Problems When Patients Hide Supplements – Part 2

Part 2 of 7 parts.

The United States has seen the use of dietary supplements steadily increase from less than 20 percent of the population in 1970 to approximately 50 percent at the time of the last survey in 2006. Individuals report using dietary supplements to increase energy, maintain strength, enhance performance, maintain health and immune system function, and prevent nutritional deficiencies. Only 33.4 percent of individuals, however, inform their doctors that they are taking herbal products and dietary supplements.

Most consumers aren't aware that the health claims on labels intended for marketing purposes may not be accurate. Although dietary supplements are regulated by the US Food and Drug Administration (FDA) as foods, they are regulated differently from other foods and drugs.

Individuals who use dietary supplements believe that these products help them retain control of their own health. Patients typically believe that dietary supplements are not drugs and for that reason have fewer side effects than conventional medications.

Whether a product is classified as a dietary supplement, conventional food, or drug depends on its intended use. Classification as a dietary supplement is usually determined by the information provided by the manufacturer on the product label or in accompanying literature, although many food and dietary supplement product labels lack these details.

The term "dietary supplement" is defined in section 201(ff) of the Federal Food, Drug, and Cosmetic Act (the Act) as a product, intended to supplement the diet, that bears or contains one or more of the following dietary ingredients:

• Vitamin;
• Mineral;
• Herb or other botanical;
• Amino acid;
• Dietary substance for use by man to supplement the diet by increasing the total dietary intake; or
• Concentrate, metabolite, constituent, extract, or combination of any ingredient described above.

A dietary supplement is intended for consuming as a tablet, capsule, powder, soft gel, gel cap, or liquid form. These products are not represented for use as conventional foods or as the sole item in a meal or diet and are labeled as "dietary supplements." Moreover, a dietary supplement may not contain a form or substance that is an approved drug or is authorized for investigation as a new drug, and for which substantial clinical investigations have been initiated and made public, unless that article was marketed as a food or a dietary supplement prior to its approval as a new drug or authorization as an investigational new drug. Vitamin D is an example of a dietary supplement that may soon begin to be marketed as a drug.

The FDA regulates dietary supplements under a different set of rules than those covering conventional foods and drug products (prescription and over-the-counter). Under the Dietary Supplement Health and Education Act of 1994, the manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. The FDA is responsible for taking action against any unsafe dietary supplement after it reaches the market. Generally, manufacturers do not need to register their products with the FDA or get FDA approval before producing or selling dietary supplements. However, manufacturers must make certain that product label information is truthful and not misleading.

The FDA's post-marketing responsibilities include monitoring safety (eg, voluntary dietary supplement adverse event reporting) and product information, such as labeling, claims, package inserts, and accompanying literature. The Federal Trade Commission regulates advertising for dietary supplements. Domestic and foreign facilities that also manufacture, process, pack, or hold food for human or animal consumption in the United States are required to register their facilities with the FDA.

Problems When Patients Hide Supplements – Part 1

Part 1 of 7 parts

I am so sick of hearing this – "They are natural and the doctor doesn't need to know about them." Yes, they are natural, but in combination with some prescription drugs, can become toxic and possibly cause your death. I have heard this all too often, from doctor's waiting rooms to our old support group meetings. I have even heard this in hospitals and vividly remember this and the son's reaction.

I understand the concerns of the medical community in trying to warn patients about the harmful effects and potential deadly effects of some supplements and herbal medications. I do my part and yet people ignore me as much as they ignore doctors. I finally was able to get one person to answer a question about who had told him to say that the herbs were natural and the doctors didn't need to know about them. He said that a naturopathic physician had advised him about this because so many medical doctors don't believe in natural medicines.

I then asked him if maybe naturopathic physicians did not know everything about the natural medicines they claimed. He admitted that maybe both were at fault and as a result, their patients were harmed the most. I said this is possible, but with what the natural medicine physicians were saying to patients, they were doing more harm and causing their patients to ignore the toxic side effects of prescription medications cause by the natural medications.

I told him this caused me to have a dislike for naturopathic physicians and regard them as quacks and not actual physicians. Alternatively, their ethics are very suspect with the advice they give out about ignoring prescription medications and what the conflicts are with their natural medicines.

The medical profession often strikes out against supplements, but in these proven circumstances, their concern is well justified and I have to support their concerns. If you are asked what supplements you are taking, please, please list all of them to prevent conflicts and even potentially deadly results. It is for your benefit they are asking.

This is why I encourage and urge everyone to fully disclose to your doctor(s) what supplements they are taking, the dosage taken, and even how long you have been taking them. I also strongly suggest that you learn everything about the supplement(s) you are taking to know what side effects are possible, what dangers may be present, and what limits you should be aware of to prevent dangerous toxic side effects.

I am writing this series of blogs to help encourage you and prevent you from ending up in the hospital from the toxic side effects of natural medicines conflicting with prescription medicines.

An Email from George

On Wednesday, George sent me an email. He said he had heard from both women and the doctor admitted she was married and was aware of the program he had stated, but it would take a full year to get the application approved and get her on the way to the USA. She had admitted that she was trying to use George to arrive sooner with him paying for her plane ticket.

George said he would loan her the money when her application under the medical immigration was approved. Then she could repay him in a year when she started earning money. Now he would wait for her response.

He then sent a second email with the nurse claiming she was not living with anyone and she wanted him to submit the application to bring her to the USA. Next, I sent him the name of her husband and what I had heard from my wife's relative. I told George that she was now married and my relative had attended the reception after the ceremony.

Next George called me and said at least one was honest when confronted with the truth. He was not going to respond to the nurse's emails now and ignore her emails and requests for visual communications.

Next, he asked me if I would get him some names with email addresses and ages. I said I have two presently and I would send him the information with the pictures. I said I have two or three more coming and I would just send them on when I received them. I told him that the first two did not drive and lived in the city. I said that information was with the emails.

George admitted he had read some the one website and found a few of the type that had used the tricks I had mentioned. He said he was happy that I had warned him and had relatives of my wife that could gather information. He said he would not have been happy if he had been tricked. I said I agreed with him, but some are legitimate claims of abuse.

I told George that he would be given directions when he decided to visit in country and if needed he would be met at the airport. George said he would stay at a hotel and he preferred that because of the air conditioning. He knew several areas around the hotel and was comfortable there. I said I would be in contact with several more relatives and so would my wife. George said thank you and he was happy that he had not kept it quiet and had the one fool him.

Suggestions When You Are Out of Insulin Early

I have been fortunate not to have any problems with my insulin. I have never had any freeze and if the apartment gets extremely hot, I use a cooler with cold packs to keep it in temperature. These are the same cold packs that come in the Styrofoam containers, which my insulin arrives. Apparently, I have been a person with the right habits as I have always stored my insulin in a pocket on the door.

I had to tell my wife many times to not slam the door shut and possibly cause problems for the insulin, but now that she also has type 2 diabetes, she is more careful. Recently I read an article that reminds people not to store insulin in the back part of the refrigerator, as there is a risk of the insulin freezing and becoming unusable.

I have been fortunate enough to have other friends that use the same insulin, I am able to borrow a vial if and when needed, and I also loan a vial if they ever need it. Others have had problems and often run out and when they go to the pharmacy, they are told their insurance won't cover their insulin because it is too early to fill their prescription. Then they often need to cover a vial out of their own pocket at over $300 per vial. Some are able to talk to their diabetes doctor and obtain a sample vial or two until they can have insurance cover their prescription.

Not everyone has a diabetes doctor that has samples to hand out and others cannot obtain it because of it being a weekend. In talking with Beverly, she said she had just been studying this and suggested the following, especially for type 1 people:

1. People who have diabetes, especially type 1 diabetes, need to have and take insulin that is effective.
2. If you have type 1 diabetes, you are in danger of DKA. Know what it is, how to prevent, recognize, and get help for DKA.
3. A back-up plan for insulin gone bad or not available.
4. To double check insulin when taken out of the refrigerator for the “feel of the temperature” of the insulin. Do not use if hot, warm, or frozen.
5. To know what their insulin should look like, clear or cloudy. Avoid it if crystals, clumps or anything unusual is noted.
6. The onset, peak, and length of action of insulins they are taking, as well as replacements if needed.
7. If insulin is not available and can’t get insulin within hours, to visit the nearest ED or urgent care center.

For type 2 and type 1, she had the following suggestions:

1. Try their diabetes doctor for samples.
2. The next option would be to see if the insurance would make an exception under the circumstances (but this may take time).
3. Use a generic brand such as Walmart’s ReliOn brand can be a much cheaper option.

Beverly suggested for both types taking regular insulin 15-30 min. before the meal and beware of potential hypoglycemia 3-5 hours after injection due to longer action of regular. She ended by saying, you do not need a prescription for regular, NPH or 70/30 insulin.

Ideas for Speeding up Your Metabolism

I have a couple of friends that can eat whatever is set before them and not gain weight. I know that they have a faster metabolism than I do and I am not jealous of them because it will do me no good and I like having them as friends. I know from my research that the rates at which our bodies burn food for energy is preprogrammed in our genes. In other words a person with a high metabolism will be able to consume more calories without gaining weight.

Certified personal trainer Mark MacDonald and author of Body Confidence says, "Your metabolism is how your body burns fuel and burns energy. We should care about it because it determines our weight. It's going to determine our appetites, and it really determines our body fat levels as well. So if your metabolism is slower, then you're not going to burn fuel as fast, and that's going to cause you to store body fat. If you have a fast metabolism, that's going to allow you to burn more energy."

Many people don't realize that if you have a slow metabolism, it is important to avoid foods that slow metabolism and it is as important as incorporating foods that improve metabolism. The good news for everyone is that they can improve his or her metabolic rate by choosing the right food and avoiding the wrong foods. A growling belly indicates falling blood glucose and they say this is bad for metabolism. MacDonald recommends eating five times per day, which may work for some people. This has not worked for me or another friend.

MacDonald continues, "Every single time you miss a meal, your blood sugar drops [and] your body over-releases a hormone that makes you burn muscle, not fat. That's why dieting fails people long-term: because it creates a core deficit that makes you burn muscle. Then you go into that next meal not craving chicken or tuna; you crave carbohydrates. That spikes your blood sugar... and it makes you over-release insulin and store fat. The more fat, the lower your metabolism.”

“To help stop the vicious cycle, add high-fiber foods, such as fruits and vegetables, to your diet. They're low in calories and the fiber is a natural colon-cleanser -- which helps keep the digestive system moving smoothly. Your colon is 18 feet long; it takes a lot of energy to push fiber all the way through," says Dian Griesel, Ph.D., author of TurboCharged: Accelerate your Fat Burning Metabolism, Get Lean Fast and Leave Diet and Exercise Rules in the Dust. "The more your body's working naturally for you, the more your metabolism's staying high."

“Need a snack? Step away from the pretzels and instead opt for a combination of protein, fat and carbohydrates,” says MacDonald. “A cheese stick (protein and fat) and piece of fruit (carbohydrate) is a good example. Eating those together will help stabilize your blood sugar, and you'll avoid the dips and spikes that wreak havoc on metabolism. If your blood sugar surges, your body stores the excess sugar as fat. If it dips, your body thinks it's in starvation mode and burns muscle. And the more muscle you have, the higher your metabolism.”

“Before each meal, drink two glasses of icy cold water,” suggests Griesel. "You'll eat less, and your body will be a little chilled, so it will start working harder to stay warm," she says. Being properly hydrated also helps grease the wheels of your digestive system, encouraging food to be metabolized more quickly.

According to MacDonald, most people are sensitive to one or all of the following foods: soy, dairy and gluten (the protein found in wheat, rye and barley). If that's the case for you, then when these foods reach the intestines, they cause inflammation that slows down digestion. "If your fuel isn't being broken down cleanly," he says, "it affects your performance: metabolism, gas, bloating, weight gain -- all of that."

Another factor is sodium. If a food comes in a box or can and has a long list of ingredients, many unpronounceable, chances are it's a processed food packed with preservatives and sodium.

One of the best ways to boost metabolism is to build muscle. "Get up every two hours and stretch for one minute," says Griesel. "Get into prone position, do some push-ups, squat against a wall. Your muscles will respond quickly. And you're boosting your metabolism because not only are you helping release your natural human growth hormone -- which is good for your longevity and your musculature -- but you're also causing more calories to get burned and therefore raising your metabolism."

Reactions to Our Meeting

Brenda called me Sunday evening. She was angry as she described the retaliation by the excluded members. They had all made it clear that they wanted me excluded from the group in no uncertain terms and wanted the group to remain as one group.

Brenda said she had sent out an email to those members stating that the group that had met all agreed that the group excluded was wrong about dietary supplements and those that met on 1 September agreed with me and not them. As such, we wanted a support group where we were in agreement and they could have their own support group where they could agree with their policies. They were not invited to our support group and we did not want them.

I said that is to be expected and Brenda interrupted to say she was not complaining to me, and knew that the rest of our support group felt the same way as she felt. She continued that she had heard from Glen and he wanted the names of those that had wanted you out of the group so they knew to reject them as they were in agreement with you on dietary supplements. Brenda added that you had done a lot for their group and they appreciated it.

I said I had also heard from Glen, and we had talked about questions to ask potential members and we came up a possible solution. I am not putting this in writing at this time, as they wanted to use this with four potential members that want to join their group.

I told Brenda that those that wanted me out will not appreciate many of the coming blogs as it will be about dietary supplements and alternative medicine. I stated that I have had a conversation with Dr. Tom about this issue and he express his appreciation of the group for separating from those that did not like my stand on dietary supplements.

Brenda was surprised about this and wondered if we should include these two groups for a meeting in the future. I said this would be a good thing, as I don't think either group will participate in a meeting with the new group.

Brenda asked if I would prepare something for a meeting with the two groups and we could consider November if necessary. I said you and Jason are planning that meeting and we could include the two groups for that. Brenda thanked me and said she would talk to Jason for his thoughts. I said you could briefly mention those ideas that you previously covered and then go right into the material you have ready. I also suggested handouts outlining the points and leaving room for people to make notes for the points they thought applied to them.

I said that next March and April could also work. I said I would talk to Beverly about doing a joint meeting and you could talk to Allison. Brenda said you really know how to make my job easier. I said that since I do a daily blog, I spend a lot of time doing research and writing and I have little time for preparing a program. I said any member is welcome to use a blog I write for ideas for a program of their own. I continued that Barry is aware of this and always has a couple of blogs in mind if he needs a program. I said this is always a good idea and Tim always talked to Barry about the planned programs. When Tim was having trouble with programs, he would ask Barry for ideas so I suggest you learn to lean on Barry if needed.

Brenda admitted she had not considered this and was talking with Sue for program ideas. I said then if you are more comfortable talking with Sue, maybe we should talk to both Barry and Sue and see if she would take the job and if Barry would give it up. Brenda agreed and thanked me for listening to her.

A Meeting on 1 Sept

Part 2 of 2 parts.

A.J asked for the floor and said he must have known this would happen and previously, others were separated from this group when they disagreed with us and since we have come together in support of Bob, Tim has chosen his side and until he apologizes to Bob and each member of this group, I am in favor of leaving him out. Brenda said then leave things alone for now and wait to see what happens. Jason said Tim has his good points and did the wrong thing this time by not asking the rest of us our feelings and I move he be out of this group. A.J seconded the motion. Allen called for a vote of members and it was 16 to 3. I was asked for my vote and I said I would abstain for now as the majority had spoken.

Sue asked if we could discuss dues and I suggested that at $10 we would raise $250 from 25 members if the five joined us. Dues of $15 would bring in $375. Allen said with the provision of being able to ask for more money next spring, I move for dues of $10 as this time. Brenda seconded the motion. The members voted in favor of this and the discussion turned to electing a treasurer. Some discussion took place of where to place the funds, as it would depend on the fees charged by the financial institutions. Since no dues would be collected this month, we suggested that the new treasurer investigate and report at the next meeting.

I suggested that we also needed to elect a new leader as well and ask A.J and Barry if they would continue in their positions. Brenda said that she would like to become the new leader as she now had the equipment. With that, Jennifer nominated Brenda as the leader and Jason seconded the motion. Her election was unanimous. Max said he would be willing to serve as treasurer unless someone wanted it. Sue had stepped aside for Brenda and nominated Max as treasurer. I seconded the motion and Max was unanimously elected. Barry and A.J agreed to continue in their positions.

Brenda then posted the information about women's diseases men can have. She pointed out to Jason the difference in thyroid cancer and Jason thanked her for that information. Sue then asked Ben how his operation had gone and he said they felt they had gotten all of his breast cancer and would still have the radiation again next Wednesday. Sue said their mother had died from breast cancer and the aggressive type. She said that her mammograms have been negative every year for the last five years and Barry had a negative mammogram on Wednesday while Ben was being operated on.

This had everyone's attention and I commented that as we outlive the ages of our parents, we may well become affected by diseases many of us have not known about in our families. Brenda said that we all need to support each other for diabetes and other diseases and illnesses. She said that Sue, Barry, and Ben all had each other for support, but this does not mean that we can't step up, help, and provide support and this is important for those of us living alone to know that we can call on others if needed.

One of the guests asked to speak and said if it had not been for a few of the members, possibly several of us could have had amputations instead of using crutches for a month or two. This is why we want to join this group and be part of a supportive group. This just emphasizes how important support can become and we feel it is important to be part of a support group like this.

Julie spoke then and said this was not something she had even thought about, and now needed to expand her ideas of support to include other diseases and illnesses a well. She continued that she was happy to see the information up for women's diseases that men can develop and asked if this would include all diseases even women's diseases that only women can have and men's diseases only men can have. Brenda said yes, and Sue said this is why we chose this topic to start the discussion and thank you for asking this, as we all need to be clear about this. Being a member of this support group should mean being supported not only for diabetes, but also for other diseases and illnesses.

Brenda added that this should even include Alzheimer's and other forms of dementia. We need to compile a list of family members and who to contact if needed. There is much more we need to do, even to knowing what the final wishes of the member might be as some members do not have family that will follow their wishes. These are topics for future meetings and we have at least opened the door for topics that need to be discussed.

Brenda said the meeting is over and now it is time to clean the room. We will want to use this room again in the future. During cleanup, we could see discussions happening.

After we were outside, I suggested to Brenda that it might be wise to hold my blogs until after their meeting. Brenda told me to post my blogs so they knew the lay of the land and that they were not included in our meeting. She continued that they should know that they are not in control and no longer part of our group.