Physician and Patient communication about Dietary Supplements
Physicians need patients to disclose what supplements they are taking, including multivitamins, because the supplements they take may interact with prescribed medications. However, many patients do not disclose or discuss the use of nutritional supplements with their health care providers due to the misconception that vitamins are safe or not worth mentioning. An estimated 15 million adults were taking some form of nutritional supplement along with their prescribed medications, and 60% did not disclose this information to their healthcare providers. the use of nutritional supplements, often they do so only at the direct request of a doctor. Our results are broadly consistent with these results, although fewer patients in Los Angeles reported using supplements to their physicians. Unfortunately, Kaufman’s study also shows that physicians rarely ask about dietary intake, although earlier widespread research indicates that many people take nutritional supplements and that there is potential for serious drug-supplement interactions. No wonder patients rarely cite healthcare professionals as a source of information about nutritional supplements.
In 1998, Eisenberg reported in the Journal of the American Medical Association that 42 percent of the U.S. population used at least one alternative therapy. Survey data continues to show that at least 35-50% of consumers regularly use dietary supplements or herbal remedies. Because it is difficult to know all about the thousands of ingredients in nutritional supplements, it may be helpful to review some key concepts. The literature suggests that providers counsel patients by asking them why they use dietary supplements, addressing regulatory concerns, and addressing available safety and efficacy data. However, many dietary supplements may consist of a mixture of natural products, some of which may be dark. With over 90,000 different supplements on the market, it can be difficult to know what is safe and what is not. In fact, the medical community is increasingly concerned that the use of certain supplements today may lead to future health crises.
However, misidentifying medicinal mushrooms can lead to liver failure, while tryptophan contamination in supplements can lead to eosinophilia and myalgia syndrome. In general, consumers may not be aware that overdose and drug interactions can occur even with dietary supplements. Natural food ingredients such as St. John’s wort 6 can also interfere with the metabolism of important drugs. Patients may not realize that substances, although natural, are still dangerous. From banning drug prescriptions to dangerously exacerbating their effects, the supplements they use can have serious consequences. Of course, manufacturers cannot knowingly use or contain compounds known to be harmful to health – 1994 legislation states that ingredients used in dietary supplements cannot be shown to cause harm.
In addition, manufacturers are not required to provide proof of product safety to the Food and Drug Administration before a dietary supplement is placed on the market, unless the supplement contains a “new food ingredient (a food ingredient that has not been marketed) in this country earlier. October 15, 1994, that was not “present in food as an item used in food in a form in which the food has not been chemically altered. To prevent harm to patients and promote the scientifically sound use of prescription drugs. The Food and Drug Administration requires manufacturers to submit data demonstrating the efficacy and safety of a drug before they can promote the drug for a specific indication. Not approved by the Food and Drug Administration.
At the same time, we provide the Food and Drug Administration with a full suite of enforcement mechanisms to take action against unsafe or misbranded supplements, including seizures, injunctions, civil fines, and even criminal penalties. The goal at the time was to strike a balance between improving consumers’ access to supplements that could be used to improve their health, and providing minimal protection for the health and safety of these consumers. While the law has indeed succeeded in shielding many safe and beneficial supplements from unnecessary regulations, it is also true that the law appears to provide a safe haven for substances that many experts believe may pose serious health risks. Observing the lack of impact of such disclaimers suggests a need to reconsider whether certain high-risk dietary supplements should be more thoroughly tested for safety before widespread use, and raises questions about whether this approach is appropriate for a more liberal direction of prescription drug use.
When a new drug is prescribed, disclosure by the patient about the use of nutritional supplements is more important than discussion of supplements because disclosure will allow the clinician to evaluate potential problems or interactions. For many patients, the use of nutritional supplements is an attempt to take care of their health and play an important role. Easy access to products without consulting a doctor can be a big advantage for consumers.
Studies show that almost two out of three military personnel take some form of dietary or herbal supplement daily. Other patient cohorts may use many different supplements with varying frequency and severity of potential interactions. On the other hand, only 2.5% of patients who report the combined use of nutritional supplements and drugs can be considered at high risk for a potentially serious interaction. Second, this study lacked comprehensive information about the health status of patients or medications taken, and it was not possible to assess whether patients were at risk of drug-supplement interactions or side effects. Previous studies have not specifically looked at specific conversations about nutritional supplements because they grouped discussions of supplements with other complementary and alternative medicine practices, patient participation in outpatient visits for three different time periods.