Dietary Supplements: Neither dietary, supplements, or even for sure safe

Dietary Supplements:  Neither dietary, supplements, or even for sure safe 

In October 2015, the New England Journal of Medicine published a review of how many people get so sick from taking a dietary supplement they sought care in an ER or got hospitalized.

They found that the answer was thousands.

What is a dietary supplement?

The concept of a dietary supplement has nothing to do with medical science, but rather is a creation of Congress.

A law passed by Congress in 1994 created the category of chemicals now referred to as dietary supplements (the Dietary Supplement Health and Education Act of 1994).  This law essentially defined a set of chemicals that could be sold to relieve symptoms with legal protection against ever having to prove they work or are safe.  The only safeguard provided was that if someone could prove they hurt people, the FDA would be allowed to take them off the market.

But any substance deemed by the law to be a dietary supplement could be sold to the public with no proof that it worked, that it was safe, or even that bottles of the product actually contain the product described in the label.   This law was largely the creation of the industries that make these substances.

The law defines a dietary supplement as one of three products:

1.  Herbals- botanical products, that is plants, such as echinacea

2.  Complementary nutritionals- purified chemicals known to be part of nutrients, such as amino acids.

3.  Micronutrients- purified forms of vitamins and minerals.

The Findings

The article found that about 23,000 Americans have to go the ER every year due to adverse effects from taking dietary supplements.  About 2000 of them end up hospitalized.

By far the age group that came to the most harm were young adults, ages 20-34.

Three main categories of harm found were:
1.  Heart problems in young adults taking weight loss and energy supplements.

2.  Kids experiencing overdosages from getting into supplements of micronutrients.

3.  Elderly people choking on pills.

The heart problems in young adults was the largest group.

Why this matters

Dietary supplements are hot.

The industry that makes them has been wildly successful in getting us to take them.    About half of all American adults have taken a dietary supplement in the last month.  We spend about a third of all we spend on prescription drugs on dietary supplements.

This is one of the great marketing successes in history, all the more remarkable for selling products that in most cases have no proof of doing anything.

Of course taking something in hopes that it will work is fine if it is harmless.  But if it can hurt you, it seems all the more important to know if it works.

By law, dietary supplements are excused from finding out if they work, and so very few have ever been studied to find out if they do anything in reality.

That makes this finding that so many young adults end up in the ER from them very important.

BOTTOM LINES

1.  Dietary supplements are a category created by Congress as part of an industry strategy to sell product, not a product of any medical or science related research.

2.  It turns out that none of them are actually a food, and as such are not really dietary.  They are chemicals and should be judges by the same two standards all chemicals should be held accountable to:  do they work? do they hurt?

3.   We now know that weight loss and energy supplements cause heart problems in thousands of young adults.

4.  Our recommendation is that no one should take any chemical on a regular basis without knowing if it really does work and what harm it can cause.

To your health,
Dr. Arthur Lavin

---

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

More evidence that Vitamin D does not deliver

More evidence that Vitamin D does not deliver

The New England Journal of Medicine in October, 2015 published an important study on an interesting claim that Vitamin D has made for several years.

Some years ago, the case was made for Vitamin D being an extremely important chemical in a wide range of body functions.   Even more, that taking extra Vitamin D, boosting one's levels, could deliver a very wide range of substantial health benefits.  These included stronger bones (less osteoporosis and bone fractures in old age) and a reduced chance of developing a rather breath-taking range of very scary diseases, including diabetes, multiple sclerosis, and colon cancer.   When these fairly well thought out claims were first proposed, we recommended use of supplemental Vitamin D pending further findings.

At the time we observed that some skepticism was in order, as only one vitamin in the last 100 years has actually been shown to offer any benefit when taken in supplement form.  Folic acid when taken by women of child-bearing age sharply reduces the chance of an infant developing spinal cord anomalies and may sharply reduce the chances of autism.   But that's it.  Taking any other vitamin has panned out to be a complete waste of time, and in most studies associated with poorer health.

So we have monitored the literature on Vitamin D, hoping it would join folic acid as a helpful supplement, but concerned the odds were against it.

Since that time, the further findings have been universally disappointing for Vitamin D supplementation.   Now abundant results clearly show taking Vitamin D or calcium- by pill or milk- has no impact on bone.  Elders who take or don't take Vitamin D and/or calcium have the same risk for bone fractures when falling, and no difference in bone density.

Now comes the  New England Journal of Medicine to look at the impact of taking Vitamin D on disease prevention, in this case colon cancer.   After studying thousands of cases, the evidence is clear, Vitamin D has no impact on the chance of developing colon cancer.  This is a very serious blow to the idea that taking extra Vitamin D can prevent illness, certainly colon cancer.

Our recommendations at this time remain that vitamins should be obtained by eating food, not taking pills.  The only exception is folic acid, from the first period to the last period, women should take 400 micrograms of folic acid.  This is the only way that one can be sure the embryo is exposed to levels of folic acid high enough to prevent spina bifida, and perhaps autism.

To your health,

Dr. Arthur Lavin

---

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

On being a toddler- The Wonder of Curiosity

On being a toddler- The Wonder of Curiosity, The Power of Language.

As many know, we have had the tremendous fortune of being able to visit our son and his wife, and our granddaughter Evie, in Hong Kong for most of October.

Last time we had some extended time together, Evie was about 9 months old and inspired some thoughts on infancy and grandparenting that I shared.  Now she is about 15 months old, and the changes and time have once again inspired some thoughts.

I think every age of life is infinitely fascinating.  Our whole lives we are filled with potentials and possibilities, and at each stage of life these potential vary.

For a very long time I have found the age of 15 months fascinating for being on the verge of so many momentous changes that open up great vistas.  We saw all this in full view during our visit with Evie who turned 15 months while we were there.

I think the most evocative property of being 15 months old is that by this age most toddlers have achieved a remarkably good understanding of language, even though their ability to formulate and speak thoughts is very limited.   This is likely the only time in any of our lives when we know the words of our mother language, but cannot yet really speak it.  At 4 months of age, very few infants if any know any words in their native language.  By 3 years of age, nearly ever child not only understands their first language, but speaks it.  Even by 18 months of age, their is so much more ability to state intention.  This makes 15 months a very tender and powerful moment in life.  It is the peak of potential, when so many ideas are coming into the young child's mind, but not yet expressible in full sentences and paragraphs.   It is a time when you aren't really sure what the child is thinking, but are repeatedly surprised to find how much is going in in there.

For us that meant many wonderful hours singing nursery songs and reading many books to 15 month old Evie.   For every new book or nursery song, Evie would seem to be attending, she would stop moving around, look intently, be in the moment, but who could tell what and how much actually being understood?  Then about 1 or 2 repetitions later, sometimes during the first introduction, she would say a word or form a hand gesture exactly on the point of the song or book, at just the right time.  We loved her saying so sweetly, "No, no, no, no" when we sang or read what the doctor said about no more monkeys jumping on the bed.  Or forming her hands into a horn when singing about little boy Blue blowing his horn.

She was completely unable to read back any of her books to us, or repeat any songs sung to her, and only barely starting to make single words anyway, but these well-timed words or gestures signaled that she was understanding the point of the story in the song or book and at the time it was said.

We also saw that a whole world of preferences and styles was appearing.  As Evie was on the brink of using words to express thoughts, her thoughts were becoming more complex, and on the verge of creating stories.

This is the really exciting part of this age- it dramatizes how much of our lives are the expression of stories.  Our understanding of stories we experience, and our creating our own stories for others to experience.

To a large degree, it is the ability to craft stories and to join them to each other's that makes us human.  That ability sits ready to emerge from birth onwards, but to see it coming together in the second year of life, and to see the full power of being human activate and take hold is so powerful.

We also saw the power of blocks of thought.  Evie had a set of a dozen or so playful narratives that she could activate at any time- pretending to answer a phone, pretending to take her dolls on  a walk, caring for her dolls and stuffed animals, and many other stories that we could not know exactly what they meant.  In each instance, when a story was activated, she went through the same motions, almost exactly.  We were watching her create set pieces, each very complex, that could be expanded or connected in time to create complex narrative behaviors.   We fully grown adults use the power of established narratives all the time.  It's how we get through much of our days, repeating functions like buying groceries, driving to work, doing house chores, even much of our social conversing and work.

Putting it all together, being with Evie this visit brought to home the big difference between being a baby and a child.  It's mostly language, but also walking.   When we are born, not just unable to walk or talk, but unable to imagine doing either, we are unable to craft stories that create new realities on the world, the reality of who we are.   Once we walk, and in particular, talk, we begin to present our stories to the world, and learn from other stories.  It is the emergence of being able to create and respond to stories that really marks the end of infancy and the beginning of the childhood.

It was beyond wonderful to spend so much time with our son, daughter-in-law, and granddaughter for the last 3 weeks.  Many thanks to all the families in the practice for their support and interest.  I look forward to being back in the office this week.

To your health,
Dr. Lavin

---

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Announcing our Second and Third FluFests for 2015- 

once again Featuring Mitchell's Ice Cream

Advanced Pediatrics is pleased to announce the second and third FluFests of this season will be held during the day on Election Day, Tuesday, November 3, and from 8AM to 11:00AM on Saturday, November 7, 2015

An important difference this year is that the company MedImmune, the only manufacturer of FluMist, had a major factory mishap and so shipments of FluMist, the inhaled version of the influenza vaccine, will be in such short supply, we will NOT have the option of the nasal flu vaccine, (flumist),  the inhaled flu immunization, for our November FluFests or at our checkups and sick visits.

Therefore, this year will be a SHOT ONLY year for our November FluFests and for influenza immunization during sick visits and check ups.

Our first FluFest for 2015 is on October 24, 2015.  And after that FluFest, we will also be making flu shots available during regular check-ups and sick visits.

We have long appreciated the ease of how well the FluMist works, and share all disappointment that the maker of FluMist failed to produce enough for the nation this year.

But we do look forward to protecting the community against the coming flu this winter, even by shot rather than sniff.

This later timing of our flu clinics will be well before the influenza virus begins to reach epidemic levels which is usually until mid-December or sometimes as late as January.

Many thanks once more to Mitchell's HomeMade Ice Cream, and to all of you, the families of Advanced Pediatrics, for your trust in us.  We hope making the provision of flu vaccine in a friendly and easy fashion can express some of our gratitude to you.

See you at the FluFests!

To your health,

Dr. Arthur Lavin 

---

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.