What are the benefits of magnesium supplements. How to choose the right type of magnesium supplement. When is the best time to take magnesium supplements. What are the potential side effects of magnesium supplementation.

Understanding Magnesium: A Vital Nutrient for Overall Health

Magnesium is a crucial mineral that plays a fundamental role in numerous bodily functions. This essential nutrient is involved in over 300 enzymatic reactions, making it indispensable for optimal health. Despite its importance, many people may not be getting enough magnesium through their diet alone, leading to an increased interest in magnesium supplements.

Magnesium supplements are designed to address deficiencies and support various aspects of health, including:

• Nerve function
• Muscle health
• Bone strength
• Cardiovascular health
• Energy production
• Protein synthesis

Given its wide-ranging impact on the body, ensuring adequate magnesium intake is crucial for maintaining overall well-being and preventing potential health issues associated with deficiency.

Types of Magnesium Supplements: Choosing the Right Form

When it comes to magnesium supplements, not all forms are created equal. Different types of magnesium compounds offer varying levels of bioavailability and specific benefits. Here are some common forms of magnesium supplements:

Magnesium Oxide

Magnesium oxide is one of the most common and affordable forms of magnesium supplements. It has a high percentage of elemental magnesium but lower bioavailability compared to other forms. This type is often used to alleviate constipation and indigestion due to its laxative effects.

Magnesium Citrate

Magnesium citrate is highly bioavailable and easily absorbed by the body. It’s often recommended for those seeking to increase their magnesium levels quickly. This form also has a mild laxative effect and can help promote regular bowel movements.

Magnesium Glycinate

Magnesium glycinate is a chelated form of magnesium, meaning it’s bound to the amino acid glycine. This form is known for its high absorption rate and is less likely to cause gastrointestinal side effects. It’s often recommended for those with sensitive stomachs or those looking to address magnesium deficiency without digestive discomfort.

Magnesium Chloride

Magnesium chloride is another highly bioavailable form of magnesium. It’s often used in topical applications, such as magnesium oils or lotions, as it can be absorbed through the skin. This form is particularly beneficial for those with digestive issues that may impair oral supplement absorption.

Choosing the right type of magnesium supplement depends on individual health needs, absorption rates, and potential side effects. Consulting with a healthcare professional can help determine the most suitable form for your specific requirements.

Benefits of Magnesium Supplementation: Beyond Deficiency Prevention

While addressing magnesium deficiency is a primary reason for supplementation, the benefits of adequate magnesium intake extend far beyond prevention. Here are some key advantages of magnesium supplementation:

Improved Bone Health

Magnesium plays a crucial role in bone formation and maintenance. It helps regulate calcium levels in the body and activates vitamin D, which is essential for calcium absorption. Adequate magnesium intake can contribute to increased bone density and reduced risk of osteoporosis.

Enhanced Cardiovascular Function

Magnesium is vital for maintaining a healthy heart rhythm and supporting overall cardiovascular health. It helps regulate blood pressure, reduce inflammation, and improve blood flow. Some studies suggest that magnesium supplementation may lower the risk of heart disease and stroke.

Better Sleep Quality

Magnesium has a calming effect on the nervous system and can help regulate neurotransmitters involved in sleep. Supplementation may improve sleep quality, duration, and the ability to fall asleep faster, particularly in individuals with insomnia or sleep disorders.

Reduced Muscle Cramps and Tension

Magnesium is crucial for proper muscle function and relaxation. Supplementation can help alleviate muscle cramps, tension, and spasms, making it particularly beneficial for athletes and individuals experiencing frequent muscle discomfort.

Mood Regulation and Stress Reduction

Magnesium plays a role in regulating neurotransmitters that affect mood and stress response. Adequate magnesium levels may help reduce symptoms of anxiety and depression, promote relaxation, and improve overall mental well-being.

These benefits highlight the importance of maintaining optimal magnesium levels through diet and, when necessary, supplementation. However, it’s essential to remember that individual responses to magnesium supplementation may vary, and consultation with a healthcare provider is recommended before starting any new supplement regimen.

Magnesium Dosage and Timing: Maximizing Absorption and Effectiveness

Determining the right dosage and timing for magnesium supplementation is crucial for maximizing its benefits while minimizing potential side effects. Here are some key considerations:

Recommended Daily Intake

The recommended daily allowance (RDA) for magnesium varies based on age, sex, and life stage:

• Adult men: 400-420 mg per day
• Adult women: 310-320 mg per day
• Pregnant women: 350-360 mg per day
• Breastfeeding women: 310-320 mg per day

However, individual needs may vary based on factors such as health conditions, medications, and lifestyle.

Optimal Timing

The timing of magnesium supplementation can impact its absorption and effectiveness:

• With meals: Taking magnesium with food can help improve absorption and reduce the likelihood of gastrointestinal side effects.
• Before bedtime: Some people find that taking magnesium in the evening helps promote relaxation and improve sleep quality.
• Split doses: Dividing the daily dose into two or three smaller doses throughout the day may enhance absorption and reduce the risk of digestive discomfort.

Factors Affecting Absorption

Several factors can influence magnesium absorption:

• Type of magnesium: Some forms, like magnesium glycinate and citrate, are more easily absorbed than others.
• Vitamin D levels: Adequate vitamin D is essential for optimal magnesium absorption.
• Calcium intake: High calcium intake may interfere with magnesium absorption, so balancing these minerals is important.
• Phytic acid: Found in some plant-based foods, phytic acid can bind to magnesium and reduce its absorption.

To maximize the benefits of magnesium supplementation, it’s essential to consider these factors and adjust your intake accordingly. Always consult with a healthcare professional to determine the most appropriate dosage and timing for your individual needs.

Potential Side Effects and Precautions of Magnesium Supplementation

While magnesium supplements are generally safe for most people when taken as directed, it’s important to be aware of potential side effects and take necessary precautions:

Common Side Effects

Some individuals may experience mild side effects when taking magnesium supplements, including:

• Diarrhea
• Nausea
• Abdominal cramping
• Vomiting

These symptoms are often dose-dependent and may be alleviated by reducing the dosage or switching to a different form of magnesium.

Interactions with Medications

Magnesium supplements can interact with certain medications, potentially affecting their absorption or efficacy. Some medications that may interact with magnesium include:

• Antibiotics
• Bisphosphonates (used for osteoporosis)
• Diuretics
• Proton pump inhibitors

It’s crucial to consult with a healthcare provider before starting magnesium supplementation if you’re taking any medications.

Risk of Magnesium Toxicity

While magnesium toxicity from dietary sources is rare due to the body’s ability to eliminate excess magnesium, it can occur with excessive supplementation. Symptoms of magnesium toxicity may include:

• Low blood pressure
• Irregular heartbeat
• Confusion
• Muscle weakness
• Difficulty breathing

Individuals with kidney problems are at higher risk of magnesium toxicity and should consult a healthcare provider before supplementing.

Special Considerations

Certain groups should exercise caution when considering magnesium supplementation:

• Pregnant or breastfeeding women
• People with kidney disease
• Individuals with heart conditions
• Those with gastrointestinal disorders

These groups should consult with a healthcare professional before starting any magnesium supplementation regimen.

By being aware of potential side effects and taking necessary precautions, individuals can safely incorporate magnesium supplements into their health routine and reap the benefits of this essential mineral.

Magnesium-Rich Foods: Natural Sources to Boost Your Intake

While supplements can be beneficial, incorporating magnesium-rich foods into your diet is an excellent way to naturally increase your magnesium intake. Here are some of the best dietary sources of magnesium:

Leafy Green Vegetables

Leafy greens are packed with magnesium and other essential nutrients. Some top choices include:

• Spinach
• Swiss chard
• Kale
• Collard greens

These vegetables are versatile and can be easily incorporated into salads, smoothies, or cooked dishes.

Nuts and Seeds

Nuts and seeds are excellent sources of magnesium and healthy fats. Some magnesium-rich options include:

• Almonds
• Cashews
• Pumpkin seeds
• Sunflower seeds
• Chia seeds

These can be enjoyed as snacks, added to salads, or used in baking.

Whole Grains

Whole grains are not only rich in fiber but also provide a good amount of magnesium. Some options to consider are:

• Quinoa
• Brown rice
• Oats
• Whole wheat bread

Incorporating these grains into your meals can help boost your magnesium intake.

Legumes

Legumes are an excellent source of plant-based protein and magnesium. Some magnesium-rich legumes include:

• Black beans
• Lentils
• Chickpeas
• Kidney beans

These can be used in soups, stews, salads, or as a side dish.

Fish

Certain types of fish are good sources of magnesium and omega-3 fatty acids. Some options include:

• Salmon
• Mackerel
• Halibut
• Tuna

Incorporating fish into your diet a few times a week can help boost your magnesium intake.

By including a variety of these magnesium-rich foods in your diet, you can naturally increase your magnesium intake and potentially reduce the need for supplementation. However, for those with specific health conditions or dietary restrictions, a combination of food sources and supplements may be necessary to meet their magnesium requirements.

Magnesium and Exercise: Enhancing Athletic Performance and Recovery

Magnesium plays a crucial role in exercise performance and recovery, making it an essential mineral for athletes and fitness enthusiasts. Understanding the relationship between magnesium and physical activity can help optimize workout routines and overall athletic performance.

Energy Production and Muscle Function

Magnesium is involved in numerous processes related to energy production and muscle function:

• ATP synthesis: Magnesium is required for the production of adenosine triphosphate (ATP), the primary source of energy for cellular processes, including muscle contractions.
• Muscle relaxation: Magnesium helps regulate calcium levels in muscle cells, promoting proper muscle contraction and relaxation.
• Protein synthesis: The mineral is essential for protein synthesis, which is crucial for muscle growth and repair.

Adequate magnesium levels can contribute to improved endurance, strength, and overall exercise performance.

Electrolyte Balance and Hydration

Magnesium acts as an electrolyte in the body, helping to maintain proper fluid balance:

• Sweat loss: During intense exercise, magnesium is lost through sweat, potentially leading to deficiency if not replenished.
• Hydration: Proper magnesium levels help regulate other electrolytes, supporting optimal hydration during and after exercise.

Maintaining adequate magnesium intake can help prevent electrolyte imbalances and support proper hydration during physical activity.

Recovery and Muscle Soreness

Magnesium supplementation may aid in post-exercise recovery:

• Reduced inflammation: Magnesium has anti-inflammatory properties that may help reduce exercise-induced inflammation and muscle damage.
• Improved sleep quality: As magnesium promotes relaxation, it can contribute to better sleep, which is crucial for recovery.
• Decreased muscle soreness: Some studies suggest that magnesium may help alleviate delayed onset muscle soreness (DOMS) following intense exercise.

Incorporating magnesium-rich foods or supplements into a post-workout routine may enhance recovery and reduce muscle soreness.

Considerations for Athletes

Athletes and regular exercisers should be mindful of their magnesium intake:

• Increased needs: Physical activity may increase magnesium requirements, especially for those engaging in intense or prolonged exercise.
• Timing: Consuming magnesium-rich foods or supplements before or after workouts may help support performance and recovery.
• Individual variations: Magnesium needs can vary based on factors such as body weight, exercise intensity, and sweat rate.

Consulting with a sports nutritionist or healthcare provider can help determine the optimal magnesium intake for individual athletic needs.

By understanding the role of magnesium in exercise performance and recovery, athletes and fitness enthusiasts can make informed decisions about their nutrition and supplementation strategies to support their physical activities and overall health.

Magnesium Supplements | Walgreens

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Magnesium supplements

Magnesium supplements are used to treat deficiencies of this vital nutrient as well as to boost the functioning of nerves, muscles, and bones. This nutrient can also be part of dietary supplements designed to improve bone strength or immunity.

Choosing vitamin supplements

Many people who use magnesium supplements also use other vitamins supplements as well. The specific nutrients you choose depends on your specific health condition and general state of health. Common supplements that are used in conjunction with magnesium include calcium supplements, omega-3 fatty acids, and zinc supplements. In some cases, magnesium is combined with other nutrients in a single supplement. Calcium-magnesium supplements are a common combination because both of these nutrients work together to build strong bones. In some cases, vitamin D is also included in the same supplement. Other dietary supplements contain magnesium in combination with chelating agents that help improve absorption.

Using magnesium supplements

Magnesium supplements are available in tablet, capsule, and softgel form. These are typically taken up to three times a day during meals to help make it easier to digest the supplement. People with gastrointestinal disorders may need to take a specific dose of magnesium every day. Magnesium also boosts the uptake of potassium and calcium supplements, so people taking these may also need magnesium supplements. This nutrient may also help lower blood pressure, so magnesium supplements may be used for this purpose as well. Your doctor can help you decide whether and when to take magnesium supplements.

8 Best Magnesium Supplements Of 2023 – Forbes Health

Magnesium has been shown to have a multitude of benefits, including heart, nerve, bone and muscle health. Diets high in magnesium are even thought to help lower rates of disease, though this could be due to the other nutrients involved in a magnesium-rich diet, and additional research is needed.

The following are areas in which magnesium is thought to benefit most:

Bone Health. It’s estimated that 60% of the body’s magnesium is stored in bones, making it a massive contributor to bone health ^{tippy-popover-container-bg-white’ }”>[1]}Magnesium. Harvard T.H. Chan School of Public Health. Accessed 5/13/2022. . The mineral also takes part in bone-building cell activity and calcium regulation through the parathyroid hormone, and is known to impact the concentration of vitamin D in the body, which also contributes to maintaining bone health. In some cases, a magnesium deficiency is thought to lead to an increased risk of osteoporosis.

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Type 2 Diabetes. Due to its role in blood sugar regulation, adequate magnesium intake may help decrease the risk of type 2 diabetes.

The link between magnesium intake and diabetes risk may be connected to hypomagnesemia, a condition that signifies low levels of magnesium in the body, according to the National Institutes of Health (NIH). More research on magnesium deficiency and the development of type 2 diabetes is needed, though, and the American Diabetes Association notes there’s not enough evidence to say magnesium supplements can improve blood sugar regulation in people with diabetes.

Migraines. Both the American Academy of Neurology and the American Headache Society note that magnesium may be an an effective therapy for migraines, due to magnesium’s role in neurotransmitter release and vasoconstriction (the constriction of blood vessels), which play primary roles in the development of migraines.

However, the use of magnesium to help prevent headaches is still being researched, and it should not be used to treat migraines without the supervision of a health care professional, as the effective dosage exceeds the RDA.

Heart health. High rates of magnesium may help reduce blood pressure, though more evidence is needed. While the U.S. Food and Drug Administration (FDA) previously noted diets rich in magnesium may help reduce the risk of hypertension (high blood pressure), they have since found the claim to be inconclusive based on a lack of data. However, magnesium is also believed to potentially decrease risk of stroke, according to NIH.

Mental health. When certain neurological pathways are not functioning correctly, conditions like depression and anxiety may develop. Research from ADD suggests a connection between magnesium and these neurological pathways, therefore magnesium supplementation may help treat these conditions. However, longer, larger clinical trials are needed to determine if this claim holds weight.

Can Magnesium Help with Sleep?

Magnesium may improve sleep due to the mineral’s ability to calm the nervous system and reduce stress. In fact, a small study evaluating 46 older adults who received 500 milligrams of magnesium for eight weeks found that magnesium supplementation improved sleep quality, the time of sleep onset and how long individuals stayed asleep ^{tippy-popover-container-bg-white’ }”>[2]}Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012;17(12):1161-1169. . Magnesium glycinate, a compound formed by combining magnesium and the amino acid glycine, may promote sleep quality and reduce daytime sleepiness.

Does it help with depression and anxiety, effectiveness, is it worth taking

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07.06.23

Svetlana Belitskaya

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Magnesium supplements are popular over-the-counter drugs that try to relieve stress and treat anxiety.

At the same time, the effectiveness of supplements with this trace element as sedative drugs has not been proven.

Even before 2020, anxiety disorders were common health problems. COVID-19 pandemicand the events of the past month have worsened the situation.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Since millions of people on Earth need sedatives every day, scientists are trying to create new effective anti-anxiety drugs that would not cause side effects and would be shown to children, pregnant women, and the elderly. They consider magnesium supplements as one of such means.

According to the State Register of Medicines, several dozens of magnesium preparations, both domestic and foreign, are registered in Russia. Several dietary supplements with magnesium are also registered in the Rospotrebnadzor database.

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In many preparations and supplements, magnesium is combined with other bioactive components: minerals, vitamins, brewer’s yeast. A combination of magnesium and vitamin B6 is usually tried as a sedative.

Russian magnesium preparation from Pharmstandard-UfaVITA. Source: “Eapteka” German preparation of magnesium. Source: Eapteka

How magnesium and anxiety are related

Mg²+ is important for the human body. The trace element is involved in the synthesis of nucleic acids, energy metabolism, insulin release, muscle contractions.

In the 1980s, scientists discovered that Mg²+ affects the functioning of the central nervous system.

There are two main neurotransmitters in the human brain – excitatory glutamate and inhibitory CNS activity gamma-aminobutyric acid, GABA.

Theoretical studies have shown that when the neurons involved in glutamate are too active, a person becomes anxious. Magnesium weakens the action of glutamate. And at the same time, it enhances the effect of GABA on nerve cells, which is important for combating stress, because when GABA is not enough, a person is anxious.

Studies have also shown that stress depletes magnesium, and low levels of the trace element lead to stress. When a person is under stress, he produces special hormones that help him survive in a difficult situation. They activate the cardiovascular and respiratory systems, increase brain activity.

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But stress hormones work in such a way that they reduce the concentration of magnesium in the blood serum and lead to its loss in the urine. The endocrine glands that produce stress hormones are sensitive to magnesium deficiency: when the level of the microelement decreases, they work more actively. And gradually, there are more and more stress hormones, and the body continues to lose magnesium and become “nervous”. A vicious circle closes: stress – loss of magnesium – increased stress – additional losses of the microelement.

In other words, magnesium regulates the functioning of the nervous system in such a way that it prevents the negative effects of stress and the development of anxiety. Therefore, scientists have suggested that micronutrient supplementation may be useful for treating anxiety.

Is Magnesium Effective in Combating Anxiety

In 2017, Nutrients magazine published a review article that analyzed the scientific literature available at the time on the effects of magnesium supplementation in treating anxiety. In total, the authors of the review found 6573 publications on this topic. But the review included only double-blind randomized clinical trials, RCTs, in which people with mild anxiety participated without serious physical illnesses and identified depletion of magnesium reserves in the body.

According to the rules of the RCT, one group of volunteers takes the study drug, the second – a placebo or a drug with proven efficacy. Who got a placebo or a drug with recognized efficacy, and who got the study drug, neither the volunteers nor the doctors know.

Eight were selected from 6573 studies according to RCT criteria. But they also turned out to be unreliable: they all had at least one of the three shortcomings.

Problems with statistical processing of results. Six out of eight studies assessed the effectiveness of treatment using the Hamilton Anxiety Scale – HAM-A. The authors of the review indicate that the use of this scale is associated with errors in data processing.

No placebo control. Three studies compared magnesium supplements to other drugs rather than placebo. The lack of “dummy” control reduces the reliability of studies, since the assessment of the placebo effect is important in the development of treatments for psychiatric conditions – anxiety, depression, addictions. At the same time, all studies with a placebo group analyzed by the authors of the review showed that the effectiveness of the “dummy” is comparable to the effectiveness of magnesium preparations.

They say the placebo effect doesn’t work for everyone, right?

The use of magnesium in combination with other bioactive compounds. Only one study out of eight used magnesium by itself. In all the rest, the trace element was supplemented with vitamin B6 or medicinal plants. Vitamin B6 can alter the functioning of neurotransmitters involved in the development of anxiety.

Instructions for Medical Use “Magne B6″PDF, 40.7 KB

As a result, the authors of the review concluded that the effectiveness of magnesium for the treatment of even mild anxiety has not been proven. Those clinical studies that seem to meet modern quality standards, upon careful examination, turn out to be not completely reliable.

Since the review was published, the situation with studies of the relationship between magnesium and anxiety has not changed.

Examine.com, an independent database of dietary supplements, lists only one study in March 2022 on the effects of magnesium on anxiety. But it is dedicated to the treatment of premenstrual syndrome, not stress and background anxiety.

A paper published in PLoS One in 2018 claims to be a randomized and blinded trial and proves the effectiveness of magnesium supplements for treating anxiety. But in fact, in the experiment, magnesium and magnesium + vitamin B6 were compared in a blind, randomized method.

Stress suppression efficacy of magnesium and magnesium in combination with vitamin B6 was approximately the same. But the study did not evaluate either placebo or other anti-anxiety agents. Therefore, it cannot be argued that the stress in the volunteers in the experiment decreased due to the intake of magnesium. Perhaps their condition has improved over time or for some other reason.

A 2021 study demonstrated the effectiveness of magnesium against social stress induced by the Trier Social Stress Test – TSST. Volunteers gave a speech introducing themselves as candidates for employment, and then performed mathematical operations. They did it in front of a jury, which was a major stressor.

The study was randomized: volunteers were assigned to groups at random. A placebo control was used: 25 out of 100 people received a dummy tablet instead of a magnesium preparation.

The experimental group of 75 people was divided into three subgroups. All subgroups received magnesium, vitamins B6, B9 and B12. The difference between the subgroups was in the supplementation of green tea and rhodiola extracts.

The results of the experiment showed that the combination of magnesium, vitamins B6, B9 has the highest effectiveness against stress, B12, green tea and Rhodiola extracts. That is, the study does not prove the effectiveness of magnesium: it is possible that stress in participants decreased due to the action of vitamins or herbal extracts.

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Do I need to take magnesium to calm down

Magnesium preparations registered in Russia do not belong to the group of sedatives. Even those manufacturers who advertise their drugs as a means of combating anxiety honestly indicate that the medicine helps with anxiety only if it arose against the background of a trace element deficiency.

The official website of Magne B6 indicates that it is effective for magnesium deficiency

If we open the instructions posted on this site, we will see that the indication for the use of the drug is an established magnesium deficiency, which may be accompanied by irritability and insomnia.

Established magnesium deficiency, or hypomagnesemia, may be asymptomatic. But it usually manifests itself with trembling, convulsions, and heart rhythm disturbances. Hypomagnesemia develops against the background of hunger, taking certain medications and serious illnesses – for example, Crohn’s disease, acute pancreatitis, alcoholism.

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You can’t self-diagnose magnesium deficiency. Such a diagnosis can only be made by a doctor based on tests. True, the manufacturers of Magne B6 posted a special questionnaire on their website, with the help of which one can suspect a lack of a microelement. However, as if by chance, they warn that the test results are not a diagnosis, and for a reliable detection of trace element deficiency, you should consult a doctor.

Magnesium Deficiency QuestionnairePDF, 40.7 KB

The effect of magnesium on anxiety has only been shown in basic research. There is no reliable clinical evidence of the effectiveness of micronutrient therapy for anxiety disorders.

Clinical Guidelines for the Diagnosis and Treatment of Panic Disorder and Generalized Anxiety Disorder – Russian Society of Psychiatrists

Guidelines for the Treatment of Generalized Disorder – American Anxiety and Depression Association

None of the domestic or foreign clinical guidelines for the treatment of anxiety contain supplements with magnesium and magnesium in combination with vitamin B6. Therefore, it is unreasonable to try to treat anxiety with a trace element without consulting a doctor.

There are five ways you can use to reduce anxiety to stay calm during difficult times. If you can’t calm down, you need to contact a psychotherapist.

Essential skills in times of stress – WHO pictorial guide

Dietary supplements and liver. Healthy and Harmful Food Supplements for the Liver

Food and herbal supplements are becoming more and more popular. According to studies, they are taken by approximately 50% of the adult population of developed countries. Most nutritional supplements are in the form of vitamins and minerals, as well as muscle building and weight loss supplements, but herbal supplements are also very popular. However, many people are not well aware of the active ingredients of dietary supplements, side effects and drug interactions. In our article, we collected data on healthy and harmful dietary supplements based on scientific research.

Why are dietary supplements so popular?

In medical practice, one often comes across diagnoses that do not require treatment, and it is only necessary to monitor its course in dynamics. In such cases, representatives of alternative medicine can easily convince a person to “do not hesitate” and drink drugs that will help cure the disease and prevent its progression. However, it is extremely rare that they inform the patient about the harm and side effects of the recommended dietary supplement / nutritional supplement.

Often people prescribe these remedies to themselves after reading forums, Instagram blogs and watching some Youtube channels. Recently, the idea that taking a dietary supplement can replace the positive health effects of proper diet and physical activity has become extremely attractive.

In addition, drugs with proven efficacy have a long list of possible side effects from taking them, and little is known about the side effects of dietary supplements. Therefore, patients can make a seemingly obvious, but in fact the wrong choice in favor of unreasonable intake of dietary supplements instead of the drug prescribed by the doctor.

Health risks associated with taking dietary supplements

Contamination with heavy metals, bacteria and fungal infections

nutritional supplements, because their pills contained large amounts of lead. Bacterial and fungal (potentially dangerous mold fungi) contamination (contamination) is also not uncommon. In a 2009 study138 out of 138 formulations studied, bacterial contamination of food additives was found.

In addition, hundreds of weight loss, sexual dysfunction, and muscle building products contain substandard or harmful substances.

Cancer risks

Taking more than the recommended dosage of the vitamin A precursor beta-carotene, such as in immune system stimulants, has been found to increase the risk of lung cancer and heart disease by 20%. In a study of 35,533 participants, supplementation with vitamin E in the form of tocopherols was shown to significantly increase the risk of developing prostate cancer in healthy men (17% higher in the study group than in the placebo group, while the dosage of vitamin E was 400 IU per day).

Risks of interaction with the main therapy, for example, chronic diseases

Patients of the older age group tend to keep silent about the multivitamin complexes and/or biologically active supplements they take, herbal preparations, as a result of which there is a risk of side effects, aggravation of the clinical picture of the underlying disease .

Incorrect positioning

Supplements are sold to children as sweetened lozenges or candies. This practice is unhealthy and carries an inappropriate educational message in the field of nutrition.

Quality problems

Food supplement quality problems have long been a commonplace in the industry. For example, a study of multivitamin and mineral supplements showed significant differences between the amounts of various ingredients listed on the labels and the amounts contained in the supplements themselves.

Are there any proven liver supplements?

There are a number of herbal medicines and herbal supplements that are being offered as natural treatments for liver disease, but it is worth noting that only a small proportion of these have been included in clinical studies.

The first group includes nutritional supplements based on milk thistle seeds , which contain the flavonoid silymarin in their composition. Taking into account that milk thistle seeds can have different content of silymarin depending on the place of growth, only nutritional supplements standardized by its composition are used in medical practice.

Clinical studies of silymarin preparations were carried out with intravenous administration of its preparations, as well as when taken in tablet form. The use of this drug in chronic hepatitis C has been studied, but after the advent of direct-acting antiviral drugs, silymarin preparations have lost their relevance in this case. In non-alcoholic fatty liver disease (non-alcoholic fatty liver disease), the effectiveness of taking the drug in tablet form was noted only in combination with other hepatoprotectors.

Studies have also been conducted on the use of silymarin preparations for the prevention and treatment of drug-induced hepatitis while taking anti-tuberculosis drugs, which showed its effectiveness as a prophylactic agent.

Based on research data, taking preparations containing milk thistle seed extract for liver diseases can be recommended in some cases only on prescription and in a standardized form.

The second group is represented by preparations containing extracts from the root licorice (glycyrrhizic acid) . The use of preparations containing glycyrrhizic acid has shown its effectiveness in various liver lesions and has been confirmed by a number of clinical studies in the treatment of hepatitis of various origins. Preparations based on glycyrrhizin are not recommended for independent use and are used only as directed by a doctor, as they have a number of contraindications.

The third group is food supplements based on artichoke or other medicinal herbs that have choleretic properties and improve the outflow of bile. The use of these nutritional supplements has not been shown to be effective in liver diseases, they are recommended only for diseases of the biliary system.

Although these are over-the-counter products, artichoke supplements require consultation with a gastroenterologist before use, as certain gastrointestinal conditions, such as gallstones, can aggravate the condition. In addition, the use of some medicinal herbs, which are recommended as cholagogues in various sources, can cause liver damage. Therefore, the intake of choleretic food supplements and medicinal herbs must be agreed with the attending physician.

Herbs and food additives harmful to the liver

Toxic liver damage is a specific type of inflammation and/or changes in the structure of the liver, often leading to liver cell death, caused by drugs, herbs and food additives, which are often recognized late because their negative impact on the liver is considered minimal or absent, and there are no specific blood tests before the stage of exclusion of other causes.

Due to interdrug interactions, including those between dietary supplements, the risk of adverse reactions during treatment increases significantly, and the rate of development of drug-induced hepatitis varies from several days to several months.

The FDA (Food and Drug Administration) estimates that there are about 50,000 adverse events each year that can be associated with the intake of dietary supplements, and these are only cases that were reported, and how many more are unreported adverse events phenomena is a big question. Adverse reactions can vary from a slight increase in biochemical parameters to severe, life-threatening conditions, such as liver failure requiring a liver transplant.

Despite the established belief that natural remedies do not harm the liver, dietary supplements and medicinal herbs can be even more dangerous for the liver than chemically synthesized drugs. This is due to the lack of clinical trials of their safety, the unknown composition of the active substances and the presence of hazardous impurities due to insufficient purification. For example, in Asia, especially in China, where herbal treatments are more common, liver damage associated with herbal use predominates over drug-induced liver damage.

Many nutritional supplements are positioned as natural remedies that are safe and cannot harm health, but this is not always true, since among natural remedies there are enough of those that are poisonous, for example, plants – belladonna, celandine and many others or snake venom.

Before appearing in medical practice, drugs go through a long path of clinical trials, during which all the side effects that occur are recorded. On the contrary, nutritional supplements are not a medicine, it is written on their packaging, clinical studies are not conducted for most of them, and one can only guess about the effect of dietary supplements on the body.

More than 100 natural food supplements have been described to date with hepatotoxic effects. The most famous among them are Herbalife, dietary supplements for weight loss and muscle building, supplements containing linoleic acid, aloe vera, green tea, kava kava, noni juice. More than 6,000 types of medicinal plants contain substances that can be harmful to the liver. Hepatotoxic effects have been reported with comfrey, ephedra, senna, dubrovnik, celandine, valerian, turmeric, pennyroyal, kava kava, black cohosh, heliotrope, ragwort, crotalaria, and other medicinal herbs, as well as some traditional Chinese medicine and Ayurveda.

Herbal remedies and dietary supplements can cause a wide range of liver damage from mild asymptomatic elevations in liver enzymes to acute or chronic hepatitis, cirrhosis of the liver, acute or chronic inflammation of the bile ducts (cholangitis), and vascular lesions of the liver. In addition, the use of anabolic steroids in bodybuilding can lead to a wide variety of liver damage, from acute hepatitis to liver tumors, both benign and malignant.

The most harmful food additives for the liver

1. Bodybuilding supplements.
2. Weight loss supplements. For example, aegelin, an alkaloid from the aegle jujube fruit, has been used for many years for gastrointestinal problems and for weight loss. However, studies show that this substance can cause serious liver damage, including the need for an emergency liver transplant.
3. Green tea extracts from Camellia sinensis are often used for weight loss. It has been proven that the substance can cause liver damage due to the production of free radicals. The negative effects of taking usually develop 3 months after the start of use and stop immediately after stopping its use. Approximately 10% of cases of liver damage are fatal. As a result, weight loss products containing green tea extract have been banned in some countries.
4. Energy drinks for frequent or high consumption and herbal complex supplements that increase energy levels.

Even vitamin and dietary supplements can damage the liver. An excess of iron or vitamin A that occurs while taking prophylactic drugs can lead to significant damage to it. Therefore, iron supplements should not be taken unless a deficiency has been diagnosed, and vitamin A should never exceed 5,000 units per day.

When taking dietary supplements and medicinal herbs, we recommend that you follow the same precautions as when taking medication and do not take them without consulting a doctor. During long-term use of drugs or dietary supplements, it is necessary to monitor the biochemical parameters of the liver at least once every three months. When taking dietary supplements and medicinal products at the same time, drug interactions may occur, so inform your doctor about any food supplements and medicinal herbs you are taking.

Doctors “Expert Gastroenterology Center” before prescribing a course of treatment, including drugs with high hepatotoxicity, recommend checking the health of the liver. This is especially true for people who are obese and regularly drink alcohol or patients who are constantly taking medications for a chronic disease. You can check the health of the liver using the comprehensive HepatoCheck-up program, which includes all the necessary examinations and an appointment with a hepatologist.

References

1. Stephanie M Woo, William D Davis, Soorya Aggarwal, Joseph W Clinton, Sara Kiparizoska, and James H Lewis
   Herbal and dietary supplement induced liver injury: Highlights from the recent literature.
   World J Hepatol. 2021 Sep 27; 13(9): 1019–1041. Published online 2021 Sep 27.