As a parent, you might try to bolster your children’s wellbeing by giving them multivitamins or other dietary supplements, but you may be doing so against hospital recommendations. Last week, the Children’s Hospital of Philadelphia (CHOP) announced that it has removed most dietary supplements from its list of approved medications, and hopes to disabuse parents of the notion that supplements are beneficial to wellness.
The hospital is not adverse to medical alternatives by any means, being no stranger to experimental treatments such as an innovative new proton therapy that precisely targets cancer growth in children. However, CHOP is saying no to unproven dietary supplements; the “natural” products that are meant to cure or prevent just about every malady you can think of. According to CHOP, they’re shunning supplements because many of these so-called miracle pills – such as echinacea, CoEnzyme Q10 etc. — are not regulated by any medical authority, are not proven to cure or treat any disease and, worst of all, they might interfere with your child’s medications that would work otherwise.
As a member of the hospital’s Therapeutic Standards Committee, which recommended the policy change that was rolled out over the summer, Sarah Erush, CHOP Pharmacy Clinical Manager, commented, ‘Because vitamins and dietary supplements are essentially unregulated, there is no sound information about adverse side effects, drug interactions, or even standard dosing for the vast majority of them. Administering these medications — particularly to children with serious health complications — is unethical when the risks are unknown, and when there are alternative treatments that have been proven in clinical trials to be safe and effective.’
While it’s nothing new that medical health professionals doubt the claims made by the dietary supplement industry, CHOP is the first hospital in the US to actually place an outright ban on most dietary supplements from its list of approved medications, albeit still allowing certain essential vitamins, minerals and amino acids. There is loose regulation in the dietary supplement industry. Manufacturers – although unable to make unproven health claims on a product’s label – can rely on word of mouth to get the message of their products across (ginkgo for memory enhancement, echinacea for colds etc.). Plus, as thousands of such supplements are sold in shops and over the internet, especially in the US, the Food and Drug Administration (FDA) has had difficulty policing each product for purity and accuracy in labelling.
The Joint Commission, the leading accrediting organisation for hospital safety and quality, complicates the issue further by expecting hospitals to treat dietary supplements as drugs, while the FDA regulates supplements more like a food. Dr. Paul Offit, chief of the Division of Infectious Diseases at CHOP and head of the Therapeutic Standards Committee, noted, ‘When the FDA doesn’t regulate them, we get caught in the middle.’ Offit has been known to argue against the use of unproven alternative medicine treatments in the past, and has now declared his hospital to have had a ‘clean sweep’ of supplements, removing the vast majority from its formulary, or list of approved medications.
While the hospital will keep the supplement melatonin, because there is at least some data on its effectiveness in treating sleep disorders, Offit explained that the use of dietary supplements has exploded in recent years, which has presented doctors with increasing difficulties. He pointed out one recent case in which a previously healthy child came to CHOP with severe pancreatitis, due to the child taking more than 90 different dietary supplements. The more and more popular supplements get, he said, the more difficult it is for your doctor to know exactly what you’re taking, and how it may be affecting your health.