If you feel a little lost in the vitamin aisle, you're not alone. Many of us dabble with vitamins and supplements, and probably just as many are overwhelmed standing in front of a wall of seemingly-similar products. How do you tell which one of these products might help you? How do you tell if it's actually working? And once you find what you want, how long should you take it for?
A Professional Recommendation:
"I've been taking [some natural product] for a few weeks, but I can't tell if it's working. How will I know?" This is a common question I get and it nearly always comes from someone who is self-prescribing. Often they got an idea or recommendation for herbs or supplements from a friend, the Internet, a magazine, or someone working at the store where they bought it. But how much should they trust these recommendations?
To answer this, I ask more questions: Did the person making the recommendation have medical training? Did they ask about your medical history? Did they ask what else you're taking? Did they ask about your diet, exercise and lifestyle habits? Did they have a plan for how long you would take this supplement/herb before they would reassess you? If you answer "no" to any of these questions, the recommendation was probably well-intentioned but not sound advice.
Taking Multiple Supplements:
It's not uncommon for patients to come in taking a grocery list of supplements and herbs. Many times they are taking multiple products for the same reason, dosing them incorrectly, and purchasing low-quality supplements. For these reasons they are usually not getting the effects they wanted and may be wasting their money. The most common products I see taken incorrectly are fish oil, red yeast rice, St. John's Wort, and Vitamin D. When someone comes to see me and takes more than three products I often suggest a "supplement holiday" so we can determine which, if any, supplements might work for them.
Interactions and Side Effects:
"It's natural, so it's safe." I hear this all the time, and I understand the reasoning behind it. In fact, fewer undesired effects are a big reason I went into natural medicine. But just because something is natural doesn't mean it will be safe for everyone. Dietary supplements and herbs can be powerful, and sometimes have serious consequences. The rule of thumb: If it can have a positive effect, it can also have a negative effect.
In some cases, taking a supplement or herb can have significant side effects* or interactions that could be quite risky. Supplements and herbs can interact with each other and medications you're taking. Too much of one nutrient can cause a deficiency in another. More serious interactions happen when multiple substances work on the same biochemical pathways or use the same enzymes in the liver and kidneys. Major interactions can take days or weeks to occur and might lead to a visit to the emergency room. Although serious complications aren't terribly common, they do occur.
*In the world of medicine we use the term "side effects," but really there are just "effects." Some effects are desired, others are undesired. I'm sure you can guess which ones we call "side effects."
Conflicting Information or Evidence:
This is a tough one, and an area where I find myself often getting into discussions with other doctors. Sometimes studies come out showing that "This Herb is No Better Than Placebo" for a headline. If the study gets published in a well-respected journal the headline soon spreads across the news.
But there can be problems, even with studies from highly-respected, peer-reviewed journals. Conflicts of interest with funding, low dosage of medicine, or subjects with treatment-resistant diseases are just some of the limitations of studies I've seen reporting negative findings. Don't get me wrong, there are truly negative studies on natural products, and these are good for the field because they lead to advancement. Sometimes we find out we've been using a medicine ineffectively for years, and negative studies help us to drop that from our practice. But it takes a skeptical (and professional) eye to find discrepancies that may explain the findings of medical studies.
The Bottom Line:
Supplements and herbs work, but they should be taken with appropriate medical guidance.
Think of them as short-term tools to help steer your health in the right direction. Ideally a balanced diet and healthy lifestyle will sustain your health. But there are times when we could use a little help, and a natural intervention is preferable.
Self-prescribing, or getting advice from anyone but a health care professional, can be risky to your health or a waste of money. If your primary care provider seems to be against the idea of you taking anything "natural," consider finding the professional guidance from another licensed health care professional. Naturopathic doctors are specifically trained to give this kind of guidance, but many medical and osteopathic doctors, nurse practitioners, and physician's assistants have undertaken special training.
Take excellent care of yourself, and seek sound advice.
Michael Stanclift, ND
Naturopathic Doctor - Carlsbad, California
*This post was originally published on the Huffington Post, by Dr. Michael Stanclift, ND