Bill Klaproth (Host): Adding anything to your regular diet to improve your health or healing; is considered a dietary supplement. So, how do you know what supplements to use and are they right for you? Here to talk with us about supplements is Kelly Edwards a pharm D and the Assistant Director of Pharmacy at Tidelands Health. Kelly, thank you so much for your time today. So, how do you determine what supplements a patient should be taking?

Kelly Edwards (Guest): Well, that is a complex issue. There really are not good guidelines out there for the public. We have recommended daily intakes on our food labels and things like that, but it really depends on the person. Each individual is unique and depending on the types of diseases that the person has or how a person metabolizes, they may have a greater need for different vitamins and minerals. One thing that I recommend to people whenever we are talking about supplement safety is just to try to find a good multivitamin and one that is certified by USP, the United States Pharmacopeia because that means it’s at least manufactured under good manufacturing processes, because supplements are not monitored by the FDA, the Food and Drug Administration. So, I definitely recommend a good multivitamin. Back in the day, I even remember during my pharmacy school training they said, “Oh you don’t need those kinds of things. You should be able to get that out of food.” But I feel like most people who are keeping up with the news and everything know our food is not the same as it was years ago. You know, they are modifying our food, it’s genetically modified and it is not as nutrient dense and so people are not getting the nutrients out of the food that they used to. And a lot of people are developing food allergies, food intolerances, gastrointestinal disorders and that can also delay the absorption of nutrients making it even more important that you do take vitamins and minerals and possibly other supplements like probiotics.

Bill: So, how do you know what specific supplements to take? I know you are talking about a multivitamin right there, which sounds like you are recommending it would probably be a good use for all of us. But what about certain supplements for certain people. I mean who are a good candidate for those and how do you understand what you should be taking or what you are really lacking in?

Kelly: Right. I would always recommend that you work with your doctor. Your doctor is going to be able to order different lab tests. Something that is really popular right now is supplementation with vitamin D and some people are promoting really high doses of vitamin D up to 5000 international units a day. Well, the recommended daily intake is only somewhere from like 400-600 international units, so you can imagine 5000 international units is a super high dose. They are touting it as anti-inflammatory and good for your immune system, but vitamin D is a fat-soluble vitamin, so no we are seeing some reports in healthcare that some people are getting toxic on those kind of levels and they are seeing hypercalcemia and some other complications from that. So, they do have blood tests that you can order and monitor your level of vitamin D, so that’s why it really is important to be knowledgeable about these things as a patient and to be informed but also to keep your physician involved and to ask for those kind of blood tests. They can monitor it and make sure that stay within normal range. They can let you know if you are low and require supplementation and then what kind of dose. I also always advocate that you talk to your pharmacist because your pharmacist can help you look for duplications in supplements. A lot of times when I’m talking to people, they are taking multiple things and unfortunately, it’s not usually just a single ingredient so a lot of times you end up getting vitamin B or vitamin D or probiotics in multiple different supplement items. And so, you don’t want to be taking too much of something and then you don’t want to just be paying for duplication of a product at the same time too.

Bill: So Kelly, when we are talking about supplements then, are there any possible problems or complications we really need to be aware of?

Kelly: Yes, there are. As I mentioned earlier, they are not regulated by the FDA, so you may or may not be getting what is on the label of a supplement drug. Also, you don’t really know how it is manufactured so there could be contaminants. One thing that I like to recommend to people when they are looking for a supplement you want to try to do some research and make sure it is coming from a reputable company. You also want to make sure that it doesn’t have fillers in it. There are a lot of people now with lactose intolerance or gluten sensitivities and oftentimes, those gluten and lactose can be found in supplements and can be causing people harm and they don’t even realize to look for that in a supplement medication. We also talked about overdosing with certain vitamins and things like that. We have to be careful there. Just because something is natural doesn’t always mean that it’s safe, I guess is really the bottom line.

Bill: So, how do you prescribe supplements then? Is it the normal way that you would prescribe other medication?

Kelly: Supplements are really just available over the counter. Anybody can get those. A doctor can just recommend that and then usually a patient can that. They can order them online. They can go get them over the counter. It is not something that has to be written on a prescription or be filled through a pharmacy. It is always a good idea to let your physician and your pharmacist know all the different supplement medications that you are taking. Because like I said, that can – some of those can interact – they can actually have drug interactions with prescription drugs or they can be impacting your health in a different way and it is just good to be able to know how those are affecting your chronic disease state.

Bill: And that is why it’s good to work through your doctor or your pharmacist when taking supplements. And Kelly, once you are on a supplement, is this something okay you are on this for life or is there a situation where okay we need to get your levels up, you are on this supplement for the next six months and then we will retest you. Are there scenarios like that?

Kelly: Yes definitely. Definitely with things like, I have mentioned a few times the vitamin D supplementation; you may be on a higher dose, get your level checked and you may not have to take that high of a dose forever. You may not even have to take the dose forever. It may just be in order to get you to an acceptable level. I do recommend that people take a multivitamin, a good multivitamin and multi-mineral supplement every day and I’m a big proponent of probiotics because I just think there are too many negative things in the foods that we are eating and we all need to replace that good bacteria into our gut. So, a good probiotic I think anybody could take and that is probably something that we would probably want to take forever. A lot of the time with supplements, it’s really going to depend on how you feel when you are taking it and if it’s doing what it said for you. So, if you are taking something for energy; if you get that back and you are working with you physician and it’s safe for you, it’s healthy for you and you can afford it; then go for it. Keep taking it. But I have just found in my own health journey, you know a lot of people respond differently to different supplement medications. Some people rave about one product, it does nothing for somebody else. So, a lot of it is trial and error. You know when you are looking for things to make you feel better, to give you energy boosts and things like that, and it is really going to depend on how that’s working for you.

Bill: And Kelly, lastly, why should someone choose Tidelands Health for their supplemental and pharmacy needs?

Kelly: Sure, well our mission at Tidelands Health is that we help people live better lives through better health and that is something that our hospital system is really trying to send this message home that we are advocates of health in our community. We take great pride in growing up our pharmacists to be knowledgeable and to really take care of the patient as a whole. We don’t just take care of our patients in the hospital or during an outpatient visit. We want them – we want to take care of them from the hospital to the home and that includes their outpatient medications and over the counter medications as well.

Bill: Well Kelly thank you so much for this informative discussion about supplements. I really appreciate it. And for more information about Tidelands Health physicians, services and facilities, visit www.tidelandshealth.org , that’s www.tidelandshealth.org . This is Better Health Radio. I’m Bill Klaproth. Thanks for listening.