New AACE Medical Guidelines for Use of Dietary Supplements; Endocrinologists Encourage Education Before Use

The American Association of Clinical Endocrinologists (AACE) has announced the release of its medical guidelines for the clinical use of dietary supplements and nutraceuticals (DS/N). As you can imagine, the endos are taking a pretty conservative approach to what sorts of supplements they think you might want to take, or what could be a help. (After all, supplements don't involve visits to THEM, or prescriptions!) But it's worth a read to see what the endos think...

"AACE Medical Guidelines for the Clinical Use of Dietary Supplements and Nutraceuticals" were published in the September/October 2003 issue of Endocrine Practice, a peer-reviewed journal of AACE. The guidelines, discussing DS/N as alternative care medicine, focus on hormonal and metabolic agents.

"The purpose of these guidelines is to clear up misconceptions regarding the use of dietary supplements," stated Donald A. Bergman, MD, FACE, President of AACE. "Many physicians and patients are unaware of the hidden dangers associated with interactions between drugs and supplements."

Numerous issues face physicians who encounter patients taking, requesting, or inquiring about use of DS/N. In addition to philosophic and controversial questions regarding the use of unproven therapies, or therapies with weak scientific substantiation, a pragmatic issue is whether the DS/N in question will interfere with conventional medications, various nutrients, or even other DS/N the patient may be taking. Patients should be strongly cautioned against taking any DS/N that may interact with any current or potentially needed medication. Furthermore, the study of drug to DS/N, nutrient to DS/N, or DS/N to DS/N interactions is not required by the Food and Drug Administration, as are drug to drug interactions. This makes it unlikely that many such interactions with DS/N have been discovered or that they will be adequately studied.

One nutraceutical in particular, St. John's wort, has shown to have potential interaction with medications such as cyclosporine, iron, and oral contraceptives. Other interactions, such as lithium and caffeine, insulin and ginseng, and estrogens and grapefruit juice, can also have serious repercussions.

Jeffrey I. Mechanick, MD, FACE, Chairman of the AACE Nutrition Guidelines Task Force, points out, "As the supplements grow in popularity, it is essential physicians become more knowledgeable about these products. The AACE guidelines are the first of their kind and offer physicians much more than a reference; rather, a springboard to further educate themselves and their patients about the benefits and risks associated with DS/N."

AACE is a professional medical organization with approximately 4500 members in the United States and over 70 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine diseases. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as nutrition, obesity, diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, and hypertension.

For an electronic version of the guidelines please visit www.aace.com/clin/guidelines

FOR AN ALTERNATIVE VIEW -- For a more holistic approach to supplements for thyroid patients, read:

The Top Five Supplements for Thyroid Support -- by Richard Shames, M.D. & Karilee Shames, Ph.D., R.N., thyroid experts and authors of Thyroid Power

Inside Mary Shomon's Medicine Cabinet