Dietary Supplements and Safety - NYTimes.com Re "Spike in Harm to Liver Is Tied to Dietary Aids" (front page, Dec. 22): A major reason that so many people are injured by dietary supplements is that they are self-diagnosing and self-prescribing based on superficial knowledge. Dietary supplements (lots of them) have helped me stay healthy or have helped me get better when I have been sick, but I take them under the supervision of a doctor. Highly trained doctors (some trained in other countries) who know how to match supplements to emerging problems and when to change the regimen are often not covered under insurance plans, leaving consumers flailing on their own. Those who specialize in this area have been marginalized by our health care system. We would save a fortune and avoid tragedies like those mentioned in this article by welcoming their expertise. I am a retired pharmacist who owned and operated a pharmacy for almost 30 years. In that time I came across a lot of incredible claims regarding dietary supplements. In fact, there was a running joke that we were trying to talk more people out of using certain supplements than recommending them. In 1994 the Senate passed the Dietary Supplement Health and Education Act, introduced by Senator Orrin Hatch. Many saw this amendment to the Food, Drug and Cosmetic Act as a gift to the supplement industry, which had a large presence in the senator's home state of Utah. In my opinion the act has done twofold harm. It has circumvented the Food and Drug Administration regarding testing and has allowed health claims cloaked in semantics to be made. Not only are millions of dollars wasted on unnecessary products, but as your article showed, these products can cause grievous medical harm. Re "Skip the Supplements," by Paul A. Offit and Sarah Erush (Sunday Review, Dec. 15): Dietary supplements are, in fact, subject to ample regulation, albeit different requirements than those for prescription drugs. The Food and Drug Administration has extensive tools to ensure that consumers have access to safe dietary supplement products. With more than two-thirds of American adults taking supplements, there is an abundance of responsible companies manufacturing safe, high-quality and beneficial choices. While we appreciate a hospital's interest in protecting its patients from marginal players who ignore the legal requirements, we worry that the writers" concerns about the regulation of these products will shut down the honest conversations their hospital should be having with patients. People today want to be part of the decision-making process when it comes to their health. When consumers believe that their physicians won't have that informed dialogue, it drives them to be less candid about their supplement use. That would be an unfortunate result for everyone. The writer is president of the Council for Responsible Nutrition, the trade association for the dietary supplement industry.