Dear Dr. Camardi,
We just cleaned out my parents' house in West Virginia so they
could move in with us, and I just could not believe what we took out
of their medicine closet. They had more vitamins and pills and
things to eat and God only knows what else in there that they say
they take because they heard on TV by some doctor that they should
because they have dementia.
To be honest, I can't even pronounce half of them and I think its
all a bunch of you-know-what, but they said you'd know about this,
so what should I do with it all?
-- Fincastle
A: Thank you for this very important question that comes up very
frequently and needs to be discussed. The first thing to do is to
arrange for your parents to have a complete evaluation by their new
doctors and to consult with a geriatrician concerning their
dementia.
That said, we must come to grips with a very real problem in our
society concerning medical advertising. I would venture a guess that
we put more thought and investigation into buying a new pair of
running shoes, a TV or a car than we do the pills we put in our
bodies. I just don't think that we, as a nation, have gotten past
the "carnival medicine show" mentality as we all look and hope for
a way to feel better based upon a suspicion that "they know
something we don't" or "why would a doctor say it" (when the answer
really lies with the boring and inexpensive balanced diet, moderate
exercise, sound sleep and a healthy lifestyle approach that we'll
discuss at another time).
Needless to say, if you are thinking about taking any supplement,
please discuss it first with your health care provider to screen for
drug interactions, expiration dates (especially with oil-based
preparations that tend to turn rancid) and side effects. Most
importantly, nobody in this field really stands by any claims for
purity, quality control, standard dosing and safety in selling you
these items.
Let's look at what your folks were taking and their claims.
If we look at the European experience with memory loss, ginkgo
biloba has been used for decades and has been claimed to improve the
blood flow in vascular dementia. As such, it has been sold
unregulated in the United States in health food stores. Review of
the literature demonstrates that it is as useful as prescription
drugs for treating dementia.
Please do not grab your wallet quite yet, as the efficacy of
prescribed drugs for dementia is quite disappointing. Now, there
will always be examples where certain people under certain
circumstances will benefit from approaches that others will not,
but they tend to be the exceptions.
Omega-3 fatty acids have been in use for almost two decades, and
a body of evidence is building, but I'd wait for a study comparing
omega-3 to placebo before I would buy a supplement. Instead, eat
cold-water fish and English walnuts (I can almost hear some of my
readers say already, "with chocolate?" Another topic for another
day).
Oriental clubmoss delivering Huperzine A has been used in China
for many years to improve memory but has not been studied
completely, so I would stay away from it. I would try to challenge
my mind by learning a new skill you always wished you had (don't
worry about being good at it -- the important thing is to work at
it) and improve my mentation in that fashion.
As for Vitamin E, take a good mutivitamin and leave it at that,
as recent studies have cast doubt about larger doses causing
unexplained deaths that most likely were because of drug
interactions and side effects that had not been studied with other
drugs.
Ginseng is presented as helping to increase energy levels and to
improve memory, but here also it is unclear as to its unique claim
and better studies are needed. I would take a good brisk walk for
20 to 30 minutes every day before I'd take ginseng. You'll get a
proven benefit from walking.
Products that contain acetyl-L-carnitine as an amino acid for
dementia:
Frankly, I'd rather have a turkey sandwich on whole wheat, hold
the mayo.
I was disturbed to see DHEA on your list. All I'd say at this
point is to throw it away as its connection to certain cancers
remains to be clarified.
Finally, lets talk a little bit about trusting the system when it
comes to medicines. Please understand that the only system that
works is the frank and open relationship you have with a caring
physician who will listen to you. Period.
The notion that there is government oversight by intelligent
people controlling and safeguarding what we put into our bodies so
that (and I hear this so often) "if it's sold on TV, it must be
checked out by somebody" is just not true.
The U.S. Food and Drug Administration tries its best, but with
its mandate, staffing and budgetary issues it can't be what we think
it should be.
What you hear and see on the airwaves is intended to induce you
to buy something. Frankly, it has become more offensive with every
passing year as their shrill claims for everything from matters that
are best left behind closed doors to how to flatten those lines and
wrinkles that have given character to your face enrich somebody else
and probably leave you poorer and frustrated.
To paraphrase the colloquialism, "aging happens," and we must
come to peace with ourselves and understand the fact that we should
use every reasonable and safe means to improve the process but not
torture our spirit with the mental lottery ticket of "the next great
breakthrough."
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