updated 6/7/2009 12:30:07 PM ET 2009-06-07T16:30:07

Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans. A few basics about herbal and other supplements and their safety and effectiveness.

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Since vitamins and herbal pills are sold at the drugstore, doesn't that mean they're safe and government approved?
Not necessarily. These are "dietary supplements" and the law doesn't require them to go through rigorous testing to prove they are safe or even that they work. The government has rules saying ingredients must match what's on the label, but it doesn't vouch for their accuracy.

The Dietary Supplement Health and Education Act adopted in 1994 says the Food and Drug Administration can go after a product when a problem comes to light — rather than having the manufacturer prove it is safe and effective beforehand, as is required of pharmaceuticals.

Haven't many of these remedies been taken for years the world over, especially in China? Aren't these natural products better for you than chemicals made in a big pharmaceutical company lab?
Roughly a quarter of FDA-approved drugs are made from plants. These have been tested for safety and effectiveness, and are sold in standard doses.

But herbal supplements contain varying amounts depending on the brand, and some natural ingredients can be harmful. Some interfere with other medicines and even things like birth control pills. Many natural remedies have had little rigorous testing to determine whether they work.

If millions of people take them and say they improve their health, isn't that an indication they work?
Some might do some good. But the mind-body connection is so powerful that a strong belief that you feel better actually can help counter pain and other physical problems. This "placebo effect" can make people think a pill is helping when their mind is really doing the work.

I don't always eat right. Aren't vitamin pills a good idea?
Doctors say Americans generally get all the nutrients they need from their diet. Vitamins from a pill are not the same as those from food and may not provide the same health benefits. Too much of some vitamins can be harmful.

What happens if a supplement makes someone sick?
The FDA can ask the manufacturer to recall the product if there are enough reports of illness or serious side effects. Since last year, supplement makers have been required to tell FDA of serious problems reported by consumers and doctors. Before that, potential dangers surfaced mostly through complaints to doctors or emergency room visits. That's how the dangers of the herbal stimulant ephedra, used as a diet pill, became known. It was blamed for dozens of heart attacks, strokes and deaths, and the FDA banned its use in 2004.

Consumers can report an illness they think may be linked to a supplement by calling 1-800-FDA-1088 or by visiting http://www.fda.gov/medwatch/how.htm. The government says you should report any serious problem even if you are not sure the product was the cause or you did not see a doctor.

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