Amy Martin’s 3-year-old twins were sick yet again. “We were just getting cold after cold,” she says.
Her solution––dietary supplements. After searching online for ideas, she picked up a bottle of elderberry gummies. And she isn’t alone: Google logged over a half-million searches for “elderberry for colds” in the past year.
But Martin soon became disillusioned. The gummies made no appreciable difference in the frequency of her family’s colds. She still gives her sons other supplements, including vitamin D, melatonin, and probiotics, but wonders whether she is wasting money.
Most herbal dietary supplements aren’t designed or marketed for children. According to Innova Market Insights, just under 5% of dietary supplement launches are aimed at children.
Nonetheless, about one-third of children in the United States take dietary supplements, according to a nationally representative survey. Between 2004 and 2014, children’s and adolescents’ use of herbal and nonvitamin supplements nearly doubled, from 3.7% to 6.7%.
Researchers still know little about whether or how dietary supplements can benefit—or hurt—kids. Parents often rely on anecdotal evidence and may be swayed by advertising or their own supplement use. According to a Centers for Disease Control and Prevention report, children with parents who use dietary supplements or other complementary health approaches are more likely to use them than those whose parents do not.
But as children’s use of herbal supplements continues to rise, so do the number of calls to poison centers. “[Supplement-related calls] have been steadily increasing since 1994,” says Susan Smolinske, director of the New Mexico Poison and Drug Information Center. That’s when legislation went into effect that allows the Food and Drug Administration (FDA) to intervene only after products are already on the market.
“What that created in this essentially almost unregulated environment is an industry gone wild,” says S. Bryn Austin, a public health researcher and professor at the Harvard T. H. Chan School of Public Health. “The industry went from 4,000 products on the market when this law was passed to well over 80,000 products.”
Austin warns parents that just because a product is on store shelves doesn’t mean it’s safe for children — or even that it contains what it claims on the bottle. The FDA has recalled 12 dietary supplements in 2019 alone, mostly because of mislabeling or undeclared ingredients.
Austin and other researchers examined the FDA’s database of adverse events related to supplements in children and adolescents. Of 977 events reported between 2004 and 2015, about 40% involved severe medical outcomes such as hospitalization, disability, or death. Supplements that promised energy, weight loss, and muscle building were associated with nearly three times the risk of an adverse event compared with those that did not.
“These products are not proven to turn anyone into an Olympic athlete or the highest scorer on their team,” Austin says. “What they are proven to do is lead to serious adverse events when the products have dangerous ingredients, which too often they do.”
In a study published in Hepatology Communications this year, researchers analyzed the ingredients of 272 herbal and dietary supplements associated with liver injury. Fifty-one percent of them had ingredients that were not listed on the label.
Representatives from the FDA and the National Institutes of Health (NIH) urge parents to communicate with their pediatrician before giving their children an herbal remedy or other supplement. The NIH also offers a series of tip sheets online. In turn, the American Academy of Pediatrics recommends that pediatricians ask parents about which supplements their children are taking.
Smolinske worries that giving these drugs to treat a disease may delay a diagnosis or evaluation by a physician. “If [parents] decide to go it on their own, they may be ignoring something that should be evaluated by a physician.” During her career, Smolinske has seen children with brain tumors and other life-threatening conditions go untreated because their parent thought an herbal supplement could cure their symptoms.
“They think that Dr. Google has all the answers,” she says.
Source: The Washington Post, August 19, 2019