Dietary Supplements Demystified Victoria Maizes, M.D.

What do you think about dietary supplements?  Do you use them? Do you find them helpful? Are you confused about choosing a high quality product?

On Friday, November 8th I was interviewed by Science Friday on the topic Navigating Dietary Supplements.  There were many excellent questions raised about the quality of products, the need for further regulation by the FDA, the evidence for herbs and the need for further research.    I answered many of these questions on the segment; here I’d like to make available some of the resources that I find most useful.

One of the resources that people can use to find safer, better products is consumer lab.  They are a third party company that pulls products from the shelves and tests them.   While they charge an annual fee, the price may be well worth avoiding poorer quality products.

Consumers can also feel more confident when products have a USP or NSF label on them.  Both the United States Pharmacopeia and the National Sanitation Foundation have quality verification programs.

Health professionals who want to learn more about dietary supplements may wish to purchase a subscription to the Natural Medicine Comprehensive database.  This is a resource that I find very useful in my clinical practice.  It covers the evidence for the dietary supplement, the risks (including interactions with drugs or lab studies) and usual doses.

Other free databases that can be used include:

Choosing dietary supplements can be difficult.  Especially if you have a chronic medical problem or if you are taking prescription medications you may want to obtain advice from a physician or pharmacist.  Drug-herb interactions can occur; you could inadvertently reduce the effectiveness or raise the blood levels of your prescription medication.  For example, St Johns wort, a popular dietary supplement used to treat depression can activate the cytochrome P450 system in your liver.  This revs up your liver metabolism and can  lower the blood levels of many medications – including birth control pills and HIV medications.

Overall, I believe that dietary supplements are of value for self care and for treating some medical problems.  Do your research before you get to the health food store or consult with an integrative physician, naturopath, or pharmacist.

 

After Cancer for the Caregiver and the Patient

Nancy (my primary caregiver during my cancer) and I went to University of Colorado’s Cancer Day program recently. It was an extensive program with breakout sessions for specific cancers like breast cancer (my diagnosis is metastatic breast cancer), colon cancer and lung cancer. Then they had general sessions with topics that included nutrition, fertility and survivorship. The handouts for the general sessions are available at this linkhttp://www.ucdenver.edu/academics/colleges/medicalschool/centers/cancercenter/CancerCare/LearnAboutCancer/Pages/ColoradoCancerDay.aspx.

The presentation Coping as a Cancer Survivor was given by Marianne Pearson an oncological social worker in Fort Collins. She offered that “An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted.” As she talked about the emotional issues one faces including: worry, feeling stress, depression, anxiety, anger, grief, sadness and being alone, I realized that now that I am in recovery so to speak, I have experienced them all at times. Less than nine months ago, I had a 3-6 month terminal prognosis, and now I am back among the living. Instead of planning my funeral I am trying to figure out how to plan my life.

When Nancy and I talked about the program afterwards, she felt they left out a big piece when they didn’t address from her standpoint as a caregiver, going from being totally depended upon to having nothing to do for the person with cancer. Her life had been completely turned upside down by devoting her full time to caring for me and now suddenly, I don’t need her any more. She said it was very disorienting. A friend I talked with this morning said some caregivers would find it relieving, but obviously there is a continuum between the two poles. It is clear that both of us have to figure out where we go from here? Am I actually well enough to do any meaningful work? How long, how much? Who will want to risk hiring me if they know I still have what is considered a non-curable and terminal illness? How much am I still worrying about when it will come back or in what form? Does that worry ever go away no matter how long we are “survivors?” For Nancy, how does she move on? Will she find some kind of volunteer work to fill her time, make new friends, or find new outlets for her creativity like she has in her art classes?

In some sense for us both, it is a brave new world with completely different parameters than we faced before. It will be interesting to see where we go from here.

Fay Octavia Elliott is a three time cancer thriver.

 

judy lief caring.com interview

Caring.com just posted an interview with me about the Courageous Women, Fearless Living Retreat. Please let your friends know there are still openings for this year’s retreat, as well as scholarship support for anyone who needs it.

http://www.caring.com/articles/courageous-women-fearless-living

 

Courageous Women, Fearless Living

Grounding, Empowering, and Nourishing Women With Cancer

Last updated: June 24, 2013