"The groundwork of all happiness is health." - Leigh Hunt

Beware of hidden allergens in dietary supplements

May 2, 2023 – If no other answer seems clear, popular dietary supplements might be the rationale to your allergic reactions.

Allergens will be hidden in plenty of supplements, from dyes in vitamin C powders to some vitamins utilized in hair products and other products. Alison Ehrlich, MDsaid on the annual meeting of the American Contact Dermatitis Society.

“Generally, our patients don't tell us what supplements they're taking,” says Ehrlich, a dermatologist in Washington, D.C. Some of the preferred supplements, she says, include anti-aging, sleep and weight reduction/weight management supplements.

Surveys have shown that many patients don't discuss taking dietary supplements with their doctor, partly because they consider their doctor would disapprove of taking dietary supplements and patients should not adequately informed about dietary supplements, she said.

“This is definitely an area we should try to learn more about,” she said.

The regulation of food supplements is carried out by the Dietary Supplements Health and Education Act of 1994which defines dietary supplements as a food category and never as drugs. Dietary supplements will be vitamins, minerals, herbs and extracts, Ehrlich said.

“There is not a lot of safety when supplements come to market,” she explained. “It is not the manufacturer's responsibility to test these products and make sure they are safe. When they are taken off the market, it is because safety reports go back to the FDA.”

Therefore, an in depth history of dietary complement intake is vital, because it could reveal possible allergens because the reason behind previously unidentified reactions, she said.

Ehrlich reported a case through which a patient claimed to have reacted to a “Prevage-like” product labeled as a crepe repair cream. The product’s ingredients included Idebenonean artificial version of the favored antioxidant referred to as Coenzyme Q10.

Be careful with vitamins

Another possible source of allergies is vitamin C supplements, which became especially popular through the pandemic as people sought additional immune system support, Ehrlich noted. “What type of vitamin C product our patients take is important,” she said. For example, some vitamin C powders contain coloring agents resembling carmine, a red dye derived from dried and crushed shells of some insects. Some also contain gelatin, which may trigger an allergic response in individuals with alpha-gal syndrome, she said.

In general, water-soluble vitamins resembling vitamins B1 through B9, B12 and C usually tend to cause a direct response, Ehrlich said. Fat-soluble vitamins resembling vitamins A, D, E and K usually tend to cause a delayed response of allergic contact dermatitis (ACD).

Herbs and spices may also act as allergens. Turmeric is a spice that has change into a well-liked dietary complement, Ehrlich said. Turmeric and curcumin (present in turmeric) will be used as a dye for the yellow color in addition to a flavoring agent, but have been linked to allergic reactions. Another popular herbal complement, Ginkgo bilobais marketed as a product to enhance memory and cognitive abilities. It is out there in pill form and as an herbal tea.

“It's really important to think about what herbal products our patients are taking, and not just in pill form,” Ehrlich said. “We need to broaden our thinking about what the herbs are in.”