Doc: Better supplement oversight would be welcome
Dear Dr. Roach: I am a 72-year-old retired operating room nurse. I grow tired of seeing endless television advertisements for “holistic” remedies that claim to cure everything from low testosterone and erectile dysfunction to baldness. The ones that claim to “cure” enlarged prostate are particularly infuriating. They might as well claim to “cure” breast cancer.
There’s an old saw that goes, “A man who acts as his own lawyer has a fool for a client.” I think that this is pretty much the case here. None of these is approved by the Food and Drug Administration nor has been proven to be effective in the treatment of any illness. They are not consistent from lot to lot, batch to batch or even bottle to bottle. Yet thousands, if not millions, of Americans continue to use them to treat themselves for real or imagined illnesses. N.E.O.
Dear N.E.O.: Well, that’s certainly one end of the spectrum of opinion about these treatments, and there is indeed some truth to what you say.
Let me first agree with you in this: For many chronic illnesses, a cure is beyond the reach of medicine at this time. People with breast cancer can be cured, but this usually involves one or more surgeries, chemotherapy and radiation, and every breast cancer patient lives with the knowledge that it can come back, even if it seems to have been cured. Enlarged prostate can be effectively treated with medication, surgery and less-invasive procedures using lasers, heat, cold, radiowaves and more, but I hesitate to use the word “cure,” which to me means freedom from any symptoms of a condition and no detectable disease until the person dies (of something else). Over-the-counter supplements are unlikely to do that.
Now let me disagree, at least a little. Many people get relief from symptoms using over-the-counter medications, herbal preparations or supplements. I am cautious to use the word “holistic,” since to me that term means being concerned with all aspects of a person’s condition: mental, physical, spiritual, and their relationships with others and within their community. It’s the kind of care we all want and that should be attempted to be provided by all medical providers, regardless of background and orientation. “Holistic” is not at all the same as herbal or complimentary.
I often evaluate the medical claims of herbal preparations or supplements when people write me, and some of them have good evidence that they are effective. The possible benefit must be weighed against possible harm (herbs, like all products, have some potential for harm), and sometimes the decision to take a supplement is rational, as long as people are aware of their limitations.
Personally, I would like to see greater oversight on supplements. I feel they should be required to show that they are safe and effective for what they are marketed for, and tested to prove they contain what they say and not ingredients that they shouldn’t contain.
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