The American Association of Clinical Endocrinologists (AACE) has released medical guidelines on the clinical use of dietary supplements and nutraceuticals with hormonal and metabolic effects, such as saw palmetto, melatonin, ginkgo biloba, creatine and chromium.
"The purpose of these guidelines is to clear up misconceptions regarding the use of dietary supplements," said Donald A. Bergman, MD, FACE, president of AACE. "Many physicians and patients are unaware of the hidden dangers associated with interactions between drugs and supplements."
The guidelines, published in the September/October 2003 issue of Endocrine Practice, highlight interactions between natural and herbal treatments and conventional drugs. St John's wort in particular has shown to have potential interaction with medications such as cyclosporine, iron, and oral contraceptives. Other interactions, such as lithium and caffeine, insulin and ginseng, and estrogens and grapefruit juice, can also have serious repercussions, warn the guidelines.
Jeffrey Mechanick, chairman of the AACE Nutrition Guidelines Task Force, said: "As the supplements grow in popularity, it is essential physicians become more knowledgeable about these products. The AACE guidelines are the first of their kind and offer physicians much more than a reference; rather, a springboard to further educate themselves and their patients about the benefits and risks associated with dietary supplements and nutraceuticals."
The guidelines review evidence available in current literature on 25 different supplement ingredients. They also provide a critical analysis of current legislation and the DSHEA.