Reports online of consumer vitamin use and amounts spent vary greatly. According to a 2016 annual report by the National Center for Complementary and Integrative Health for the Centers for Disease Control, Americans spent $12.8 billion out of pocket on vitamins and supplements. NCCIH used a massive survey sample of 44,700, and points out this spending level is a fraction of what Americans spend out of pocket on prescriptions and on other forms of alternative health care. It also amounts to hundreds of dollars per household, a reason for us to look into whether we are getting the value we expect for that investment. Supplement companies are doing very well, as evidenced by the volume of advertising they purchase to bombard us with confusing, and sometimes false, claims about their products.

Paula Wrenn column photo

Though designed to benefit us, all supplements have the potential to cause harm. Makers of dietary supplements are not required to prove effectiveness, safety or quality of a product prior to marketing their products. Further, they are not required to report discovery of adverse effects to the FDA. Random testing by reputable labs has found that some manufacturers of supplements use insufficient amounts of the main active ingredient noted on the label, among other issues.

Certain supplements, such as those that are fat soluble, can cause toxicity when taken in high doses. Vitamin A, often taken with the intent to protect the eyes and improve skin, would be one to monitor carefully. Vitamin C, taken in large doses, can cause kidney stones. Despite some risks, vitamins and supplements can be beneficial when used wisely.

Alexander Valley Healthcare physician Shellie Burdick, DO, recommends starting with a diet rich in fruits and vegetables to assure we have the nutrients we require for good health. That is always the best and most cost-effective way to achieve balanced intake of vitamins and fiber.

Assuming a generally good, balanced diet is already in place, who is likely to benefit from taking vitamins or supplements? There are times in many of our lives when supplements can prove useful. For example, physicians often recommend that older adults losing bone density and cancer patients receiving certain treatments take calcium to protect their bones. Topical and oral forms of plant-based Arnica may be recommended to speed healing and reduce bruising and scarring from minor surgeries. Vegans and those with gut malabsorption problems should discuss supplements with their physician.

It is often recommended that pregnant women take vitamins, especially folic acid. Mothers of young, picky eaters often worry their children are not getting what they need from daily peanut butter sandwiches or mac and cheese meals. For those children, a single daily multi-vitamin may be recommended. An extra word of caution: Store sweet-tasting children’s vitamins where young children (who might equate their taste with candy) cannot get to them.

Many physicians do not object to prudent use of vitamins and supplements by their patients, some of whom may have cultural beliefs and traditions involving certain herbs. Because certain vitamins and supplements have the potential to be detrimental if misused, and because they may occasionally pose problems when combined with certain medications, consumers should discuss use of food supplements with their physician before taking them. They should remind their doctors they take these products before surgery or dental work.

Consumers who feel these products are helpful and that they do no harm should still seek out and read cautions. A simple online search starting with the words “vitamin studies” will bring up a number of articles related to specific health concerns on credible websites (National Institutes of Health, Johns Hopkins, Harvard). For example, NIH warns against smokers using in excess of the daily Vitamin A recommendations because studies indicate doing so can lead to increased risk of lung cancer for those patients.

If you wish to research the quality of the supplement brand you want to use, a website that can prove helpful in terms of quality is This website lists brands that have undergone independent source testing. It provides general information to the public and more specific information for those who want to become members. Reputable health websites will counsel that taking supplements is not a shortcut to good health, nor does it override poor eating habits.

“We are fortunate to live in a country with an abundance of food options that allows us to have the necessary plant-based choices containing the vitamins, nutrients and fibers to stay healthy,” says Dr. Burdick. I believe the topics of a balanced diet and use of supplements should be part of an ongoing conversation with your health care professional.”

Paula Wrenn is a Cloverdale resident who has co-authored a book about end of life. She currently serves as board chair for Alexander Valley Healthcare. She can be reached at

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