Nutritional supplements: a difficult conversation to have with patients

Food as medicine

Almost daily patients tell me about nutritional supplements and how they have heard…

Often parents tell me about how removing something from their child’s diet, or adding something to their child’s diet is supposed to change their child’s behaviors.

Adults tell me how they recently started to add something to their daily diet and how they have already started to notice a positive change.

These anecdotal stories are interesting but not scientifically based. We humans can easily and inadvertently fool ourselves.

To make this subject more confusing is the fact that there is an industry that is trying to sell nutritional supplements to solve all sorts of problems. This industry is not allowed to say they cure anything, but they can cleverly allude to “curing things”.

Examples of “cures” without actually making a medical claim:

  • Boosts energy
  • Heart friendly
  • Calming and restful
  • Promotes a good night’s sleep
  • Supports memory and learning
  • Used by millions of active people around the world

This industry spends a lot of money promoting their pills and powders.

If you want to learn more, may I suggest you read the Federal Trade Commission’s Dietary Supplements: An Advertising Guide for Industry.

Should I discuss nutritional supplements with patients?

I often wrestle with the benefits of discussing nutritional supplements with patients. I want to help educate, but teaching the complexities of science based medicine is time consuming and daunting. Often if I even slightly bring up the subject, patients will stiffen and perceive me as being judgmental of them.

So, as long as the food supplement is inert and not getting in the way of sound treatment protocol, I smile and say. “I’ve noticed that people that eat a well balanced diet, sleep enough, and walk a bunch everyday report that they feel better. I guess my mom was right. She was big on veggies, walking, and getting enough sleep.”

Nutritional supplements and cognitive decline

The National Institutes of Health (NIH) reported:


While some research suggests that a diet high in omega-3 fatty acids can protect brain health, a large clinical trial by researchers at the National Institutes of Health found that omega-3 supplements did not slow cognitive decline in older persons. With 4,000 patients followed over a five-year period, the study is one of the largest and longest of its kind.


This was a well structured study. Sorry I can’t report that we have found the magic pill, but it is better to have sound clinical evidence than simple anecdotal stories and hopeful speculation.

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