Physician skepticism common as patients increasingly turn to nutrient- or botanical-based remedies


When Florida physician Bernd Wollschlaeger, MD, asked an elderly female CKD patient to tell him all the medications she was taking, she listed four or five. When he asked her to bring her medications to her next visit, however, she brought in a shoebox filled with 84 different supplements.

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He asked her why she had not mentioned these at the previous visit, and she responded, “Well, these aren’t medications; they’re supplements, so I didn’t think they mattered.” As Dr. Wollschlaeger relates, she did not realize that using just one of these compounds could potentially interact with her prescription medications or otherwise cause a health setback.


As chairman of both the medical advisory board and the CME committee of the American Nutraceutical Association and coauthor of the American Botanical Council’s The ABC Clinical Guide to Herbs, Dr. Wollschlaeger knows just how common the use of vitamins, supplements, herbs, botanicals (plants or plant-derived substances), functional foods (such as tomatoes, for their lycopene content), and medicinal foods (such as health bars with added medication) has become.


“This is happening a lot in patients with chronic kidney disease, diabetes, hypertension—chronic diseases that affect the kidney,” says Dr. Wollschlaeger, clinical assistant professor of family medicine at the University of Miami and owner of Aventura Family Health Center in North Miami Beach, Fla.


Estimates put the U.S. dietary supplements industry at $23 billion in sales. This is largely driven by the ever-expanding population of chronically ill individuals who are self-prescribing their way to potentially greater energy, regained muscle, and relief from the side effects of the multiple medications in the regimen they take every day.