Practicing Safe Supplementation
By Seth D. Torregiani, D.O.
Taking supplements such as vitamins, minerals, herbs and other biologically active compounds to support one’s health or help treat a disease can be a confusing business. Used wisely, these substances may indeed enhance health and treat disease and, in some cases, may even reduce or eliminate the need for conventional medications. But I often see a great deal of confusion and misunderstanding about their use among patients and health professionals alike. Below are some basic tips about using supplements safely.
Your supplements are medicines.
Because they’re usually sold over the counter, many people believe that supplements are simply benign compounds and not as dangerous as medications. However, their effects on the body can be as potent as medications and, just like prescription drugs, can have dangerous side effects. For example, when taken in moderate doses, fish oils have an array of positive health effects, from reducing blood pressure, elevating mood in depression, decreasing triglycerides, preventing heart disease, and many other benefits. In high doses, however, fish oils may actually increase LDL (bad) cholesterol and increase the risk of bleeding and stroke.
Furthermore, just as drugs can interact with other drugs, supplements can also interact with drugs. Such interactions may cause undesired, even dangerous, effects on the body. Magnesium, for example, can reduce the effectiveness of certain antibiotics and blood pressure medications.
Look for standardized, pharmaceutical grade preparations.
Some companies, though by no means all, prepare their supplements according to pharmaceutical industry standards, others guarantee the purity and concentration of the supplement on the bottle itself, and still others offer independent, third-party evaluations of their products’ quality. These measures generally ensure that the compounds in a supplement are high quality, that the supplement is free of contamination or impurities, and that the dose of the supplement specified on the packaging is the actual dose found in the tablet or pill.
Purchasing vitamins or supplements with the U.S. Pharmacopeia (USP) seal on their packaging is one such way to ensure that the quality of the supplements has been verified by an independent professional trade organization.
Some herbalists or practitioners of Chinese medicine may prepare special or custom mixtures of herbs and medicinal plants for their patients that are not available commercially. Again, ensuring that the practitioners are well-trained and credentialed, and that the sources for their herbs come from reliable, verifiable companies who serve the trade, is the key to using these compounds safely.
Try to Avoid Fads.
Just like diets, supplements can go in and out of fashion (remember phen-fen?). In medical school, my pharmacology professor wisely cautioned me not to be the first (or last) to prescribe a new drug. The same goes, I believe, for supplement use. Just because something is new or heavily promoted by the media does not necessarily make it good, or effective. When a new supplement gets hyped, or a new indication for a supplement is promoted, it is often best to wait awhile before jumping in. This will help ensure that the supplement is indeed safe and effective and has an established track record before you take it.
Tell your doctor what you are taking.
Be open with your doctor, and tell him or her everything you are taking, supplement-wise. This will help your doctor prescribe medications more wisely, avoiding possible interactions or side effects. And as important as it is for patients to be open and honest with their physicians, I believe it is equally incumbent upon the medical profession to listen to patients with an open mind, respecting each patient’s desire to be healthy as the motivating factor for taking supplements. I have had patients tell me of doctors who appear intolerant or even hostile when their patients inform them of supplement use. Such behavior does not make for an open exchange of information.
Seek professional help.
While the health food store or vitamin shop clerk may be knowledgeable about the supplements they sell, their knowledge probably does not extend to interactions with conventional medicines or treating complicated diseases. A health professional trained in the use of supplements and their interactions is your best resource for information and guidance. Delaware now has the benefit of a growing community of health professionals who are knowledgeable about the use of supplements, herbs and other medicinal compounds, both in the northern and southern parts of the state.
This article appeared in the Delaware News-Journal in early September, 2007
Dr. Seth Torregiani practices osteopathic manipulative medicine, acupuncture and integrative medicine in Newark, DE. He has recently added facial rejuvenation acupuncture to his practice. For more information, call (302) 266-9010 or visit www.dr-seth.com.