Herbals

Interesting question. Perhaps I should start by clarifying what the FDA (Food and Drug Administration) is responsible for... and that is pretty much just foods and drugs :). However, I also believe that it is responsible to treat nutritional supplements and herbal medicines "like drugs" in that we should consider things like effectiveness, dosing, safety, side effects, and drug interactions when we "prescribe" herbs and nutritional supplements. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA) which has enabled the patients in this country to continue to have access to nutritional supplements and herbal medications of our choosing without a prescription. However, it also gave the FDA a different scope of regulatory oversight than we see with prescription drugs. The FDA is responsible for taking action against any UNSAFE dietary supplement after it reaches the market (which means that supplement manufacturers are responsible for bringing safe products to market). Prescription drugs must be proven to be safe and effective to get FDA approval. Nutritional supplements are not required by anyone to be safe and effective. I could go on at length about how to take supplements safely but that's not what you asked. As far as the way I practice medicine goes, I incorporate recommendations for any evidence-based therapy which is appropriate to my patient's needs whether that be conventional or complementary. Thanks for your question. Interesting question. Perhaps I should start by clarifying what the FDA (Food and Drug Administration) is responsible for... and that is pretty much just foods and drugs :). However, I also believe that it is responsible to treat nutritional supplements and herbal medicines "like drugs" in that we should consider things like effectiveness, dosing, safety, side effects, and drug interactions when we "prescribe" herbs and nutritional supplements. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA) which has enabled the patients in this country to continue to have access to nutritional supplements and herbal medications of our choosing without a prescription. However, it also gave the FDA a different scope of regulatory oversight than we see with prescription drugs. The FDA is responsible for taking action against any UNSAFE dietary supplement after it reaches the market (which means that supplement manufacturers are responsible for bringing safe products to market). Prescription drugs must be proven to be safe and effective to get FDA approval. Nutritional supplements are not required by anyone to be safe and effective. I could go on at length about how to take supplements safely but that's not what you asked. As far as the way I practice medicine goes, I incorporate recommendations for any evidence-based therapy which is appropriate to my patient's needs whether that be conventional or complementary. Thanks for your question.

Your doctor and your pharmacist can both provide advice about avoiding interactions between drugs and supplements. Make sure to tell them both about everything you're taking, including supplements and over-the-counter medications. Prepared Patient has two feature articles that may be helpful to you, "Vitamins & Supplements: Before You Dive In" (http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue4.cfm) and "Side Effects: When Silence Isn't Golden" (http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue2.cfm). Your doctor and your pharmacist can both provide advice about avoiding interactions between drugs and supplements. Make sure to tell them both about everything you're taking, including supplements and over-the-counter medications. Prepared Patient has two feature articles that may be helpful to you, "Vitamins & Supplements: Before You Dive In" (http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue4.cfm) and "Side Effects: When Silence Isn't Golden" (http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue2.cfm).