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What Are Health Supplements?

Health or dietary supplements refer to a diverse group of products commonly consumed for the purpose of supplementing the diet and enhancing health.

They are usually presented in dosage forms such as capsules, softgels, tablets and liquids.  Some examples of health supplements include vitamins, minerals (e.g. calcium, iron, magnesium) and herbal supplements (e.g. Echinacea, Guarana).

These products typically contain ingredients from natural sources.  They are not medicinal products meant to prevent, treat, cure or alleviate the symptoms of medical diseases or conditions and are generally considered low-risk. 


What is HSA’s Role in Ensuring the Safety of Health Supplements?

Unlike medicines which contain potent medicinal ingredients, health supplements are currently not subject to approvals, licensing or registration before being sold in the local market.  They are also not assessed for their effectiveness by the Health Sciences Authority (HSA), unlike medicines for which we study their efficacy based on data from stringent clinical trials before granting approvals for them to be administered to patients.  This practice is similar to that found in regulatory systems of developed countries such as USA. 

Under the current system, dealers (who include manufacturers, importers, wholesalers/distributors, re-packers and retailers) are responsible for the safety and quality of their health supplements before these go into the local market.  Dealers must ensure that their products do not contain prohibited ingredients and the levels of toxic heavy metals found in the products are within safety limits set by HSA.

Health supplement dealers generally do not need to apply for a permit from HSA before they advertise their health supplement products.  However, they must ensure that their products do not make claims to treat illnesses or diseases.  Dealers must also be responsible for determining that the claims on their products are accurate and truthful, as well as ensure that the information is printed in a clear and legible manner.  The label and packaging material should also provide sufficient information to enable consumers to make informed decisions when purchasing and consuming the products. 

In line with the approach adopted in the regulatory systems of developed countries, we have in place a post-market surveillance programme to monitor the safety of health supplements.  It has two components:

  • The first is a risk-based market surveillance programme to sample and test products found in the market.  We also obtain feedback from consumers, the media and the industry as part of our intelligence gathering. 

  • The second component is our adverse reaction monitoring programme, which draws on our network of local healthcare professionals to pick up signals of any products that may be causing reactions.  We also obtain information from our international network of national regulatory partners on serious side effects caused by certain products.  This system of checks and controls has enabled us to initiate past recalls of harmful and inferior quality products. 


What Are Some Common Risks Linked to Health Supplements?

Although health supplements generally contain low-risk and low-potency substances derived from natural sources, being low-risk does not mean that they are 100% safe.

Taking a combination of supplements or consuming them with other medication can be harmful and even life-threatening.  Similarly, an “overdose” of a health supplement can also cause health problems.

In addition, there are cases in which unscrupulous manufacturers produce health supplements with undeclared or unlabelled potent medicinal ingredients.  Taking such products can be extremely harmful and can lead to serious health problems.

Some health supplements in the market today are formulated with new ingredients without in-depth scientific research.  This means that unlike western medicines, the claims on health supplements may not be backed by scientific data and evidence from clinical trials.


What Can I Do as a Smart Consumer?

Because of the wide range of products available in the market today, consumers need to be knowledgeable in their choice and consumption of health supplements.  They must understand what supplements they are taking and the purpose for doing so.  Many of these products claim to promote well-being and help people “look and feel good”, and there is a natural tendency for consumers to be easily drawn to the hype.  In fact, taking health supplements have almost become a lifestyle for some individuals.

The majority of people who take health supplements experience no ill effects.  However, as with any health product, we must never rule out the possibility of unexpected risks.  In view of this, you should always seek expert advice from a doctor or pharmacist before starting any self-medication with health supplements, especially if you are unsure if the product meets your health needs or if you are already undergoing medical treatment.


Tip 1: It is all in the name:
As spelt out in their name, health supplements are meant to supplement and not to replace the variety of foods necessary for good health.  Taking health supplements does not mean that you can skip your regular meals or stop eating certain foods all together.  A combination of a varied and balanced diet, healthy lifestyle and regular exercise is the most ideal way of staying in the pink of health. 

Health supplements are also not intended to prevent or cure any diseases.  They are not meant to substitute the medicine prescribed by your doctor. 


Tip 2: “Too much of a good thing can be bad”:
Always check the product labels and take the correct dosage.  Do also take note of whether there is a limit to the amount or duration that the product can be taken safely.

Some ingredients found in health supplements can do more harm than good when consumed in high amounts or when taken for a long period of time.  For example, taking excess levels of Vitamin C may cause abdominal pain and diarrhoea.  Some people may also experience an upset stomach if they take too much calcium or iron.


Tip 3: Know the dangers of interactions:
Taking a combination of supplements or with other medicine or foods can also be potentially dangerous and even life-threatening.  For example, taking Warfarin (a drug to prevent heart attacks, strokes and blood clots), aspirin (a drug usually taken to prevent strokes, reduce fever and pain) and Vitamin E together may increase the possibility of internal bleeding.  St John's Wort (a herbal ingredient) may also reduce the effectiveness of prescription drugs for heart diseases, certain cancers and oral contraceptives.

If you are scheduled to undergo a surgery, do inform your doctor about all the supplements you are taking to avoid any drug/supplement interactions which could lead to changes in heart rate and blood pressure, or cause internal bleeding.  You may also be required to stop taking these products before the operation.


Tip 4: Talk to your doctor:
Consult your doctor or pharmacist before you start using any health supplements.  This is especially so if you are pregnant, breast-feeding or have a chronic medical condition.  Parents may also wish to seek medical advice before starting their children on health supplements. 


Tip 5: “Natural” does not always equal “Harmless”:
Do not assume that all products claiming to contain only “natural”, “organic” or “herbal” ingredients are safe and “milder” than western medicines.  Some plant products can actually be potent.  Also, some “natural” products may also contain substances that can cause adverse reactions when consumed with other foods or products. 


Tip 6: Wise up when claims seem too good to be true:
Be wary of product advertisements that boast medical claims such as “strengthening the immune system against infections”, “reduces cholesterol”, and “prevents heart disease”.  

Do not be misled by exaggerated claims that promise instant or “quick fix” results; for example, to burn fat and slim down quickly.  Some of these products may claim to be “clinically tested” and “scientifically proven” but chances are these are untrue.

Generally health supplements are not subject to the same stringent standards of clinical tests as approved medicinal drugs. 

Also be discerning about personal testimonials from friends and relatives.  People react differently to different products – what worked for someone else may not necessarily work for you.


Tip 7: Know your sources:
Buy your health supplements from a licensed clinic, registered pharmacy or established retail store.

Avoid unfamiliar or dubious sources such as the Internet.  Although some online dealers may sell them at a significantly lower price, it is not worth the risk as no one can vouch for the quality or safety of these products.


What Should I Do When Problems Arise?

If you suspect that the health supplement you are taking makes you unwell, see your doctor or pharmacist immediately.  He will make a professional assessment and then inform HSA if necessary.

You can also get in touch with HSA at Tel: 1800 2130 800 or Email: hsa_info@hsa.gov.sg.


Last updated on 14 Jun 2011 10:13:37
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