This is an attitude prevalent among
many members of the medical community. They have a complete dislike
for supplements and some are very vocal about it. This study gives
them one more reason to vocalize their feelings. While the American
Heart Association is the only medical group advising against
supplements, they proclaim that with all the groups against it that
older patients should not be using supplements.
Now I will agree that some vitamins and
minerals, plus some herbal supplements are more than a passing
concern. Some deadly hazards exist if taken with some prescriptions.
So how do we warn patients, certainly not by taking them away from
patients and advocating against them. Talk with the patient and
explain to them the actual hazards for the particular supplements
that generate the problems with the prescription medications.
According to the study, there is some
evidence that some supplements in general are raising the mortality
rate, but this has been concluded without some factors being
confirmed. This being an observational study leaves open the
possibility of confounding by indication. Specifically, there is the
possibility that women with higher risks for mortality or who
developed serious chronic illnesses, as they grew older had a wider
use of supplements.
Physicians are offered several lessons.
They should ask what nonprescription therapies are used by the
patient and make sure their records reflect these therapies. The
study does say that physicians make such errors as the peril of their
patient. Physicians should be a trusted resource for patients, but
many physicians refuse to recognize dietary supplements and ignore
their existence rather than being the needed resource for their
patients. Physicians could help monitor what their patients use and
warn them when problems could exist or develop.
Older patients can be a problem because
they think more could be better and if they are experiencing a
medical problem, often they will turn to dietary supplements and not
communicate with doctors that have played down supplements. So
physicians that are against and discourage supplement use are not
keeping the lines of communication open for future years when their
patients need them for advice on supplements.
For the doctors that believe “trash
the vitamins - convince your patients”, they are putting their
patients at risk in the future because they have severed the lines of
communication. Their patients will never trust them for information
about the dangers for some supplements or even supplements in
general.
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