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In Russia, a man died after taking dietary supplements bought on a popular marketplace for two months. He suffered irreversible liver damage. Izvestia, together with doctors, figured out how safe supplements are, how to choose them, and why their uncontrolled intake can lead to serious consequences.

Death after dietary supplements

According to the immunologist Daria Kartasheva, at the beginning of taking dietary supplements, the man was healthy. And two months later he was admitted to the intensive care unit with a diagnosis of fulminant hepatitis. The patient was in critical condition and doctors were unable to save his life.

“He had irreversible liver damage, and a person cannot live without a liver,” explained immunologist in his Telegram channel. At the same time, she did not disclose what kind of dietary supplements the deceased took, but noted that it was not zinc, not iron, and not vitamin D, but “a natural herbal supplement.”

Photo: Izvestiya / Dmitry Korotaev

That’s why the doctor called take dietary supplements with caution: only if they are prescribed by a doctor, and only to compensate for the deficiency of vitamins and trace elements in the body. In addition, it is important to know that supplements cannot be “drink in handfuls”, it is imperative to follow the prescribed dosage.

“You need to give up the uncontrolled intake of dietary supplements – when you have 10 cans, and you drink from them daily,” Kartasheva explained. – But you can, for example, take iron, if there is such an appointment. And as soon as it returns to normal in the body, you will stop drinking this supplement, review your diet and get enough iron with food, or eliminate the cause of its loss.

The more dietary supplements and other drugs a person drinks, the higher the risk of toxic liver damage. And this can lead to serious consequences for the body, the doctor concluded.

What is a toxic injury?

As the gastroenterologist of Medicina JSC (clinic of Academician Roitberg), Doctor of Medical Sciences Olga Sharkhun, explains to Izvestia, toxic liver damage that has occurred in a patient is an acute or chronic damage to liver cells (hepatocytes) due to exposure to various toxic substances or “liver poisons”.

tablets

Photo: Izvestia/Alexander Kazakov

– These include some drugs (for example, antipyretic, antiviral, anti-tuberculosis, anticonvulsant and others), alcohol – in large quantities and of poor quality, vegetable poisons (mustard, ragwort, pale grebe) and, finally, industrial poisons (arsenic, phosphorus , pesticides and others), says the doctor.

According to her, taking medications and dietary supplements is a really hot topic. They should not be selected independently in the online store, but strictly prescribed by a doctor (and in the case of supplements, also by a nutritionist or nutritionist), who will study the composition, analyze the patient’s history and possible drug interactions that can enhance the toxic effect. The doctor will correctly select the dosage, frequency and duration of taking the drugs. Even the most harmless over-the-counter drugs, if taken incorrectly, can have a negative effect on the liver.

– A particularly severe form of toxic hepatitis is called the fulminant form (or fulminant hepatitis), which is characterized by massive death of the liver parenchyma, a decrease in liver size and severe jaundice. In 80%, fulminant hepatitis, which was diagnosed in a man, ends in death, concludes the interlocutor of Izvestia.

What are dietary supplements?

According to Rospotrebnadzor, more than 60% of Russians suffer from vitamin deficiency. At the same time, few take dietary supplements – only 8% of the population. In the medical community, Olga Sharkhun notes, they are also treated differently: some experts consider them useful for maintaining health, others argue that supplements cause considerable harm, and still others do not pay attention to them, considering them useless dummies.

online pharmacy

Photo: Izvestia / Kristina Kormilitsyna

According to the current regulations, biologically active food supplements (BAA) are natural or identical to natural biologically active substances, as well as probiotic microorganisms, intended for consumption simultaneously with food or incorporation into food products.

– Dietary supplements are not medicines. They are used for the prevention of diseases or as auxiliary substances to the main drugs. In our country, dietary supplements are equated to food products, but their use is safe only if the rules for taking and dosages of each specific drug are strictly observed. An overabundance of vitamins can be just as dangerous as their deficiency, ”explains to Izvestia the head of the therapeutic department of the Institute of General and Professional Pathology named after academician of the Russian Academy of Medical Sciences A.I. Potapova, candidate of medical sciences Maria Sheenkova.

According to her, unlike drugs, dietary supplements do not go through a long process of research on the chemical composition and their toxicity. Therefore, it is important to purchase proven dietary supplements, and before buying it is necessary to take tests and consult a doctor regarding the name and composition of a particular supplement.

It is possible to combine dietary supplements with drugs as part of complex therapy in the presence of certain diseases. In this case, additives from the group of parapharmaceuticals are purchased.

Customer in a pharmacy

Photo: Izvestia / Dmitry Korotaev

– For example, for colds and coughs, it is recommended to use supplements that contain smooth licorice. This plant is also known as licorice root or liquorice. In addition to the fact that it treats cough, it also stimulates the hormonal activity of the adrenal cortex, and increases blood pressure. Therefore, such dietary supplements should not be used by people taking antihypertensive drugs for high blood pressure, says Sheenkova.

Also Korean ginseng immunomodulator is contraindicated for people with arterial hypertension, adds Olga Sharhun. Cholagogue herbs found in some supplements can cause biliary colic in patients with gallstones. And some herbal supplements, such as St. John’s wort, are incompatible with certain antidepressants, oral contraceptives, and anticonvulsants.

Where is the best place to buy dietary supplements?

According to Maria Sheenkova, It is best to buy dietary supplements in offline pharmacies. Many people buy dietary supplements on the Internet, on marketplaces – however, their use can be detrimental to health.

pharmacist at a pharmacy

Photo: Izvestia/Alexander Kazakov

– Some dietary supplements have identical or similar names to the trade names of medicines. Therefore, a situation is possible when, instead of an effective medicine, a person takes a good, but ineffective biologically active supplement in case of illness, – notes the interlocutor of Izvestia.

In addition, some supplements with different active ingredients are marketed under the same trade name, which can lead to selection of an unnecessary or even unhealthy product.

— One and the same biologically active additive in content can be produced under different trade names. A person thinks that he is taking different substances, but in fact he receives an overdose of one drug, the expert concludes.

How to make sure the quality of dietary supplements?

In order to make sure the legality and quality of dietary supplements, first of all, you need to carefully read what is written on the labels. Packaged and packaged biologically active food supplements must be indicated in Russian:

– name of the product and its type;

– number of technical conditions (for domestic dietary supplements);

– application area;

– the name of the manufacturer and its legal address (for products imported into the territory of the Russian Federation – the country of origin and the name of the manufacturer);

– weight and volume of the product;

– compound;

– nutritional value (calorie content, proteins, fats, carbohydrates, vitamins, trace elements);

– storage conditions;

– expiration date and date of manufacture;

– method of application (in case additional preparation of dietary supplements is required);

– recommendations for use, dosage;

– contraindications for use and side effects;

— special implementation conditions (if necessary).

— According to the Higher School of Economics, share of illicit trafficking in dietary supplements in Russia is almost 60%. These additives may contain hazardous substances that are not listed on the label. Therefore, if the listed information is not on the label, the dietary supplement is not worthy of trust and it is better to refuse to buy it., – advises the head of the therapeutic department of the Institute of General and Professional Pathology named after academician of the Russian Academy of Medical Sciences A.I. Potapov.

pills, pharmacy

Photo: Izvestia/Alexander Kazakov

Who regulates the dietary supplement market?

Examination of biologically active food additives is carried out by authorized organizations on the basis of the documents of the State System of Sanitary and Epidemiological Regulation of the Russian Federation.

– Independent examination is impossible. However, at the moment, an experiment is being carried out on the labeling of biologically active additives. It started on May 1, 2021 and will last until February 28, 2023,” says Maria Sheenkova.

Laboratory

Photo: Izvestia / Kristina Kormilitsyna

From March next year, participants in the circulation of dietary supplements must be registered in the national system “Honest Sign”, and from April, manufacturers will be required to apply digital marking codes to each unit of product. A special Data Matrix code will appear on dietary supplement packages, by scanning which, the buyer will be able to track the path of the product from production to the counter and make sure of its quality and safety.

According to industry representatives, an increase in the share of counterfeit products, which is distributed through e-commerce, has recently been recorded. According to HSE experts, the introduction of a labeling system will reduce the “grey” dietary supplements market by 50%. It is designed to ensure the traceability of the product and become a guarantee of its legality and safety for consumers.

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