The American Journal of Medicine
Volume 123, Issue 7 , Pages 577-582 , July 2010

How Physicians Should Evaluate Dietary Supplements

  • James K. Glisson, MD, PharmD

      Affiliations

    • Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Miss
    • Corresponding Author InformationReprint requests should be addressed to James K. Glisson, MD, PharmD, Department of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
  • ,
  • Larry A. Walker, PhD

      Affiliations

    • National Center for Natural Products Research, University of Mississippi, University, Miss
    • Department of Pharmacology, School of Pharmacy, University of Mississippi, University, Miss

References 

  1. United States Food and Drug Administration. Dietary supplements. http://www.fda.gov/Food/DietarySupplements/default.htmAccessed October 1, 2009
  2. United States Food and Drug Administration. Dietary supplement labeling. http://www.fda.gov/Food/DietarySupplements/DietarySupplementLabeling/default.htmAccessed October 1, 2009
  3. New dietary ingredients in dietary supplements: background for industry. http://www.fda.gov/Food/DietarySupplements/ucm109764.htmAccessed October 1, 2009
  4. Current good manufacturing practice in manufacturing, packaging, labeling, or holding operations for dietary supplements. http://www.fda.gov/ohrms/dockets/98fr/cf0441.pdfAccessed October 1, 2009
  5. Marder M, Viola H, Wasowski C, et al. 6-methylapigenin and hesperidin: new valeriana flavonoids with activity on the CNS. Pharmacol Biochem Behav. 2003;75:537–545
  6. Garrard J, Harms S, Eberly L, Matiak A. Variations in product choices of frequently purchased herbs. Arch Intern Med. 2003;163:2290–2295
  7. Gurley B, Gardner S, Hubbard M. Content versus label claim in ephedra-containing dietary supplements. Am J Health Syst Pharm. 2000;57:963
  8. Gilroy C, Steiner J, Byers T, et al. Echinacea and truth in labeling. Arch Intern Med. 2003;163:699–704
  9. Glisson J, Rogers H, Ogletree R, et al. The clinic at the health food store? (Employee recommendations and product analysis). Pharmacotherapy. 2003;23:64–72
  10. de los Reyes G, Koda R. Determining hyperforin and hypericin content in eight brands of St. John's wort. Am J Health-Syst Pharm. 2002;59:545–547
  11. Shekelle P, Morton S, Maglione M, et al. Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Evidence Report/Technology Assessment No. 76 (Prepared by Southern California Evidence-based Practice Center, RAND, under Contract No 290-97-0001, Task Order No. 9). AHRQ Publication No. 03-E022. Rockville, MD: Agency for Healthcare Research and Quality; February 2003;
  12. Westfall T, Westfall D. Adrenergic agonists and antagonists. In:  Brunton L,  Lazo J,  Parker K editor. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 11th ed.. New York, NY: McGraw-Hill; 2006;http://www.mcgraw-hill.co.uk/tpr/domain/goodman/online.htmlAccessed October 1, 2009
  13. Haller C, Benowitz N. Adverse cardiovascular and central nervous system events associated with dietary supplements containing Ephedra alkaloids. N Engl J Med. 2000;343:1833–1838
  14. Josefson D. Herbal stimulant causes US deaths. BMJ. 1996;312:1378–1379
  15. Ephedra: FDA prohibits sales of dietary supplements containing ephedra. http://ods.od.nih.gov/Health_Information/Ephedra.aspxAccessed October 1, 2009
  16. Israelsen L. Spiking: Is the end near?. Nutraceutical World. 2009;June:57–58http://www.nutraceuticalsworld.com/articles/2009/06/spiking-is-the-end-nearAccessed October 1, 2009
  17. Huang W, Wen K, Hsiao M. Adulteration by synthetic therapeutic substances of traditional Chinese medicine in Taiwan. J Clin Pharmacol. 1997;37:344–350
  18. Gryniewicz C, Reepmeyer J, Kauffman J, Bushe L. Detection of undeclared erectile dysfunction drugs and analogues in dietary supplements by ion mobility spectrometry. J Pharm Biomed Anal. 2009;49:601–606
  19. Steam dietary supplement. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm174339.htmAccessed October 1, 2009
  20. Import alerts. http://www.accessdata.fda.gov/ImportAlerts/ora_import_ia6610.htmlAccessed October 1, 2009
  21. Sweet B, Gay W, Leady M, Stumpf J. Usefulness of herbal and dietary supplement references. Ann Pharmacother. 2003;37:494–499
  22. Walker J. Evaluation of the ability of seven herbal resources to answer questions about herbal products asked in drug information centers. Pharmacotherapy. 2002;22:1611–1615
  23. Chambliss W, Hufford C, Flagg M, Glisson J. Assessment of the quality of reference books on botanical dietary supplements. J Am Pharm Assoc (Wash). 2002;42:723–734
  24. Natural Medicines Comprehensive Database. http://www.naturaldatabase.comAccessed July 31, 2009
  25. Medwatch: The FDA safety and adverse event reporting program. http://www.fda.gov/Safety/Medwatch/default.htmAccessed on October 1, 2009

 Funding: Dr Walker's work is partially supported by a cooperative research agreement with the US Food and Drug Administration: “Botanical Dietary Supplements: Science-Base for Authentication.” These perspectives are those of the authors and do not represent the views of the FDA or its employees.

 Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.

 Authorship: All authors had access to the data and played a role in writing this manuscript.

PII: S0002-9343(10)00082-3

doi: 10.1016/j.amjmed.2009.10.017

The American Journal of Medicine
Volume 123, Issue 7 , Pages 577-582 , July 2010