Dietary supplement polypharmacy: an unrecognized public health problem?

Area of Science:

• Public Health
• Pharmacology
• Nutritional Science

Background:

• Polypharmacy, defined as excessive or inappropriate medication use, is a recognized public health issue.
• Dietary supplement use is increasing, particularly in the United States, yet patterns of use remain poorly understood.
• Emerging reports of excessive herbal supplement intake have introduced the concept of 'polyherbacy'.

Purpose of the Study:

• To highlight the need for research into the nature and extent of multiple and inappropriate dietary supplement use.
• To introduce and define the concept of 'dietary supplement polypharmacy'.
• To explore the utility of clinical interviewing and population surveys in understanding supplement use patterns.

Main Methods:

• Review of clinical vignettes reporting excessive herbal dietary supplement use.
• Discussion of the complementary roles of clinical interviewing and population surveys.
• Identification of research gaps in understanding dietary supplement consumption.

Main Results:

• Clinical cases suggest a potential for excessive and inappropriate use of dietary supplements, mirroring polypharmacy.
• The term 'polyherbacy' has emerged to describe excessive herbal supplement use.
• Both clinical interviews and population surveys are valuable for investigating supplement use patterns.

Conclusions:

• Further research is crucial to define and quantify 'dietary supplement polypharmacy'.
• Understanding dietary supplement use patterns requires a multi-faceted approach.
• Addressing inappropriate supplement use is essential for public health and patient safety.