Supplements

by Janet Dauble

Most of us have been through the drug mill in search of a cure for our many symptoms and we have often had side effects. The following is a classic example of what can happen from this excerpt from the "People's Pharmacy" article from the January 20, 2008 Pasadena Star-News:

"First I was put on Zocor to control my cholesterol. That caused Restless Leg Syndrome (RLS), so I was prescribed Requip. I then became depressed and was prescribed the antidepressent Lexapro. It made me into a zombie, so I was prescribed a low dose of Ritalin, a stimulant drug for ADHD.

I developed a mild heart arrhythmia (likely an effect of the Ritalin) and was prescribed a calcium channel blocker (CCB) to control the heart rhythm. I took the CCB for about three weeks and felt so bad, I wanted to commit suicide.

When I tried to refill the Zocor at the local pharmacy instead of through mail order, the pharmacist told me he could not give me the CCB and a statin at the same time. That did it for me. I had been a zombie for far too long.

I swore off all prescription medicine. Without all these pills, my mental fog lifted, the terrible muscle spasms I had everywhere relaxed, and I no longer had RLS."

Many of us have been there and done that. Then we looked to the wonderful field of natural remedies to heal our many symptoms. Environmental Medicine physicians see the need for supplements in their patients. Sherry Rogers' books and newsletter recommend supplements. And, Carolyn Gorman's book Less-Toxic Alternatives has a comprehensive chapter on supplements. There is no doubt that they can be very valuable in building better health.

Unfortunately, supplements also can cause bad effects. Not necessarily "side effects" because the effects are likely allergic reactions to the ingredients and/or binders; the symptoms from these ingredients can be different for individuals. And, one of the big problems is that people taking natural remedies do not check the ingredients for allergens. Nor do they expect to develop more symptoms from these safer products. Therefore, they do not connect new symptoms with them, and, they end up going to their doctor about a new symptom or taking additional supplements for the new symptom(s).

Alison Johnson reprinted a letter in her September 19, 1997, MCS Information Exchange on this matter. The letter by Dr. Robert W. Boxer of Skokie, Illinois, an AAEM member, was published in the Chicago Tribune on Feb. 7, 1997:

As an allergist interested in food allergy, I frequently recommend nutritional supplements. Allergic patients don't always absorb nutrients well, and some agricultural soil has become relatively depleted of essential nutrients. And there also is significant adulteration of part of our food supply due to antibiotics, hormones, pesticides, and herbicides.

Some physicians think patients probably need to receive the nutrients that are important for optimal health and not necessarily just the amount necessary to prevent disease, and those two requirements are probably significantly different. The supplement industry is largely unregulated, though, and most substances are available without prescription.

For better or for worse, a large segment of our population is taking nutritional supplements. There are many scientific studies on supplements, and, of course, there is also considerable anecdotal experience.

Recently, I have been increasingly impressed with how frequently patients suffer mysterious undiagnosable, untreatable ailments that can be traced to the use of a nutritional supplement, often one that the patient either denied using or one the physician failed to inquire about or the patient forgot to volunteer information about.

In one instance, a man had a perplexing cardiac arrhythmia, and there was discussion about the advisability of multiple cardiac medications, removing his gall bladder, which was non-functioning, or other possible approaches. But unbeknownst to his physicians, he was taking an excessive amount of zinc, unbalanced by copper, through a nutritional network product recommended by a neurologist for a neuropathy that he also had.

Once he discontinued this supplement, his arrhythmia promptly ceased and has not reoccurred. Another patient experienced back pain, and when she discontinued a fish oil-based vitamin supplement, her back pain went away.

Although these are anecdotal, they are only the tip of the iceberg in any physician's experience.

Again, it's not that nutritional supplements don't have an important role, it's that patients and doctors need to remember to consider them as a factor in any difficult-to-diagnose, non-responding condition. The same is true for other preparations available without prescription.

Even if the bottle says it is hypoallergenic and it is free from major allergens, you could be allergic to its ingredients. Vitamin C, for example, may be made out of citrus, cherry, rose hips, sago palm, etc., to which you may be personally allergic. After about a month on Vitamin C made from sago palm, my ears hurt. (A hypoallergenic Vitamin A capsule once made me melancholy for two days. I later found out that it was made from a variety of fish. I am allergic to some fish.)

I suggest calling the manufacturer of your vitamins to ascertain the source from which it was made if not stated on the bottle. And, even though, for instance, the bottle says there is no soy or corn, etc. in it, the source may be soy or corn which was processed to be considered no longer soy or corn by the manufacturer. I found out a few years ago that trustworthy supplement companies have been selling probiotics which contained malto-dextrin, a rice-related or corn-related product without disclosing it. It explains why I came down with two very bad cases of the flu after trying to take a new acidophilus made from an "exotic plant with no corn in it" some years ago. Fortunately, I correctly made the connection to the probiotic but could not figure out why. Klaire Laboratory and Allergy Research/Nutricology do not use malto-dextrin in their probiotic products, but that others may continue to use it. Vitamin C is also hard to find which has no corn in it. The cassava Vitamin C from Allergy Research has no corn in it.

I tend to be very skeptical about the latest cure (by drugs or supplements). Since 1983, I have been told about one remedy after another. One member very excitedly told me about a new supplement that she and her daughter could tolerate and which was helping them. She wanted everyone to know about it. I cautioned her to wait three to six months before telling anyone about it. A few months later she told me that she and her daughter had become worse after taking the remedy. Therefore, the next time your friend who is taking his twentieth miracle remedy pressures you to take it also, tell him if he is still taking the remedy six months from now and feels better, to let you know about it then. Often people will continue to take supplements that cause reactions because they have been told they may be going through a "healing crisis" which they must persevere through. However, that should not go on for months.

I recommend keeping a diary of foods, supplements, etc. and symptoms, and putting a sticky note on the bathroom mirror or the refrigerator to remind you whenever you try something new and the date it was begun. This is particularly helpful if it should affect your brain and cause mood swings or cognitive problems as well as physical symptoms. You can, also, alert family members whenever you try something new so that they can monitor your improvement or degeneration.

Supplements must be balanced per individual need and be allergen-free per individual. Tried and true supplements should be prescribed by Environmental Medicine physicians and be purchased from sources such as The American Environmental Health Foundation, Allergy Research, or N.E.E.D.S, so that the binders and capsules of the supplement be as hypoallergenic as possible.

Besides considering which supplements would be helpful and which ones individuals can tolerate, there are other considerations to be made. Here is a very interesting article by Lynn Lawson, published in the March/April 1998 issue of the CanaryNews newsletter:

The hardest chapter of my book to write was the one on food--a subject at once confusing, complicated, shifting, and contradictory. [Staying Well in a Toxic World: Understanding Environmental Illness, Multiple Chemical Sensitivities, Chemical Injuries, and Sick Building Syndrome is out of print. We have copies in our library.]

Supplements, as food, are also in that chapter, and supplements are now the focus of attention internationally. Are they food? Are they dangerous? How much should they be regulated? In this swirling controversy, I am often at a loss about what or whom to believe. Last July, nineteen suppliers and retailers of fish oil products received notice of violations of California's Proposition 65 because these products contained illegal levels of DDT and DDE, according to the November 1997 Natural Foods Merchandiser...

A Consumers Union scientist recently warned an Australian man that the glandular product he was seeking and many other such products on the market are made from the bovine body parts that scientists consider most likely to contain infectious levels of the agents that cause mad cow disease."Unfortunately," cautioned Sheldon Rampton and John Stauber in PR Watch (third quarter 1997), which they edit, "Lobbying by the multi-billion-dollar supplement industry has effectively guaranteed that most people will never hear about the risks associated with its products." Major supplement producers, they go on to say, hire the same major PR companies that lobby for major corporations such as the pharmaceutical, tobacco, and chemical companies.

A recent Associated Press analysis of FDA records found that the agency had received more than 2,500 reports of side effects and 79 deaths associated with dietary supplements. While most such products are safe, says Elizabeth Yetley, FDA's chief of special nutritionals, the agency has listed 16 supplements as risky [Ephedra, Chaparral, Comfrey, DHEA, Dieter's teas, Pennyroyal, Sassafras, Licorice Root, Flax Seeds, Kava Kava, Vit. E, Vit. A., Vit. D, Vit. C, Iron, Selenium]...

On the other hand, to get some perspective, the February 7, 1991, New England Journal of Medicine reported that "drug complications were the most common type of adverse event" occurring in hospitalized patients; and the October 9, 1995, Archives of Internal Medicine estimated that "140,000 patients died in the US because of adverse drug reactions in 1971."*

Picking one's way through this minefield is not easy. "What is happening is the emergence of a market-driven health industry in which traditional health care and the alternative sector are able to carve out separate market niches by positioning themselves against each other. As standards of efficacy and safety erode, health consumers are left to choose which sector offers the most convincing imagery," say Rampton and Stauber. And we are bombarded daily by expensive, slick, professionally produced imagery: for example, in 1997 advertisers spent $32 billion on broadcast commercials. While it is encouraging to see organic food, natural products, food supplements, and alternative medicine taking their rightful place in society, it is well to realize that "bigness" does not always mean "goodness." Growing at a rate of 23 percent annually, the organic food industry now generates $4 billion a year. Swallowing up its competition, Whole Foods, now the dominant health-food chain, celebrated a 900 percent growth rate in the 1990s. While its stock tripled, however, it took an anti-union stand, refusing to sign a United Farm Workers petition in support of California's low-paid, pesticide-fogged strawberry workers, according to the April 5 In These Times.

What to do? Be skeptical of all advertising, whether in the mainstream media or in the new, colorful, attractive health/lifestyle magazines. Consider the sources: know that they stand to gain from these artfully done pictures and text. Be skeptical too of articles: know that advertising drives and influences most publications. Analyze arguments and don't be fooled: it's still "buyer beware" out there.

One final word on natural remedies: recent studies recommend to not mix St. John's Wort or kava** with any anti-depressants. According to the article : "Root Effect of Kava" from the June 7, 1998, Rocky Mountain News, "People who take medicine for stress or depression should not independently substitute an herbal remedy or combine the two....The consequences could be serious. A man taking the anti-anxiety drug Xanax suffered neurological damage after he tried to wean himself off the prescription and overlapped with kava, according to an article titled "Coma from the Health Food Store," published by the scientific journal Annals of Internal Medicine." One of our members tried to go off Sinequan and overlapped St. John's Wort with it. She has become much more chemical and food sensitive. Be sure to check with your doctor and pharmacist before combining medications with medications, and medications with herbs.

Also, grapefruit tends to amplify medicinal effects all day long. Therefore, if you are a grapefruit eater, you need to adjust the dose of medications and/or natural remedies. According to the article "Grapefruit Interactions Could be Life-threatening," from the June 22, 1998, Pasadena Star-News, "researchers have discovered that a still-unidentified component in grapefruit affects an enzyme that metabolizes many medicines [estrogen, calcium channel blockers, cholesterol-lowering drugs, etc.]....No one should take grapefruit interactions lightly. We are aware of at least two deaths in which grapefruit and antihistamines were implicated. One man was taking Seldane, while the other person was on Hismanal." Since this article was written, there may be more drugs which interact with grapefruit. Ask your doctor or a pharmacist for advice.

(This Feb. 2008 edited article was initially published in the Vol. 16, No. 1, July 1998 Share, Care and Prayer newsletter.)

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*An undated Associated Press article by Brenda Coleman reported on a study that found "Bad reactions to prescription and over-the-counter medicine kill more than 100,000 Americans and seriously injures an additional 2.1 million every year....The authors analyzed 39 studies of hospital patients from 1966 to 1996. Serious drug reactions affected 6.7 percent of patients overall and fatal drug reactions 0.32 percent, the authors reported in today's Journal of American Medical Association....The most surprising result was the large number of deaths, the authors said. They found adverse drug reactions ranked between fourth and sixth among leading causes of death, depending on whether they used their most conservative or a more liberal estimate."

**According to a "People's Pharmacy" article in the July 6, 1998, Pasadena Star-News, kava "has been used for centuries to relieve anxiety, reduce fatigue and facilitate sleep." Side effects include skin dryness, flaking and discoloration and a report of a photo toxic reaction after sun exposure. Kava is not to be taken with alcohol as "it could increase sedation."

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