Supplements In Medical Practice

This past week I received an email from someone I respect very much, offering help on guiding patients with fatty liver disease.  He is an expert on environmental medicine and the effects of toxic exposures (including pesticides, volatile organic chemicals and heavy metals) on the body.

I had reached out to him because I had watched one of his integrative medicine lectures and he mentioned a detox protocol he uses in patients with fatty liver disease to help heal the liver and reduce the risk of progression to cirrhosis.

When I heard that, I knew I had to reach out and ask for help.  You see, as a family doctor who works with LOTS of people who are overweight and obese, I have a lot of patients with fatty liver disease.  And like most other medical professionals, although I know fatty liver disease has about a 25% chance of progressing to liver cirrhosis and liver failure and is one of the leading causes of liver transplant, I don’t have much to offer in terms of treatment.

Receiving my colleague’s email was really exciting for me, but when I opened it I found there a LOT of herbal and dietary supplements on the protocol.  This presents a problem for me as a medical professional.

cartoon vitamin bottlesIn the United States, thanks to the Dietary Supplement Health and Education Act of 1994, supplement manufacturers are not allowed to claim their products treat or prevent diseases.  Their claims have to be purposely vague, such as “Part of a Heart Healthy Lifestyle,” “Promotes Healthy Nerve and Muscle Function,” or “”Provides Immune Support.”

What do these claims mean?  Not much, actually.  All supplement manufacturers make these exact same claims, because those are the only claims they are allowed to make.

Here is an example.  You all know I work with the Shaklee Corporation.  Shaklee has sponsored 4 peer-reviewed studies, authored by Dr. Yasuhiko Kojima (the Japanese researcher that discovered interferon) about the botanical formula marketed as NutriFeron.  One of the studies, published in 2004 in the Journal of Gastroenterology, showed that study participants with Hepatitis C had significant reductions in their viral titers after taking the formula for 3 months, with no major side effects.

According to the DSHEA, I can tell you about the study but I can’t use the study to recommend to patients with Hepatitis C that NutriFeron would help their disease.  That would be considered “treatment” and treatments must be approved by the FDA (a process that is long, arduous and much more expensive than any supplement manufacturer could support).

There are lots of supplements that are used to treat diseases.  Niacin treats high triglycerides.  Coenzyme Q10 treats heart failure (and in fact reduces the risk of death from heart failure).  Magnesium treats high blood pressure, migraines, anxiety and insomnia.  Potassium citrate treats osteoporosis and kidney stones.

But I can’t say so.

So if you see me in the office, and I tell you that a certain vitamin or mineral or supplement would help you, please feel free to ask questions and clarify why that product would help.  Just be mindful that supplements don’t “treat” disease.

They build health and wellness, make your immune system work better, help manage stress, promote heart health and optimal blood cholesterol, help you lose weight and encourage healthy sleep.  But they don’t treat disease.

PS – Thanks to Dr. David Katz for his article in the Huffington Post, which prompted this post.

QUESTION: Do you take supplements?  Do you feel supplement manufacturers should be able to make disease claims IF they have the research and quality data to back it up?