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Health Canada is tracking your Supplements

Health Canada wants your MD to track your use of Health Supplements

Last January Health Canada issued a directive urging doctors to monitor patients’ use of natural health products and report any potential side-effects or adverse reactions to them.

Although it seems a bit intrusive it is an indication of the growth in use of vitamins, supplements and herbal remedies by their patients. Personally I think they will try and convince us that most side-effects and adverse reactions are caused by the food that we eat and the supplements that we take and not by the fine pharmaceuticals prescribed by our physicians.

Health Canada says they are concerned because people do not tell their physicians about their supplements and many physicians do not even bother to ask if their patients are taking any vitamins or herbs.

Sales representatives from the Health Food Industry do not call on doctors but the representatives from the pharmaceutical industry are there all the time. When adverse reactions show up they try and convince the physician it was not the drug the patient took but the grapefruit the patient ate for breakfast that caused the severe reaction. As people from my generation used to say, it was not the martinis that made you drunk but all those olives.

In January of 20ll Health Canada sent a notice in its quarterly Canadian Adverse Reaction Newsletter advising medical professionals to be vigilant about natural health products. It urges doctors to be aware of which natural health products their patients are taking and provide detailed information about natural products that have a suspected link to adverse reactions in patients.

Natural Health Products, which include herbal remedies, vitamins, minerals and supplements, are regulated by Health Canada and under the new regulations they must be approved and assigned an NPN (natural product number). Although the majority of the products you use have already been approved, there are still thousands of products whose applications are pending approval waiting to be assessed by Health Canada.

I would guess that it is possible that the large pharmaceutical companies could be leading the push behind this movement because they do whatever they can to protect their sales. The most recent statistics show that 7 out of every 10 Canadians are now taking natural health products and sales in Canada last year were $3.5 billion, according to Helen Sherrard, president of the Canadian Health Food Association, an industry group. When you have the majority of Canadians taking health supplements and spending that kind of money you get the attention of the pharmaceutical industry.

On the other hand there are some rare instances where taking herbal supplements can interfere with a prescribed course of therapy and this usually happens when people are undergoing chemotherapy.

Tracy Truant is an investigator with the Complimentary Medicine Education and Outcomes program at the B.C. Cancer Agency at the University of British Columbia’s School of Nursing. She has conducted many surveys that show that nearly half of patients are taking at least one natural health product, not realizing that these products could interfere with chemotherapy or radiation treatments or even make their treatment ineffective.

The fact is that if you are undergoing chemotherapy you should not be taking antioxidants. Furthermore during chemotherapy you are given drugs that completely suppress your immune system because if you did not take these drugs your body would try and kill the anticancer drugs since they threaten the destruction of cells in the body. That is why people undergoing chemotherapy cannot take supplements to boost their immune system because they would limit the effectiveness of cancer fighting drugs.

Then we always have good old St.John’s Wort. This is the only herb of all the herbs out there that is actually detoxified in your liver at a site called cytochrome p-450, the same site at which nearly all drugs are metabolized and detoxified. So in spite of the fact that nearly every drug is contraindicated with any other drug, poor St.John’s Wort  takes the whole blame for the whole health food industry. Forget Coumadin which backs up every drug in your liver and causes a positive interaction with every drug that person takes. Instead concentrate on making sure the patient does not take any St.John’s Wort.

Then we have the misinformation. Health Canada claims that fish oil could lower your blood pressure too much if you are taking blood pressure medication. Did it ever occur to anyone to stop the prescription drug and just take the fish oil? They also promote other fallacies claiming that fish oil, garlic, Vitamin E and ginseng thin your blood. These claims are entirely false and only drugs that reduce platelets such as aspirin, coumadin (warfarin) or plavix have the ability to thin your blood.

In the past Health Canada has always approved natural health products based on their safety record. In other words if the supplement had been around a long time and there were very few reported adverse reactions and it contained the full amount of the ingredients specified on the label it was approved. The movement to tighter regulations is also spurred on by the fact that the majority of people who work in the health food industry have very little or absolutely zero knowledge of the products they recommend to people.  When you come to a store such as mine you are able to draw on the knowledge of a graduate from the Faculty of Pharmacy at the University of Toronto who is highly trained and educated in pharmacology, physiology, biochemistry and has a very complete understanding of how supplements work in your body and how they interact with other supplements and prescription drugs. You do not get this at any other health food store.

It is possible that as Health Canada increases the standards for the health supplements and their approval process, they may also regulate the knowledge of the people who work in the health food industry.

Every day I am invited to join in a discussion or be educated by one of my suppliers about a new health supplement. Unfortunately the people who are “educating” the staff at health food stores are merely convincing them that they should push their products. It is no different than the pharmaceutical reps that convince physicians to prescribe their products. In the same way that your independent pharmacist can give you honest advice about a product I am one of a very small rare group of people who can do the same in the health food business.

And all this brings me back to the physicians Health Canada wants to monitor your supplements. This might make sense if any of them had the extensive knowledge required to understand the pharmacology of vitamins, minerals and herbal supplements. But they don’t. When I talk to some of the clients at my health food store they tell me how their physicians arbitrarily tell them to discontinue certain supplements because they have some superior knowledge. The truth is most of them use the “I’m the doctor” approach, pretend they know what they are talking about and then tell you what to do. When they go to medical school they take one half year course in pharmacology during seven years of school. They do not take any courses in herbal medicine or supplements. Who are they to be monitoring our supplement use?

To move smoothly in our medical system it is important to have a good relationship with your GP (general practitioner). This means you have to let your physician do their job and let them monitor your supplement use but you do not have to like it. Never argue with your physician and if you have been told to stop taking certain supplements I am always available for a second opinion.

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