5 posts tagged “patient-doctor relationship”

Supplement safety smarts

Posted January 24th, 2019 by

It’s easy to see the temptation of taking dietary supplements. Getting vitamins, minerals and herbs or other “health foods” in pill form sounds simple. And some of the products’ claims — “Live longer!” or “Have more energy!” — may seem enticing. But even though most supplements don’t require a prescription, it’s best to check with your doctor before taking them because they may come with risks — read on to learn more.

Healthy intentions

The BBC recently highlighted the potential risks in a piece called “The food supplement that ruined my liver.” As Texas resident Jim McCants recalls, he was hitting age 50 and hoping to prevent the heart problems that his father died from, so he sought to make some lifestyle changes. These included taking a green tea supplement, which wound up damaging the Texas resident’s liver so badly that he needed a transplant. Years later, McCants still struggles with kidney disease and abdominal pain — all because of a product he thought would make him healthier.

McCants isn’t alone. More than 50% of U.S. adults take a dietary supplement, often in the form of multivitamins, calcium, folic acid or vitamin D. And supplements are nothing new. The Chinese have been using herbal medicines for thousands of years, and you can even find some of them on drugstore shelves to this day.

It is possible to have a vitamin or mineral deficiency or imbalance, and to need some types of supplements because of this or for other health reasons (like needing folic acid during pregnancy). Take supplements as recommended by your doctor or licensed healthcare provider — but be sure to discuss any questions, concerns or adverse effects.

Risky business

How can products that are seemingly healthy be potentially hazardous? A lot of supplements contain ingredients that can actually harm rather than help your body. This is especially true if you have a health condition or take prescription or over-the-counter medication. Here are some common supplement pitfalls:

  • Medication mix-ups. Vitamins B-6, C and E can make certain kinds of chemotherapy less effective. Vitamin K can prevent warfarin (a common blood thinner) from working correctly. Vitamin B-6 may also hinder how other drugs work, such as anticonvulsants and Levodopa (a Parkinson’s disease treatment). St. John’s wort can make birth control pills and antidepressants less potent. (Keep reading for resources on possible supplement/treatment interactions.)
  • Surgery hazards. If you’re scheduled for surgery, taking some supplements can make anesthetics less powerful or lead to high blood pressure or bleeding. Give your doctor a heads-up about any supplements when he or she first mentions that you’ll need an operation.
  • Pint-sized dangers. If you’re pregnant or nursing, certain supplements — as well as prescription and over-the-counter medications — can harm your baby. Be sure to check with your doctor before taking anything.
  • Age effects. Supplements are geared primarily for adults. Dosage recommendations haven’t really been created for children. And supplements may work differently in people older than age 65.

Other risky supplement behaviors include:

  • Mixing different supplements
  • Using supplements instead of drugs that your doctor prescribed
  • Overdoing it with supplements — just to name a few examples: Taking too much iron can lead to vomiting and liver damage. Excess amounts of vitamin A (hypervitaminosis A) can result in headaches and weaker bones. Too much B-6 (called B-6 toxicity) may lead to lack of muscle control (ataxia), numbness, gastrointestinal issues and other symptoms.

Less oversight

The U.S. Food and Drug Administration (FDA) doesn’t regulate dietary supplements in the same way that it does with prescription and over-the-counter medications. What a label says about a product’s effects and ingredients may not be entirely accurate. However, if it turns out that a supplement is dangerous or that the makers made false claims, the FDA can issue warnings or take it off the market.

Doctor-pharmacist tag team

Ask your physician what he or she recommends in terms of taking — or not taking — dietary supplements and what’s best for you. And tell your doctor right away about adverse effects you’ve experienced while taking a vitamin or supplement, just as you would with prescription drugs.

Another great resource is right around the corner — your local pharmacist. Make it a habit to swing by the drugstore’s pharmacy counter, even if you’re just buying an over-the-counter treatment. As a medication specialist, your pharmacist knows how drugs affect the body and will be able to help you determine if a specific product has the potential to interact with any of your prescription medications. Try to use one pharmacy for all your prescriptions so your record will be complete and easy to access.

Do your research

Besides talking with your doctor and pharmacist about dietary supplements, vitamins, minerals, herbs and over-the-counter treatments, here are some resources that may be useful:

  • Supplement specifics. For more information on individual supplements, how they work and what common dosages are, check out the handy list on MedlinePlus.
  • Drug interaction checkers. Are your medications safe to take together? Try checking one of these sites (although they’re not exhaustive, so a doctor or pharmacist is still your best resource): RxISK and Drugs.com
  • Vital vitamin and mineral info. What amount of vitamins and minerals do you need each day? Find out with this chart from the 2015–2020 Dietary Guidelines. Helpful hint: Click “Next column” or “Previous column” in the upper right to find the relevant gender and age range.
  • Medication record charts. Keep track of all your treatments (prescription and over-the-counter) and your supplements on your PatientsLikeMe profile and with this smart chart from the FDA. Give an up-to-date copy to your doctor and pharmacist at each visit.

It’s worth a little extra work up front to do your research and keep your doctor and pharmacist in the loop.

“Your local pharmacist is an excellent resource to help you decide if supplements might be right for you,” says Maria Lowe, Pharm.D., from the PatientsLikeMe Health Data Integrity Team (our group of in-house healthcare professionals). “As pharmacists, we are not only trained to be experts in drug therapy but also in various methods of self-care. It’s our job to help our patients find the optimal way to combine those treatment modalities whenever we can.”

What steps do you take (or will you take now) when it comes to supplement safety? Join PatientsLikeMe or log in to talk about this topic with others who are living with health conditions.

Defining “good” health care: 2 new studies reveal patient perspectives

Posted March 28th, 2018 by

Do you feel you’re getting the best possible care from your doctor? In two recent studies, PatientsLikeMe members answered this question and shared their perspectives on the health care they’re receiving. The results show that while patient opinions about care and provider performance vary according to condition, diverse patient groups agree on the top factors that define “good” care. Here’s the full scoop…

Poll results: Good care is harder to get for some conditions

Last month, 2,559 PatientsLikeMe members took part in a 6-question poll about doctor-patient relationship and what it means to get “good care.”

The results suggest that patients with certain conditions, especially those living with fibromyalgia, PTSD and MDD, are less satisfied with their care.

The poll also found that patients with these conditions are less likely to:

  • Believe their provider has fully explained treatment options. Just 47% of fibromyalgia and PTSD patients and 53% of MDD patients agree their provider has done so, compared to 63% of patients living with ALS, MS and Parkinson’s disease.

  • Report that they are receiving the best possible health care for their condition. Only 40% of fibromyalgia patients, 49% of PTSD patients and 45% of MDD patients believe they are receiving the best possible care, vs. 66% of ALS patients, 61% of MS patients, and 57% of Parkinson’s disease patients.

  • Change providers even though they think they are not receiving the best care or effective treatment. More than half of these patients (53% of PTSD and 56% of MDD and fibromyalgia patients) have stayed with a provider in this situation vs. just 31% of ALS patients and 36% of MS and Parkinson’s patients.
Why is this the case?

“A positive or negative experience with care could be provider-related, but also related to the fact that patients living with ALS, MS and Parkinson’s often have access to condition-specific specialists or centers of excellence while those living with other conditions do not,” said Sally Okun, PatientsLikeMe’s VP of Policy and Ethics. “This makes it even more important that patients advocate on their own behalf to ensure all avenues to get good care are being used.”

See the full poll results at news.patientslikeme.com.

The patient definition of “good care”

Prior to the poll, more than 200 people (including PatientsLikeMe members, clinicians, researchers and more) shared how they define good health care and what matters most to them, from taking an active role in their care to accessibility and cost. PatientsLikeMe researcher Emil says, “Now more than ever we need to pay attention to that patient role.” In this video, he breaks down the key study takeaways:


Are you getting the best possible care? 10 Ways to tell

Based on what the study uncovered, we turned the 10 major factors that define good health care into a check list. Speaking about the poll and the survey, Sally Okun says, “These complementary studies give a snapshot of what is most important to patients, and give patients the tools to find providers willing to meet the characteristics of good care.”

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