How to make the vitamin industry happy

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Typical.

Damn the vitamin industry anyway. They've earned my undying enmity, thanks to an inexcusable labeling decision compounded by the inexcusable stupidity of a doctor my wife saw. As we were finally informed a year and a half after our daughter's birth, St. John's Wort may or may not be an effective treatment for depression, but it's a very effective antidote to hormonal birth control, which neither the doctor nor the vitamin labelers could be bothered to mention.

I'd like to see the doctor's medical license revoked; recommending a nutritional supplement held to only vitamin standards to treat a condition normally treated by prescription drugs is legitimate, I suppose, but only marginally. Recommending a drug (including a "nutritional supplement" used like a drug) without bothering to mention side effects of that magnitude is absolutely inexcusable (and I'm reasonably certain it had been on the market long enough for those side effects to have been established). Unfortunately, my wife remembers neither the doctor's name nor the brand of vitamin, and doesn't think it's worth pursuing...

"St. John's Wort may or may not be an effective treatment for depression, but it's a very effective antidote to hormonal birth control"

I guess I'm pouring salt in open wounds, but St. John's Wort is known to mess up many drugs. I didn't know it affected birth controls specifically, but I'm not surprised.

By Torbjörn Larsson (not verified) on 19 May 2006 #permalink

"St. John's Wort may or may not be an effective treatment for depression, but it's a very effective antidote to hormonal birth control"

I have to say, this is a new effect on me. I would also point out that St. John's Wort is not a vitamin. It is an herb, and I wouldn't call it a "nutritional supplement," but rather an herbal remedy. However, the problem (lack of regulation, lack of scientific rigor) is the same.

I was referencing memory, so I had to check. Wikipedia says: "Pharmacokinetic interactions

St John's wort has been shown to cause multiple drug interactions mainly through induction of the cytochrome P450 enzyme CYP3A4, but also CYP2C9. This results in the increased metabolism of those drugs, resulting in decreased concentration and clinical effect."

and goes on to list a depressingly long list of substances from many classes, including contraceptives. ( http://en.wikipedia.org/wiki/St._John's_Wort )

It seems not wort to use it.

By Torbjörn Larsson (not verified) on 19 May 2006 #permalink

Hmmm...St. John's Wort=overhyped "cure" and extensive self-diagnosis. At least your wife went to a doctor. Too many people start taking herbal supplements without considering what the herbs might do. As people put it "They're safe 'cause they're natural." As I love to point out, poison ivy is all natural. That doesn't mean I want to rub it on my skin!

I read about the St. John's Wort/birth control interaction some time ago in a women's magazine..Cosmo or something like that. I've never had a doctor tell me to take an herbal supplement for a medical condition, if my PCP did, I'd find a new one. If the depression was enough to warrant medication, that medication should be administered in specific dosages by a physician. Herbal supplements are too variable. That doctor should lose their license.

On the vitamin front, anyone else ever notice prenatal vitamins are cheaper (cut them in half for the proper dosage) than other "women's" vitamins. I complained to my PCP about the expense of multi-vitamins, she told me to buy pre-natal vitamins and cut them in half. Twice as many vitamins for the same cost.

As for unintended pregnancy, a friend got pregnant while on the pill because she didn't know that antibiotics decrease the effectiveness of the pill. She said no one ever warned her that could happen. I told her there's always a little warning sticker on my antibiotics that says the pill won't work while taking them. My friend told me her bottle didn't have a warning on it.....I asked her to show it to me, turns out there was a big red sticker telling her about this little side effect. It's certainly something the doctor should have mentioned when he gave her the antibiotics.

By Pygmy Loris (not verified) on 19 May 2006 #permalink

A colleague tamed persistent allergies with megadoses of Vitamin C and now swears by it, and is suspicious of all those who want to regulate vitamins. A relative cured a persistent facial tic by eating a guava a day; this after doctors Indian and American had tried everything and finally offered to sever the nerve as the only remaining option.

As it so happens, I was reading Ian Talbot's "Khizr Tiwana, the Punjab Unionist Party and the Partition of India". {Khizr Tiwana was the last premier of undivided Punjab.} Talbot says that Khizr developed an anal fistula in the early 1930s and "conventional medical treatment in Europe in 1935 failed to do the trick, although x-rays revealed the extent of the problem. Khizr finally overcame this using a 'miracle cure' of an oil based ointment provided by a Mianwali pir {Muslim saint}."

The point is that a person suffering from something doesn't care about what works on the average; they want something that works for them, whether or not it be scientific. Perhaps we differ sufficiently that something that doesn't work on the average nevertheless works sufficiently well on a small percentage of people. If that is the case, then not trying would be unscientific.

It's certainly something the doctor should have mentioned when he gave her the antibiotics.

Sounds like two people dropped the ball--the pharmacist should have gone over that with her when the pills were dispensed, too.