Types of Supplements

Key Points

• Supplements can be classified as herbal remedies, vitamins and minerals, nutraceuticals, or combination products.

• Primary care physicians should be familiar with the most popular products and, when necessary, be able to find additional information on indications, safety, and efficacy.

• When discussing the safety of combination products, consider each component individually.

• Marketing information frequently outpaces the information available through good-quality scientific research.

• Price does not necessarily correlate with quality for many products.

Supplements fall into four overall classes: Herbals, vitamins and minerals, nutraceuticals, and combination remedies. In 2007 the nonvitamin, nonmineral products used by adults in the 30 days prior to the survey were fish oil/omega 3 fatty

Box 52-5 Herbs that May Alter Blood Pressure*

Raise Blood Pressure

American ginseng

Broom

Ephedra

Arnica

Cayenne

Ginger

Betel nut

Cola

Licorice

Blue cohosh

Coltsfoot

Yerba santa

Lower Blood Pressure

Aconite/monkshood

Eucalyptus oil

Melatonin

Alpha-linolenic acid

Evening primrose oil

Mistletoe

Arnica

Fish oils

Night-blooming cereus

Baneberry

Flaxseed/flax oil

Oleander

Betel nut

Garlic

Omega-3 fatty acids

Bilberry

Ginger

Pasque flower

Black cohosh

Ginkgo

Periwinkle

Bryony

Goldenseal

Pleurisy root

Calendula

Green hellebore

Shepherd's purse

California poppy

Hawthorn

Texas milkweed

Coleus

Indian tobacco (lobelia) Turmeric

Curcumin

Jaborandi

Wild cherry

Danshen

Maitake mushroom

Data from Basch EM, Ulbricht CE. Natural Standard Herb and Supplement Hand

book: The Clinical Bottom Line. Boston, Elsevier-Mosby, 2005; and Brinker F. Herb

Contraindications and Drug Interactions, 3rd ed. Sandy, Oregon, Eclectic Publica

tions, 2001.

^Includes the most freque

ntly used herbs; list is not comprehensive. Derived from

expert opinion, case reports, preliminary trial evidence, and anecdote. Note that

1 these effects can potentially have therapeutic benefit.

acids, glucosamine, echinacea, flax oil or pills, and ginseng (Barnes et al., 2008).

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