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The opaque world of dietary supplements

Posted in Health

My sister swears by fish oil, aka Omega 3, as a holistic way to lower cholesterol. I happen to take it too, for entirely different motives. But, if I had high cholesterol levels, maybe I would had heeded her call to start downing fish oil for no other reason that she recommended it.

Let’s be honest: raise your hand if you have never taken a supplement that a friend or family member recommended, without thinking about it twice. Be it for sleep, losing weight, lowering cholesterol, hot flashes and on an on. I have been on the recommending side myself.

Maybe, just maybe, it is not such a good idea. That was my takeaway after attending an instructive lecture at St. John’s Health Medical Center in Santa Monica, aimed at explaining the roles of supplements, specifically for women who have undergone breast cancer. But you don’t have to have had cancer to benefit from some of the advice that was dispensed.

The dietary supplement industry is big business: over 26 billion dollars a year business in the United States alone. The shiny side of this coin is that these numbers show a willingness on the part of Americans to want to take care of themselves, by ingesting multi-vitamins or other, non-prescriptions, more “natural”, alternatives. But the supplement industry is also a highly unregulated industry, where the burden of proof falls squarely on the shoulders of those who produce the supplements. You can see where the conundrum starts.

The Food and Drug administration does have regulations manufacturers are supposed to adhere by but it does not have the financial means nor the manpower to study every single herbal pill that comes on the market (of which there are hundreds new ones every year), and will not start investigating problems unless side-effects have cropped up in the dozens and have been reported by the same companies who manufacture the supplements. The same double-blind studies that apply to conventional medications are rarely available for supplements and, when they are, again they are conducted by the same people who are selling you the products.

This doesn’t mean every supplement is a waste of time, and, as someone who has been under the care of a homeopathic MD for the last 20 years, I believe there is wisdom in ancient practices whose results are purely anecdotal but, as a cancer patient who is taking a hormone blocking medication, I have to be careful what I ingest. Far too often, we are not aware of the interactions of supplements with conventional medications, and they can be disastrous at worst, or just diminish the effectiveness of your prescription drug at best.

Here are some guidelines I came away from the lecture with that could be helpful to the public at large:

  •  If you are about to undergo surgery, any kind of surgery, you will most likely be told to stop, two weeks prior, aspirin, green tea, Vitamin C and E, ginger, valerian and a few others. The list of supplements that can make you bleed excessively is actually much longer, so let your surgeon know what you are taking;
  •  Buy your supplements from your doctor or your dietician. Or from a reputable holistic pharmacy. Avoid anything that is manufactured in China (many Chinese supplements have been found to contain lead) and it is best to purchase ones made either in North America or Europe (where they have stricter standards). And even so, recently some studies conducted on a bunch of supplements from the Target brand have been found to contain nothing much of what they were supposed to. There are a couple of sites that conduct studies and compare brands: consumerlab and Natural Medicine consumer database are the most reliable but they do require a small subscription fee.
  •  If you do experience an adverse effect, be it just a tummy ache, do report it. By law, every supplement label must contain the phone number of the manufacturer, where a dedicated line can also help you answer questions as to known interactions with other medications. After receiving a certain numbers of complaints, the manufacturer is legally bound to report them to the FDA who, in turn, will start an investigation.
  •  If you are taking a prescription drug, don’t assume the supplement you are taking is totally harmless and will not interfere with it. Ask your doctor, do some online research. If you are a cancer patient, Sloan-Kettering Cancer Center has a brilliant website that lists all natural remedies’ interactions with most cancer drugs. For instance, if you have had breast cancer and are taking a hormone blocking medication, you should not take St. John’s worts, ginkgo, grapefruit extract or resveratrol (to name just the most common);
  •  Promising and reliable early studies on the effectiveness of supplements are available for about seven of them:
    Turmeric (curcurmin) as an anti-inflammatory
    Maitake Mushrooms for lowering blood sugar
    Omega Three (fish oil) for lowering LDL cholesterol levels
    Milk Thistle for liver problems
    Astragalus could help with chemo side effects
    Melatonin for sleep
    Probiotics for healthy gut.

Above all, always ask questions before taking a supplement.

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22 Comments

  1. Hmm so much food for thought here…
    In Australia, companies that make supplements and so-called complementary medicines only need to prove safety and quality, NOT efficacy. Certain supplements do seem to work for some people, but we also cannot discount the power of placebo effect. Having said that, we should remember that even prescription medicines don’t work the same way in everyone – some people need to try multiple different drugs to find one that is both efficacious and tolerable.

    And, yes, finding the right brand is important, particularly for plant-based supplements, because there may be differences in how “pure” the active component is, what part of the plant is used, where it was grown, etc.

    One last thing: I remember hearing/reading about a study some time ago that showed that people who took multi-vitamins tended to be LESS healthy than those who don’t. This was mostly because they were already “unhealthy”, and were just looking for an easy fix. Like you said in your post, and in comments above: see a doctor, get tests if you need to; just don’t go in blind.

    January 5, 2017
    |Reply
    • camparigirl
      camparigirl

      I heard the same thing, which makes sense: compensating for the lack of nutrious food by gulping vitamins. Thank you for weighing in, brilliant pharmacist that you are.

      January 5, 2017
      |Reply
      • You are too kind! I don’t think there are many pharmacists who’d decline a chance to offer an opinion on complementary medicines

        January 6, 2017
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  2. silvia
    silvia

    Generally speaking we should all be more aware and pay more attention to what we ingest. I never take anything that is not prescribed by my doctorv or my nutritionist. The fact that dietery supplements are not real drugs makes us feel more comfortable and easy in buying them without advice. As a matter of facts herbs are as powerful as drugs because a molecule is a molecule being it chemichal or natural and as you pointed out very well the subject needs to be handled very carefully.
    On the other hand I totally rely on my daily magnesium supplement, probiotics and fermented papaya to enhance my immune system and I truly benefit from them.
    Thanks dear, very interesting.

    January 5, 2017
    |Reply
    • camparigirl
      camparigirl

      I didn’t want to get too technical but the reason why some “natural” remedies can interfere with prescribed meds is that they can use the same enzyme for absorption, either causing havoc or diminishing the efficacy of the drug.

      January 5, 2017
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    • camparigirl
      camparigirl

      🙂

      January 4, 2017
      |Reply
  3. This is a great post Campari Girl!

    There are so many supplements on the market some claiming near miraculous properties! A young friend of mind thinks that by taking three or four green tea extract capsules per day she will lose weight (without exercise and diet!!!!) So many people belive there is a magic bullet for weight-loss.
    I do take two supplements: Vitamin D (air here in China is so bad I can’t get enough sunlight); melatonin for jet-lag: as I have to fly back and forth from UK to China it plays havoc with my body clock and 3 nights with 2.5mg of melatonin helps me to re-set my sleeping patterns. You’ll be amused to hear that my darling dog who lives in Scotland and who has canine cognitive disorder (ie he has dog-dementia) but is healthy otherwise, was put on to two doses of melatonin each week by our vet, to stop him wandering around in a confused state at night – bit like me really!!
    I am on heaps of post-stroke medication (western) so NEVER touch any of the Chinese medication I am offered, even when from reputable sources, as I have no idea how it would interact with my conventional meds which have kept me on an even keel after 4 strokes and several TIAs. However I do know that the Chinese medicine cornucopia has several plant based medications which are now being seriously looked at in the west – including one anti-malarial.

    January 4, 2017
    |Reply
    • camparigirl
      camparigirl

      I am a firm believer (and user) of acupuncture which has solved many skeletal-muscular problems of mine over the years. I do believe ancient pharmacopea have a lot of wisdom that should be studied today. But because some compounds are indeed powerful, it’s best to check how they interact with whatever else we are taking.

      January 4, 2017
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      • I, too, am a firm believer in acupuncture. After my 2nd (biggest) stroke, and following 2 weeks in hospital in HK I was referred to a Chinese doctor here in BJ who specialises in post-stroke acupuncture. Over 10 weeks his treatment improved my left hand/arm use, and gave me back feeling in them. He said he wished I had seen him after my first stroke as it might have helped minimise the damage to my vision etc. After 10 weeks he said that was it, even though I wanted to continue he said it would not have any effect. A top chap in my book!

        January 5, 2017
        |Reply
  4. Ellie
    Ellie

    Glad to read this post and the comments. I always thought I was lazy and careless because I never take/took anything, apart from gallons of cod-liver oil when I was a child !!!!! – thinking as you do that I can rely on a very varied diet to take care of my body’s needs – unless something happens to upset the balance, in which case, consult a doctor. I’m wondering whether my love of anchovies, sardines, tuna fish etc comes from my omega 3 childhood !!!

    January 3, 2017
    |Reply
    • camparigirl
      camparigirl

      Good old cod liver! I bet your body craves omega 3 because you did take so much when younger. I have started eating more sardines, anchovies etc that, incidentally, are likely to contain much less mercury than bigger fish.

      January 3, 2017
      |Reply
  5. It’s interesting that you mention Melatonin as a an effective supplement – I read in a few online sites (which already says a lot, of course) that melatonin isn’t good for much apart from helping with jet lag, and taking it regularly will actually mess with your body’s ability in producing this hormone naturally… Any links you’d like to point me to so I can read more about it? Thank you kindly 🙂

    January 3, 2017
    |Reply
    • camparigirl
      camparigirl

      My understanding is that, as melatonin is a naturally produced hormone, taking it as a supplement only works for short term problems, helping the hormone to get back into balance (that is why it is effective for jet lag). My nutritionist also explained to me that dosage is key – we need much less than we think, it is not one of those supplements that the more we take, the more we sleep. On the contrary, taking too much can mess you up. Here is an article I found on the Sleep Foundation website. https://sleepfoundation.org/sleep-topics/melatonin-and-sleep Bottom line, it doesn’t work for everyone and taking it in the appropriate manner and dosage is key.

      January 3, 2017
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      • Thanks for this link! I’ll read it through.

        January 10, 2017
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  6. I’m an older lady and don’t take any supplements. I should talk to my doctor to see if I need to. I worry about calcium as I don’t eat that much dairy.

    January 3, 2017
    |Reply
    • camparigirl
      camparigirl

      It can quickly be established with a blood test. It doesn’t necessarily mean you need more calcium because you are older. I believe a lot of it has to do with how much you built when you were younger (and genetics plays a part too). And how menopause affects you (if you are already there). There is an osteoporosis test you will most likely get done when you get to be around my age, to see if your bones need help. All this stuff to look forward to!

      January 3, 2017
      |Reply
  7. Very enlightening! My doctor and I had a conversation recently about what supplements would be beneficial and what others are a waste of money. She’s saving some ‘cheddar’ now. 😉

    January 3, 2017
    |Reply
    • camparigirl
      camparigirl

      I have taken different supplements at different stages of my life, all prescribed by my doctor (mostly, until I veered on my own and went on a B12 binge – next time I had my blood taken, my B12 levels were through the roof. Good think it’s harmless but…lesson learnt). But I stopped taking a multi-vitamin a long time ago. I believe that if you ingest enough nutrients through food, multi-vitamins are a waste of money.

      January 3, 2017
      |Reply
  8. winstonmoreton
    winstonmoreton

    I wonder if yogis use health supps

    January 2, 2017
    |Reply
    • camparigirl
      camparigirl

      Well, in a sense they do, as real yogis follow the principles of ayurveda which, like acupuncture, is an ancient practice proven to have many benefits. Ayurvedic practitioners have known forever that turmeric is an anti-inflammatory (and I have used it for 20 years to gargle with when I have a sore throat).

      January 3, 2017
      |Reply

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