Traditional “Knowledge” About Dietary Supplements
- “Ask your doctor” isn’t the answer.
- Inconsistent information provokes anxiety, especially in pregnant women.
- Anxiety may lead to abortion.
Notes:
The FDA’s admonition that a pregnant woman should consult her health care provider before taking dietary supplements does not really address this problem because doctors do not have access to reliable scientific information about the safety of dietary supplements during pregnancy either. Furthermore, not all “health care providers” are equally cautious about the unproven safety of dietary supplements, and many providers as well as consumers believe that, in the United States, a product cannot be marketed unless it is known to be safe.
The information available to consumers about using dietary supplements in pregnancy is sometimes plainly contradictory. Table 2 (use link in slide above) provides examples of four dietary supplements -- black cohosh, ginger root, nux vomica, and peppermint -- which some widely-available information sources recommend for nausea and vomiting in pregnancy and which others warn pregnant women not to use. Such conflicting advice can provoke anxiety, especially in a pregnant woman who may be even more concerned about the safety of her developing embryo or fetus than about her own safety. This anxiety may lead a woman who fears that she has inadvertently harmed her fetus to terminate her pregnancy. Clearly, this is not what the FDA intended in its final rule on “structure and function” claims for dietary supplements, but allowing claims for supplements that have not been adequately tested in pregnancy may have this effect.