1 in 5 people use herbs and other dietary supplements to improve their health and well being. But with all the conflicting information out there, it can be hard to tell: Are supplements good for you, or not?
On this episode of Health Matters, Dr. Brent Bauer talks about the possible benefits and pitfalls of taking supplements, and how to go about choosing the best products for you.
Buy Dr. Bauer’s new book, Mayo Clinic Guide to Holistic Health today.
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Kristen Meinzer: This is “Health Matters,” a podcast from Mayo Clinic where we discuss the latest medical advice, news, and research to help you live a happier and healthier life.
My name is Kristen Meinzer. I’m a writer and journalist. And this episode, we’re talking about supplements. One in 5 people use herbs and other dietary supplements to improve their health and well-being. But with all the information out there, how do you know which ones are good for you and which ones aren’t?
Here to help us answer that question today is our guest Dr. Brent Bauer. He is the director of research at the Mayo Clinic Complementary and Integrative Medicine Program. And he also has a newly released book, Mayo Clinic Guide to Holistic Health. Dr. Bauer, welcome to the show.
Dr. Brent Bauer: Well, thank you for having me. It’s a real honor and a pleasure.
Kristen Meinzer: Dr. Bauer, I know that our listeners have a lot of questions about supplements. There are advertisements everywhere about supplements. But there‘s also a lot of bad information out there, too. First and foremost, what is the technical difference between a prescribed medication and a supplement, especially if a doctor can prescribe both?
Dr. Brent Bauer: Probably about a hundred million dollars, because that’s about what it costs to bring a drug to the market with all the testing and the clinical trials. A drug that reaches the United States where a physician can prescribe it has gone through thousands and thousands of trials.
There’s this tremendous amount of regulation. That’s a prescription drug. A dietary supplement. That category was actually created in the early ‘90s under an act called the Dietary Supplement Health and Education Act.
Really what they’re saying is there’s been a lot of things around for a long period of time, multivitamins, vitamins, minerals, herbs, botanicals, amino acids. That’s the category. They created a category called dietary supplements. And if it falls in there, basically they are identified as ingredients we would normally think of as something we would take to try and help our health.
But they’re coming from a long history of use. They’re usually natural products. And so they’re very different from a prescription medication.
Kristen Meinzer: That being said, sometimes doctors will say to their patients, take such and such supplement. In that case, is that a prescription? Is that a recommendation? Which is it?
Dr. Brent Bauer: Typically, let’s say somebody has arthritis and I think they should give a try to glucosamine chondroitin, something like that. I don’t write a prescription because it’s not going to be recognized. They’re going to take my recommendation, hopefully with some guidance about finding a good quality manufacturer, and they’re going to go online or to their local drug store or retail store, and they’re going to pick up a bottle, but they don’t need a prescription for that.
Kristen Meinzer: Let’s talk about supplements as far as how they’re tested and monitored. You gave us a little peek into this, but can you tell us more about what’s happening there?
Dr. Brent Bauer: At a much lower level, you’ll sometimes hear people say, “Oh, supplements aren’t controlled by the FDA.” And that’s true to one level. They’re not controlled to the same degree, but there are a number of rules and regulations. For example, the FDA does require that manufacturers have to follow what are called good manufacturing practices, or sometimes labeled GMPs.
That just means that what I say on the label it has x percent of this supplement, that’s what has to be in the bottle. Now, the challenge, of course, is that, there isn’t great oversight, right now. The FDA does not go into the store, pull things off the shelf, and look at every single one.
We would like to believe that having a law, everybody would follow it, but that doesn’t always work that way. I have to look at what are the manufacturers, how are they producing their products, and what their certifications are. There’s certifications in the United States, there’s certifications in Europe, there’s certifications in Australia. And the more that the company meets those certifications, the more we’re getting the indication that that‘s a really good manufacturer, and at least we’re getting what we think we’re buying.
Kristen Meinzer: Before these supplements even hit the shelves, what’s going on with the research, development, and evaluation of them?
Dr. Brent Bauer: Well, another key challenge is that most of these supplements are not something that I can get a patent for. If I’m a company selling a supplement, I could do a lot of research, maybe show the value of curcumin for arthritis, but it’s really hard for me to profit from that.
It’s been challenging to get that kind of research done, not like with pharmaceutical drugs where there’s often hundreds of millions of dollars invested. Here there tends to be a lot lower degree or quality or quantity of research.
Whereas with a drug, we might see 5,000 participants in a trial. Sometimes with herbal trials, we might see 100 or 150. Doesn’t mean the science isn’t good. It just means it’s very hard to be definitive with one trial, even two or three trials and say, yes, this supplement is really good, or this supplement is really bad.
We have a little limitation. Let’s just call it the quality and quantity of some of the research on herbs and dietary supplements.
Kristen Meinzer: But is it required that there is research done on them? Or could a company just say, “Hey, here’s a pill and it has this thing in it.”
Dr. Brent Bauer: As long as the company is referring to something that’s been out there for a long time. For example, ginseng has been used for centuries to help with fatigue. If they have a ginseng product and they say this might be helpful for improving your stress levels or helping with energy they’re not making a specific medical claim and they’re not taking it into a new direction. If they said, take our ginseng, it’s going to treat your blood pressure, that would be a medical claim and under the Dietary Supplement Health and Education Act.
They can’t make medical claims. That’s one of the distinctions you’ll often see. That kind of weird lingo. They won’t come out and say, “Take some palmetto, it’ll help men with large prostates pee less often.” What you’ll hear is, “Hey, take this, it can promote men’s prostate health.”
If I say I’m promoting prostate health, I’m not making a medical claim, but my hope is that the listener will say, ”Oh, that’s talking about my prostate, and I’m peeing too often at night, I should take that.”
Again, a kind of a convoluted area. You have to do a little sifting through the different areas. But at the end of the day, it’s going to really come down to us as consumers to understand what we’re taking, why we’re taking it, and how it fits in with everything else we might be doing.
Kristen Meinzer: All right, so you’re saying a package can claim this may help with energy or this product may help with prostate health. What other things can a supplement help? What are they usually used for or recommended for?
Dr. Brent Bauer: If you go to TV, they’re recommended for everything. Every advertisement, every 20 minutes. Let’s be cautious. But having said that, there are really a couple of things we might look to a supplement to help us with. One is a deficiency. If I’m vitamin D deficient, I’m going to take vitamin D3.
It’s one of those things that’s not easy to take a dietary approach and fix my vitamin D deficiency. Sometimes we’re going to treat a symptom that hasn’t fully responded to the best conventional approach. If I see a nice patient, with bad osteoarthritis, wear and tear arthritis, let’s say of the knee, and we might have tried physical therapy, maybe we tried some acetaminophen or some other over-the-counter medications, they’re not getting a good result, I’ll often have them try something like glucosamine and chondroitin, or sometimes curcumin.
Sometimes we’re treating a deficiency, sometimes we’re trying to treat a specific symptom. And then probably the third category is what we often hear advertised. You should take supplement X because it’s going to do all these wonderful things.
It’s going to promote health and make you live forever and be beautiful, and those are ones we have to be very careful about. Those are also ones where we often hear the claims, “This will help you lose weight. This will help you build muscle. You’re an athlete, you should take this.” That’s where we see a lot of people get into trouble.
When you hear claims that sound too good to be true, generally they are. But if you’re a physician and you are looking at a deficiency, supplements can be absolutely life saving. And if you’re looking at symptom control and perhaps you haven’t been able to tolerate the prescription drugs, or you don’t like prescription drugs for some reason, sometimes supplements are extremely helpful.
Kristen Meinzer: We’ve talked about supplements on their own, but how do supplements fit into an overall treatment plan?
Dr. Brent Bauer: The answer is almost never take a supplement. The answer is almost always let’s look at your whole lifestyle. Are you getting good nutrition? Are you getting good exercise? Do you have a mind-body practice that you do every day? Do you have a good sleep practice? Are you socially connected? What are you doing for spirituality? How much time do you spend in nature? Those are really critical elements that have been shown to reduce the risk of Alzheimer’s, reduce the risk of cancer, reduce the risk of heart disease, make us live longer and better.
That’s the foundation. And only when I have my patients really understand the value of the foundation, then we step back and say, “Okay, you’ve built that foundation. Do you still have symptoms? Do you still have a problem? We might then target a supplement. Or do you have a deficiency we might target?
And then sometimes we’ll get into that slightly more esoteric area of, “Yeah, I’ve
done all that, but I’m still concerned about my risk of Parkinson’s disease, and then we’ll look at some of the supplements that make claims in that area, and then we might do it on an individual basis. Find something that they can try for more of that broad spectrum approach, if you will.
Kristen Meinzer: It’s not necessarily going to replace prescriptions, but it may be part of a bigger picture of whole body and whole life care for the patient.
Dr. Brent Bauer: I always tell my patients that my best wish is that they can take as few as possible drugs and as few as possible supplements. Every time we put something into our bodies, there’s a potential for harm because we’re all different. Just because you took an herb and I took an herb, we could have very different outcomes.
Let’s not take anything that’s not evidence-based or really geared to a specific purpose for ourselves. And let’s make sure we don’t get into the trouble of herb and drug interactions because a lot of drugs can interact very poorly with a lot of the different supplements.
Kristen Meinzer: If I’m understanding correctly, you may recommend supplements to people as part of a bigger holistic approach, not for something that’s critical, something that seems like an emergency, something that’s very pressing.
Dr. Brent Bauer: Yes, absolutely. A perfect example is melatonin. Melatonin works relatively well for some people, not for all people. But I would never say take melatonin, that’s the end of the story. It would always be, “Well, let’s try melatonin even as we work on improving sleep hygiene, making sure we’re limiting caffeine, making sure we’re getting exercise.
There are some cases, though, where patients need some help right away. And then we say, “Okay, maybe we start the supplement, even as we work on lifestyle.”
It’s sometimes the chicken or the egg phenomenon here, but the answer is always these are supplements. What are they supplementing? They’re supplementing our lifestyle approach. They are never, almost, never are they the answer. They’re always supposed to come on top of that nutrition, exercise, mind, body practice, et cetera.
Kristen Meinzer: I don’t know why it never occurred to me until you just said it out loud right now, but the fact that supplements are supposed to supplement other things, they’re not necessarily a standalone treatment, they’re not necessarily a standalone solution. It’s right there in the name.
Unlike prescriptions, supplements don’t undergo as rigorous research or testing, and FDA oversight. It isn’t very strict. Now be aware that supplements can’t make specific medical claims, but they can claim more general benefits. Supplements can also be good for deficiencies – like a lack of Vitamin D – and also to treat symptoms – like those related to osteoarthritis. They can also be a good alternative if prescription drugs aren’t working well for you.
Keep in mind that if a supplement is offering something that sounds too good to be true it probably is. And while supplements can help support your wellbeing, they can never replace healthy lifestyle habits. Now, what are the limits of vitamin and mineral supplements when it comes to disease prevention and reduction?
Dr. Brent Bauer: Again, if we had a dollar and you said, “I want to invest in not getting disease down the road,” probably 95 cents of that dollar is going to go to the good exercise program, buy some good walking shoes, buy some good organic food, and buy a good meditation program. Then we have about a nickel left over to say, “Well, you know, I just want to cover the bases. I’ve read about this. I’ve talked to my doctor.” That might be a very reasonable strategy, but the power of what can help me not get a disease, what can help me be healthier 10 years from now.
Generally it isn’t the supplements that we should think of first. It really should be the icing on the cake.
Kristen Meinzer: But can that extra little bit of supplement actually help prevent or stave off an illness before someone turns to more traditional medicine?
Dr. Brent Bauer: Most of the recent studies kind of say no, right? We’ve seen a lot of these things in the news, ”Don’t take a multivitamin. They don’t work. Don’t take vitamin D, it doesn’t work. And I think we have to be careful. A lot of those studies we’re looking at large populations. We looked at a thousand people who were taking vitamin D. We watched them for six months, and couldn’t tell the difference between those who took vitamin D and those who didn’t. Therefore, vitamin D doesn’t work.
Well, that’s a silly way to study vitamin D. Really, the way to study vitamin D is find people who are deficient, give them vitamin D and see what impact it has. But most of those studies don’t do that. Most studies for a multivitamin, we’re not necessarily choosing people to participate who have nutritional deficiencies who might actually benefit from a multivitamin. We’re taking a wide spectrum of folks, many of whom have very good diets and of course aren’t going to benefit from multivitamins.
We have to be careful that we don’t read one little study and say, “Aha, HerbX! Everybody should take it!” That’s probably not true. We also have to be a little cautious when we see these blanket statements like fish oil is no good, multivitamins don’t work. Well, anybody who’s being very dogmatic in this arena is probably not fully correct. They’re probably not magical like some people would hope. The truth is how you as an individual use them really makes all the difference.
Kristen Meinzer: Is there definitive data on this? You mentioned some of the studies are not really doing the kind of research that’s going to come up with what we need to know about their effectiveness. But are there some bits and pieces of research that actually are comprehensive, that actually are telling us, yes or no, supplements are effective?
Dr. Brent Bauer: Oh, absolutely. There’s been a great growth in the amount of research on dietary supplements in the last 20 years. There’s no question we have a lot more data today than we did 20 years ago. And some of it’s very intriguing. Vitamin D is one that’s gotten a lot of press. Again, when you look at patients who are low on vitamin D and you get their vitamin D to normal, it does seem to reduce colds and flus.
It does seem to help patients who are older, perhaps, walk better, maybe not fall quite as easily. But again, that’s a very different story than saying, “Okay, I’m 75-years-old. I think I better take some vitamin D.” Well, if you already have normal vitamin D, extra vitamin D won’t help you. So then the research isn’t being applied properly.
Kristen Meinzer: Got it. It’s not really black and white. It’s a question of whether supplements work or not? It’s more about how you use them, and in what situations. Now you alluded before to the fact that there can be some interaction issues between prescriptions and supplements. Can you tell us more about how prescriptions and supplements might interact well or not so well in a person’s system?
Dr. Brent Bauer: There’s a number of ways that this can happen in terms of interactions between drugs and supplements. One of the classic things to think about is that some of the herbs actually speed up metabolism of drugs and some herbs actually slow down metabolism. If I have a drug, let’s say it’s a drug to prevent heart transplant rejection. And I take an herb that speeds up the metabolism of that drug. All of a sudden, my anti-transplant drug level is way too low and I experience heart transplant rejection.
And that’s actually happened several times with St. John’s Wort. One of the herbs that’s often used for depression. The same thing has happened with pregnancy: there’s been a couple of cases of women who were on oral contraceptives. They took St. John’s wort, it sped up the metabolism, and they became pregnant because there wasn’t enough effect of the oral contraceptives to prevent pregnancy. This is one of those classic things where we recognize herbs, can stimulate the liver both to speed up or slow down metabolism.
This is one of those important reasons why I always say before you start something new, talk to your primary care team. Make sure, especially if you’re on a lot of drugs, make sure you’re not getting yourself into potential trouble.
Kristen Meinzer: Are there any supplements that could have negative long term effects on overall health?
Dr. Brent Bauer: Oh, yes. Unfortunately, there’s a lot of things that can harm people. I don’t know if you remember ephedra or Ma Huang? That was an herb that’s very popular for weight loss and actually seemed to help people lose weight. But you know, we tend to be Americans. If a little’s good, a lot must be better. And so people started taking way too much. And as a result of that, that had a pretty high likelihood of harming the liver. A lot of people got liver damage and quite a few ended up with liver transplants.
That was a clear case where the herb caused significant, severe damage. There were other herbs that have been associated with liver damage. Kava. Kava has been claimed to hurt the liver. That’s probably not as true as we once thought. But the point is, almost anything we take, natural, synthetic, drug supplements, even food. Too much can cause damage. If we drink enough water, we can die because we can get into electrolyte problems. We have to be careful.
Natural doesn’t mean safe, and everything has to be treated with respect, especially because each one of us is so unique. What works for one person may actually be toxic for somebody else.
Kristen Meinzer: Let’sgo back to FDA approval for a moment here. The FDA’s relationship with prescription drugs, it’s much stricter. Knowing this, if supplements aren’t dealing with the same level of scrutiny from the FDA as prescription drugs, how do we know which really are trustworthy?
Dr. Brent Bauer: This is where I say it’s time to do some homework. Again, if I’m going to buy a car, I do a lot of work. I really read the consumer reports. I do this. I do that. I try and invest a lot of time. When I make that purchase, I’ll be happy with that purchase for a long period of time. I think the same thing applies to dietary supplements. If I really am vitamin D deficient, I’ll probably take vitamin D for the rest of my life. I want to apply that same level of thoughtfulness to finding the best vitamin D for me.
Now, sometimes your physician or your primary care team may have some good ideas. It may be a common question for them. Always start there. But then I really do recommend people do homework. If you have a good company, dig into the website. How are they doing their manufacturing? Do they have certifications from not only the good manufacturing practices kava kava in the U. S., but have they done it with other countries? How are they doing their analysis? If I’m creating an herb from, let’s
say, Kava, how did I harvest the Kava? How did the Kava come to my company? How did I process it? How did I encapsulate it? And how do I know along each step of the way that I maintain good quality?
A company that can show you their quality metrics kind of from start to finish, that’s a company that we can probably feel fairly comfortable investing in as part of our ongoing healthcare.
Kristen Meinzer: However, nowadays, there’s an issue that’s been found over and over again. And that’s fraudulent supplements. Like this product actually looks like it’s from that trustworthy company. I did the research, but it’s not, it’s just the same label, but who knows what’s in those pills?
Dr. Brent Bauer: You’re absolutely right. And unfortunately this affects everything in America now because we love the convenience of online shopping. We love the convenience of having competition. There’s many good things about the marketplace, but this is one area where people have been burned, thought they were going to the reputable site, but turned out it wasn’t. It was a knockoff or something like that. That’s a bigger question that I don’t have a good answer to from a medical perspective. Everybody beware out there.
Kristen Meinzer: Then there’s the concerns about fillers, too.
Dr. Brent Bauer: When you buy that capsule, it may be a natural product you’re taking, but what else is in the capsule? A lot of the fillers can actually have some negative effects. That’s another level of research we want to do when we’re going to lock in on a supplement we want to take for a long time. We want to actually look and see what kind of fillers are in there. Are they ones that might give us some side effects or problems down the road?
Kristen Meinzer: It sounds like maybe going directly to the original manufacturer is probably better than going to an everything store for some of these kinds of things.
Dr. Brent Bauer: In general, I think that’s true. I mean, we’ve worked with a few major manufacturers to do research at Mayo Clinic on a variety of herbs. I’ve actually visited their production facilities. We know them real well. That’s my recommendation to my personal patients. If I’m recommending that they start a vitamin of some type or something, I’m always going to recommend the manufacturers we’ve worked with directly.
Now, sometimes that may be because of the quality. Maybe they are a little more expensive. Sometimes patients will look for lower costs. And I don’t think that’s wrong, but I think we just have to be extra careful in a day and age where unfortunately, there’s some people online who aren’t always out for our best interest.
Kristen Meinzer: Sadly, that’s the case in lots of arenas, including our health. Now, Dr. Bauer, when I’m doing my own research, is there some sort of trusted certification organization or a certain kind of label I should look for across the board as this is the real deal?
Dr. Brent Bauer: There are a couple companies out there that have been doing this. One is called United States Pharmacopeia. And what they do is they go and they pull different supplements off the shelf. They do their own very deep dive analysis. And if what the label says is actually what’s in the bottle, then that company’s allowed to put the USP verified label on that different supplement. Now the challenge with that is there’s not a lot of companies that have gone through that process.
Sometimes I’m looking for an herb and I’m looking at a whole bunch of them, but none of them have been USP certified. It’s a very nice process if it’s available and you find one, you can be relatively certain that a third party, completely separate from the company, has looked at that product and came back and put that label on because they did meet the qualifications they needed.
Kristen Meinzer: Taking supplements can come with complications: If you’re already taking prescriptions or other supplements, notify your primary care team. There might be interaction issues you should know about.
A lot of supplements are herbal – but just because they’re natural doesn’t mean they’re safe for you. While a little may be good for you, that doesn’t necessarily mean more is better. Overdoing it can have long term negative effects.
Treat shopping for a supplement the same way you would shopping for a car. Look into the company, how they process their product, and make sure you buy from a reputable source to avoid fraudulent products.
Let’s say I’ve started to take a supplement. How should I evaluate whether or not the supplement is actually helping me? Are there certain checklists I should look to, certain ways I should measure my own body’s responses?
Dr. Brent Bauer: Absolutely. That’s the perfect question. Because that’s what I do with every patient. If they’re coming to me and they say, “I want to take X to help my Y problem,” that’s great. Let’s sit down before you take the first dose and really chart out why. Well, I’m going to take melatonin because my sleep’s poor, I’m waking up at 3 o’clock, I wake up tired. Great. Write all that down. Take the melatonin for a month and ask those same questions again. Are you sleeping longer? Are you falling asleep more easily? Now we actually have some apple to apple comparison. And that’s the only way to do this because otherwise three months, six months down the road, I don’t know if it’s working. I can’t tell if it’s any better. Maybe I’ll take another one and all of a sudden people are taking six or seven.
We don’t know which one worked, which one didn’t. I encourage everybody that I see to kind of become a scientist and rather than having a clinical trial of a thousand participants, you have a clinical trial of one and that’s you. Do your homework again and really think about why would I take glucosamine? Well, both of my knees hurt. They hurt eight out of ten everyday and it’s limiting my walking to no more than blocks. Well, glucosamine chondroitin generally takes quite a while to work, so maybe three months later I’ll ask them to do that same analysis.
Well, you know what, both knees are down to six out of ten. It didn’t cure it, but we didn’t expect it to, but that 6 out of 10, I’m now walking 20 blocks. Now we can say that you, as an individual, experienced the benefit. Then we always ask, did you have any side effects? Did you get liver problems? Did you get stomach problems? If you had no negatives and you’re seeing the outcome we were looking for, that becomes one that I’m going to say, let’s continue with it. As long as we see those benefits.
Kristen Meinzer: Well, I’m just going to be a naysayer here for a second and ask a question about the placebo effect. Is there a chance that supplements actually just convince us that they’re working because we think they are, but maybe they’re not physiologically changing something in us?
Dr. Brent Bauer: Oh, absolutely. And guess what? Same thing with the drugs you got from the pharmacist. We all have a really robust placebo response. And that’s usually guesstimated around 30%. If you have 100 people in the room, half take a real blood pressure pill, half take a sugar pill, those people taking the sugar pill, about 30 percent of them will have a significant response to their blood pressure. Recognize that if we say to our brain, “This is going to do something,” for many of us, it will do something. If we’re going to do a research trial we can’t just say, everybody take glucosamine, everybody come back in a month and tell us if you felt better.
We would have a hard time seeing the difference, like how much of that is placebo. What you want to do is have half the group take a placebo, half the group take the real stuff, and you follow them out for three months. And if the placebo group gets a 30 percent response and the glucosamine chondroitin group gets a 60 percent response, now you can say, “Wow, there’s something powerful there.” That becomes meaningful.
Kristen Meinzer: Fascinating. I had no idea the placebo effect was so powerful—30 per cent.
Dr. Brent Bauer: Yeah. And that varies. You might hear some people quote slightly higher, slightly lower, but we are very susceptible creatures. We can work to our advantage. I often encourage my patients, “Hey, you’re embarking on this new thing. Let’s really crank the exercise. We’re trying to get sleep improved.
Let’s go, go, go. And a lot of times that positivity gives them that positivity. And that seems to be part of the response. We do want to engage the placebo response, not in a fake way or a false way, but just recognize our brains can respond to how we talk to it. If I take melatonin and say, well, this stuff’s probably junk, I don’t know why I’m taking it, what a dumb idea, I suspect your response is going to be lower than if you say, well, I’ve really done everything I can to enhance my sleep. I want to try this one more thing. Studies are pretty encouraging. It looks very safe, I think you’re going to get two different responses, largely based on what you kind of did to prepare your brain.
Kristen Meinzer: Well let’s say we’ve prepared our brain, we’ve taken that melatonin, we’re sleeping like a baby. We’re feeling great. Then what? Do we go back to you and say, “Doc, I think I’m cured,” and then you’ll tell them to stop taking the melatonin? Or will they keep taking it for life?
Dr. Brent Bauer: Like with any drug, my goal — and I think most physicians’ goal — is to try and get you off of it. If we can, if I have high blood pressure, I have to take a pill because I don’t want the strokes and the bad things. But you know what? I can work on losing weight and exercising more and eating better.
Maybe in six months, my blood pressure will go down so low. I might not stop the blood pressure pill, but I might cut it in half. And I still keep losing weight and maybe I get to a point where I don’t need the drug at all. Same thing with the supplements. A lot of times I just needed that little help with my sleep.
I have been using melatonin for three months. Maybe I won’t stop it, but maybe I cut the dose in half. Maybe I go every other day. I say, I’m still sleeping great. Guess what? The lifestyle probably kicked in. We may not need it. Perfectly fine, put it on the shelf. Sometimes, though, that turns out like that’s what I needed. I needed the glucosamine chondroitin. I can’t stop it. Perfectly acceptable. As long as we’ve done our homework and we know that it’s agreeing with you, not causing side effects, and you’re getting the response we looked at.
Kristen Meinzer: Now, one thing that most of us are familiar with is who goes to the doctor, we fill in our intake form every time we come in. But one question that’s always on the intake form is what medications are you on right now? Should I be putting supplements on there or should I only be putting prescription medications on there?
Dr. Brent Bauer: Please put them all on there. If you come to me, we actually have a prompt. It’s not just what are your drugs? This includes things like dietary supplements, herbs, and so forth. It’s not enough for me just to know what drugs you’re on. If you’re also taking six different herbs and we don’t get that conversation, we may miss an opportunity to help you. I may miss the whole reason that you’re having abnormal liver function test or the whole reason your kidneys aren’t working.
In fact, if you’re not prompted after you fill in your medications, absolutely put in everything you’re taking because that’s a great discussion point. Let’s look at those. Are there ones that we would say are maybe not good for you? Maybe not good for the medications you’re taking because we’re concerned about interactions.
Kristen Meinzer: And what advice do you have for patients who would like to take a more integrative approach to their health care, where they incorporate a combination of conventional and alternative medicine?
Dr. Brent Bauer: There’s a number of good resources out there. The Mayo Clinic website has a lot of good information. But you can go to the National Center for Complementary and Integrative Health. That’s one of the NIH centers, focusing on dietary supplements, massage, acupuncture, and so forth. They have a lot of good information on a lot of different herbs.
There’s a number of databases out there, of course, some of which charge a fee to use. But I think doing a little research can make you very smart about a few things. I don’t have to know a thousand herbs, but I see patients every day who are using glucosamine, chondroitin, curcumin. I need to know those really well so I can focus on those. If I as an individual want to take something, I don’t have to know everything, but I better do enough homework to kind of figure out how likely it is to work, what’s the evidence say, what are the risks, and what drugs could I not take with that.
Kristen Meinzer: And then we should also, I presume, talk with our physicians as well.
Dr. Brent Bauer: I always want my patients to look at me as a collaborator in this. Everybody should have a comfort level talking to their primary care team. And if you don’t have that, it may be an issue of either presenting things differently or finding different primary care because honestly, this is a really important thing. If you are using supplements, it’s part of your health care. It may be a very important positive part, but I still need to know that. It may be causing problems that you didn’t think about, but I might know. And we might save ourselves a lot of trouble and unnecessary testing if we have that dialogue.
Absolutely always talk to your primary care team. Now, many of the doctors I work with don’t have a lot of experience with supplements, but guess what? We have resources within our practice. We have pharmacists who are trained to sit down and talk about that. Even if I’m not very knowledgeable, as a physician, I should at least know how to refer you on to somebody in the practice to a resource that can sit down and answer your questions and make sure you’re being safe and getting the benefit you’re trying to get from the supplements.
Kristen Meinzer: This has all been fantastic. Dr. Brent Bauer, I have learned so much from you today, a lot to think about as I take my own supplements and talk with my own personal care team about my health. Thank you so much for joining us today.
Dr. Brent Bauer: Well, thank you very much. It’s been fun as well. And I hope that this is something that your listeners can profit from in terms of optimizing their health.
Kristen Meinzer: If you’re considering taking a new supplement, make sure you have a targeted reason for why. And after a trial period, reassess: how has your health and how have your symptoms changed? Are you feeling any side effects? That way you can see how and if the supplement is working for you.
Remember that mindset matters, and so do our lifestyles.
Even after a prolonged period of taking a supplement, if you continue to work on your lifestyle habits, you might be able to lower your dosage or stop taking it altogether. Lastly, your doctor is a collaborator in your care. Choose a care provider you feel comfortable speaking with about your physical health and the supplements you’re considering or already taking. They can help answer your questions and make sure you decide on the best supplements for you.
That’s all for this episode, but if you’ve got a question or a topic suggestion, you can leave us a voicemail at (507) 538-6272. We might even feature your voice on the show. You can find more information about Dr. Bauer’s book, Mayo Clinic Guide to Holistic Health in the show notes online. For more Health Matters episodes and resources, head to www.mayoclinic.org.healthmatters. Thanks for listening and until next time, take care and stay healthy.
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