Thursday, December 20, 2012

Supplements (3)


Choosing a good supplement


I will not recommend any type of supplements so as not to show bias to any particular type. While I believe some supplements are good, I must caution that we must be knowledgeable and selective in what we take.

Most importantly, we must take products approved by the relevant Health Ministries, particularly the Drug Control Authority of Malaysia, which has some of the most stringent standards in the world.





EVIDENCE-BASED MEDICINE
Undoubtedly, excessive medical claims with food supplements abound in the industry. BUT REMEMBER THAT THESE SUPPLEMENTS ARE TO HELP NOURISH YOUR BODY. IT IS YOUR OWN BODY THAT DOES THE HEALING AND REPAIR.

HEALTH FOOD ADVERTISING
Advertising of health products must be vetted by the Malaysian Advertising Board, MOH for approval before they are allowed to be exposed to the public. An advertisement should have K.K.L.I.U _ _ _ _ _ (number) approval number. If they do not have this number, it means the claims have not been approved by the authority and the information could be misleading.

Most of these supplements do not have proper clinical trial data to back them up, which is acceptable if they are not meant to be medicinal or curative. However, even if they have positive clinical trial data, the data are usually useless if you know enough about statistics carefully. The trials are usually conducted with very few subjects and are not statistically significant to prove anything. No one will pay the millions needed to conduct proper clinical trials on natural products which they can’t patent. Thus most of the data are from observational studies.

Clinical trials on drugs became very prevalent with the introduction of modern medicine in the turn of the 19th century. Clinical trials are now required to show that drugs are effective and safe. First, they experiment on animals and then humans. In humans they then have to determine the correct dosage of drug. Drugs are usually made from chemicals that are toxic, and thus have side effects. There is usually a trade-off between efficacy of a drug and its side-effects. The higher the dose, the more effective is the drug, but also the higher the side-effects. Clinical trials are needed to determine the correct dose based on an acceptable degree of side effects and efficacy.

Most supplements are from natural sources, either plants or animals, (but note that synthetic drugs are increasing), and usually safe in the recommended doses. What makes them unsafe is if they are not manufactured according to proper techniques, quality controls and adulteration with drugs (i.e. adding sidenafil [ingredient in Viagra®] to natural supplements, or steroids added into herbal products). According to a local expert on adulteration, 80 percent of “to good to be true” products are adulterated with Western medicines like steroids, aspirin, paracetamol, caffeine, etc. 

To be honest, how can a herb have an immediate effect like Viagra. If herbs work (without adding in a drug), there is no need for Pfizer to spend US$1 billion to develop the drug, and bear in mind a lot of drug research are discontinued during the R&D process. About 2  out of 10 development candidate make it to the market and once launched only 4 out of 10 actually makes money. If herbs work, Pfizer should be spending their billions in buying plantation land and planting the herbs!