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How much influence do healthcare practitioners have in shaping their patients’ dietary supplement use?
In an era when the trusted voice of just one influencer can turn a trend into a phenomenon, supplement industry insiders might find themselves asking this key question: How much influence do healthcare practitioners have in shaping their patients’ dietary supplement use? And how might their authority and expertise suggest smarter—perhaps even more successful—supplementation strategies?
Those are questions worth asking given the supplementation boom that COVID-19 wrought. And given that docs, nurses, and pharmacists are likely growing more curious about supplements themselves, it’s a question whose answer could open new doors for supplementation, and for better human health.
Mum’s the Word
As the medical director of the Meno Clinic–Center for Functional Medicine (Wilson, WY), Mark Menolascino, MD, MS, ABIHM, ABAARM, IFMCP, already is curious—and informed—about supplements. But he also has a background in primary-care medicine, and perhaps because of that background that he understands why supplement use “skyrocketed” during the pandemic’s early days.
“Aside from masking and isolating,” he explains, “primary-care medicine wasn’t offering many actionable steps to protect a person’s lungs, optimize their immune system, or enhance detoxification.” The upshot: Supplements swooped in to the rescue.
Yet while 29% of Americans are, in fact, taking more supplements now than they were before the pandemic, according to a survey1 conducted by The Harris Poll on behalf of the Samueli Foundation, that same survey found that fewer than half of them claimed to have consulted their healthcare providers before taking them.
The reasons behind that reticence, the survey found, ran from doubt that respondents’ providers would be interested in their supplement regimen (35%) to concern that said providers might even judge them for it (26%).
But “I can tell you as a practicing family physician that healthcare providers are interested in what supplements their patients take,” insists Wayne Jonas, MD, executive director of Samueli Integrative Health Programs (New Alexandria, VA). What’s more, he says, “Healthcare providers are the best source for information about what’s appropriate and safe for patients.”
“The key,” Jonas wagers, “is having practitioners engage in open and nonjudgmental dialogues with their patients to develop plans that support healthy lifestyles.”
But how can such dialogues happen when the health practitioners involved actually do harbor judgements around supplementation—as many do?
For example, David Foreman, RPh, ND, founder and president of Herbal Pharmacist (Oceanside, CA), claims that his fellow pharmacists tend to be “very skeptical about the dietary supplement industry,” he says. “There’s a definite distrust of quality, efficacy, and safety with natural products, and when you throw in the potential for drug interactions, you can see why my brothers and sisters in pharmacy are skeptical.”
And though certifications from organizations like NSF International, ConsumerLab, and the U.S. Pharmacopeia help allay some clinicians’ qualms, Jonas adds, “At a high level, we know there are many alternative therapies and supplements on the market that make extravagant claims. And often the science just isn’t there.”
Thus patients can find themselves “left alone to sort through the internet,” Menolascino laments, “frequently unaware of quality or efficiency.” And that’s a state of affairs that serves no one well. “Even my patients who are quite knowledgeable about supplements aren’t always entirely sure why they’re taking them,” he concedes. “And this is where it’s so important for people to do their research and talk to healthcare professionals.”
Alas, many healthcare professionals are no more supplement-savvy than their patients—which is why even Foreman the skeptic posits that “supplements aren’t the boogeyman; it’s usually a lack of knowledge that makes a practitioner anti-supplement.”
Indeed, Menolascino recalls receiving scanty nutrition instruction in medical school, and none on nutritional supplements. “I like to say that we got three hours of nutrition lectures that mainly revolved around scurvy and rickets,” he says.
It was only via training in functional and integrative medicine that he “learned that food truly is medicine,” he says, “and that the quality of nutritional supplements matters. And in my medical practice, I’ve seen that administering high-quality supplements in the right doses helps patients reverse complex symptoms and regain energy and vitality.”
Will Cole, IFMCP, DNM, DC, a wellness expert for NOW (Bloomingdale, IL), shares that open mindset. Though some of his colleagues still consider supplements “too out-there,” as he puts it, he believes the products can be “great tools for restoring deficiencies and encouraging the healing process,” he says. “There’s a lot of strong medical research readily available online that supports the benefits of many natural supplements.”
Can We Talk?
To provide further educational support, the Samueli Foundation collated what Jonas calls “basic supplement-use information that providers and patients need to know” on its DrWayneJonas.com website.
“We know that many physicians want information about how best to work with patients to understand their supplement use,” he says, and he says the site offers actionable tools for doing so, like a questionnaire that physicians can use to ask patients about everything from their lifestyles and behaviors to social and emotional issues—and, of course, supplement use.
For practitioners eager to engage on the supplement subject, that might be just what the doctor ordered. As Foreman says, “It would be awesome to have practitioners initiate the conversation when someone’s making a purchase or showing interest in supplements. We need to ask consumers more questions—even the basics.”
For example, he wants to know if patients are taking “the right product for the right condition,” he says, as well as if the product will interact with their current conditions or medications, which brand they’re choosing—“to gauge quality,” he says—and if they’re taking the proper dose.
Regarding that latter point, Cole encourages his patients “to listen to their bodies,” he says, “and if they need to start at a lower dose than what’s recommended on the label, that’s okay.”
Menolascino even asks his clients to bring “all their medications and supplement packages” to appointments so that he can instruct them on “exactly what to take and what not to combine,” he says. The clear reason? “Supplements are rarely one-size-fits-all.”
Nor are they panaceas, which is why Cole advises patients to keep expectations in check. “You can’t supplement your way out of a poor diet,” he says. “If you’re nutrient-deficient because you aren’t eating the right foods, supplementation can’t replace what you need from food. I always want to make sure that food comes first.”
Which underscores the important role that consumers themselves play here. And while that role involves doing their homework around health—and putting what they learn into action in their own lives—it also includes asking practitioner questions.
Foreman welcomes “simple questions like, ‘What should I take? Is this safe to take with my medications? How much should I take? Does this have side effects? How long will it take to work?’” he says. “I wish they would always ask these questions, but I offer the info before they ask anyway. It removes the worry and reassures them.”
Which is just what practitioners should do. As Jonas says, “With more people taking supplements, we need to ensure that they have the information they need to make informed, healthy decisions—and industry can be a major facilitator by providing truthful and clear information about products.” Just as importantly, “Individuals should be talking with their doctors. They’re partners in care and will know what’s safe and best for personal health goals.”