Supplements – Page 2

Avoid memory supplements

Today, there are about 80,000 dietary supplement products on the market, up from 4,000 25 years ago. Of those, some 500 are memory supplement products. The US Government Accountability Office (GAO) tested three of the most popular memory supplement products to determine whether they contained the ingredients listed on their labels. It found that two of the three did not and warns that they could be dangerous for older adults. Avoid memory supplements as they might contain unsafe ingredients.

For two of the three memory supplement products the GAO tested, the GAO found they did not contain Ginkgo biloba, even though it was listed as an ingredient on their labels, or the product contained far less than its label indicated. Rather, both memory supplement products contained an unknown substitute, and the GAO could not therefore vouch for the products’ safety. The third memory supplement product tested contained the fish oil and other ingredients listed on its label.

The GAO warns that heavy-metal contaminants in supplements, such as arsenic, cadmium, chromium, lead and mercury, can be dangerous to people’s health. They may cause cancer. Indeed there are many ingredients in supplements that can cause harm.

Notwithstanding the fact that supplements are largely unregulated, and they may contain ingredients that are dangerous to people’s health, supplements are a multi-billion dollar industry. Memory supplements, which are a tiny share of the supplement market, generated $643 million in sales in 2015.

Curiously, the government claims that it does not allow importation of prescription drugs because they may be unsafe, yet it allows the unfettered sale of supplements, which are likely to be more unsafe than drugs bought from verified pharmacies abroad. Moreover, though the FDA has authority to regulate dietary supplements, generally the FDA tends not to do so and, when it does, it is only after they go to market. The FTC has authority to regulate advertising of supplements but does precious little in that regard to ensure truth in advertising.

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November 21, 2018

Amarin makes unsupported claims about its heart disease medicine

As we all know, some pharmaceutical companies will go very far to sell their products. Shefali Luthra reports for Kaiser Health News that Amarin has been making unsupported claims about the benefits of its medicine, Vascepa. Don’t believe their fishy marketing.

Amarin’s medicine is simply purified fish oil. And, Amarin is claiming that it can work miracles for people with cardiovascular (heart) disease. The problem is that the evidence it just released to support its claims is questionable at best. Cardiologists who reviewed its study say that the placebo–mineral oil–to which Vascepa was compared, may have caused blood test changes, according to Forbes. So, comparing Amarin to the placebo, which may have caused heart problems or strokes, may be inappropriate. Put differently, Amarin’s use of a placebo that was not inert in its clinical trials could have made Vascepa, by comparison, appear to have clinical benefits it does not in fact have.

Amarin’s stock price is up for the moment. But, its advertising and promotion of its questionable claims about Vascepa’s clinical benefits may be leading to unwarranted increases in sales of its medicine. Some doctors will be more likely to prescribe it to people who may not benefit at all from it.

It is concerning that Amarin is able to market and advertise its drug as helping with heart disease without strong supporting evidence and FDA approval. To date, the FDA only has approved Vascepa to address high triglyceride levels, which can cause pancreatic issues.

Without a good clinical trial with an inert placebo, Amarin’s claims about Vascepa are likely to be inaccurate; its clinical benefits may be no better than standard fish oil supplements, which may have little if any benefits.

Supplements can be harmful for a number of reasons, including that they are not overseen by the FDA and can contain ingredients that can be dangerous to your health. Amarin is trying to suggest that because its fish oil product is FDA-approved it is safer. But, it is difficult to know for several years whether a drug is safe or who if anyone it helps. In this case, there is no evidence to suggest Vascepa is any better than fish oil supplements.

Vascepa costs $280 a month today, up more than 40 percent in five years.

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November 13, 2018

Do not take supplements on blind faith

As a primary care doctor, I come across several interesting situations, challenges and experiences. Some are inspirational and some are eye opening. As I have become increasingly aware of the potential dangers of supplements, I have started asking my patients if they are taking any. Many of my patients are taking supplements on blind faith, assuming that they are helpful to them, when they may be harming themselves.

Some of my patients tell me that they are taking supplements because they can get a good deal on them. Some tell me that they are encouraged to take supplements by their family members and friends who work in stores that sell supplements. Some mistakenly believe that supplements will help them live longer.

But, most of the supplements you take have not been checked for drug interactions and are probably not safe for people older than 65. Moreover, places and companies who sell supplements don’t know what prescription medications you are taking and cannot warn you about harmful drug interactions.

According to the National Center for Complementary and Integrative Health (NIH), the “natural” label on supplements does not always mean “safe.” Be aware that an herbal supplement may contain dozens of compounds and that all of its ingredients may not be known. The regulations for dietary supplements are not the same as those for prescription or over-the-counter drugs.

For example, the Centers for Disease Control and Prevention (CDC) reports that castor oil is a stimulant laxative that may cause thorough evacuation of the bowels within 2-6 hours of ingestion; this strong result of taking castor oil also can cause dehydration and electrolyte imbalance. Long-term use of castor oil may reduce your ability to absorb nutrients.

Curcumin (turmeric) is among the most popular supplements. It is believed to be an antioxidant, anti-inflammatory and anti- carcinogenic. But, a recent multicenter, randomized double blind, placebo-controlled study by Lang et al. reported that the combination of mesalamine and curcumin may have a beneficial effect in mild to moderately active ulcerative colitis. It may cause liver toxicity and stomach upset specifically in larger doses for longer duration.

Curcumin can also lower blood glucose levels so diabetics should be cautious taking this supplement. Last but not least, curcumin does interfere with blood-thinners such as aspirin, Coumadin and Plavix. I had one patient who developed worsening of acid reflux symptoms with curcumin. And, it is reported that curcumin interferes with antacids like ranitidine which is available over the counter.

My advice is to talk to your doctor before buying any over-the-counter medications or supplements. Do not waste your money on something that you don’t know for sure will be beneficial for your health. With the tsunami of social network, comes the chaos of information which can confuse us all. This is where your primary doctor can guide you in making smart choices.

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May 1, 2018

Are fish oil supplements just another red herring?

There appears to be precious little evidence of the benefits to individuals of fish oil supplements, according to research out of the University of Auckland in New Zealand and, more recently, a US study published in the New England Journal of Medicine.

The researchers at the University of Auckland found that if you’re hoping to help your heart by consuming fish oil supplements, you might want to stop hoping and switch to eating fish rich in omega-3 fatty acids. But, you should do so in moderation. Researchers analyzed the results of 18 randomized clinical trials between 2005 and 2012 and found essentially no basis for recommending people take fish oil supplements.

The US researchers tested whether fish oil supplements help people with dry eye, a common condition in which the eye is inflamed, causing vision problems and pain. In their study 500 people received either fish oil supplements or a dummy pill every day over a year. They found that people who took the supplements had the same symptoms at the end of the year as people who took the dummy pill.

So, instead of taking fish oil supplements, eat mackerel, herring, tuna, halibut and salmon, which all provide omega-3 fatty acids, otherwise known as fish oil. Eating broiled or baked fish could reduce your risk of cardiac death. But, beware, if you eat fried fish, you likely increase your risk of heart disease.

Eating fish also may increase your exposure to methylmercury. Swordfish, king mackerel, shark, or tilefish have high levels of methylmercury. Higher mercury consumption is associated with a higher risk of cardiovascular disease; however results are mixed. As always, the key is moderation and a balanced diet.

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April 24, 2018

Should you be taking vitamins?

Liz Szabo reports for the New York Times that older Americans are popping supplements like candy. Doctors may recommend certain vitamins like vitamin D and folic acid, and dozens of others are marketed widely. But, the evidence suggests that most of these supplements offer no health benefits for otherwise healthy individuals and that some ingredients in some supplements do harm. Should you be taking vitamins?

If you are otherwise healthy, speak with your doctor. You should likely skip the vitamin pills and instead eat a balanced diet. The preponderance of independent studies on almost all supplements suggests that the benefits are at best negligible and the dangers, at times, significant. For example, the biggest studies show that vitamin E and folic acid supplements do not promote heart health. What’s worse, the studies show that too much vitamin E can mean you are at higher risk of heart failure, prostate cancer and death from any cause.

Still, nearly seven in ten older adults take at least one vitamin and nearly three in ten take four or more vitamins. There appears to be a misplaced belief that you can get more of the nutrients you need from vitamin pills and that more vitamins in your system is better for your health. But, pills are generally no substitute for eating a healthy diet, some ingredients in some vitamins can cause serious health risks, and taking more vitamins can be harmful to your health.

Before believing the “experts” and spending your money on a supplement, you might want to review the scientific evidence on www.Cochrane.org. Cochrane is a global independent network of researchers, professionals, carers, patients and people interested in health. The people at Cochrane “gather and summarize the best evidence from research to help you make informed choices about treatments.”

You can read the independent research findings about these vitamins on Just Care:

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April 11, 2018

No evidence oral beauty supplements improve skin

A meta-study of research on oral beauty supplements by nutrition scientists at the British Nutrition Foundation (BNF) shows no good evidence that oral beauty supplements improve the skin. As with vitamin and herbal supplements, people are wasting billions of dollars on oral beauty supplements that do not delay the skin aging process, reduce wrinkles or otherwise make them look more youthful.

Oral beauty supplements are taken as pills, powders or drinks rather than applied topically. The researchers looked to see whether oral beauty supplements could be a defense against external harms to the skin, such as the sun, smoking, alcohol or lack of sleep. They found that these supplements, sometimes called nutraceuticals, do not reduce wrinkles or maintain elasticity in your skin.

According to the researchers, the ingredients used in many oral beauty supplements cannot be shown to make your skin ‘youthful’, ‘firm’ or ‘glow.” What we do know from other sources is that rather than offering benefits, several ingredients commonly found in oral supplements can be dangerous to your health and well-being. You need to watch out for 15 common ingredients in supplements that can cause serious harm.

What’s the best oral solution to keeping your skin looking youthful? A balanced and healthy diet. You want to be sure to eat essential vitamins, including foods rich in vitamins A, C, B2, B3 and B7, and minerals, including iodine and zinc, and skip the nutraceuticals.

To delay the skin aging process, you also want to stay out of the sun, use sunscreen when you are in the sun, not smoke, and minimize your alcohol intake.

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March 7, 2018

Eating green leafy vegetables could help your memory

A new cognitive study in Neurology suggests that people who eat green leafy vegetables on a daily basis are more likely to hold onto their memory than people who do not. The observational study, which does not show cause and effect, supports the value of the Mediterranean diet on memory and overall mental ability.

The study followed almost 1,000 people between the ages of 58 and 99 over an average of just under five years. Participants completed two or more cognitive assessments during this timeframe.

Researchers observed that the people who ate one or two portions of leafy vegetables, such as kale, spinach, collard greens and lettuce, each day had significantly better memory, spacial ability and perceptual speed than those who ate little or none of these leafy vegetables. Specifically, those eating about 1.3 portions of leafy greens on a daily basis had a mental ability 11 years younger in age than those who did not.

It appears that leafy greens’ nutrients, including vitamin K, nitrate, folate, beta carotene, phylloquinone, lutein, α-tocopherol, and kaempferol may be responsible in some significant way for preserving people’s mental health. But, beware. It’s not simply about the nutrients in the leafy greens. It’s about their formulation in the leafy greens.

Nicholas Bakalar reports for The New York Times that there is no evidence that these nutrients in supplements offer the same benefits as they do in leafy greens or any benefits at all. The study’s lead author says that you cannot convert the nutrients’ formulation in a leafy green into a pill.

What to make of this study? It’s hard to say since it is purely observational on a relatively small sample. But, why not eat more leafy greens? Unlike supplements which carry substantial risks of harm, eating more lettuce and kale appears to be smart nutrition.

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January 4, 2018

Vitamin E supplements: Should you take them?

One question I bet you have because it’s one my patients ask me over and over again is which vitamin supplements you should be taking. For example, should you take Vitamin E supplements? Before I can answer, I want to know what you’re eating because what you eat matters. If you are eating a balanced diet, there should be no need to take vitamin supplements.

Today, I’ll talk about Vitamin E supplements. People mistakenly think that Vitamin E prevents certain cancers. But, if you look at the studies relating to colorectal cancer, they show that Vitamin E does nothing to prevent colorectal cancer. Some people also mistakenly think that Vitamin E helps protect against Alzheimer’s. But three different studies show that taking it has little or no benefit for people suffering from Alzheimer’s disease or people with mild memory loss.

What is also true is that the Vitamin E supplements, along with other vitamin supplements in high concentrations, carry risks. There is no evidence to suggest that taking too much Vitamin E from food is harmful to your health. If you are taking anticoagulants, talk to your doctor about Vitamin E supplements. They have been shown to interact with anticoagulants, which could lead to bleeding risks.

In short, if your diet is balanced, you are probably getting enough Vitamin E. Eating nuts, leafy greens, and any fortified foods Vitamin E can easily let you meet your daily recommended value of Vitamin E. If you’re on a low-fat diet, be sure to eat leafy greens, since many low-fat diets may not provide you with enough Vitamin E.

Don’t take a vitamin supplement without speaking with your doctor about it. A dietary change could help you avoid spending the extra money on supplements and the potential risks associated with them.

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May 15, 2017

Taking supplements? You’re at risk for liver damage

There’s plenty of data to suggest that taking vitamin or herbal supplements offers little value if you are otherwise healthy. It’s much better to eat a healthy diet and exercise; it also saves you money. Now, new findings published in Hepatology indicate that if you’re taking supplements, you’re at risk for liver damage.

Your liver serves to make sure that your body benefits from the nutrients in the food you eat and gets rid of harmful substances in your blood. But, certain herbal, body-building, and weight-loss supplements have been found to harm the liver in ways that prevent it from doing its job. Other supplements marketed for depression, sexual performance and to treat digestive issues were also found to harm the liver.

Supplements studied were found to cause about one in five of all liver injuries. Although the researchers could not determine which particular ingredients in the supplements caused liver damage, they found that anabolic steroids found in body-building supplements, green tea extract and agents in multi-ingredient nutritional supplements were likely culprits.

The Food and Drug Administration, FDA, does not regulate supplements or oversee their safety in any way. Just last week, GNC, the world’s largest retailer of dietary supplements entered into an agreement with the U.S. Department of Justice to change its use of certain dietary ingredients and supplements. It also paid the federal government a $2.25 million fine. GNC was selling supplements with synthetic stimulants and claiming they were natural plant extracts.

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December 14, 2016

Millions of Americans spend billions on alternative treatments or “complementary medicine”

There’s endless talk about the $2.8 trillion dollars Americans spend each year on health care. Believe it or not, that’s not all we spend on care. Millions of Americans, about a third of all adults, spend billions on alternative treatments or “complementary medicine.” What kind of care are we buying, what are we spending and what are the risks and benefits?

A June 2016 National Health Statistics Reports paper finds that 59 million people spent over $30 billion dollars out of pocket on complementary medicine in 2012. Complementary medicine comes in many flavors, including chelation therapy, acupuncture, Ayurveda, biofeedback, chiropractic manipulation, hypnosis, energy healing therapy, meditation, yoga and massage therapy. Supplements are another form of complementary medicine, with fish oil, which has no proven benefits, the most often used product.

Complementary medicine only represents about 1.1 percent of total health care spending. But, it constitutes a healthy portion of our out-of-pocket costs (9.2 percent) relative to what we spend for conventional physician treatments and prescription drugs.

We spent $12.8 billion out of pocket on natural product supplements, about one fourth (24 percent) of what we spend on prescription drugs. And, there’s no compelling evidence these products provide benefits. Moreover, herbal supplements may not be what you think they are.

We spent $14.7 billion out of pocket on complementary practitioners, almost 30 percent of what we spend out of pocket on traditional physicians.The average out-of-pocket expense per person for visiting a complementary practitioner was $433. That’s more than the average out-of-pocket expense for purchases of natural product supplements, $368, or for self-care, $257. Of note, adults spent about as much as children on natural product supplements and self-care but far more on visits to complementary practitioners.

If you have a chronic condition and are using complementary alternative medicines, be sure to let your doctor know. According to a study in the British Journal of Cancer, the use of alternative medicines, particularly herbal remedies and supplements, may cause serious problems. Some, such as St. John’s Wort, garlic and cod liver oil, can have adverse interactions with conventional treatments.

If you want an alternative health care treatment, check with your insurer to see what kinds of treatments are covered. Ask about which practitioners or products you can use, whether pre-authorization is required, whether there is a limit to the number of treatments you can get, as well as your out-of-pocket costs.

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July 12, 2016

Category: Supplements