Dosage confusion

[SusieD]

Am I the only one who is confused by dosage instructions for various nutritional supplements?

In this instance Im refering to NAC supplements. On the ones Ive seen it says on the jar to take one 600mg/daily and NOT to exceed stated dose. Yet when you look at others that are also 600mg they say take between 1 and four/daily.

How do you know what is a safe level to be taking? Ive tried googling it but there doesnt seem to be a recommended level - just says that excess dosages e.g. 7g/day can cause serious side effects in some people.

As I understand it - NAC helps to break down mucus, (amongst other things) which is why its recommeded for certain respiratory illnesses, however could this not be a bad thing in the case of dry eyes - particularly if there is a possibility you may not have enough of the mucus layer to begin with?

You tend to think that because they are nutritional supplements and you dont need a prescription for them, that they are unlikely to cause problems - but in light of my own experiences, Im really wary of taking anything now in case I make matters worse.

[neil0502]

You tend to think that because they are nutritional supplements and you dont need a prescription for them, that they are unlikely to cause problems - but in light of my own experiences, Im really wary of taking anything now in case I make matters worse.

I never particularly trusted the over-the-counter supplement industry. Not that I think the FDA is great and wonderful and kind and honest and perfect, BUT ...

The supplement industry has fought a brutal and expensive fight against being regulated by the FDA. Because they aren't, they've been able to make wild, unsubstantiated claims for years, and have NOT had to even prove that their products are safe when used as directed.

If you browse this website: http://www.consumerlabs.com/ you start to get an idea that they don't even give you everything that they're promising on the label--often coming up dramatically short.

I err to the conservative on supplements. If there are thirty recommendations and the majority of them say to take 1,000mg a day with a minority saying to take 2,000mg a day, UNLESS I find some peer-reviewed, randomised, controlled testing that showed safety and efficacy in higher doses--I play it safe and take the lower dose.

I try to remind myself that--though we may be challenged and frustrated and hurting--we STILL have a lot to lose

Best,
Neil

Here's the description of the US law on "supplements:"

FDA regulates dietary supplements under a different set of regulations than those covering "conventional" foods and drug products (prescription and Over-the-Counter). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.* Manufacturers must make sure that product label information is truthful and not misleading.

FDA's post-marketing responsibilities include monitoring safety, e.g. voluntary dietary supplement adverse event reporting, and product information, such as labeling, claims, package inserts, and accompanying literature. The Federal Trade Commission regulates dietary supplement advertising.

Just like our Congress, with Ethics issues, the supplement industry is policing itself. The chickens are watching the hen-house

[Rebecca Petris]

If you have the opportunity I would suggest consulting a nutritionist. I don't know anything about NAC but there are certainly some supplements that are toxic at certain dosages.

It is never safe to assume that something is safe in any quantity simply because it is not a regulated drug.

[DrG]

As I understand it - NAC helps to break down mucus, (amongst other things) which is why its recommeded for certain respiratory illnesses, however could this not be a bad thing in the case of dry eyes - particularly if there is a possibility you may not have enough of the mucus layer to begin with?

First of all, somebody who complains of constant mucus strands in the eye cannot be suffering from a mucus deficiency.

Local, i.e. topical NAC is a mucolytic, i.e. it reduces the viscosity of mucus. It does not destroy mucus-producing cells. There are studies of topical NAC for dry eye to relieve subjective and objective symptoms, as well as a treatment for the filamentary keratitis of severe dry eye, as well as a healing agent for corneal ulcers, as well as an agent to relieve the irritation of excess mucus filaments. So, no, I don't think that topically applied NAC can be harmful. However, a few people will always have an unfavorable response to something.

For some reason somebody brought up the idea of taking oral NAC for dry eye, although there is very scant evidence in the literature to suggest that it is useful when taken this way. In response to one of the posters who complained of constant discomfort from mucus filaments resulting in constant picking at the eyes, the idea of topical, as opposed to oral NAC was mentioned. There is plenty of information available in the medical databases for the topical application of NAC for this purpose.

I certainly have not recommended that topical or oral NAC has any utility as a mainstay treatment for the most common forms of dry eye.

[SusieD]

I dont have these mucus strands at all. I never have any excess mucus (not that Ive seen anyway). That is what made me think it would possibly only be helpful for those who do have these mucus strands etc.

I was more interested in the antioxidant activity of NAC. Im not taking it at the moment and probably wont as I cant afford anything else at the moment!

I dont want to make a big issue of NAC (weve been there!!) - I was using it as an example. Taking the focus of that for a minute, its the same with the omega 3 supplements. Flaxseed/fish oil, different brands all suggest different dosages and sometimes its hard to ascertain how much of this stuff you should be taking to actually make a difference (I suppose for some, all the omega in the world will not help). Everyone recommends these oils but there are no real guidlines as to how much to take.

I dont assume they are safe because they are not prescribed by a doctor - Im just saying there can be a tendency for people to think that.

I agree with everything you said Neil.