About Supplements

Doctors often fail to give patients important advice or warnings about vitamins, minerals, herbs, and other dietary supplements, according to a recent  study.

That’s dangerous, since many take dietary supplements which can have significant risks—including potentially dangerous interactions with prescription drugs—the researchers reported. 

The researchers analyzed transcripts of audio recordings from 1,477 office visits to 102 primary care providers. During those visits, providers discussed 738 dietary supplements with 357 patients.

The study was the first to examine medical discussions about vitamins, herbs, and minerals. It found that doctors are doing a very poor job of advising patients about five major topics relating to supplement use. In fact, during a typical visit less than two of the following topics were even mentioned.

• Purpose of the supplement. Fewer than half (46.5 percent) of the doctors discussed the patient’s reason for taking the supplement.
• Dosage or time of day to take the supplement. Only 28.2 percent of the doctors offered any guidance on how to take the supplement.
• Risks. Only 17.3 percent of the providers discussed potential adverse effects.
• Efficacy. Only 16.7 percent of the doctors provided information on the effectiveness of the supplement.
• Cost. Only 4.2 percent discussed the cost or affordability of the supplement.

What You Should Know About Supplements

Here’s what medical providers should tell their patients, explains Amy Doneen, ARNP, medical director of the Heart Attack & Stroke Prevention Center in Spokane, Washington.

1. Many supplements haven’t been rigorously studied. “Patients love supplements because they think they’re doing something that’s good for their health. “However, a lot of the health claims manufacturers make are based on anecdotal reports or very small studies, not the large double-blinded placebo-controlled clinical trials required for prescription drugs. While patients don’t like to hear it, medication can be the safer therapy for many diseases because more is known about its effects, risks and benefits.”

2. Supplements are natural medicines that can have powerful effects. The FDA warns that these products can be dangerous—or even life-threatening—in some situations, including using supplements instead of prescription medications or combining vitamins, herbs, or other products with OTC or Rx drugs. For example, Coumadin, ginkgo biloba, aspirin, and vitamin E all thin the blood, so taking these products together can increase the risk of internal bleeding. Another supplement, St. John's wort, may reduce the effectiveness of Rx drugs for heart disease, depression, seizures, certain cancers, and oral contraceptives, according to the FDA.

3. Natural doesn’t mean safe. Since 2007, the government has received more than 6,300 reports of serious adverse events linked to use of dietary supplements, including heart, liver and kidney problems, allergic reactions, nausea, pain, and vomiting. These reports included 115 deaths, 900 emergency room visits, more than 2,100 hospitalizations, and more than 10,300 serious outcomes (with some reports including multiple adverse events).

4. The FDA does not approve dietary supplements for safety and effectiveness before they go on the market. However, it does review (not approve) new ingredients for safety. Manufacturers are required to meet minimum safety standards and avoid claiming that their supplements treat, prevent, or cure any disease. It’s smart to check the FDA’s list of tainted supplements (those containing hidden ingredients that can be potentially hazardous). Ask your healthcare provider for guidance in distinguishing between helpful and questionable products and if a supplement is appropriate for you.

5. A healthy diet is the best way to get the nutrients you need. “Popping a supplement doesn’t replace the benefits of a healthy lifestyle, including eating fruits and vegetables, fish, and lean protein, exercising regularly, getting enough sleep, and taking great care of yourself. If you’ve been downing dietary supplements to make up for unhealthy habits—it may be time to make a few changes.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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