Vail Dear Doc column: Separating fact from fiction when it comes to ‘natural’ medicines
VAIL CO, Colorado
Take a medicine and get better than you were before. Is that just marketing hype? What is the real story? These are good questions, and it is important to separate fact from fiction. A very good place to start is the Food and Drug Administration (FDA). They require pharmaceutical companies to produce prescription drugs that perform as they claim. Furthermore the FDA requires extensive safety testing from not just the side effects of the medication, but even to ensure the name is unlikely to be confused from other prescription medications. Unlike prescription medications, which can only be prescribed by a licensed provider (doctor, dentist, nurse practitioner or physician assistant), over-the-counter products are classified by the FDA as nutritional supplements and are not regulated. That is really important because it means that over-the-counter products are not regulated with respect to safety, potential drug interactions or even if their often wild claims have any validity. It is no wonder so many “natural products” claim to give you more energy, feel younger, sleep better, have less stress and a better sex life. It sure sounds good!
You started me on a new medicine for my gout and I really feel better. My joints feel better all over and exercise comes easier. Is it in my head, or is something else going on?
– Feeling Younger in Eagle
Dear Feeling Younger,
Congratulations! Most likely you are truly feeling better. Many medications not only treat disease but can actually reverse it or have other related health benefits. There are many examples.
Newer gout medications may actually reverse the chronic destructive joint changes high uric acid can cause. Metformin, a common diabetes medication, may be able to prevent the development of true diabetes when it is taken when you are still in the pre diabetic state. Inhaled steroid medications not only treat asthma, but may prevent the long term deterioration of lung function typically caused by asthma. Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs) have been shown to decrease the risk of heart failure associated with vascular disease. They also preserve kidney function when taken by diabetics.
Beta blockers, common blood pressure medications which are often prescribed after a heart attack, lower the risk of a subsequent heart attack. Tamoxifen has long been used to decrease the likelihood of a woman developing recurrent breast cancer. Recently a relative of tamoxifen, raloxifene is a medicine to treat osteoporosis that can also reduce the chance of a woman at high risk of breast cancer from developing it.
None of these benefits are idle claims. Rather each has undergone strict scientific testing and evaluation regulated by the FDA in order to prove their claims. Over-the-counter supplements lack this oversight and so the claims they advertise may have little or nothing to support what they say. Now, that doesn’t mean that supplements don’t work. Often times they do, even if we don’t understand fully how they do so. If you feel the benefits are there, that is important in itself. Nevertheless, the over-the-counter supplement and drug business is estimated to be as large as the prescription industry itself! In other words, there is a lot of financial gain out there.
My best advice is to be a smart consumer. Become educated about everything you are taking, whether prescription or not. Look for scientific validation of the advertised benefits, not just claims or testimonials. If you are taking non-prescription drugs or supplements, tell your doctor who can best inform you of the risks and benefits, as well as possible interactions with prescribed medicines. Don’t forget arsenic is a natural product, so the word natural does not always mean safe or good.
No matter what you do, always make sure you have a healthy diet, and are getting plenty of sleep and exercise.
Dr. Drew Werner is a medical staff leader at Valley View Hospital in Glenwood Springs, a family physician at TotalHealth Care and the Eagle County Health Officer. He lives in Eagle with his family. E-mail comments about this column to firstname.lastname@example.org.
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