Thursday, May 17, 2007

DSHEA II

Yesterday I wrote a blog entry about the WSJ Health Blog survey which stated that a third of young doctors didn’t know about the DSHEA and the complete non-regulation of dietary supplements.

Fair enough. A patient looking for information on these supplements might be told otherwise by a well-meaning, but ill informed doctor. In fact, data regarding dietary supplements from placebo controlled trials has been lacking until recently. In other countries (like Germany, which published “The complete German Commission E monographs— therapeutic guide to herbal medicines.” In 1998) there is more data regarding these products. They take these products more seriously. The UK’s “Medicine Control Agency” in 2002 published a list of supplements it was calling “medicinal” and therefore illegal to be sold without regulation. I personally think that’s overkill.

In the U.S., the attitude taken is that these supplements are often not worth testing because:
1)The quality of the products is so variable, since there is no standardization
2)They appeal to a crowd who wouldn’t believe a negative study anyway
But, I have to say I’m seeing a lot more supplement related studies, and guess what? No surprise that all of them appear to be NEGATIVE!

Anyway, none of this has anything to do with what got me so angry. It’s this comment from Christian Goodman:

“Makes one wonder what else doctors are misleading their clients about. That’s one reason why I always say; get a second opinion.”
- Christian


I see. So because a doctor wasn’t aware of federal regulations regarding products which are essentially placebos, you deduce that doctors are “misleading” patients about other things which are more important. That makes about as much sense as saying an English teacher not knowing about what’s inside a number 2 pencil.

I also object to the word “client”, as if we were lawyers trying to sue a 7-11 for a slippery floor. We see “patients” Christain, NOT “clients”.

Why is there an incessant drumbeat of negativity about doctors and what they don’t know and won’t say? The public has no idea how much new medical information occurs EVERYDAY! Fifty years ago there were like fifty drugs. Now there are HUNDREDS, but Pharmacology is still taught in the same amount of time. Medical school is still only four years.

So forgive us doctors if we weren’t cognizant of the oversight on BOGUS NUTRITIONAL SUPPLEMENTS THAT DON’T DO ANYTHING!! I’ll just stick to learning about medicine that is actually proven to work, thank you.

Anyway, I'm off with the family on vacation for a few days. See you next week. And STAY ANGRY!!!!

5 comments:

Happyman said...

good post Angry. I too am almost visibly fuming when a patient asks me about supplements.

It especially peeves me when a Medicaid patient wants me to write a rx for "vitamins" because "I'm weak" (Medicaid pays for MVI tabs in NY if a doctor writes a prescription for it).

I remember I once had a patient who was like 300 lbs saying he didn't have a good appetite, and needed vitamins. Good to see there's some ammo for us to say "forget about the vitamins - go to the gym already!"

Rob said...

Out of curiosity, what are the most popular supplements people take thinking they will actually do something (if you know). I remember somebody recommending saw palametto to me once (for prostate health?) but I never really followed through.

Mike said...

When I did my report in 2000, the following were the top 14 selling supplements

1)Gingko biloba
2)St Johns Wort
3)Ginseng
4)Garlic
5)Echinacea
6)Saw palmetto
7)Kava kava
8)Grapeseed
9)Cranberry
10)Valerian rot
11)Evening primrose
12)Bilberry
13)Milk thistle
14)Ginger

Quite a list. Sounds like a recipe from Macbeth.

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