By Janet Choi, MD, Chief Medical Officer at Progyny
We’re all seeking quick solutions to better health. Look at weight loss. Prescription injectables have become the go-to in recent years. For many, it’s working, and it’s being monitored in partnership with a trusted care provider. But it’s not just primary care physicians prescribing these injectables. Virtual providers, some with questionable training in specialty areas, are also commonly prescribing these medications without access to a full patient history that provides much-needed relevant context. The desire for a quick fix to optimal health can also come with confusion on what sources to trust. With health and medical advice coming from sources on social media including non-medical professional bloggers, it’s a true but alarming fact that many times the information is not medically accurate. It’s personal preferences and biases that are not substantiated with clinical studies. This can pose significant risks.
Take supplements, for example. This is something we see a lot of in women’s health and family building, yet it’s another area with significant questions around medical advice and proven effectiveness. Whether you’re looking or not, you likely can’t seem to avoid seeing advertisements and promotions for supplements everywhere, and for health conditions you may have as well as those you never thought about. What you may not know is that supplements, vitamins, and herbs are not regulated or approved by the FDA, and they are not tested for quality, consistency, or safety.
Particularly in menopause and fertility, many women find themselves eager to find that cure all or boost to help them quickly achieve their goal. With conditions so personal and emotional like infertility, repeated pregnancy loss, or menopause symptoms, which can be hard to manage, many women are eager to try anything promoted to help. But without trusted medical advice, there could be more harm, including emotional disappointment, than is ever necessary.
How do you know what supplements to trust and what can add value? When patients ask me (and they often do), this is what I share.
Tried and true
For women who are trying to get pregnant or who are already pregnant, I always recommend folic acid. Even though it’s found in some foods, your body may not absorb enough from food alone. Taking at least 400 mcg of folic acid each day is important to help reduce the risk of spinal cord defects in a developing baby. Many studies and professional health guidelines recommend folic acid for pregnancy health.
Calcium and vitamin D are also well-researched supplements that help keep our bones strong, especially when combined with weight-bearing exercise. I encourage my patients to take them regularly. Since I’m post-menopausal, I even try to take these myself to help with my bone health, though, to be honest, there are days—and sometimes even weeks—when I forget. Keeping these supplement bottles by my toothbrush (because, thankfully for my teeth/gums and for the people I talk with every day, I do remember to brush twice a day) has helped me stay on track with the supplements I need to take.
On the fence? Ask the experts
That said, when I’m thinking about myself as a patient or consumer, I do explore and sometimes try supplements. How do I decide which ones to try? Luckily for me in my personal circle and profession, I have a group of trusted healthcare and research friends to ask for advice. If you don’t have the benefit of that, you can rely on another of my verification methods – published research studies on supplements in PubMed, Google Scholar or at the NIH Website. When looking for myself, I think about the possible benefits versus the risks or side effects. If the side effects are mild—like nausea—but the risks of serious problems, like blood clots or organ damage, are low, I might try it. I also try to check out the manufacturer. Since the FDA doesn’t regulate supplements, I look for ones that are tested for quality by independent groups like USP, NSF, or ConsumerLab.com.
Then, I give it some time. For example, when I was dealing with hair loss from perimenopause, I tried some hair supplements for 6-9 months because as a doctor and from research, I knew that on average it can take time to see results. I didn’t have any side effects, but I also didn’t notice any changes, so I stopped. The same thing happened when I tried collagen supplements for my joints and skin. After 6 months of daily use, I didn’t see any improvements, so I stopped. Again, because supplements are not FDA regulated and we don’t necessarily have rigorous clinical research to rely on, not everyone is going to respond the same way/get the same desired result. If there is a question in your mind, always consult your physician and, if you do decide to trial a particular supplement, document your start date and see if you are noting changes (whether good or bad).
Trusted information and discernment over non-verified hawking
At the end of the day, when people ask me about the safety of supplements, I stick to what I said at the beginning—they’re not FDA regulated, and most of them haven’t been tested enough to prove their effectiveness. In fact, if a supplement claims to “treat” or “cure” a medical condition, it should be reported to the FDA. I also understand how frustrating it can be for people with infertility or menopause symptoms, like brain fog or sleep problems, when medical treatments aren’t helping. If someone asks me about a specific supplement for fertility or brain health, I’ll talk about the studies I know, including any risks, especially if they are pregnant or trying to get pregnant.
I also share resources, like the FDA’s supplement ingredient directory, where people can look up a supplement to see if there are any safety warnings. And I can’t emphasize this enough, I always recommend that patients talk to their primary care doctor before trying a supplement to make sure it won’t interfere with any medications they’re already taking. Ultimately, the best way to achieve our goals for better health is through a balanced diet, exercise, and good lifestyle habits, but it’s hard to ignore the appeal of supplements. That’s why it’s important to be an informed and careful consumer, and partner with a trusted medical provider.