Tuesday, July 29, 2014

A Vent about Supplements

I humbly acknowledge that I'm not very smart and don't have all the answers. And I humbly ask for forgiveness if I step on any toes with this. But I have to get this off my chest.
An acquaintance I know on a social media site has been very vocal about promoting certain supplements for various health reasons. Making claims about disease prevention, and improving certain metabolic parameters.
I'll admit I'm a skeptic when it comes to supplements. Not because I'm paid by big pharma, or that I sell medications in my clinic. As far as I'm concerned I'm just a cheap bastard who believes in cheaper meds, but also strongly believes in picking the best for my patients based on what's been proven.
And so when it comes to many supplements, I'm just not convinced of their benefits- there is simply a paucity of scientific evidence. And yes, I know those of you who will come out to say Evidence-Based Medicine is evil, because everything is funded by pharmaceuticals- if you believe that then you're a bigger idiot that I thought. I daresay most studies in medical journals are NOT funded by pharmaceuticals.
But anyway, after reading one too many posts on this social media site, especially when making claims about improving insulin resistance and hinting that they may be beneficial for diabetes patients, I had to ask him: where are you getting your information from? Care to cite your references?
 
I was somewhat unprepared for the answer that he sent me:

It was a screenshot from Google! Not even Pubmed, or Uptodate.
 
And perhaps this is my biggest beef with advocates of supplements. If you can show me good studies supporting its use, I'm all for it. Because, despite what you think, I don't burn up in flames when I touch a multivitamin. I've on occasion taken St. Johns Wort for mood- based on some clinical studies (will blog about that next maybe- but this job is going to kill me someday). And I've been known to suggest red rice yeast extract for my patients who are deadset against prescription statins. But if you're wanting to convince me, or my patients, that something is beneficial, seriously, the best you can come up with is Google? Makes me tempted to ask: if so, the next time you have a ruptured appendicitis, are you going to Google this and take some supplements for it? Or are you going to seek help from a surgeon who was trained based on the latest in scientific evidence?

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