Dietary supplements

Dietary supplements are products sold as tablets, capsules, powders, liquids and other forms. They may contain vitamins, minerals, herbs or other botanicals, amino acids, enzymes and many other ingredients.^{[1, 2]}

Supplements are not medicines; they are not meant to diagnose, treat or prevent diseases. In Türkiye, dietary supplements are regulated by the Turkish Food Codex Takviye Edici Gıdalar Tebliği (Communiqué on Food Supplements), and products approved by the Ministry of Agriculture and Forestry are registered in the Gıda Güvenliği Bilgi Sistemi (Food Safety Information System).^{[1, 2]}

No supplement can take the place of an adequate and balanced diet; the main goal is to meet your nutrient needs from food first.^{[1, 2]}

According to the Turkish Dietary Guidelines (TÜBER), supplements can be used when needs can't be met through food. The situations and risk groups the guidelines list are:^[2]

• People on a low-energy diet or who have cut one or more food groups out of their diet^[2]
• People who can't eat an adequate and balanced diet because of poor appetite, illness or other reasons^[2]
• Pregnant women and older adults^[2]
• Strict vegetarians and vegans; for example, vegans need vitamin B12 support^[2]
• People whose nutrient needs are higher because of health problems^[2]
• People taking medications that affect how nutrients are absorbed or used^[2]
• Babies, children and teenagers; children should take supplements only on the advice of a health professional and only products suited to their age^{[1, 2]}

Many supplements contain active ingredients that have strong effects in the body. The chance of side effects goes up when supplements are taken in high doses, in place of prescription medicines, or when many different supplements are taken together. “Natural” does not mean safe: some herbal products, such as kava and comfrey, can damage the liver.^{[1, 3]}

More is not better. For example, too much vitamin A can cause headaches and liver damage, reduce bone strength and cause birth defects; too much iron can cause nausea and vomiting and can damage the liver and other organs.^[1]

• Tell your doctor, pharmacist and dietitian about all the supplements you take; write down each product's name, its dose, how often you take it and why.^[1]
• Before you start, ask: What is the possible benefit for me? Is there a safety risk? What is the right dose? How, when and for how long should I take it?^[1]
• Don't go over the period of use and the daily serving on the label; also count the amounts you get from food.^[2]
• Check the label to see whether the product is suitable for the age group that will take it.^[2]
• You can check whether a product is approved in the Food Safety Information System; unapproved products may be sold, especially online.^[2]
• What the label says may not always match what is in the product; some products sold as supplements have been found to contain prescription drugs.^[3]

First, we look together at your eating pattern, your symptoms, the medications you take and any test results you have. Our first goal is to meet your needs through food.

We talk through together whether you need a supplement and, if so, which one may suit you. If you take medication, or if you are pregnant or breastfeeding, we make this decision together with your doctor. Sessions can be face to face or online.