Nutritional Suppliments question

[Skeptic Ginger]

.... bundled together with potentially helpful stuff like fish oil or Vitamin D and B12 for the elderly. The generally negative bias about supplements by the medical community does not help.

Why do you think the medical community would support evidence of the effectiveness of some treatments but ignore the effectiveness of something else? It's not like my paycheck depends on Big Pharma or that the supplement industry is somehow not Big Pharma.

 

[Skeptic Ginger]

They do not control usage.

And that matters why?

My practice has no stake in prescription drugs. If patients seek treatment they don't go away saying, gee, I could have gotten that drug without the medical advice. They come to me for the advice, not for the RX.

 

[Skeptic Ginger]

The medical community may be beginning to see the light. I have seen it for quite a few decades now.

Get over yourself. I've practiced evidence based medicine since I graduated from nursing school in 1976. I became a nurse practitioner in 1985. In 1976 there was a big move toward accepting alternative care along with science based care because the fad at the time was to be culturally sensitive. After I became responsible for prescribing, the trend had switched to science based outcomes as a measure of effectiveness. There is no distinction between science based medicine and any other medicine. Either there is evidence the prescription is effective or there is no evidence. The origin of the treatment (ancient or modern) and whether the treatment requires a prescription or is over the counter is irrelevant.

 

[fls]

They do not control usage.

We don't control usage of aspirin either, but we still make evidence-based recommendations for its use.

Linda

 

[JJM]

The medical community may be beginning to see the light. I have seen it for quite a few decades now.

Then, let me update you, since 1994 "supplements" has come to mean all manner of useless products, some of which may be hazardous. Therefore, you should narrow your terminology to include only those that have passed rigorous, scientific scrutiny in order to avoid confusion and to disassociate yourself from Big Suppla.

 

[Perpetual Student]

Get over yourself. I've practiced evidence based medicine since I graduated from nursing school in 1976. I became a nurse practitioner in 1985. In 1976 there was a big move toward accepting alternative care along with science based care because the fad at the time was to be culturally sensitive. After I became responsible for prescribing, the trend had switched to science based outcomes as a measure of effectiveness. There is no distinction between science based medicine and any other medicine. Either there is evidence the prescription is effective or there is no evidence. The origin of the treatment (ancient or modern) and whether the treatment requires a prescription or is over the counter is irrelevant.

Hmm, since 1976, you say? So, have you been you counseling patients against the practise of annual chest x-rays all these years because of the lack of scientific evidence supporting its efficacy?

 

[Perpetual Student]

Then, let me update you, since 1994 "supplements" has come to mean all manner of useless products, some of which may be hazardous. Therefore, you should narrow your terminology to include only those that have passed rigorous, scientific scrutiny in order to avoid confusion and to disassociate yourself from Big Suppla.

Was there something about this statement that you did not understand?

Unfortunately the term "supplements" is so broad that it includes practically anything that is ingested that is not a food or prescription medication and is intended to have some positive effect on health and/or well being, whether such effect has been scientifically established or not. So useless stuff like mega vitamin C doses, harmful stuff like ephedra are bundled together with potentially helpful stuff like fish oil or Vitamin D and B12 for the elderly. The generally negative bias about supplements by the medical community does not help.

 

[fls]

The medical community may be beginning to see the light. I have seen it for quite a few decades now.

So when the medical community recognizes that some supplement claims are evidence-based and many are not, they are demonstrating an anti-supplement bias. But when you recognize that some supplement claims are evidence-based and many are not, you are enlightened.

Linda

 

[Perpetual Student]

So when the medical community recognizes that some supplement claims are evidence-based and many are not, they are demonstrating an anti-supplement bias. But when you recognize that some supplement claims are evidence-based and many are not, you are enlightened.

Linda

Exactly!

 

[JJM]

Was there something about this statement that you did not understand?

Unfortunately the term "supplements" is so broad that it includes practically anything that is ingested that is not a food or prescription medication and is intended to have some positive effect on health and/or well being, whether such effect has been scientifically established or not. So useless stuff like mega vitamin C doses, harmful stuff like ephedra are bundled together with potentially helpful stuff like fish oil or Vitamin D and B12 for the elderly. The generally negative bias about supplements by the medical community does not help.

Help me understand here, you acknowledge that most "supplements" are useless, and many are harmful; yet a bias against "supplements" is unhelpful?? I put the term in quotes because I refer to the accepted use of it for the last 15 years.

How is a bias unhelpful? When it comes to child-abuse, I am outright bigoted; and proud to be that way.

 

[Eos of the Eons]

http://www.latimes.com/features/health/la-he-supplements-list25-2009may25,0,1382198.story

A GREAT article on what is in diet supplements, and why they should be avoided.

I like when the media gets it straight!

 

[Eos of the Eons]

My doctor prescribed some simple supplements to me - Calcium with vitamin D. She told me how much to take of each and why. If the supplement is needed, and the contents are known, then doctors will prescribe them. If the contents of supplement are unknown and pretty much never shown to have anything but bad effects (ephedra), then I sure hope a doctor doesn't prescribe it!

 

[Prometheus]

My doctor prescribed some simple supplements to me - Calcium with vitamin D. She told me how much to take of each and why. If the supplement is needed, and the contents are known, then doctors will prescribe them. If the contents of supplement are unknown and pretty much never shown to have anything but bad effects (ephedra), then I sure hope a doctor doesn't prescribe it!

Has ephedra actually been shown to never have anything but bad effects? I thought it was just a naturally occuring form of pseudoephedrine, that caused problems when people used way too much of it for extended periods, and for inappropriate reasons.

 

[JJM]

Has ephedra actually been shown to never have anything but bad effects? I thought it was just a naturally occuring form of pseudoephedrine, that caused problems when people used way too much of it for extended periods, and for inappropriate reasons.

No, it is a natural source of ephedrine and other stimulants.

Read "Natural Causes" by Dan Hurley (Broadway Books, 2006(?)). The FDA convened an expert panel that concluded the effective-dose was hazardous, and the safe-dose was inneffective. Yes, ephedra can help you lose weight, but at that dose it can have serious side effects ... such as death.

 

[Prometheus]

No, it is a natural source of ephedrine and other stimulants.

Read "Natural Causes" by Dan Hurley (Broadway Books, 2006(?)). The FDA convened an expert panel that concluded the effective-dose was hazardous, and the safe-dose was inneffective. Yes, ephedra can help you lose weight, but at that dose it can have serious side effects ... such as death.

I'll add that to my reading list, thanks! What condition were they looking at, though? Just weight loss? Is it also dangerous when used in smaller doses that are effective as a stimulant, but not for weight loss?

In college I used to use ephedra (in the form of raw ma huang which I purchased from a Chinese herb shop and boiled as tea) as a stimulant during exam periods. It seemed to me to work about as well as coffee, but never gave me jitters. Was I endangering myself using it this way?

 

[JJM]

{snip] In college I used to use ephedra (in the form of raw ma huang which I purchased from a Chinese herb shop and boiled as tea) as a stimulant during exam periods. It seemed to me to work about as well as coffee, but never gave me jitters. Was I endangering myself using it this way?

I can only say the FDA panel found it unsafe for any use.

Herbs are a difficult category of sCAM. Certainly, many have biological activity- good, bad and ugly. The field is HUGE and it is difficult to find a true expert on any product.

 

[Eos of the Eons]

I can only find that if you take enough ephedra to have any effect, it will be bad. You can take it at safe doses, but nothing (nothing good or bad) will happen to you, so why bother.

It was probably the caffeine that gave you a boost for your exams if you took ma huang from a herb shop, and let's hope there wasn't enough ephedra to frac with your body.

 

[stilicho]

The FDA has begun enforcing the rules again and have cited Cheerios for false medical claims already.

Not sure if you're right about the political aims but the makers of Cheerios ought to be cited.

It's interesting to note that the first "health food" nuts in the 19th century were also staunchly religious:

http://polyglotveg.blogspot.com/2007/11/shredded-wheat.html


Slyvester Graham was a Presbyterian minister. The Kelloggs were Seventh Day Adventists. Charles William Post's religion is not readily available. But he attended the sanitorium operated by the faith-fuelled vegetarians of Kellogg and his business partners.

There has historically been a close association between "health foods" and religion.