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How excessive dietary supplement intake causes kidney damage

Dietary supplements are substances taken to improve health or wellness by providing adequate amounts of essential nutrients like vitamins, minerals, and many other ingredients needed by the body.

However, they cannot take the place of foods that are critical to a healthy eating routine.

Supplements come in the form of pills, capsules, powders, drinks, and foods.

According to experts, supplements are not necessarily intended to cure diseases or health conditions, except when approved by the country’s Food Drug Administration for a specific health claim.

The United States National Centre for Biotechnical Information, National Library of Medicine, noted that dietary supplements mostly include vitamins, minerals, herbs, botanicals, amino acids, enzymes, and other ingredients, adding that they, when approved, offer health benefits to the body.

However, recent studies have shown a clear link between excessive or uncontrolled intake of these supplements and chronic kidney diseases and damage.

Over the past decades, chronic kidney disease has been said to affect at least 10 to 15 per cent of the world’s population, according to the World Health Organisation.

When combined with the epidemics of hypertension and diabetes, the number of patients with chronic kidney disease has increased rapidly in recent years, thus impacting significantly on global health burden.

Owing to the high prevalence, morbidity rates, and medical costs of CKD, prevention and optimal management of the disease is an important public health issue.

However, since there is no effective kidney-targeting drug that can inhibit the progression of CKD other than treatment of underlying medical conditions such as hypertension, hyperglycemia, and dyslipidemia and monitoring of complications, interest in the effect of nutrition or dietary supplements on kidney disease is increasing.

Diets such as protein restriction diet, the Mediterranean diet, and plant-based diets are currently being investigated for their potential roles in delaying CKD progression or complicating it.

Today, there are thousands of dietary supplements available on the market, including vitamins and minerals, plant ingredients and extracts, proteins and amino acids, omega-3 fatty acids, probiotics, and prebiotics, according to the National Centre for Biotechnological Research.

Some research has indicated that dietary supplements can compensate for the nutritional deficit derived from unbalanced diets that can assist in prolonging the lifespan and provide some benefits for diseases, although evidence of direct effects is still insufficient.

However, nutritionists and dieticians have warned that they should only be consumed when they are recommended by registered experts and should not be used as an alternative for the nutrients themselves which are obtained from actual food.

In the last decade, the prevalence of dietary supplement use has increased dramatically, and the global market size of dietary supplements is valued at nearly 121 billion USD in 2018, research by the NCBR and its institute revealed.

The use of dietary supplements in modern society is not limited to the middle-aged and elderly, and the interest in dietary supplements is growing among young people as well, especially in Nigeria, where it is considered fancy to take these supplements for skin-related benefits.

This is because most dietary supplements are not classified as drugs by the National Agency for Food, Drug Administration and Control and are easily obtainable over the counter, with unrestricted exposure to advertisements.

It is true that getting the right amount of nutrients is an essential part of one’s diet and is vital for one’s health. This is because nutrients supply your body with what it needs to properly function daily. They boost energy, improve muscle and body tissue and even help fight against infections.

An online health resource, Webmd.com, in an article on the subject, revealed that over-the-counter medication, commonly prescribed medicines and even some dietary supplements can negatively impact the kidneys and cause their function decline.

This, it noted, can lead to kidney damage, adding that if one already has any kind of kidney problem, it may be aggravated.

A Registered Dietician-Nutritionist and Founder of the Geeky Nutritionist Consultancy, Uju Onuorah, while speaking with our correspondent, stated that several studies have highlighted a potential link between excessive intake of dietary supplements and kidney damage.

She said, “Some supplements, particularly those containing certain herbs, might pose risks for individuals with chronic kidney disease. These supplements could exacerbate kidney damage or lead to renal dysfunction. Additionally, there are some inclusive studies on whether dietary supplements can cause kidney disease, although prolonged and excessive use of some dietary supplements has been associated with potential nephrotoxicity and renal dysfunction.

“It is important for individuals to be cautious when considering the use of dietary supplements, especially if they have pre-existing kidney conditions, for example, CKD.

“Consulting a healthcare professional before starting any new supplement regimen is recommended to ensure the safety and appropriateness of the supplements for one’s specific health status and needs. Intake of non-medically prescribed dietary supplements should be avoided.”

Another nutritionist based in the United Kingdom, Dr Samuel Olayemi, noted that one may need to avoid some vitamins and minerals, including some dietary supplements if they have any form of kidney disease.

According to him, some of these vitamins include Vitamins A, E and K.

“These vitamins are more likely to build up in your body and can cause harm if you have too much.  Over time, they can cause dizziness, nausea, and even death.  You should only take these vitamins if your healthcare professional gives you a prescription for them. There is also some concern about vitamin C.

“Although some people may need to take a low dose of vitamin C, large doses may cause a buildup of oxalate in people with kidney disease.  Oxalate may stay in the bones and soft tissue, which can cause pain and other issues over time,” he explained.

 Speaking further, he said chronic kidney disease changes one’s need for some nutrients, noting that the waste products that build up in the body each day can change how the body uses vitamins and minerals.

Olayemi added, “Some of the medicines you take can change how your body uses certain vitamins and minerals. Some vitamins are lost during dialysis treatment if you are on dialysis. Following a special diet for chronic kidney disease can mean you miss certain vitamins and minerals from foods.

“On days when you may not feel well enough to eat regular meals, you may not get enough daily vitamins and minerals. Because everybody is different, it’s recommended to consult your doctor before beginning any new supplement or vitamin regime.

“You’ll want to discuss with them the current medications you’re taking, any conditions or diseases you currently have, and your current lifestyle. You may also want to disclose a family history of kidney disease if one is present, and other important factors.

“Even if your kidneys are healthy – or you think so – discussing with your doctor what supplements are right for your diet is important.”

He also stressed that NAFDAC needs to stop the sale of some supplements over the counter.

Another nutritionist and team lead at a Rivers State-based organisation, Mrs Omawunmi Amao, stated that some dietary kidney supplements may have adverse effects on the kidneys, which are important organs for filtering waste products from the blood and regulating fluid and electrolyte balance in the body.

She noted that research has shown that a high dosage of Vitamin C may increase the risk of kidney stones.

According to her, Vitamin C can be converted into oxalate, a substance that can combine with calcium to form kidney stones.

The nutritionist also noted that creatine supplements, which is a popular dietary supplement used by athletes to improve muscle strength and performance, may cause kidney damage and risk of kidney stones.

Amao noted that the reason was that creatine can increase the production of waste products in the body, which may overload the kidneys.

Speaking further, she said, “Some herbal supplements have been associated with kidney damage and kidney failure. This is because these supplements can contain substances that are toxic to the kidneys or that interfere with kidney function.

“Iron is an essential mineral for the body, but excessive amounts of iron supplements may cause iron overload in the body, which can damage the kidneys. This is because the kidneys are responsible for filtering and regulating the levels of iron in the blood.

“Protein supplements are commonly used by athletes and bodybuilders to increase muscle mass and improve performance. However, high doses of protein supplements may increase the workload on the kidneys, which can lead to kidney damage over time.”

Since everyone is different, Amao noted that it was important for individuals who intend to use supplements to speak to a certified nutritionist and dietician first.

“Nutritionists are the only ones who can determine which supplements, vitamins, and medications are truly safe for you to take.

 “Additionally, your doctor will perform various tests, like a physical examination, urine test, and blood work, to determine whether your dietary supplement regime is working for you. These tests help your doctor to keep an eye on your kidney function too, which can help them adjust your medications if needed,” she noted.

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