January 27, 2012
Trash the Vitamins - Convince Your Patients
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.