Tuesday, January 20, 2009
Age Matters: Don't take a supplement just because you saw it on TV
Dr. Michael Camardi
Recent columns
About Dr. Michael Camardi
Dr. Michael Camardi is a geriatrician at Carilion's Center for Healthy Aging. Age Matters is his new Roanoke Times column, appearing the third Tuesday of every month.
Camardi has been with Carilion for about three years and was one of the experts who reporter Beth Macy spoke to for her series, “Age of Uncertainty.” He wanted to start this column to help answer questions he’s often heard as part of his job.
Camardi was founder and past medical director of the geriatric liaison program for Jacobi Medical Center (Albert Einstein College of Medicine) in Bronx, N .Y.
Camardi trained at Winthrop University Hospital (Stony Brook University Medical School), where he was chief medical resident. He has received numerous commendations for his contributions to education, patient advocacy, community relations and hospital administration.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014, or e-mail them to extra@roanoke.com with “Age Matters” in the subject line.
Dear Dr. Camardi,
We just cleaned out my parents' house in West Virginia so they could move in with us, and I just could not believe what we took out of their medicine closet. They had more vitamins and pills and things to eat and God only knows what else in there that they say they take because they heard on TV by some doctor that they should because they have dementia.
To be honest, I can't even pronounce half of them and I think its all a bunch of you-know-what, but they said you'd know about this, so what should I do with it all?
Fincastle
A: Thank you for this very important question that comes up very frequently and needs to be discussed. The first thing to do is to arrange for your parents to have a complete evaluation by their new doctors and to consult with a geriatrician concerning their dementia.
That said, we must come to grips with a very real problem in our society concerning medical advertising. I would venture a guess that we put more thought and investigation into buying a new pair of running shoes, a TV or a car than we do the pills we put in our bodies. I just don't think that we, as a nation, have gotten past the "carnival medicine show" mentality as we all look and hope for a way to feel better based upon a suspicion that "they know something we don't" or "why would a doctor say it" (when the answer really lies with the boring and inexpensive balanced diet, moderate exercise, sound sleep and a healthy lifestyle approach that we'll discuss at another time).
Needless to say, if you are thinking about taking any supplement, please discuss it first with your health care provider to screen for drug interactions, expiration dates (especially with oil-based preparations that tend to turn rancid) and side effects. Most importantly, nobody in this field really stands by any claims for purity, quality control, standard dosing and safety in selling you these items.
Let's look at what your folks were taking and their claims.
If we look at the European experience with memory loss, ginkgo biloba has been used for decades and has been claimed to improve the blood flow in vascular dementia. As such, it has been sold unregulated in the United States in health food stores. Review of the literature demonstrates that it is as useful as prescription drugs for treating dementia.
Please do not grab your wallet quite yet, as the efficacy of prescribed drugs for dementia is quite disappointing. Now, there will always be examples where certain people under certain circumstances will benefit from approaches that others will not, but they tend to be the exceptions.
Omega-3 fatty acids have been in use for almost two decades, and a body of evidence is building, but I'd wait for a study comparing omega-3 to placebo before I would buy a supplement. Instead, eat cold-water fish and English walnuts (I can almost hear some of my readers say already, "with chocolate?" Another topic for another day).
Oriental clubmoss delivering Huperzine A has been used in China for many years to improve memory but has not been studied completely, so I would stay away from it. I would try to challenge my mind by learning a new skill you always wished you had (don't worry about being good at it -- the important thing is to work at it) and improve my mentation in that fashion.
As for Vitamin E, take a good mutivitamin and leave it at that, as recent studies have cast doubt about larger doses causing unexplained deaths that most likely were because of drug interactions and side effects that had not been studied with other drugs.
Ginseng is presented as helping to increase energy levels and to improve memory, but here also it is unclear as to its unique claim and better studies are needed. I would take a good brisk walk for 20 to 30 minutes every day before I'd take ginseng. You'll get a proven benefit from walking.
Products that contain acetyl-L-carnitine as an amino acid for dementia:
Frankly, I'd rather have a turkey sandwich on whole wheat, hold the mayo.
I was disturbed to see DHEA on your list. All I'd say at this point is to throw it away as its connection to certain cancers remains to be clarified.
Finally, lets talk a little bit about trusting the system when it comes to medicines. Please understand that the only system that works is the frank and open relationship you have with a caring physician who will listen to you. Period.
The notion that there is government oversight by intelligent people controlling and safeguarding what we put into our bodies so that (and I hear this so often) "if it's sold on TV, it must be checked out by somebody" is just not true.
The U.S. Food and Drug Administration tries its best, but with its mandate, staffing and budgetary issues it can't be what we think it should be.
What you hear and see on the airwaves is intended to induce you to buy something. Frankly, it has become more offensive with every passing year as their shrill claims for everything from matters that are best left behind closed doors to how to flatten those lines and wrinkles that have given character to your face enrich somebody else and probably leave you poorer and frustrated.
To paraphrase the colloquialism, "aging happens," and we must come to peace with ourselves and understand the fact that we should use every reasonable and safe means to improve the process but not torture our spirit with the mental lottery ticket of "the next great breakthrough."
