Vitamins and Supplements

Will insurance pay?

As a general rule, health insurance does not cover OTC supplements. However, prescription supplements may be covered.

Your doctor may be required to explain why they are needed and the specific medical condition they are intended for.

• Some vitamins are considered necessary after a gastric bypass and similar procedures.

♦ Most insurance companies cover most or all of the cost of prescription versions of prenatal vitamins. Your insurance provider will usually have a preferred generic vitamin that could significantly reduce your expenses.

Many more managed care plans are trying to increase awareness on prevention. It seems a matter of time before they start to offer at least limited coverage for supplements, especially vitamins.

If your insurance does not cover your supplements, keep in mind that some may be tax deductible as a medical expense. Again, they must be a necessary part of your doctor’s treatment plan and not simply over-the-counter vitamins. Consult your tax preparer or IRS Publication 502 for assistance.

Excerpt from IRS Publication 502:

You can't include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural medicines,” etc. unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician.

Otherwise, these items are taken to maintain your ordinary good health, and aren't for medical care.

Supplement use in the United States

Americans have been taking multivitamin & mineral (MVM) supplements since the early 1940s. MVMs are still popular dietary supplements and, according to estimates, more than one-third of all Americans take these supplements.

MVMs account for almost one-sixth of all purchases of dietary supplements and 40% of all sales of vitamin and mineral supplements.

No standard or regulatory definition is available for an MVM supplement, such as what nutrients it must contain and at what levels. Therefore, the term can refer to products of widely varied compositions and characteristics. As a result, many types of MVMs are available in the marketplace.

♦ The U.S. supplement market was valued at $55.7 billion at the end of 2020. The U.S. supplement market is expected to grow to $66 billion by 2024.

Vitamin sales have been growing the fastest. Vitamin C and D experienced an enormous spike during the pandemic.

♦ Growth is also being fuel by an ageing population and a greater concern for fitness and well-being.

With so many dietary supplements available and so many claims made about their health benefits it can very difficult decide if a supplement is going to be useful or safe.

About dietary supplements

Dietary supplements were defined in a law passed by Congress in 1994 called the Dietary Supplement Health and Education Act (DSHEA). According to DSHEA, a dietary supplement is a product that:

• Is intended to supplement the diet

• Contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and certain other substances) or their constituents

• Is intended to be taken by mouth, in forms such as tablet, capsule, powder, softgel, gelcap, or liquid

• Is labeled as being a dietary supplement.

♦ Herbal supplements are one type of dietary supplement. An herb is a plant or plant part (such as leaves, flowers, or seeds) that is used for its flavor, scent, and/or potential health-related properties. “Botanical” is often used as a synonym for “herb.”

An herbal supplement may contain a single herb or mixtures of herbs. The law requires that all of the herbs be listed on the product label.

♦ Research has shown that some uses of dietary supplements are beneficial to health.

Scientists have found that folic acid (a vitamin) prevents certain birth defects.

Other research on dietary supplements has failed to show benefit; for example, several major studies of the herbal supplement echinacea did not find evidence of benefit against the common cold.

Reliable sources of information

It’s important to look for reliable sources of information on dietary supplements so you can evaluate the claims that are made about them.

To get reliable information on a particular dietary supplement:

• Ask your healthcare providers. Even if they don’t know about a specific dietary supplement, they may be able to access the latest medical guidance about its uses and risks. A laptop is as common as a stethoscope these days.

Ask, see how fast your doctor turns to the internet for information. Peek over his shoulder and see where he goes for information. You may be surprised, most likely you can go there to.

• Look for scientific research findings on the dietary supplement.

• Do not depend upon websites promoting their latest greatest supplement for weight loss.

• Seek out federally funded studies or reports authored by reputable universities and medical research groups.

Safety considerations

If you’re thinking about or currently using a dietary supplement, here are some points to keep in mind.

• Tell all your healthcare providers about any supplement you use or plan to use. Work with your doctor to ensure and coordinate safe care.

♦ It’s especially important to talk to your healthcare providers if you:

Take any medications (whether prescription or over-the-counter). Some dietary supplements have been found to interact with medications.

• The herbal supplement St. John’s wort interacts with many medications, making them less effective.

→ Are thinking about replacing your regular medication with one or more dietary supplements?

• Expect to have surgery. Certain dietary supplements may increase the risk of bleeding or affect the response to anesthesia.

• Are pregnant, nursing a baby, attempting to become pregnant, or considering giving a child a dietary supplement. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.

♦ Have any medical conditions. Some dietary supplements may harm you if you have particular medical conditions.

• By taking supplements that contain iron, people with hemochromatosis, a hereditary disease in which too much iron accumulates in the body, could further increase their iron levels and therefore their risk of complications such as liver disease.

• Ginkgo biloba is a popular herbal remedy used to treat a variety of conditions. It is best know for the treatment of dementia, Alzheimer's disease, fatigue, anxiety and depression.

Many seniors take this supplement. Many seniors also take anti-inflammatory drugs for arthritis or pain. Taken together there is an increased risk of bleeding.

Ginkgo bilola is believed to lower blood pressure, so taking it with a blood pressure pill may cause blood pressure to drop too low.

• If you’re taking a dietary supplement, follow the label instructions. Most importantly talk to your healthcare provider if you have any questions, particularly about the best dosage for you to take and any possibility of interactions with your current medications.

If you experience any side effects that concern you, stop taking the dietary supplement and contact your healthcare provider.

♦ Keep in mind that although many dietary supplements (and some prescription drugs) come from natural sources, “natural” does not always mean “safe.” For example, the herbs comfrey and kava can cause serious harm to the liver. Also, a manufacturer’s use of the term “standardized” (or “verified” or “certified”) does not necessarily guarantee product quality or consistency.

• Be aware that an herbal supplement may contain dozens of compounds and that all of its ingredients may not be known. Researchers are studying many of these products in an effort to identify what ingredients may be active and understand their effects in the body.

• Consider the possibility that what’s on the label may not be what’s in the bottle. Analyses of dietary supplements sometimes find differences between labeled and actual ingredients. For example:

An herbal supplement may not contain the correct plant species.

The amounts of the ingredients may be lower or higher than the label states. That means you may be taking less or more of the dietary supplement than you realize.

The dietary supplement may be contaminated with other herbs, pesticides, or metals, or even adulterated with unlabeled, illegal ingredients such as prescription drugs.

Regulation of dietary supplements

The Federal Government regulates dietary supplements through the FDA. The regulations for dietary supplements are not the same as those for prescription or over-the-counter drugs. The manufacturers are responsible for ensuring their products are safe and the label information is truthful and not misleading.

♦ Manufacturers of dietary supplement are not held to the same rigorous standards as manufacturers of drugs. As a result, they do not have to provide evidence that their products are safe or effective.

Manufacturers of dietary supplements will make health claims but since those claims cannot be proven they are required to follow up their claims with the words:

This statement has not been evaluated by the U.S. Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure, or prevent any disease.

♦ Manufacturers of dietary supplements must follow Good Manufacturing Practices, GMP. To ensure consistency and quality. The FDA attempts to monitor them. But when a supplement is manufacture in another country the FDA has very limited resources to use in such cases. The FDA is already stretched thin trying to monitor the overseas manufacture of drugs and drug ingredients. So monitoring overseas manufactured supplements are not a first priority.

♦ The supplement market recently made the news in India. The Daily News & Analysis (DNA) from India reported:

About 60 to 70% of dietary supplements being sold across India are fake, counterfeit, unregistered and unapproved, besides it is extremely difficult to identify them …

Source: NIH, FDA,DNA