Reports on the Adverse Effects of Nutritional Supplements

Adverse reactions to prescribed drugs in the UK, which account for approximately 10% of all hospital medical admissions, have been recognised for over 40 years and lead to the development of the specialty of pharmacovigilance.  

Reports of adverse reactions to nutritional supplements have also appeared over a similar period with a substantial increase over the last decade in the international literature.  In the United States there has been enough public concern for the Food and Drug Administration to demand that all reports made to US manufacturers of an adverse event to a nutritional supplement that they produce are reported to them as from 22nd of December 2007 www.fda.gov/medwatch/otc.htm and http://www.fda.gov/cder/regulatory/public_law_109462.pdf  The US public can now record such adverse events on line themselves.

At present in the UK there is no similar legal requirement or mechanism for reporting adverse reactions to non-prescribed nutritional supplements.

The three best reports that are relevant to the UK consumer are:

• Safe Upper Levels for Vitamins and Minerals: Report of the Expert Group on Vitamins and Minerals May 2003
  See report here
• Review of Dietary Advice on Vitamin A: Scientific Advisory Committee on Nutrition
  September 2005
  See report here
• Cochrane Review of Antioxidant Supplements.   April 2008
  Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases.  Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C
  See report here

There are two additional main sources

• The Office of Dietary Supplements of the National Institutes of Health in the US provides excellent information on nutritional supplements including their safety ods.od.nih.gov
• Health Canada has a useful set of monographs on Drugs and Health Products nutritional and herbal preparations with some brief information on adverse effects www.hc-sc.gc.ca/dhp-mps/prodnatur/new-neuf-eng.php