Supplements (again)

Over half of American adults take supplements. Some take prodigious amounts. This can be a bad idea. One paper in The New England Journal of Medicine estimated that supplements are responsible for 23,000 emergency room visits a year, often because of liver damage.

A few supplements have their place. Women who are trying to have a baby benefit from folic acid. People who have been shown to be deficient in vitamin D, vitamin B12, and omega-3s may also benefit from these supplements. This may be particularly true for old people who are not getting enough sunlight and/or their diets are lacking in such foods as fatty fish, plant oils, or certain seeds and nuts.

As to boosting longevity, no large clinical trials have shown that supplements extend human life span.

The supplements market has been described as having a “wild west” nature. Unlike medicines, supplements do not require FDA approval before they can be sold. Also, what’s on the bottle’s label might not match what’s inside the pill. One study of supplements found that, for the majority, the amount of the ingredient shown on the label differed from the actual amount—in some instances by as much as 100 percent.

Some supplements have been found to include lead, arsenic and mercury. Researchers at the University of Michigan estimated that 15 million American adults take a supplement, such as turmeric or red yeast rice, that could potentially cause liver toxicity.

 I’ve taken supplements in the past. I don’t anymore.

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Allergy advice—too late

I don’t have seasonal allergies (knock on wood), but many of those around me do. They’ve started suffering from itchy, watery eyes and other symptoms. A recent article in The New York Times offers advice that centers on taking action prior to allergy seasons. But, as far as I can tell, the first allergy season has already started—at least here in California and in Arizona. Anyhow, maybe this advice, which comes from allergists, could be helpful next year.

First, you must figure out your personal allergy season when your symptoms are most intense: tree pollen from late winter to spring; grass pollen from late spring through summer; and weed pollen from late summer through fall. This helps you determine when your medications might be most effective. Internet sites such as Pollen.com might help to find allergy forecasts.

After you’ve determined your season, the experts say to start taking your medication—such as Claritin, Zyrtec, and Allegra—about two to four weeks before your pollen season begins. This helps to block the histamines in your body from triggering itching, sneezing, and congestion.

To prevent pollen from wafting into your home, keep your windows closed starting a week or two before allergy season. Maybe even clean or replace filters on your air conditioner or air purifier and keep outdoor clothing and shoes away from areas where you spend a lot of time.

The docs also suggest using your inhaler before you go outside and keeping your skin moisturized to create a protective barrier.

Good luck!

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Rx to OTC switch

I’ve read that the FDA is considering broadening the types of dugs that can be sold without a prescription—that is, making them available “over the counter.”  FDA commissioner Martin Makary told CNBC that “everything should be over the counter” except drugs that are deemed unsafe or addictive or that require clinical monitoring.

Over the years, plenty of drugs have migrated from Rx to OTC, including those that treat allergies, joint pain, heartburn, overactive bladder, and acne, as well as those used for birth control. Examples include:

Nasonex—a steroid nasal spray.
Lastacaft, Pataday—eye drops to relieve itchy eyes.
Astepro—an antihistamine nasal spray.
Voltaren Gel—a nonsteroidal anti-inflammatory topical gel.
Plan B—a form of emergency contraception.
Opill—a once-daily birth control pill.
Xyzal, Claritin and Zyrtec—antihistamines.
Differin Gel—acne treatment.
Prilosec and Nexium—for heartburn.
Oxytrol—for overactive bladder.
Narcan—to reverse an opioid overdose.

Note that OTC versions aren’t always the same as their Rx versions.

It will be interesting to see what, if any, previously prescribed medications will soon be available over the counter.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

A doctor’s advice on consulting AI

Over a third of Americans use AI for health advice. In 2025, 66 percent of physicians also used it.

Dr. Adam Rodman, director of AI programs at Beth Israel Deaconess Medical Center in Boston says, “I believe that when used appropriately, these large language models [AI chatbots] are the greatest tool for empowering patients since the invention of the internet.”

He recommends using chatbots, such as ChatGPT, to enhance, not replace, your medical appointments. To do this, he suggests first pulling up your doctor’s medical notes (they should be available online). After removing all your identifiable information, copy those notes into a chatbot. Next, give the chatbot an update of your condition, then ask it to concisely summarize all this information. Finally, ask the chatbot: “Given this context about my health, please give me three questions I should ask my doctor about [insert health concern here] during my upcoming visit.”

Because chatbots depend on having a full picture of your health and medical conditions, Dr. Rodman says you can learn how to describe your symptoms by asking the chatbot to “interview me as if you’re a doctor.” Such a question-and-answer session can lead to a clearer explanation of your condition and help to exclude other conditions that might cause unnecessary alarm.

Chatbots try to please their users by adding layers of information. For this reason, you need to be aware they may lead you down a rabbit hole of scary possibilities. To avoid this, you need to tell the chatbot explicitly why you are asking a question. For example, “I am having a bad headache today. Here is my last note from my primary care doctor. What are some strategies to make it better?”

Diagnostic errors cause almost 800,000 deaths or permanent disabilities in the United States each year. For this reason, Dr. Rodman believes that AI can be one of our best tools for saving patients’ lives. At the same time, he advises that you need to be cautious about seeking second opinions from chatbots or rely on it for advice on treatment plans. Just use what you’ve learned as a conversation starter with your doctor.

I've never tried any of these suggestions.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.