Evidence-based supplement recommendations

[rev ronin]

Does anyone have a resource or taxonomy I could use for trying to align the evidence bases for pharmacological medications vs. alternative supplements? I'd like to present things to patients in a level playing field--not even dealing with logical fallacies like "it's natural, it must be good!" but wanting to provide a rational, objective, evidence-based discussion for e.g., why I recommend NSAIDs vs. scads of Turmeric, or why D3 is a sound recommendation for the Pacific Northwest.

 

I'm mostly interested in making sure my practice is consistent and accurate about the level of relative risks, but being able to demonstrate the true relationship between the levels of testing and publication on pharmaceuticals vs. supplements to my open-minded patients is also highly desirable.

[RuralER/Ortho]

Meathead checking in here.... the only sphere that has more outrageous supplement claims is the fitness arena.

 

A reasonable source for some info on various supplements is www.examine.com . Generally primary literature is linked. Again, far from perfect.

 

For recommendations on specific companies,for example fish oil brands, www.labdoor.com is the best site I'm aware of.

 

Hopefully this will be of at least some help.

[Febrifuge]

I am also gradually working on a way to talk about this stuff with patients. Lately there's been some progress using the analogy of lawn care and gardening. I had someone tell me they "never use chemicals" on their lawn, and then turn around and suggest that for taking care of some weeds we have in ours, we use white vinegar. I said LOL that's acetic acid, which is a chemical you chucklehead, and we laughed about it, the friend agreeing with me, but saying you know, there's a difference.

 

And I think that's it: there are chemicals we think we know well, and feel okay about, and don't think of as "chemicals," and then there's everything else. It's about comfort. It's not about effectiveness. My friend also said to be careful not to get the white vinegar on any plants I don't want to see dead. Compare that to some of the organic chem nonsense in the appropriate aisle at Home Depot, with long weird names and the ability to kill broad-leaf plants but have no effect on grass.

 

Not sure yet how to put it all together, but if the goal is educating and getting people to think, I find the indirect approach is often good.

[Planteater]

Check out this site: http://www.informationisbeautiful.net/visualizations/snake-oil-supplements/

 

It has links to the studies when you hover over a particular vitamin/supplement. It's fun to look at too. My pharmacology teacher in PA school shared it with us and I kept the link favorited for my own reference.

 

You'll want to use a laptop or desktop to view. It's not properly functional on a tablet or mobile device.

[dchampigny]

Lexicomp has a good section on supplements/natural stuff.

 

The big problem is that people think if one is okay, three is fine, and six is better. We need better education to say that just because it is not a prescription, it can still harm you! And, we don't know a lot about these.

 

I've seen some weird ones...

[Reality Check 2]

The German Commission E is a much more effective system than our FDA and goes over every supplement and herbal. Can't sell them in Germany without Com E approval.

 

Used to only be available in German but English now too. My technical German is poor despite being fluent in the past conversationally.

 

I think it costs to access but incredibly helpful.

 

However, doesn't take into account American manufacturers and purity of substances not sold in Germany.

 

I still reference it with patients.

[ventana]

PDR actually has an herbal so something supplement