What even your doctor may not know

Perhaps another reason mainstream medical professionals are so readily embracing alternative modalities, such as homeopathic, herbal and dietary supplements, is that many share the same misconceptions the general public often holds. The most common beliefs are that all-natural supplements are approved by the FDA and that they have to demonstrate through clinical trials to be safety or effectiveness before they can be marketed — neither is true.

In a study just published in the Archives of Internal Medicine, researchers at John Hopkins University School of Medicine in Baltimore, MD, tested 335 doctors from 15 internal medicine residency programs across the United States last year. They tested the doctors’ basic knowledge of dietary supplement regulatory issues. The average score among doctors was 59% — failing. More than a third of the doctors thought supplements were FDA approved for safety and effectiveness before they could be sold. Disturbingly, most doctors also didn’t know that serious adverse events from supplements are supposed to be reported by medical professionals through the FDA MedWatch system, which means that most complications may be going unreported. The current Warnings and Safety Information on dietary supplements available from the FDA can be found here.

The belief that alternative modalities have been tested and shown to be safe and effective is widespread. Few realize that the government has spent nearly $965 million through the Office of Alternative Medicine since it was established in 1992 (renamed the National Center for Complementary and Alternative Medicine in 1999) “to conduct and support of basic and clinical research studies, using well-established tools of rigorous scientific design, conduct and oversight.” Yet, in nearly 15 years, not one therapy has been soundly demonstrated to be efficacious and not one new breakthrough treatment has been scientifically established, according to the National Council Against Health Fraud.

The John Hopkins researchers found, however, that an online educational module improved the doctor’s knowledge of herbs and dietary supplements. After taking the course, the doctors' test scores increased to an average of 91%.

Patients who go to their doctors with questions or rely on their doctors to advise them on supplements may not be finding the reliable help they need, said the John Hopkin’s researchers. But it’s important to share with your doctor what over-the-counter things you are taking, even vitamins and supplements, as adverse reactions or complications with your other medicines and care can occur. A second consult with your pharmacist might be a good idea, given this study's findings, too.

Some general information on dietary supplements, regulations and label claims is available on the FDA/Center for Food Safety & Applied Nutrition site and through the Public Citizen Health Research Group.