SCIENCE, FAITH, OR GOOD FORTUNE?

Published in the March 2008 edition of the East Bay Psychiatric Newsletter


I take a bunch of pills every day—ten to be exact. But despite my scientific training and “prove it” attitude when it comes to most things, seven of these ten pills are non-proven, over-the-counter nutritional supplements that I take mostly as a matter of faith. You won’t find me acting this way in other areas of my life, so why do I behave this way is this particular area?

The simple answer is that when it comes to my health, I’ll do just about anything to improve my odds of remaining well and lengthening my life. Scientific evidence seems less important when non-toxic supplements like a high potency multivitamin, glucosamine, folic acid, vitamin C, selenium, omega-3 fatty acids, and vitamin E are concerned. And I haven’t even mentioned the Echinacea tea and other herbal teas I drink routinely to “boost one’s immune system and add anti-oxidants to prevent aging of cells.” I have fallen prey to the poorly documented claims that if I take these remedies I will delay the onset of Alzheimer’s disease, ward off colds, keep my knees and varicose veins from worsening, improve my cardiovascular status, and maybe even live longer.

There is some documentation for these claims from the multi-billion dollar nutritional supplement industry, but for the most part it is anecdotal and has not been subjected to the rigorous double blind studies that I would normally demand. Studies that would definitively demonstrate value or lack thereof for some of these substances could take decades to complete. They may even be too costly or cumbersome to undertake at all. At age 64, I do not have 20 years to learn that it might have been helpful to take some of these supplements for the prior 20 years. By then it will be too late for me, so I have to proceed now on sparse evidence and hope.

I am not looking for the fountain of youth. My hope is an ordinary one--to live to a ripe old age without being afflicted by the physical infirmities or serious decline in cognitive functioning that so many people suffer from in their last years. One of my patients recently told me that her 96-year-old father simply “stopped.” He went to bed one night saying he felt over-tired, woke up the next day not feeling well, held his 94 year old wife’s hand during breakfast, and then died right there sitting at the kitchen table. He had experienced no serious physical decline, no major illness, and no loss of mental acuity. I asked my patient if I could sign up for the same end-of-life contract her father had arranged for himself, and she and I smiled, knowing it doesn’t get any better than that.