Suppliments

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PsyDr said:
Remember when they tested all of the testosterone boosters on amazon, and many turned out to be anabolic steroids? PsyDr remembers....

www.forbes.com

Steroids For Sale Online at Amazon and Sears

Why are dietary supplements laced with steroids readily available on Amazon and Sears online marketplaces?
www.forbes.com www.forbes.com

@borne_before Maybe some vitamin "e"? I heard it's good for the "i"s... and spelling. 😉
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OMG that has been driving me crazy every time I open SDN.
 
PsyDr said:
Remember when they tested all of the testosterone boosters on amazon, and many turned out to be anabolic steroids? PsyDr remembers....

www.forbes.com

Steroids For Sale Online at Amazon and Sears

Why are dietary supplements laced with steroids readily available on Amazon and Sears online marketplaces?
www.forbes.com www.forbes.com

@borne_before Maybe some vitamin "e"? I heard it's good for the "i"s... and spelling. 😉
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The old LD showing again 🙁
 
WisNeuro said:
I'll throw a plug in for fiber supplements. Now that's something that most people are deficient in their diets.
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MCParent said:
+1. People have seen my Metamucil on the counter and been like “isn’t that an old people thing??” I tell them to try a scoop and about 6 hours later they’re ordering some on Amazon. Life changing.
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WisNeuro said:
Yeah, few years back I added that to my daily regimen and there was a noticeable drop in my LDL without making any other big lifestyle changes. That and my GI tract works FAR better with it than without. TMI. Sorry, not sorry.
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Precisely the reasons I started eating kale for breakfast a few years ago. Getting more fiber was recommended to both of us by our midwife as part of an overall health assessment during the my wife's first pregnancy. Kale with balsamic vinegar and olive oil, with a couple sausages on the side has turned out to be an easy, quick, repeatable breakfast for me.
 
calimich said:
Precisely the reasons I started eating kale for breakfast a few years ago. Getting more fiber was recommended to both of us by our midwife as part of an overall health assessment during the my wife's first pregnancy. Kale with balsamic vinegar and olive oil, with a couple sausages on the side has turned out to be an easy, quick, repeatable breakfast for me.
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Kale's good for insoluble fiber, but not much soluble. Soluble fiber is the one that is thought to have a bigger impact on cholesterol and glucose levels, as well as slowing things down and keeping you feeling full longer. Avocado could help a little in that regards with this particular meal.
 
borne_before said:
What brands for fiber and omega threes?
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For the fiber, go for psyllium husk. Metamucil works, but there are some cheaper generics that do the job as well made from psyllium husk. There are some cheaper generics that contain wheat dextrin, I'd pass on those, as some of the data suggests that it doesn't work as well.
 
R. Matey said:
What's the SDN consensus on St. John's Wort for depression? My understanding is the research is fairly mixed, but I've read some psychologists who will recommend it (thinking of a specific CBT for depression workbook right now).
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As a psych, I'd be hesitant about recommending any supplements to any patient!
 
borne_before said:
As a psych, I'd be hesitant about recommending any supplements to any patient!
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I don't recommend any to patients, but they ask about certain supplements with cognitive claims very often, so I review that literature and let them know what is and is not supported by any real evidence.
 
R. Matey said:
What's the SDN consensus on St. John's Wort for depression? My understanding is the research is fairly mixed, but I've read some psychologists who will recommend it (thinking of a specific CBT for depression workbook right now).
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Correct, the research on St. John’s Wort is mixed with marginal support for mild-moderate depression. However, the main thing to know is that it interacts with several medications including antidepressants and should not be taken together for this reason.
 
WisNeuro said:
I don't recommend any to patients, but they ask about certain supplements with cognitive claims very often, so I review that literature and let them know what is and is not supported by any real evidence.
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I also don't recommend any to patients/clients, but I do sometimes recommend they make sure to discuss their supplements/OTC medications with their doctor or pharmacist. Recent example: patient wondering if he had early dementia (he didn't), but his list of meds included numerous powerful anticholinergics including 100mg of Benadryl every night for sleep. While I don't make specific recommendations, I do sometimes like to inject a little healthy fear to enhance the likelihood they will be more circumspect or more prepared to ask a qualified professional for their input. Just because it's OTC does not make it safe. Kratom is an excellent example of this, but even more mainstream stuff can have risks that far outweigh the benefits.
 
StellaB said:
I also don't recommend any to patients/clients, but I do sometimes recommend they make sure to discuss their supplements/OTC medications with their doctor or pharmacist. Recent example: patient wondering if he had early dementia (he didn't), but his list of meds included numerous powerful anticholinergics including 100mg of Benadryl every night for sleep. While I don't make specific recommendations, I do sometimes like to inject a little healthy fear to enhance the likelihood they will be more circumspect or more prepared to ask a qualified professional for their input. Just because it's OTC does not make it safe. Kratom is an excellent example of this, but even more mainstream stuff can have risks that far outweigh the benefits.
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Yeah, in cases like those/if a patient asks, I may say something like, "I'm not a physician and cannot give you any medical advice, and I'm not telling you to make any changes to your medications--always talk with the doctor prescribing your medicines before doing that. What I can say is that the research shows/does not show ____. You could talk with your _____ (e.g., primary care doctor) more about that if you'd like." I also include similarly non-prescriptive, informational "recommendations" (more just like FYI points) in reports if they're appropriate, which I preface by saying any decisions regarding pharmacological interventions remain at the sole discretion of the patient's prescribing medical providers.
 
Yep, you never make any recommendations about whether or not to take any med/supplement, but you can always provide information that is in your scope and tell them to talk to their prescribers. Telling a patient what the research says about a specific claim is not a recommendation. But, if I think it's necessary, I will put fairly strong language in a report if I think something is harming the patient. For example, elderly patient on a ton of anticholnergics, plus opiates, where I will say something to the effect that they should really see a geriatrician or at the very least talk with their prescribers about possible medication reconciliation. Most of the time it is obvious from chart review that these people have had different providers over the years who have never reviewed previously prescribed meds and have always just added on other stuff, without modifying older meds.
 
While reading this thread, a new patient of mine just told her PCP that I suggested a medication increase for her opioids. I've seen her once and we have absolutely not discussed increasing her medication in any capacity, nor would I ever. So there's that too, no matter how careful you are.
 
thebalmofhurtminds said:
While reading this thread, a new patient of mine just told her PCP that I suggested a medication increase for her opioids. I've seen her once and we have absolutely not discussed increasing her medication in any capacity, nor would I ever. So there's that too, no matter how careful you are.
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Yeah, I suspect sometimes this is due to confusion or patients mixing up their providers (e.g., getting you confused with their psychiatrist), and sometimes it's willful deceit. I've definitely had patients misremember feedback I've given them, or just outright lie to other providers about what I've said or what occurred during our appointments.
 
Weimy2112 said:
Kratom great at reg dose, around 2g, few times per week (energy mood pain & weight loss). Sadly many take multiple mega doses daily, those are ones who run into problems. Google "Kratom Dr. McCurdy" for legit info. He's at Univ. of Fl & studies this plant exclusively.
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I’ve lightened my opinion on kratom since making that post 3 yrs ago. Not happy with it being sold in massive bulk bags still tho.
 
Does anyone ever discuss food choices with patients, such as considering the MIND DASH diet for people concerned about cognitive decline?
 
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