Dr. Tierowna Low Dog, MD, said in a session at the recent International Conference on Plant Science that the increasing complexity of dietary supplements means they are moving — not further — out of the comfort zone. traditional health care providers.
The ICSB is an annual meeting hosted by the National Center for Natural Products Research at the University of Mississippi in Oxford, MS.
Common plant language distorted in the modern market
Dr. Low Dog herself is a very experienced herbalist. On her property in northern New Mexico alone, she grows 64 different varieties of medicinal plants. She has made several trips of ethnobotanical discovery around the world, including a recent visit to practitioners of traditional herbal medicine in Uganda.
“Wherever you go when you are with plant people, there is a common language that we speak”,she says.
But that traditional knowledge goes through a modern industrial supply chain and product formulation spinner and bears little resemblance to what a practitioner like her might learn in the field.
“For a doctor specializing in integrative medicine, it is difficult to find on the shelves what he recommends to a patient. Take something simple like echinacea. There are 15 different products,”she says.
Complexity of formulas daunting even for experienced practitioners
Even with her vast knowledge, she said she could still be confused by the products referred to her by patients. Adding multi-ingredient supplement formulas throws a big wrench into an already crowded wellness visit.
“In a 20-minute visit, you’re supposed to review all of their supplements, check out their labs, and then actually engage with them. For most doctors, even if they’re interested in supplements, that’s just too much.she says.
Dr. Low Dog gave an example of two products that were brought to him by one of his patients. Each had a long list of ingredients, and one housed many of them in a proprietary blend that obscured exact amounts and information about the types and strengths of extracts used. So she said there was little information to rely on to try to answer the question of whether using these products was a good idea in this particular case.
What hope, then, for the general practitioner?
“What would I feel safe recommending to a pregnant woman? There are legitimate concerns about quality. There are legitimate security concerns,” she says.
“Many primary care patients take multiple medications. These concerns about potential drug interactions are real,”she says.
Pharmacists to the rescue
Dr. Low Dog said dietary supplements often contain a warning to consult a doctor before use. But the sad truth is that few doctors know more about supplements than their receptionists.
As a solution, Dr. Low Dog said pharmacists could step in to close this loophole. Compound pharmacies were once a source of herbal medicinal information in this country before the industry embarked on the single-constituent pharmaceutical journey.
“There is a vast area where medicinal plants can play to improve people’s lives. I have long pleaded for pharmacists to reclaim this area,”she says.