Purchasing health risks over the counter

New studies show "natural" supplements and nonprescription pain relievers can be ineffective, costly and sometimes harmful.

By Dr. David Lipschitz, Special to the Times
Published August 28, 2007

Each year, Americans spend millions of dollars on vitamins and supplements. Often patients come in to our Center for Aging with bags full of pill bottles - from aspirin and vitamin C to ginkgo biloba and fish oil. But what really works?

This year three prestigious academic journals published studies on the efficacy and side effects of commonly used vitamins, supplements and over-the-counter pain medicines. This research again compels me to caution about the potentially serious side effects of taking unnecessarily high doses of vitamins, minerals, alternative medicines and even over-the-counter painkillers.

Antioxidant supplements, including vitamins E, A, C and beta-carotene, are often promoted as "anti-aging" drugs, because they help the body neutralize toxic oxidants.

Those supplements mimic the body's normal production of neutralizing enzymes.

But with advancing age, the function of these enzymes decreases. Cells thus become more susceptible to damage, contributing to a higher risk of cancer, Alzheimer's, heart disease and compromised immune function.

Unfortunately, a report in the Journal of the American Medical Association demonstrated that rather than lengthening life expectancy and promoting health, antioxidants in pill or capsule form can actually increase the risk of Alzheimer's disease and cancer, shortening life expectancy.

How could this be? First, at the doses commonly taken, the antioxidants act as drugs, are artificially prepared and bear little relationship to the naturally occurring vitamins in fruits, vegetables and nuts. The message is clear - consuming these nutrients in pill form can be hazardous to your health.

'Natural' supplements

There is also bad news regarding the most popular alternative remedies. Thousands of individuals take glucosamine and chondroitin sulphate to relieve pain caused by osteoarthritis. Both are natural components of the joint linings and are thought to help lubricate damaged joints.

While reports have shown some symptomatic relief, the only way to truly assess the benefit is to compare the effects of glucosamine and chondroitin to those of a harmless pill a placebo, in a clinical trial where neither the patient nor the physician is aware of which is being taken.

But a study published in the New England Journal of Medicine, funded by the National Institutes of Health, showed that taking glucosamine and chondroitin sulphate was no better than taking the placebo, and essentially was worthless.

A similar clinical trial, also published in the New England Journal of Medicine and funded by the NIH, showed that saw palmetto, widely used to help relieve symptoms of an enlarged prostate, also provided no benefit.

So what should you do if you take any of these items and are convinced of their help? We do know that taking a placebo can indeed have a positive therapeutic effect if the patient strongly believes it to be beneficial.

So by all means, if you're convinced they are helping, continue taking glucosamine/chondroitin or saw palmetto, as long as you do not experience any adverse effects.

But if you never have taken them, don't start - doing so most likely is a waste of money. And if you are taking them and do not experience benefit, I suggest you stop.

OTC pain relievers

Lastly, a study published in the Archives of Internal Medicine showed that the over-the-counter pain pills acetaminophen (Tylenol), ibuprofen (Motrin) and naproxen (Aleve), when taken four or more times weekly, increased the prevalence of high blood pressure, in turn leading to an increased risk of heart attacks and stroke.

While more studies are needed, this report emphasizes the importance of being judicious about using any medication. Individuals who require pain relief have little choice but to take a pain pill, and until further information is available, acetaminophen remains the first choice.

However, those with minor pain should consider alternate approaches.

We must all be wary of taking any and all medications - prescribed, over-the-counter or otherwise. Remember, just because something is labeled as "natural" does not mean it will be helpful or free of side effects.

Gerontologist David Lipschitz holds both a medical degree and a Ph.D. and is the director of the David W. Reynolds Center on Aging, in Little Rock. Write to him at askdrdavid@msn.com. His Web site is www.drdavidhealth.com.