By Dena McDowell, MS, RD

It is estimated that Americans spend over $15 billion a year on dietary supplements. However, searching for information about complementary and alternative medicines can be both overwhelming and confusing. As a result, most consumers who purchase supplements obtain product information from websites or salespeople.

Supplements are not regulated

What many consumers don't realize is that supplements are not regulated by the Food and Drug Administration (FDA). Hence, they are not subject to standardized testing, which means that ingredients listed on the package may not actually be contained in the supplement itself. Additionally, companies are free to advertise any health claims they want, often falsely marketing their herbs without referencing the supplement's potentially harmful side effects. (For example, supplements that contain Ephedra are associated with heart attacks, stroke, arrhythmias, increased blood pressure, and heart palpitations.) Moreover, many sites don't list the dosage that could cause these side effects.

Medical implications of supplements

It is important to know what you are purchasing, as well as the supplement's side effects and overall safety. You should also be informed about whether a supplement will adversely affect your preexisting medical conditions. Talk to your physician about any herbal medications you are taking to make sure there are no drug-herbal interactions.

Tips for purchasing supplements

Below are a few things to remember before purchasing herbal medications:

• Look for the USP label on the package. The USP label indicates that the product has undergone third-party testing for purity and safety.
• Research the product before use. Look for peer reviewed studies proving the effectiveness of the product. References/resources should be cited and proper research standards should be used in testing. These methods should be stated.
• Ignore studies published by the company. These studies are for promotional use and are suspect unless other studies by independent researchers have been done showing the same relationship.
• Do not believe anecdotal information. Anecdotal information is usually not verified and is suspect.
• Pay attention to your body's reaction to the supplement. Be aware of any side effects and discontinue use if you experience any.
• Research the company online. It is best to find information from credible sources from educational (.edu), government (.gov) or organizations (.org) websites, not commercial (.com) websites.
• Remember: Buyer beware. If the product promises fixes that sound too good to be true, they probably are.

Further website resources

Here are some reputable websites to check for the safety of herbal remedies, as well as complementary and alternative medicine:

www.consumerlab.com
Consumer Lab's interactive website investigates the supplement industry and provides standardized testing for safety and purity.

www.longwoodherbal.org
The Longwood Herbal taskforce provides information on many common herbal supplements for consumers, patients and medical professionals.

www.cancer.org
The American Cancer Society's website provides information on supplements, vitamins and minerals.

http//nccam.nih.gov
This is the National Institute of Health's complementary and alternative medicine website.

www.fhcrc.org
The Fred Hutchinson Cancer Research Center provides user friendly summaries of many common herbal remedies.

www.herbalmed.org
The Alternative Medicine Foundation provides information on plant-based alternative therapies.

www.herbalgram.org
The American Botanical Council provides information on herbal supplements