Drugs and Supplements

Howard LeWine, M.D.

Benefits of vitamin D supplements still debated

For the past few years, vitamin D has been gaining a reputation—not entirely earned—as a wonder vitamin that offers protection against some cancers, bone-weakening osteoporosis, heart attack, Alzheimer’s disease, and other chronic conditions. Not so fast, caution two reports in the journal BMJ. One concluded that “highly convincing evidence of a clear role of vitamin D does not exist for any outcome.” The other showed a link between low blood levels of vitamin D and increased risks of dying prematurely from cardiovascular disease, cancer, and other causes. But it isn’t clear if low vitamin D causes chronic conditions, or whether chronic conditions cause low vitamin D levels. To play it safe, get the amount of vitamin D recommended by the Institute of Medicine: 600 IU of vitamin D a day for everyone ages 1 to 70 and 800 IU for those 71 and older. Eating foods rich in vitamin D or getting a few minutes of sunshine a day can do the trick.

Patrick J. Skerrett

Selenium, vitamin E supplements increase prostate cancer risk

Taking supplements of selenium or vitamin E, once thought to prevent prostate cancer, seems to do just the opposite. A new report shows that men who take vitamin E or selenium are at higher risk for developing prostate cancer. Bottom line: men shouldn’t take selenium or vitamin E as a way to prevent prostate cancer, or anything else for that matter.

Patrick J. Skerrett

New study adds caution to testosterone therapy for “low T”

Mass marketing of testosterone therapy may have men eager to try this seemingly simple fix. But the latest science should have them scratching their heads and putting away the credit card—at least for now. A new study published in the online journal PLOS One shows an increase in the risk of having a heart attack in the months after starting testosterone therapy. The potential for danger was highest in older men. A report in the November 6, 2013, issue of JAMA showed that men who used testosterone therapy didn’t fare as well after artery-opening angioplasty as men who didn’t take testosterone. Neither was the type of study that can prove cause and effect. They can only show associations, or links. That means there’s no smoking gun here that testosterone therapy is harmful. But the studies do suggest caution. Given the uncertainly over the benefits and risks of testosterone therapy, what’s a man to do? Take a cautious approach, advises the Harvard Men’s Health Watch.

Anthony Komaroff, M.D.

Do “energy boosters” work?

Stroll the aisles of any pharmacy or “health food” store and you’ll see a multitude of herbs and other supplements that claim to boost energy. Yet there is little or no scientific evidence to support such claims for most of these substances. The fact is, the only thing that’ll reliably boost your energy is caffeine or other stimulant—and their effects wear off within hours. Substances commonly touted as energy boosters include chromium picolinate, coenzyme Q10, creatine, dehydroepiandrosterone (DHEA), ephedra, ginkgo biloba, ginseng, guarana, and vitamin B12. Instead of relying on a supplement for energy, try switching to a healthful diet—more vegetables, fruits, whole grains, nuts, lean protein, and unsaturated fats—and exercising more. That’s truly a better way to beat an energy shortage, and it’s one your whole body will appreciate.

Howard LeWine, M.D.

Taking aspirin linked to lower risk of colorectal cancer

Aspirin has many uses, from easing a headache or cooling a fever to preventing heart attacks and the most common kind of stroke. It may be time to add “preventing colorectal cancer” to the list. New results from the Women’s Health Study, a clinical trial that evaluated the benefits and risks of low-dose aspirin and vitamin E among nearly 40,000 women, show that aspirin reduces the risk of developing colorectal cancer by 20%. The effect isn’t immediate, but instead takes ten to 20 years to be seen. Aspirin isn’t without its drawbacks, including gastrointestinal bleeding and ulcer formation. Both occurred slightly more often among women taking aspirin. Although the Women’s Health Study results sound promising, don’t go reaching for the aspirin bottle just yet. Taking aspirin—and any other drug—is really a balancing act between benefits and risks.

Howard LeWine, M.D.

Fish oil: friend or foe?

News out of Seattle is sure to fuel confusion about fish oil supplements. A study by scientists at the Fred Hutchinson Cancer Research Center in Seattle linked eating a lot of oily fish or taking potent fish oil supplements to a 43% increased risk for prostate cancer overall, and a 71% increased risk for aggressive prostate cancer. Fish oil loaded with omega-3 fatty acids, which play important roles in health. Deficiencies in them have been linked to a variety of health problems, including cardiovascular disease, some cancers, mood disorders, arthritis, and more. But that doesn’t mean taking high doses translates to better health and disease prevention. Despite this one study, you should still consider eating fish and other seafood as a healthy strategy. Twice a week is a good goal.

Patrick J. Skerrett

Aspirin-like drug may help diabetics control blood sugar

An old, aspirin-like drug called salsalate could help control blood sugar in people with type 2 diabetes. In the TINSAL-T2D trial, 286 volunteers took pills containing either salsalate or a placebo for nearly a year. Over the course of the trial, those in the salsalate group had lower blood sugar levels, and some were even able to reduce dosages of other diabetes medications they were taking. Experts aren’t exactly sure how salsalate helps control blood sugar, but its effectiveness supports the idea that inflammation plays a role in type 2 diabetes. Although the results are promising, what we really need to know about salsalate (or any new or repurposed drug) is how its long-term benefits and risks stack up against each other. The trial was too small and too short to determine those risks. According to the researchers, such “outcomes require continued evaluation before salsalate can be recommended for widespread use” by people with type 2 diabetes.

Howard LeWine, M.D.

Better use of medicines could save billions

Wiser use of prescription medications by everyone—doctors and their patients—could save the U.S. health care system more than $200 billion a year. That’s the conclusion of a new report, Avoidable Costs in U.S. Healthcare, from the IMS Institute for Healthcare Informatics. Inefficient or ineffective use of medications lead to six million hospitalizations, four million trips to the emergency room and 78 million visits to doctors and other care providers each year, according to the report. Those are huge numbers. Although $213 billion represents less than 8% of what Americans spend on health care each year, it’s still a staggering sum. It also exacts human costs that aren’t reflected in the estimates. The report identifies 6 things that can be improved to address the problem: 1) not taking medications as directed, 2) taking too many medications, 3) delayed treatment, 4) overuse of antibiotics, 5) medication errors, and 6) underuse of generic medications.

Patrick J. Skerrett

A good day to check your medications

For many people, medications are a mainstay for preventing and treating disease. Managing multiple conditions and multiple medications can be confusing, especially if you store some of your pills in the medicine cabinet and others in a kitchen cabinet or pill drawer. Every once in a while, it’s a good idea to take inventory of all of your medications. As a reminder to do just that, the American College of Endocrinology has declared April 15th as National Check Your Meds Day. The college recommends checking to make sure the labels on the medications you got from the pharmacy match exactly what your doctor prescribed. It’s also important to check expiration dates.

Daniel Pendick

7 common causes of forgetfulness

Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are many mundane—and treatable—causes of forgetfulness. Here are seven common ones: lack of sleep, some medications, an underactive thyroid, drinking too much alcohol, stress, anxiety, and depression. If memory lapses are bugging you, it’s worth a conversation with your doctor to see if any reversible causes are at the root of the problem. Something like getting more sleep, switching a medication, or a stress reduction program could get your memory back on track.