Earlier this year, a 49-year-old man visited Dr. Danielle Belardo, a cardiologist, with chest pain. For some time, he had been treating his high cholesterol not with the statin suggested by his doctor, but with berberine and red yeast rice supplements. He had heard they were more natural.
The supplements hadn’t managed his condition — far from it. Dr. Belardo discovered that he not only still had high cholesterol, but also had elevated liver enzymes and coronary artery disease so severe that he needed open-heart surgery.
She referred him for the procedure and started him on two medications to bring down his cholesterol, including a statin. She also told him to quit the supplements. A few weeks later, the liver issues resolved.
At a time when Americans are buying and taking record amounts of supplements — well over half of adults consume one — some doctors and dietitians are trying to convince patients to take it easy.
At her practice in Pasadena, Calif., Dr. Belardo often takes a hard line, regularly “de-prescribing” supplements. Last year, she persuaded one patient to stop taking 132 of them, including some to “detox” the kidneys and liver. Marily Oppezzo, an instructor of medicine at Stanford Prevention Research Center and a registered dietitian, said she channels the decluttering powerhouse Marie Kondo by asking patients which ones spark “real, evidence-backed joy.”
A wide variety of gummies, pills and powders are categorized as supplements, including vitamins and minerals, compounds like creatine and herbal products such as ashwagandha and kava. Almost all doctors say a few of them have their place; women benefit from taking folic acid, for example, when trying to have a baby. Some people have vitamin or mineral deficiencies that supplements can help address.
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