Dietary Supplements

In the distant past, medicine, religion and the priesthood were intertwined. In most civilizations studied, the priest was the medicine man to whom people went for help when sick. These priests found very quickly that giving the patient a potion from animal parts, plants, tree bark or herbs made lots of them better. Occasionally, they would come up with a real winner like aspirin, from the bark of the white willow tree. For the most part, however, what they gave was harmless and ineffective. However, neither the medicine man nor the patient knew it. Rather, they both believed with the strength of their religion that the potion was miraculous and helpful. So, there is an intense, almost an inborn belief in humans to want to believe that medicine, vitamins, pills, and herbs can confer good health and a long life. A modern wag has wryly commented that the main difference between man and animals is the desire by humans to take pills. The point of the above comments is to remind you of the placebo effect, which basically means that if a person really wants to believe a positive effect is occurring, he or she will be absolutely certain that this is a fact. And that is why the Scientific Method described in the preceding section is necessary. Personal bias, whether by the physician or the patient, has no place in deciding whether a heart valve, a medication or, for that matter, an herb or vitamin really works.

Modern science, using the Scientific Method, has brought us enormous improvements – a safe water supply, many public health measures, computers, cars, telephone and even the Internet. In medicine, we have proven drugs and medical devices to help us when we do get sick. Longer life span has been granted us through scientific study of exercise and better eating habits. Yet, we humans will often buy and take a complementary medicine supplement solely on the basis of what a friend or a young clerk at a health food store says. At the same time, we physicians have become much more knowledgeable in this field.

The field of complementary alternative medical care continues to grow. However, all of these products are in the Dietary Supplement field as defined by the FDA (Food and Drug Administration). This is different from the drugs we take. For pharmaceutical drugs, there are strict regulatory steps and oversight by the FDA. However, in the Dietary Supplement field, the FDA has no regulatory or oversight role. So, a company can package any herb or vitamin or a mixture of any of these it wants, promote it and sell it. The company should not make health claims but, to varying degrees, it may do this in a discreet but fairly clear cut manner.

So, the lesson is to be cautious. We encourage our patients to discuss their questions and concerns about dietary supplements with us.