When Marjorie Williams was coming down with a cold this fall, she got lots of advice from friends. "At the first sniffle, I just start popping chewable zinc tablets" said one. "Echinacea plus vitamin C every two hours" said another. A third touted the value of eating garlic -- raw -- and taking 2,000 milligrams of vitamin C all year around as a preventative. Or, there are homeopathic remedies such as gelsemium, if it feels like the flu."
Do such remedies really work? And if you decide to treat yourself with items found in health food stores, how do you know what to take, and what brands are good? Could any of these things hurt you?
A Pharmacists View
Nicholas Galeota, MS, RPh, director of Pharmacy at SUNY Downstate Medical Center, believes there is a place for supplements; however, with this qualification: "You have to do a bit of research if you want to avoid wasting money and save yourself from possible negative side effects."
Properly prepared foods are the best sources of the standard vitamins and minerals, plus they contain beneficial "trace" elements that may not be replicated by commercial supplements. However, there is truth in the charges that todays agricultural methods produce foods that are less nutrient-rich than the ideal. Also, such processing procedures as removing the germ from wheat flour and the husks from rice kernels (in order to make "white" bread and "white" rice) further reduce nutrient value. And foods are best when fresh: Extended storage periods and long- distance shipping contribute to nutrient loss. Many producers try to correct for this through fortifying foods with added-back nutrients, but theres still a case to be made for taking additional vitamins and minerals. Nutritional supplements, such as vitamins and minerals, can also be important for people in certain categories.
Who Can Benefit From Nutritional Supplements?
- Seniors - daily supplementary vitamins and minerals, even if they eat an adequate, balanced diet.
Children - daily multiple vitamin supplement. In particular, vitamin D and calcium.
Pregnant women - daily vitamins and minerals, with Folic acid.
Nursing mothers - daily vitamins and minerals.
People who are run-down, ill, or immunosuppressed, including those with HIV disease, or undergoing treatment for cancer.
Calcium supplements are a good idea for anyone who does not consume a diet rich in this important mineral.
Your Physician as Resource
How can one really know if she needs supplements? Talk to your primary care physician. Deficiencies, such as anemia due to low iron, can be detected through blood tests. Fatigue could indicate inadequate nutrition and thus be eased by supplemen-tation, but it could also point to other medical problems that your doctor could unearth.
There is a further downside to treating yourself with supplements. In older people, for example, liver and kidney function are less efficient than in younger years. Excess vitamins and minerals can build up in the bloodstream or organs, causing problems. Too much calcium can contribute to kidney and bladder stones; too much iron is destructive to the liver, heart and kidneys. In excess, the anti-oxidant mineral selenium can cause nausea, fatigue and gastrointes-tinal symptoms. The fat soluble vitamins, A and E, are not easily excreted by the body, and they, too, can accumulate. Consulting a doctor is always best.
Choosing a Formula
With so many products out there, how can you decide which to take? Mr. Galeota advises looking for a balanced multi-vitamin/mineral formula that gives you close to the Federal Department of Agriculture (FDA) recommended daily allowance (RDA) of vitamins and minerals.
When it comes to judging an individual product, you are more or less on your own. However, the "house brands" sold by large health food and drug stores chains are usually reliable. On request, many manufacturers will provide information about tests of the potency, or "bioavailability," of ingredients in their products. Sometimes this information is available on line. "Knowledge is power," Mr. Galeota advises. "Before you take something you are unsure about, get all the information you can."
In the ill-defined area of "remedies," the number of choicesand challenges is vast. Does Mr. Galeota recommend homeopathy, or treating oneself with tonics, poultices, herbal teas, or other plant-based remedies? "This kind of self treatment has a very long history," he says. In fact, many of the prescription and over-the-counter drugs sold today had their origins in folk remedies based on plants. Taxol®, digitalis and cyclosporin, three powerful drugs now used, respectively, to treat cancer, heart problems, and organ rejection in transplant patients, all had origins in herbal folk remedies. Nevertheless, treating yourself poses many questions. For one thing, the fact that some herbs are extremely potent raises the possibility that you could do yourself harm. "Check with your doctor when in doubt. Also, let your doctor know what herbs you are taking in order to avoid conflict with prescription medications."
Herbs and "Tonics"
The neighborhoods surrounding Downstate have a wonderfully varied ethnic and cultural mix, many with rich traditions of herbal healing. Remedies such as senna leaf, used as a natural laxative; ginger root, used as a mild stimulant; and clove oil, to relieve gum pain, have a long history of use in these cultures.
For the pharmacist, the problem with all of these remedies is that they have never undergone the stringent controlled tests for safety and effectiveness required of prescription drugs. That means it is hard to say with certainty whether, or how well, any of them work. Mr. Galeota speculates that their effectiveness depends in part on the strength of the users belief in them. "As we know from the placebo effect, the mind has a powerful ability to heal." That said, many herbal products may well be both beneficial and safe (barring allergy to a particular herb)with the following words of caution: The potency of herbs can vary wildly, and there are no national standards enforcing purity in the growing and production of herbal preparations. Consumers would be wise to purchase only products distributed under reputable, nationally known brand names.
About homeopathic preparations, which are based on extreme dilutions of plant extracts, Mr. Galeota tries to keep an open mind. He knows of no conclusive evidence either for or against their effectiveness. To the extent that they are prepared from herbs with demonstrated medicinal value, he sees no harm in trying them.
On the other hand, Mr. Galeota specifically warns against the following remedies sold in health food stores: Ephedra, melatonin, DHEA and Co-enzyme Q10. Ephedra (also known as Ma Huang), touted as a stimulant and cold remedy, is suspect because it is an ingredient in some preparations associated with fatalities. Melatonin, recommended as a sleep aid and anti-jetlag remedy, and DHEA and Co-enzyme Q10, both said to be "anti-aging" remedies, all occur naturally in our bodies; nevertheless, Mr. Galeota worries that studies have not established optimum dosages, nor confirmed their long-term safety in supplement form.
In summary, Mr. Galeotas view of supplements is: Proceed with caution. Exercise special caution around supplements or remedies for children; pregnant women and nursing mothers; older people; and anyone with an immune system disorder or who has a major underlying medical condition. Do not ingest anything unless you are sure it will not be in conflict with any prescription medications you are taking. St. Johns wort, for example, may reduce the effectiveness of cholesterol-lowering drugs, oral contraceptives, and AIDS medications. Ginko biloba, used by many to improve memory, can react with ibuprofen. Learn all you can first about anything you put into your body, and always keep your doctor informed. "Nature has given us many treasurers," says Mr. Galeota. "We just have to be careful what we do with themto use them for our benefit, and not for harm."
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