Advice on taking supplements, talking with your provider

[Mark_ABH]

Hello, everyone!

We see lots of discussion on this forum about taking supplements for bone health, so we thought to share this Q&A with Dr. Wayne Jonas, executive director of integrative health programs at Samueli Foundation.

Here are some highlights:

On when physicians should talk with patients about supplements ...

"There are three times they should do this. If a physician has never asked about it, he or she should start at the very next visit. Be thorough and direct. Another time would be after the patient has had a major health condition, such as cancer or a heart attack, as they will often start taking supplements then. A third time would be during an integrative health visit in which the physician asks questions about supplements and the prescription medications he or she is on.

On concerns about supplements ...

"The number one concern is quality because supplements are not regulated before hitting the market, and not all of them contain what the packaging says they contain."

On not being judgmental ...

"Another key to these discussions is to not judge your patient. We saw in the survey that some of the respondents were concerned about being judged for the supplements they were taking. Make sure the patient understands you are there to assist and guide them."

healio.com/news/primary-car...

[lgd333]

Thank you for the information. My doctor is dead against vitamins etc as he says one should get enough of these through their diet. Only through blood tests recently, has he put me on iron for 1 month and folic acid for 3 months.

[Met00 in reply to lgd333]

There does seem to be a lack of consistency, probably because doctors have limited training in this area. My doctor told me supplements should be avoided because they're unregulated, then told me to buy my own vitamin D!!

[lgd333 in reply to Met00]

I also was tested long ago for vitamin d and it was low. I was given a month's prescription and then I didn't query it again. I have my own supply but don't take any at the moment.

[Met00 in reply to lgd333]

A good blood Vit D level is vital for none health as it plays an important role in calcium absorption. If your D was low before, it will almost certainly drop back to the same low level if you don't supplement.

[lgd333 in reply to Met00]

Yes I know, but being epileptic I'm on so many other medications and find the side effects of all enough. I'm also on Risedronate Sodium for my osteoporosis.

[Met00 in reply to lgd333]

That's tough. I don't think Vitamin D has side effects, but having too low a blood level can cause various problems.

[chloropha in reply to Met00]

The last I heard (I expect this has not changed) medical school (physician tract) provides ONE course in nutrition. Can anyone imagine gaining anything close to adequate knowledge of a vast and extremely complex territory in three months' time? Almost none of my many doctors (different specialties & some in same) have ever even heard of many/most of the supplements I take. And if they have heard of it, are not prepared to comment – other than perhaps "be careful, not regulated." Yet there are a growing number of controlled (scientific) studies on such supplements all over the world. I can read them, you can read them, why ever can our doctors NOT read them?

This situation is completely unacceptable, and I will go further to say: irresponsible, as well. One introduction to a study has said that as patients are more and more interested, as they ARE going to use supplements despite – that it is the obligation of the medical world to catch up from its severely lagging position. (This by a medical researcher/practitioner.)

There is no excuse for practitioners to be uninformed. Even formerly traditional medical sources such Mayo Clinic, Mt Sinai, Cleveland Clinic, Johns Hopkins, Harvard Health, Dietary Supplement Database (NIH) Medline Plus, RxList, WebMD, and others such as National Center for Alternative and Complementary Health (NIH), VeryWellHeatlth, Natural Standard, Herbalgram, ConsumerLab, nccam.nih.gov, etc. have recently built fast- growing, well researched databases that focus on or include alternative supplements.

Get with the times, all ye MDs!

[Hidden]

Thank you!

[Hidden]

Re: Supplements DEXA scan —2.6 -2.7 have been on hiatus from alendronate. Dr asked what supplements I’m taking said to throw out vitamin K2 (no reason why) go back to alendronate. Feeling like mouse running on wheel. It’s a disease - just have to live with it.

[Met00 in reply to Hidden]

I'm surprised your doctor has even heard of K2, so suspect he/she's thinking of K1 or says throw it out because he/she doesn't know what it is!

[HeronNS in reply to Hidden]

Your doctor needs better education!

hindawi.com/journals/jeph/2...

healthline.com/nutrition/vi...

[HeronNS]

Anyone with risk of bone thinning should be made aware of this study: hindawi.com/journals/jeph/2...

I personally didn't follow the details of this study but I have taken Vitamin K2 since 2015, among other things, and my second DXA scan was an improvement over my first, without taking any pharmaceuticals.

[Ruth-S]

Thank you. Great article. I am looking for follow-up as this article was written in 2012. I will post more if I find it.

[HeronNS in reply to Ruth-S]

Good point. I read it in 2015. There has been more evidence since then, but as it's too difficult for me to search while I only have access to a very annoying small tablet I can't provide any links. If you do find something please do share. Thanks.