The Rational Use of Nutritional & Herbal Supplements

As part of my practice, I often make specific recommendations to my patients for nutritional and herbal supplements. Although hyped by enthusiasts as “cure-alls” and criticized by cynics as “worthless,” supplements can be used in ways that are evidence-based and scientific. Some examples include

In acute conditions:
Echinacea for a viral respiratory illness
DGL for acid reflux
Probiotics for diarrhea
SAMe for depression

In chronic conditions:
Alpha lipoic acid for neuropathy
L-theanine for anxiety
Vitamin D for osteoporosis
Magnesium for migraine

In long-term prevention, wellness and vitality:
Red yeast rice to lower the risk of cardiovascular disease
Glucoraphanan to lower the risk of cancer
Curcumin to lower the risk of neurodegenerative disease
DHA to improve and protect cognitive function

Many supplements can act in two or even three categories: acute, chronic and preventative. Some examples include DHA, curcumin, and probiotics.

There is on-going scientific debate about the optimal use of supplements, just as there is debate about medications and surgery. That is the nature of science. In advising patients regarding the use of supplements, my role is to make recommendations based on the current level of evidence, the risks and the alternatives.

There is an important issue involving quality and purity in the field of nutritional and herbal supplements. Unlike medications, these substances are not regulated by the FDA. There is a wide range of reliability among the manufacturers of these substances. There have been important investigations of off-the-shelf supplements showing that many brands have misleading labeling and poor quality. For these reasons, I recommend two specific companies (Metagenics and Xymogen) that are manufactured according to pharmaceutical standards and are also “third party tested” for quality and purity. We sell products from these companies in our office and through on-line web-based stores. They are also the companies that make the supplements that I take and that I give my family. If you would like to review or order products from these companies, click here.