Personal Side Effects & Understanding Supplements with Dr. Reshma Kapadia Patel

Summary:

In this episode of CareLab, Emilia Bourland and Brandy Archie welcome back Dr. Reshma Kapadia Patel, a doctor of pharmacy with over 20 years of experience. They discuss the often-overlooked world of supplements and their impact on health, especially for seniors. From the unregulated nature of supplements to the importance of consulting healthcare professionals, Dr. Patel provides valuable insights into making informed decisions about supplements and vitamins.

Key Takeaways:

• Supplements are not regulated by the FDA, unlike medications, leading to potential safety concerns.
• Many seniors use supplements, often without understanding possible risks or interactions with medications.
• USP-labeled supplements are a safer choice, as they are tested for accuracy and content.
• Consult with pharmacists to avoid harmful drug-supplement interactions and ensure proper dosages.
• Prevention through diet is preferred over supplement reliance, and natural sources should be prioritized when possible.

Transcript:

Emilia Bourland
Yay, welcome to Carilab!

Brandy Archie
Welcome to Care Lab. We're back. And not only are we back, but we're back with a guest that's coming back to us, which I'm so excited.

Emilia Bourland
Yeah, So Dr. Reshma Kapadia, our first repeat guest, but hopefully not the last, we're really, really excited to have Dr. Kapadia back. So she is a doctor of pharmacy. She's been a practicing pharmacist for over 20 plus years and has a passion for helping older adults navigate the world of pharmacy and decrease overuse of medications that can contribute to adverse events and outcomes.

She's a big educator and advocate for safe and effective and minimal treatment to prevent adverse events and keep people healthy at home for as long as possible. If you haven't heard our first episode with Reshma Kapadia, then you should definitely go check that out after you listen to this one, obviously. But we're so excited to have you back today. Thank you so much for being here again.

Reshma Kapadia Patel
Thank you. Thank you for having me. I'm excited to be back with you talking on this platform and educating our seniors.

Brandy Archie
Exactly. Okay now before we start educating doing all the good stuff we're supposed to do I Have a question that's not serious at all so and you got to go first freshman if you were a pill What would be your most common side effect?

Emilia Bourland
Yeah

Reshma Kapadia Patel
Wow! That's hard one. And you know, I'm gonna say something that most people probably won't think about, but it's such an important thing, is how, you know, being in touch with our body and how is this pill making me feel? Do I feel...

like a little more sleepy? Do I feel more not focused? Do I feel like my muscles hurt? So I would just say the biggest thing is be in touch with our emotions, and our feelings and see what's going on inside of us. Because once you take a pill and you kind of see, I didn't feel like this yesterday. I didn't feel muscle pain in my legs.

I didn't feel my heart racing. I didn't feel like my eyes feel kind of blurry. You know, there's so many different side effects. I can't just pick one, but I would say look inside yourself.

Brandy Archie
So you're saying if you were a pill that I was taking, you would make me feel more intuitive to look inside myself. I love that so much.

Reshma Kapadia Patel
Yes, you put that. Yes.

Emilia Bourland
Dang, that was poetic.

Reshma Kapadia Patel
Hehehehehe

Brandy Archie
It was. Amelia, what you got? You better come on.

Emilia Bourland
I don't know. This is really hard if I were a pill. know, euphoria obviously would be my greatest side effect, duh. No, honestly, I really don't even know how to answer this question. It's got to depend on, you know what? I think it's got to depend on the person and the nature of your relationship with that person, right?

Like just like people can sometimes experience medications differently, we experience people differently. So I'm sure for some people, hopefully like for my kids, probably the side effect of being around mom is that they feel like safe and comforted. For maybe for like people that I'm.

working with or like careg hopefully their side effe is they feel confid right? You know, those that would hope for at the goal. But I don't kno a hard question and an app we have a pharmacist here hard to answer. What about

Brandy Archie
You gotta ask the people that deal with me all the time, but I what I want.

Emilia Bourland
that's what i'm saying, like, i don't know! i'm only gonna say positive stuff, listen, i'm not gonna throw myself under the bus here, okay?

Reshma Kapadia Patel
Ha!

Brandy Archie
So if I'm gonna say positive stuff what I'm striving to do is for the side effect to feel like the sunshine walked into the room I'm trying always to Make every thing a little bit better in whatever context that is. So I hope that bringing in sunshine

Reshma Kapadia Patel
awesome.

Emilia Bourland
Yep, that's good. That's good. Side effect.

Reshma Kapadia Patel
Yeah.

Brandy Archie
I got plenty of other bad side effects, but we're not gonna talk about those.

Emilia Bourland
I was gonna say, just don't, can probably think of some bad side effects, but I don't know that I'm willing to share them publicly. Yeah. So we're here to talk today about something that I find endlessly fascinating that I think is really controversial amongst people. that is like, and we're just kind of gonna dig into this big broad topic, which is

Brandy Archie
Fair enough, fair enough.

Emilia Bourland
supplements. They can be really confusing to know if they're good or bad, what's in them. They're not necessarily regulated. So I'm just going to toss the ball straight to you, Reshma, and say like, okay, supplements, go. Yeah. Yeah.

Reshma Kapadia Patel
That's a big topic. Very big topic. yeah, so supplements are a 50 plus billion dollar industry in the US, which like you mentioned is not regulated by the FDA. The FDA does regulate medications. So medications you get over the counter.

well at such as aspirin, ibuprofen, Advil and then the prescription medications that your doctor prescribes. But the herbal and supplement industry which is all the vitamins and herbs are not regulated by the FDA. They do have manufacturing guidelines that they have to follow but that's it.

no safety or efficacy for supplements. So it is a big industry out there. One in three seniors use supplements. So it's widely used and commonly used among seniors. There's a lot of claims made with supplements that's not always accurate.

So they can't claim that it cures something or prevents something. So that's an important thing to remember when you are listening to advertisements or commercials or flyers about a supplement is to remember they can't claim a cure. But they can say it will support or promote gut health or brain health or heart health.

So they can say that which you know is very fine -line to say that it's secure or it's going to help you. And then the other big thing with supplements is you know it's the whole placebo effect as well. So in studies we've seen that the placebo effect is huge.

Reshma Kapadia Patel
So 70 % of the time if you think this medication or product is going to help you, 70 % could be a placebo. Just because you think it is, it is. So there's been studies done on that. So remember that as well when you go out to get a supplement is that we're putting our faith in something that we're not sure what's really in that product.

Brandy Archie
Good, good.

Reshma Kapadia Patel
Now do I feel that supplements are needed? Yes, for sure. Are they overused? Yes. We need to have balance because certain medications will make certain vitamins and nutrients in our bodies deficient. So we should remember that and supplement when we can.

what's really happening right now as well in the industry is where we're thinking that there's no toxicity, this is a natural product, I can take it, it's not going to interact with my medications, and that's not true. So remembering that if you're on medications, supplements are needed, it's very important to talk to a pharmacist or your provider and ask questions.

because a lot of herbs do have drug interactions with medications. And not only that, but natural products can be harmful when taken in excess or overused at doses that are not recommended. So it's a lot in the supplement industry that still needs fine line, you know, tuning.

where we are still not at a place where we can just say it's safe.

Brandy Archie
Okay, I have so many questions. And before I...

Emilia Bourland
I can't even keep track of the number of questions that I have.

Brandy Archie
Okay, in my head, I'm just like, and this and exactly. So I'm gonna start with probably the hardest question first, which is why do we not regulate our supplements? For multiple reasons, because like all the things you said are kind of complicated. The physicians do prescribe like vitamin D or whatever when they see that it's needed. So it's like part of the regimen and it could be a lot more, we could know a lot more if it was regimen, cause we'd have more research and then we'd have more rules.

What is the reasoning that you think that we're not regulating it?

Reshma Kapadia Patel
Well, one of the big reasons is lobbyist.

So unfortunately right now there's a lot of lobbyists in the supplement industry that are, you know, not, you know, going behind the fact that it's a natural product and that it shouldn't be harmful. And so we don't need to regulate it. That's the big thing that I'm hearing right now in the

industry with supplementations and vitamins and herbs, why they're not regulated more. think, you know, and the chances of it causing death is very rare, but it happens like a phedra. You know, it wasn't, it's a supplement. And once they found out that it causes death, they did something about it. But

And I feel like our system is reactive more than proactive right now with this topic. you know, as I feel like more people are getting educated and think what you guys are doing, podcast and giving knowledge to your consumers, they are going, we're hopefully going to see a change. But right now there's so many barriers.

to regulating supplements.

Emilia Bourland
How important is it for someone who is taking a supplement or thinking about taking a supplement to have a conversation with their doctor and their pharmacist about that?

Reshma Kapadia Patel
huge, huge. We can catch a lot of things when it comes to medication management with supplements and vitamins. And just talking to your pharmacist and provider, letting them know what you're on is huge. You know, people think, and again, that perception that's out in the industry

that supplements are safe and it's a natural thing and we have it in our body and it's just adding, you know, because we're depleted right now for a certain reason. So that whole perception of the safety and the naturalness of this product tends to have patients not even mention that at their wellness visit with their physicians.

But it's huge because we've seen lots of drug interactions with herbs and medications and then supplementation like the vitamins, the nutrients. Those is we're checking mainly are they on a dose that may be toxic for them. So that's the important thing with the vitamins and nutrients is making sure they're not on a too high of a dose or maybe they're not on them.

Brandy Archie
Okay.

Reshma Kapadia Patel
supplement because they're on a medication that depletes them of let's say B12 or something like that. So it's very important to speak and have a pharmacist or physician look at your medications and review and see what do we need to add, how much do we need to add, is it too much and is there drug interactions with these medications together.

Brandy Archie
So on that topic, like, or on that point, one of the things that we hear a lot is you should get all your medications from the same pharmacy as much as you can so that that pharmacist there, no matter how many doctors you have prescribing, can have one whole list and be like, these things shouldn't be happening. However, if I'm buying some over -the -counter something, then my pharmacist doesn't actually know that I'm taking it. Are there any besides like walking up to the counter?

Are there any other ways for us to like have an understanding of what is too much or what is too little or what interacts with what?

Reshma Kapadia Patel
Yes, that's a great point. Working with the pharmacist at your independent pharmacy or the pharmacy that you get your medications filled at is a great resource. The only problem is they don't have the time to look deeply into your medication profile. I do highly recommend that all patients fill their medications at one pharmacy and then let their

Brandy Archie
Yeah.

Reshma Kapadia Patel
pharmacists know that I'm also taking these supplements whether they buy it from that pharmacy or Target or anywhere else that doesn't have a pharmacy. But just to let them know now there are pharmacists and groups coming up and that have been in the industry that do medication management for patients and that's one thing that I do as well is advocate to get your meds looked at.

reach out to a pharmacist or someone that's knowledgeable about medications and drugs and how they should be used with someone in the industry that has the training and the background and the knowledge to look at those medications and say okay this is what you're on and what can we add or like I said take away. So

Brandy Archie
so there is like, that's a thing that like, if I go to my CVS and they give me my prescription and they say, do you have any questions? There's 30 people behind me and I waited 30 minutes to get this. So I don't feel like I can be like, well, let me take out all other stuff and then like, tell me about, just, does it feel right? But you're saying I could come to you or another, like, I don't want to call it aftermarket, but another pharmacist that's outside of like your pharmacy system and like say, here's all my stuff and like have a consultation. That's like a thing.

Reshma Kapadia Patel
Yes, exactly, exactly. It is a thing. And I think people forget that pharmacists have a lot of knowledge when it comes to their medications. And I think people know that when they go to the store, but when they go back home, they just think to call their physician. But again, the physician is busy, just like the pharmacist, and you may end up talking to the nurse.

And nurses are great resources as well, but when it comes to drug interactions and all of that, like what's the appropriate dose for me, they may not, they're not educated or may not know that unless they got educated in that area. So yes, it is definitely a thing that's happening in the industry right now. There's quite a bit of pharmacists starting to realize the need.

and the importance of this kind of service for patients and caregivers because caregivers are the ones who give their mom or dad or whoever may be their medications or husband or wife and you know it's it's very confusing and it's it can be overwhelming as well and so yes there a lot of people also tend to go to the internet and look up

Brandy Archie
huh.

Reshma Kapadia Patel
things because they're like, yeah, the internet will give me an answer and it will. But you just need to make sure that the resource that you're getting your information from is trusted and valid and accurate because there's so much information out there that it's not always true. So yeah, definitely reach out to your pharmacist. And you know, I know

there's quite a bit in the industry. It's just right now it's still coming up. It's, I'm sure if you put it in the Google search, you'll find something.

Emilia Bourland
So, okay, here's another question for you. If you are buying a supplement, how do you know what you're really getting? You know what I'm saying? Like, how is there, let's say you need vitamin D or, you you want some like biotin for your skin or, I mean, there's so many different products and things out there that will tell you that they can do all kinds of things. Like, how do you actually know what you're getting? Because that feels scary to me.

Brandy Archie
Tumor egg.

Reshma Kapadia Patel
You don't. Yes, and that's the thing. You don't. You don't know what you're getting, which is the scary part of this whole process and why I feel we do need regulation because there's so many companies out there. All the government is looking at is how their manufacturing is, but that's it.

which is very scary. And that's why we've had a lot of situations where patients have taken products, natural supplements, and then ended up with horrible situations and death. So I don't want to scare people out there, but I want you guys to be vigilant about what you do get and be knowledgeable that what you're getting is vetted and safe.

and usually so I always recommend people go from a trusted source which they know that have had studies done on them or safety or efficacy reviews done on them so that they know that it's actually the product they're saying it is and I think that's the biggest thing. We don't know how that product is going to affect anybody or if it's going to help or not.

but what we can do is say, okay, is this product really ginkgo biloba? And is that what I'm taking? Or am I taking more than that or not that at all? So, in, you know, I've heard of situations and I know of situations where manufacturers claim that the product is ginkgo biloba and

it's not it's rice powder or something else and so that's kind of scary too so it's very important to get a product that is usp labeled so on that product it will say you know a little seal that's usp so that means it's been tested and this is accurate and safe and it says what it is that it's

Reshma Kapadia Patel
known to have let's say ginkgo biloba in that product.

Emilia Bourland
That's a rule.

Brandy Archie
But does the USP seal help you know like they're testing to say like there is ginkgo biloba in here, but are they qualifying that the amount that's in there that they say is in there is in there? Are they also doing that?

Reshma Kapadia Patel
Yes, so they're also doing that as well. Yes, so you know there's lots of products out there. So like if you go to Sprouts, you'll see tons of products at Walmart, Target, with you know Ginkgo biloba and it's in five or six different manufacturers. You don't know which one to pick. It's overwhelming. So I would just the best thing to do is see if they have that seal.

they have that USP seal on it then you know that that's the product the amount is true and it's been tested so that's why they put that seal on there because of this whole there's manufacturers out there that want to say we are quality product and we are delivering what we say we are delivering now they I don't know about the claims that they'll make but they can say promote or support

Brandy Archie
Yeah.

Reshma Kapadia Patel
some kind of issue, but really each individual is going to have a different experience with that as well.

Emilia Bourland
So we know that supplements aren't regulated, but that doesn't necessarily mean that there's, and we know that part of regulation involves a lot of research, right? That's how we define the basic efficacy of things and yada, yada, yada. But that doesn't mean that there is no research on supplements. Like is there, just because it's not regulated, are

Is there research that's out there and available for people to look at regarding some of the supplements that they might be interested in taking? That's a tough question, sorry.

Reshma Kapadia Patel
Yes, yes, no, and there is research actually showing that some herbs, vitamins, all of that, how it can be beneficial and for what it's used for and what results have shown for, you know, healthy heart support or... But it's very important also to see who is that research funded.

That's a huge thing because there is a lot of research out there.

Emilia Bourland
But it doesn't make it all good, right? Like, just because there's a lot of something that you can find information doesn't mean the information is good. It's the same thing with research. Is it high quality or is this terrible?

Reshma Kapadia Patel
Exactly, exactly. So having an independent research study done with a good number of patients and for a longer time is more important to see than just a study. yeah, there was a study done and it showed this but it had like 10 patients and it helped heart disease.

Brandy Archie
Okay.

Reshma Kapadia Patel
don't really believe that and especially if it's funded by that manufacturer or a partner of the manufacturer that happens as well. So you want to be very diligent and not always just fall for that yeah there was a study you know we don't know so I always am cautious as well when it comes to looking at studies and research about the product.

Now we know vitamins are very helpful, especially when you're on medications or as you get older and you're not eating as well or your metabolism decreases, you don't feel as hungry, all the different things combined with aging. So vitamins are huge and important. A lot of doctors and providers and even me

we do recommend a multivitamin daily. It's for even if you're not aging it's just a great supplement to add to everyone's diet but again making sure you're using the right multivitamin and then looking at medications that you're on too because if you're on a blood thinner and you're taking you know a multivitamin that has vitamin K in it you know it can

contradict the effects of it. So we want to be diligent and aware of you know what we're taking, looking at what we're taking and then make sure we have a seal or something that is recommended by someone who knows that this is a good product.

Brandy Archie
This feels very overwhelming and complicated. I mean, I'm just being honest. First of all, we need to pay attention to who makes it and if it's got a seal on it. then we need to also understand how to read research, right? And pick through what's good research and what's not good research. And then we need to make sure that all of the things that we are taking that are good, they all might be good individually.

Emilia Bourland
Yeah

Brandy Archie
But together, they might be counteracting each other. Even if it's not making you feel bad, it might make you not get the benefit that you need. So I'm saying all that to say, last time we talked, we spent a lot of time talking about how prescribed medication is not generally all of our first go -tos and that we try to use more natural methods to deal with things at the levels that we have trouble with it.

We know that there's clinical reasons for doing certain things, but maybe every time you have a headache, you don't necessarily take aspirin, right? And so my question is, in all of that lung lead up, is it better or how do you feel about, if I know that turmeric, for example, it has anti -inflammatory properties and it helps in my arthritis pain and I put it on my food and then I see a turmeric pill and I say, well, more of it should be better. So I'll take it in a pill. That's more than I can put on my food.

Reshma Kapadia Patel
Yes.

Brandy Archie
Should we just like, how should we think about that and incorporating like these natural elements that Eastern medicine does all the time into how we make our bodies feel.

Reshma Kapadia Patel
Yes, that's a great question. And I think starting off with natural for prevention is a great idea. And especially trying to get it from your diet. So if we can try to get what we need from our daily intake of fruits and vegetables and protein every day, I feel that that's

first step to a healthy lifestyle and getting all the nutrients the vitamins that you need now our bodies are you know always talking to us and letting us know how we feel so being in tune with how you feel I think is huge as well so you know the amount of food we eat we know okay now we're full we're gonna stop eating

So our bodies are always telling us kind of, okay, this is what we need as an individual for ourselves. And we have cravings and those cravings are also information trying to say we may need a certain nutrient. So I feel like, you know, listening to ourselves, like when we're sick, we want hot tea or chamomile or ginger or something. And it's because we're our bodies are saying, okay, we need to increase our immune system.

So I think in that way, that's a good way to first start and then you know, you could easily add supplements in again, making sure that they're safe, effective and have the seal on it. But you mentioned adding turmeric to your food. Now adding turmeric topically or in your food is not good, is a good amount for you.

it's not going to harm you, it's not going to be toxic levels, it's not going to cause a problem. Now let's say you're just like, okay now there's a supplement for turmeric so I can just take that instead and you go out and buy turmeric to add to your know intake and now you may have more turmeric than you need. Turmeric is actually a very safe product it's not really

Reshma Kapadia Patel
has much harm at all that I've seen in research. But for example, let's say if you did that with garlic and you put garlic in your food and they're like, I heard garlic helps the heart and it's really good for blood pressure and so I'm just gonna go out and get a garlic pill. Well we have seen that patients end up in the hospital with a ulcer, stomach ulcer.

because the garlic is very acidic and caused erosion to the stomach lining. you know, it's not always safe. So again, speaking to your pharmacist or provider, letting them know what you're taking is huge. But yeah, so, you know, prevention is great. And that's why my first suggestion would be

is to find it in our diet, in our food intake. Try, you know, supplements. And supplements are also great short term. The garlic situation with the patient that had too much garlic and ended up with the ulcer was a long term, you know, she was on it for over six months. So short term use of supplements is also safer than long term use and like extended forever.

amount of time. Because our bodies, you know, we know intuitively and history, we don't eat the same thing every day. We don't have the same amounts of, you know, food, servings or it's always changing for us. And so I feel like using our body as a guide to guide us in our cravings, in our hunger, satiety.

I think that's a great place to start, personally, with supplements.

Emilia Bourland
Well, this has been very interesting and eye -opening. I definitely learned some things that I was not aware of before. Like if I, you know, need to take a vitamin or something like that, that I'm going to be looking for to make sure that what I'm getting is, you know, hopefully more reliable. So thank you so much for being on today to discuss this very, very important topic. We'd love to have you back on again sometime.

because you're so great.

Reshma Kapadia Patel
Thank you, thank you. I enjoy talking to you guys and love the questions and they make me think and I love that. Yeah, anytime.

Emilia Bourland
Where can people find more from you, more of your wonderful education and information?

Brandy Archie
and how to get their medications reviewed.

Emilia Bourland
Yes.

Reshma Kapadia Patel
Yes, so my name again is Reshma. I pharmacy consulting and medication management and my website is wisemedrx .com and email is reshma at wisemedrx .com. So if you have any questions or need a consult or medication or supplement questions, I am happy to help.

Emilia Bourland
Thank you again so much for being here. Dear listener, slash maybe viewer, if you're watching this on YouTube, please take a second to subscribe, take a second to like, take a second to share this with anyone that you think might benefit from the information. And if you can, leave us a review because that's one of the best ways for other people who might benefit from this information to find us kind of naturally and organically is if we have good reviews for the podcast.

Reshma Kapadia Patel
Thank you.

Emilia Bourland
So thank you so much for listening. Thanks for watching. And we'll see you next time right here on Care Lab. Bye.

Brandy Archie
Bye!

 

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