I have never been a fan of dietary supplements. In fact, I have spent many hours trying to talk my patients out of taking nearly all of them. My reasons for doing so are based on both my conservative approach to medical therapies in general, and on my skepticism about these products in particular. A recent article in the New England Journal of Medicine gave me more ammunition to oppose their use.
Here’s what I mean by a “conservative approach” to medical therapies. I believe that there should be a good reason, backed by good evidence, to take any medication – prescribed or over the counter. Since every medication (or supplement, herb, vitamin, mineral, etc.) carries some risk of adverse side effects, and costs some money, I have never ascribed to the “it can’t hurt” school of thought. “Why not?” has never seemed to me a compelling reason to recommend or prescribe anything. There is a profound lack of reliable evidence supporting the use of the vast majority of OTC supplements that patients take.
This is of course compounded in the common scenario where people are taking multiple prescribed medications or OTC products, in which there is also a real risk of unanticipated interactions among compounds.