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Tuesday Feb 12, 2019

Are Your Patients Wasting Money on Supplements?

Walk into any vitamin store with a health complaint, physical or mental, and you will find a variety of products "perfectly suited" for your needs. Most people know that vitamins and other nutrients are essential for life, and we can't function normally without them. The average consumer, however, doesn't have a clear understanding of these products' risks and benefits, and marketers are benefitting from the public's limited knowledge. In fact, more people are taking vitamins than ever before.

[dietary supplement capsule]

In January, I partnered with the American Osteopathic Association to conduct a Harris Poll(thedo.osteopathic.org) of a random group of 2,001 adults regarding their vitamin/supplement intake habits and motivations. The results showed that 86 percent take vitamins/supplements, but less than 25 percent have a confirmed nutrient deficiency.

Based on what I've seen in my clinical practice, these numbers are not surprising. Many of my patients are taking supplements to "stay healthy" or as a means of self-treatment for a variety of conditions. The truth is that taking supplements without an indication is unlikely to improve health and can cause legitimate harm.(www.consumerreports.org)

Vitamins, minerals and other supplements are mega businesses in the United States. The FDA estimates that the industry has grown to encompass a nearly $40 billion market.(www.fda.gov) As demand continues to grow, so do wild claims from some marketers. What's most worrisome is that the supplement trade is incredibly underregulated. Supplement companies are not required to prove safety or effectiveness before bringing their products to market. That means we have to wait for actual harm to occur before the FDA can take action.

Whenever I bring up the topic of supplement regulation on social media, I am met with heavy skepticism from the naturopathic community. "Supplements are safe," they often comment. Actually, it is common for patients to incorrectly assume equivalence between the terms "natural" and "safe." However, that is far from the reality. A study in the New England Journal of Medicine showed that, on average, there are 23,000 ER visits per year related to supplement use.(www.nejm.org) Despite what these so-called natural companies say, these are not benign substances. Not only can supplements cause toxicity and interact with other medications, they may not even contain what's listed on the label.(www.healio.com)

The FDA announced this week that it is taking steps to crack down on false claims(www.nytimes.com) from supplement marketers, and the agency likely will seek expanded authority to regulate the industry.

Meanwhile, there is a great need for education in this space -- for physicians and patients alike. I encourage my patients to first focus on a healthy diet and exercise plan -- before spending money on vitamins -- because this approach can correct many deficiencies and bring a host of other benefits.

We also should urge patients to stay away from outlandish trends such as vaping vitamins(www.scientificamerican.com) and to be skeptical of exaggerated claims made by marketers. Just because a biotin deficiency can lead to hair loss doesn't mean that taking mega doses will grant you fabulous locks.

If nearly 90 percent of patients are experimenting with supplements, we should aim to broaden our knowledge of the subject and broach it openly with our patients. Also, we must not forget to add the supplements patients are taking to their electronic health records because interactions can be deleterious to treatment plans. I strongly believe that we as family physicians can and should be the first defense against the influx of misinformation presented to our patients.

Mikhail Varshavski, D.O., is a family physician in New York City and a leading voice in the social media health space. You can follow him on YouTube,(www.youtube.com) on Twitter @RealDoctorMike,(twitter.com) and on Instagram @Doctor.Mike.(www.instagram.com)

Posted at 04:15PM Feb 12, 2019 by Mikhail Varshavski, D.O.

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