will not only cause stones, but also affect blood coagulation function. ； If you are taking anticoagulant drugs and taking vitamin E or fish oil every day, the risk of bleeding will increase several times. I once had an aunt who had been taking warfarin after having a heart stent. She heard from her sister that fish oil can clear blood vessels, so she took 3 pills a day. As a result, her arms were covered with bleeding spots, and she almost had a serious accident.

To be honest, I have also been into the trap of supplements when I was working out. At that time, I heard from bloggers that taking branched-chain amino acids can build muscle and reduce fatigue. I took a spoonful every day before and after training. After taking it for two months, I went for a physical examination. The serum creatine kinase was directly high. The doctor said that my metabolism is not strong, and the extra branched-chain amino acids cannot be metabolized, but put a burden on the kidneys. I stopped for a month and then checked again, and it was normal. From then on, my advice to others is always, don’t treat supplements as “health insurance”. If you stay up until three o’clock every day to eat fried chicken and drink milk tea, it will be useless no matter how much vitamin C you take to protect your liver. The nutrients you supplement can’t keep up with the amount you make.

Of course, this does not mean that all supplements are a scourge. For example, the doctor tells you to take folic acid during pregnancy, or your elderly family members take D3 plus calcium. Then take it as you should. Just don’t just buy a bunch of Internet celebrity products and stuff them into your mouth. Before buying, look at the ingredient list and calculate the dosage. If you are not sure about the amount, ask your doctor or nutritionist. After all, if something goes wrong with what you eat, you will be the one to suffer. You cannot use your own body as a guinea pig for the gimmick of "may whiten your skin, protect your liver, or lose weight", right?