By Mark Lebetkin
The Active Times
Dietary supplements can be scary.
It’s not uncommon to walk into the supplement aisle in your local pharmacy -- or grocery store -- and feel like you've entered the Wild West of the health world. Officially considered food by the FDA, these pills, powders, tinctures and teas are not held to the same standards as drugs, and yet their makers make wild promises that are hard to ignore: they'll make you smarter, calmer, fitter, happier and healthier. They’re "natural" because they're made of plants like ginseng and gingko biloba, or things you eat, or compounds your body produces anyway.
And you're right to be suspicious. The FDA doesn't ensure standardization, meaning two capsules of St. John’s wort from two makers are likely to be far more different from each other in terms of potency and quality than two brands of ibuprofen. The FDA ensures those are virtually identical.
And then there's the question of what works.
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Some supplements can be very effective, but potentially very dangerous. Take ephedrine, for example. This extract from the ephedra plant has been found to be an effective weight-loss supplement when paired with caffeine (1,2,3) and is found in so-called diet pills (and is used to make crystal meth, by the way). It can still be bought over the counter in small quantities in Sudafed or other nasal decongestants, but can be addictive and cause serious heart problems -- even sudden heart attacks -- when not used under the guidance of a doctor. And it’s banned in most sports, for that matter.
So which ones do work and won’t get you kicked out of the NCAA, or worse?
Because supplements don’t have to go through the same approval process as drugs, the level of science around any given one is far below what you’d expect for something your doctor prescribes. That said, many supplements, like creatine, melatonin, and fish oil, have been through the scientific wringer, and although they’re not as well tested as their pharmaceutical counterparts, turn out to work almost as well -- and better in some cases.
We did some digging into the databases and came up with some supplements that do (some of) what they say they do. These won't work miracles, but they have been shown to work.
As with "normal" drugs, you should consult your doctor before taking any of these since they may not be for all ages and health conditions, and may interact with other medications.
Many of the promised effects of these supplements wither under scientific scrutiny. For example, evening primrose oil is sold as a way to reduce PMS symptoms, but human trials have found it to be only as useful as a placebo. Don’t waste your money.
The Petasites hybridus root, or butterbur, is a shrub native to Europe (as well as some parts of North America and Asia) that has traditionally targeted ailments including migraine and fever for centuries, according to the National Institutes of Health. But more recent research also backs the historic use of this plant in treating migraines. A 2006 review of 293 patients by a Swiss research and headache diagnosis center showed higher doses of the Petasites root extract Petadolex reduced the occurrence of headaches over a roughly four month period. Last year, both the Canadian Headache Society and a committee of the American Headache Society issued papers recommending its use for migraines. But a word of caution: there is not enough research to back the safety of its long-term use, and the NIH says that the plant in its unprocessed forms contains chemicals that may harm the liver. Consumers should be careful to look for forms of butterbur that have been processed to remove these chemicals, called pyrrolizidine alkaloids.
This pungent bulb is frequently touted for its heart health benefits, with a number of studies indicating it can help lower blood pressure in patients with hypertension. But its supplement form isn’t too shabby either. Research from the Los Angeles Biomedical Research Institute at Harbor-UCLA indicates that consuming aged garlic extract, available in capsule form, can help slow down atherosclerosis—or the hardening of the arteries—when it is taken along with B vitamins, folic acid, and the protein compound L-arginine. Over the course of a year, the study tracked the progression of atherosclerosis, one of the leading cause of heart attacks and stroke, among 65 moderate risk patients between roughly 50 to 70 years of age. The study found the patients who took the supplements had their arteries harden more slowly than those who were on placebos.
Green tea is frequently touted as one those all-around good-for-you additions to your diet, and for good reason: it has high concentrations of antioxidants called catechins, which are the same class of healthful compounds found in dark chocolate. It lowers cholesterol, increases heart health and protects against ovarian and certain other cancers. Green tea supplements are currently being sold as fat burners as well, but those claims remain unsubstantiated by research. Still, with all its other benefits, green tea—either as an extract or a drink—is worth adding to your diet as long as you have no problems with caffeine.
The root of this plant, also called kava kava or ‘ava, has been used throughout Oceania and Hawaii for centuries to make a drink with a number of apparent medicinal—and intoxicating—purposes, and in recent decades has been marketed as a supplement for treating anxiety. Several human trials have borne this out for short-term treatment of non-psychotic anxiety. It once even showed promise as a less side-effect laden alternative to Xanax and Valium (1,2). However, there was a scare in the early 2000s when some 25 people worldwide reported serious liver problems—at least one fatal—possibly linked to the supplement. Human research has since resumed, confirming kava’s ability to calm nerves, and so far has found no ill effects on liver function (3,4). Still, if you have liver problems, you should steer clear. Look for an extract or capsule that isn’t combined with other herbs, and don’t take for more than three months at a time. Also check with your doctor about drug interactions.
Whoever named this fruit of the chaste tree the “women’s herb” must be in cahoots with sitcom writers who would have you believe every menstruating woman is entirely in thrall to her uterus once a month. In reality, only about up to eight percent of women experience the kind of severe symptoms of premenstrual syndrome that may require treatment, according to the government’s Office on Women's Health. That’s where this supplement could really come in handy. A study of 162 patients with PMS by the Institute for Health Care and Science in Germany, published in 2012, found that extracts of the fruit helped ease PMS symptoms and treat irregular menstrual cycles. The NIH does caution however that this treatment may affect hormone levels, so pregnant women or those taking hormonal contraception should steer clear of this supplement.
Long used in traditional Indian cuisine as well as in Ayurvedic treatments, this spice from the root Curcuma longa is more than just a flavorful seasoning in curries. Reviews by the University of California have unearthed a body of research on this golden yellow root, and at least six human trials have shown it is safe for adult consumption and has some anti-inflammatory effects. Researchers believe it may work by restricting compounds involved in inflammation. Research reviewed by the NIH has also indicated that turmeric may also help ease upset stomachs, and alleviate the pain of osteoarthritis, with research from the Siriraj Hospital in Thailand indicating it may be just as effective and safe as ibuprofen in reducing osteoarthritic knee pain.
The leaves and fruit of this Egyptian shrub, which are often sold in the form of "senna tea,” have long been trusted by doctors as a laxative -- so much so that it’s given before colonoscopies (1,2,3). The advertised "slimming” or “diet" properties of the tea should be taken with a grain of salt (or sugar, since it’s reported to taste unpleasant) since those effects are due to its laxative properties, and the tea form is less well studied than standardized supplements. Still, in measured doses, the supplement is likely to take care of your constipation—just don’t take more than you need to, er, get the job done, and don’t use for more than two weeks at a time.
Makers of this supplement, pronounced “Sammy,” claim it can relieve the pain of osteoarthritis and help with depression—and for the first claim, there’s solid enough evidence to say they’re right. SAMe, which stands for S-Adenosyl methionine, an amino acid that your body naturally produces, even has the backing of several European countries, where it is sold as a prescription drug for arthritis. Studies have shown it can be as effective as anti-inflammatory drugs typically recommended for arthritis, such as naproxen and ibuprofen, but doesn’t harm the stomach and has fewer side effects than these popular choices (1,2).
The root of this wildflower found throughout northern climes (hence its nickname “Arctic root”) has found its way to the supplement aisle to treat a number of problems -- anxiety, depression, aging and, well, just about everything. The scientific evidence for its varied benefits are limited, but the one area in which this supplement shines is fighting fatigue. No wonder it’s so popular in Scandinavia and Russia during their dark Arctic winters. There have been studies from Russia and Armenia of its effects on students in the midst of exams, cadets in night training and doctors on the night shift, all of which showed that this plant’s extract made them less tired and better able to perform mental tasks. A small Belgian study found that it may even improve physical endurance as well, and a couple of studies from Sweden and the UK have found it beneficial for stress-related fatigue (1,2).
The benefits of a good night’s sleep need no explanation, which is why insomnia is big business in the over-the-counter drug market. The most common pharmaceuticals can't be taken for extended periods and are less effective the longer you use them. Not so for melatonin. Melatonin is your body's natural "sleep hormone," which can be supplemented in pill form. While it doesn’t work for everybody, melatonin has been shown in a number of studies to help insomniacs of all ages get to sleep with no major side effects or withdrawal symptoms (1,2,3,4). Although it’s safe for most people (check with your doctor for drug interactions) melatonin works especially well for people over 55.
Those little translucent capsules you keep hearing about are the real deal: fish oil is good for your heart. It contains high levels of omega-3 fatty acids, which have been shown by many studies to be one of the best ways to reduce the level of triglycerides, a type of fat, in your blood -- which means a lower risk of heart disease. One major review, looking at 11 studies and over 39,000 patients at moderate to high risk of heart disease, found that fish oil significantly reduced the risk of heart attack.