Many of us take dietary supplements such as vitamins, minerals, herbs, or other products to boost our health. Since many supplements contain natural ingredients, it’s easy to assume they are always safe. But “natural” does not always mean safe, especially when combined with medications. Nor does it always mean effective.

            Let’s get the “effective” part out of the way first. A law passed by Congress in 1994 restricts the FDA from reviewing dietary supplements before marketing as they do with prescription medications. Most of the claims made by the manufacturers about the benefits of their product have no basis in fact.

            If these products were simply useless, you would only be wasting your money, but they are far from guaranteed safe.

            Some products have been banned by the FDA after being on the market for extended periods when their side-effects were found to be very dangerous but may still be available by mail-order. These would include ephedra (Ma Huang) and DMAA, used for weight loss and energy, that cause high blood pressure and strokes.

            Some are discouraged but still sold. Kava, easily available online, is used for anxiety but can cause severe liver damage. Yohimbe is used for erectile dysfunction and bodybuilding; it can cause high blood pressure, kidney failure and heart problems.

            Colloidal silver is claimed to have immune support and anti-bacterial properties but can leave your skin permanently discolored.

            Fat-soluble vitamins (A, E, D and K) are not easily removed from the body. While they are safe in low doses, high doses of Vitamin A can damage the liver, as several Texas families following RFK Jr’s advice discovered. High does of Vitamin D can dangerously raise your blood calcium.

            Finally, some supplements can interact with prescription medicines you may be taking. St John’s Wort causes a more rapid breakdown of many medications so that they lose their effectiveness. These include birth control pills and anti-depressants.

            Calcium supplements interfere with the absorption of many medications, causing them to be less effective. Green tea extracts (but not the amount in a cup of tea) affect the breakdown of many medications.

            Finally, there is the serious concern that many supplements are adulterated with inactive and/or toxic ingredients. The under-staffed FDA is unlikely to ride herd on these products unless there is a mass poisoning event that commands their attention.

            What should you do?

            In general, don’t waste your money. Beyond a daily multivitamin, most OTC supplements are useless.

            If you wish to take a supplement, buy it at a legitimate pharmacy or health food store that will be there if there are problems. Look for independent lab testing by the USP (U.S. Pharmacopeia) or NSF (National Science Foundation).

            If you are taking prescription medications, ask your doctor to check for possible interactions before you start taking any supplements.

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer

            My parents were smokers, most likely beginning their long partnership with the tobacco industry when they were teens.

            Dad quit cold turkey in 1964 when the first Surgeon General warning was aired on prime-time TV. He’d spend the next year sucking on hard candies as suggested by all in the know.

            Ma quit some years later. Dad smoked Kents, Ma Winstons. When they opened a new pack about mid-afternoon (pack-and-a-half champs), the smell was a bit intoxicating. I hated the smoke itself, but that smell of fresh tobacco was equal to mimeographed worksheets from school – oh man, and who can forget the boxes of candy cigarettes? The packaging looked so real.

            It seems upon reflection that everyone smoked. Aunts and uncles, adult cousins – shoot – everyone 16 and older smoked. The art of holding a cigarette is a lasting memory. Ladies would take a drag, tap the ciggie on the edge of an ashtray (one placed strategically beside every chair in the house) and then smooth out the ash so it wasn’t raggedy looking.

            Men generally held their butts in a cupped hand to keep it smoldering, then bringing the fingers up to the lips. Flicking a spent ciggie to the curb was a special talent reserved for those emitting a tough-guy persona. But most housewives patrolled their groomed yards for offending butts and admonishing anyone, man, woman, or child, if they dared to fling one. “Pick that up! Who raised you?!”

            Given all we know today about the harmfulness of smoking, I still find numerous cigarette filters along the grass line of my yard. I guess the careless way people fling a butt out their car window as they speed down North Street means their upbringing is suspect. “Who raised you?!”

            Cigarette smoking looked so glamourous on the big screen. Actresses used them like sexual objects with thick red lipstick accentuating the mouth as a sensuous curl of white smoke disappeared and reappeared down their smooth throats. Betty Davis was an expert. And in keeping with the macho fingering of a cigarette, Cary Grant was brilliant.

            I was talking to my friend, and we got on the topic of our cigarette-smoking days. She recalled holding a cocktail glass in one hand and a cigarette in the other and being very sophisticated. She went on to say that doctor visits always concluded with the doc and she going over her medical exam while enjoying a butt together.

            That reminds me, in 1971 while recuperating in Tobey Hospital after a medical procedure, smoking was allowed in the rooms. As a gift, my mother gave me a carton of Silver Thins to help me convalesce. Yes, we came a long way baby.

            As a little kid, I was the gofer. “Run uptown and get me …,” was an oft-heard refrain from Ma as she sat in her command central seat in the living room. I’d be dispatched quite often to buy cigarettes. With a note requesting that the grocer give me a pack of Winstons and signed with her signature ensuring the purchase was for her and not me, the cigs were passed over the countertop that I could barely see over. But the best part was I could keep the change as payment for my service. I consumed my body weight in Hershey chocolate during my salad days.

            Cigarettes had a whole culture in and onto itself. Roaming through antique shops, you’ll find ashtrays in rock crystal, animal horn, copper, jewel-incrusted, and plain old ordinary glass and pottery. These household items were even styled into smoking cabinets or ashtray stands. My mother even had my baby shoes bronzed with an ashtray in the center. My brother got a picture frame that I always envied.

            While reminiscing with my son recently, I asked if he was ever sent to the store at the top of the street where my parents lived, now known as the “Onset House.” Yes, it was a multi-generational carcinogenic errand family industry – he, too, was sent to the store for cigarettes purchased on the certification of a signature. And he, too, got to keep the change.

            You’d think my parents would have succumbed to a disease attributable to smoking. No. They both lived into their nineties and basically passed from old-age complications. They spent their long lives free from lung cancer, COPD, or other smoking-related illnesses.

            Luck of the draw, I guess.

This Mattapoisett Life

By Marilou Newell