Table 4.

Examples of Physician-Patient Discussions about Dietary Supplements

Example 1: Patient asking for physician’s opinion about a list of dietary supplements:

Patient: What kind of a professional would look at that page and tell me, in my condition, is any of this any good?

Doctor: Whether these herbs are any good?

Patient: Yeah.

Doctor: Well, I actually know a fair bit about herbs and vitamins.

Patient: I think I’m overkilling here. [some intervening conversation]

Doctor: Ginkgo biloba...You know, I really don’t think that is going to be very helpful for you. There is some weak evidence, probably out of Europe, that for people who have mild dementia it might help, and you don’t have mild dementia. [Both chuckle.] No, ‘you don’t have dementia’ is what I should say, and that is probably quite pricey, isn’t it?

Patient: No, about five or six bucks. I get so many catalogs that I can shop [for supplements].

Doctor: I bet there is some ginkgo in this [other supplement on your list] here. I think both of those may not be all that helpful for you.

Example 2: Physician cautions against taking high doses of vitamins

Doctor: …a multivitamin is perfect. Now, taking too much of vitamins can have toxicity. So never take more than just a simple multivitamin a day, okay? So if you’re taking high doses of vitamin E, vitamin C…, let me know, because I need to know how much you’re taking. High doses do have toxicities in the vitamins you know. Little bit is a good thing, a lot is a bad thing.

Patient: Of anything.

Doctor: Of anything.