“Natural” Doesn’t Mean Good For You –Potential Risks of “Dietary Supplements”

dietary supplements and vegetables
dietary supplements and vegetables

The wife of a California Congressman died last year after ingesting White Mulberry – a plant that is used as an herbal remedy for a variety of conditions including diabetes, obesity and high cholesterol according to Kaiser Health News (https://khn.org/news/article/tom-lori-mcclintock-death-herbal-remedy-diabetes-weight-loss-white-mulberry/

How can something “natural” and available over-the-counter be harmful?

Because they’re not regulated by the FDA as medicine – they are regulated as “food”.  The FDA does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.  Further, the FDA can’t even inspect a company’s manufacturing process unless it has reasonable evidence that its products are harming people.

People often equate natural with safe because it came from the earth, “but so does cocaine and heroin” points out Dr. Fatigma Stanford, MD from Harvard Medical School and Massachusetts General Hospital. 

Recommendations can be found everywhere, and its hard to know which can benefit your health and which may be harmful.  The scientific evidence isn’t always clear.  And the products you buy in stores or online may be different than those used in studies.

In this article from Penn Medicine, they discuss what many supplements do and some common risks.  https://www.pennmedicine.org/updates/blogs/health-and-wellness/2020/february/the-truth-about-supplements. And my favorite part of the article is the final point – ‘That nothing beats the nutrient power of a healthy diet”!

Debunking First Aid Myths

When you’re scrambling to make a burn feel better or stop bleeding, knowing what to do can make a big difference.  There are many myths about First Aid, some of which can actually can do more harm than good.  Should you put butter on a burn?  Apply a cold steak to a black eye? 

Myth #1: Put Butter on a Burn

Mild burns can be treated at home, but don’t grab for the butter!  Butter unfortunately adds foreign particles and increases the risk of infection.  But what should you do instead?  Scripps has a blog post that answers that and many more questions: Debunking 7 First Aid Myth’s.

New COVID Boosters

Many people have questions about the new COVID vaccine boosters.  Keep reading for answers to some of the most common ones here.

What’s new in this latest round of COVID vaccine boosters? 

The original COVID vaccines were effective at preventing infection and very successful in preventing complications from the Alpha and Delta strains.  But they are less effective against the Omicron variants which are more transmissible and immune-evading.

On September 1, 2022 the CDC approved new boosters from Pfizer (for ages 12 and up) and Moderna (for ages 18 and up).  These updated boosters add Omicron BA.4 and BA.5 to the original vaccine composition. 

Moderna COVID-19 vaccine, Bivalent is the name for Moderna’s new booster.  Pfizer’s new booster is called Pfizer-BioNTech COVID-19 vaccine, Bivalent.  Bivalent just means there are two strains in the vaccine (alpha and omicron).  I think we should call it COVID vaccine 2.0.

Is it better than the original?

As COVID has mutated into different strains and subvariants, it has gotten better at evading the vaccine.

For the original strain (Alpha) and the later strain (Delta), Pfizer and Moderna initial two-shot series were about 75% effective at preventing infection and 90-95% effective at preventing serious complications.  But the vaccines were less effective against Omicron – only 30-40% protection against infection and 70% protection against hospitalization.  A 3rd booster shot boosted effectiveness against infection to 75% and 88% for severe disease.

Unfortunately, it’s unclear exactly how much protection the new booster shots will provide, but models suggest 80% protection from infection and around 90% for prevention of complications. 

How could they approve the new booster without large clinical trials?

Believe it or not, this is something that has been done for decades with the flu shot.  The flu shot is reformulated every year based on an educated guess of what the circulating strains will be in the coming year.  They might take 1 or 2 strains out and put in different ones. 

Flu shots are made using eggs and take 9 months to produce.  Because large clinical trials require time (a minimum of 3-6 months, often longer), it’s not feasible to run clinical trials each year.  They have decades of data showing the vaccine is safe and effective (some years more than others), so they approve the latest formulation based on that history.  This has been a very effective strategy allowing the flu shot to adapt each year just in time for the next flu season.

They have adopted a similar process for the new COVID vaccine booster.  They have extensive safety and effectiveness data for the original COVID vaccines (over 600 million doses given in US).  Additionally, they have safety and immunogenicity data from a clinical study of a bivalent COVID-19 vaccine that contained mRNA from the Alpha strain and mRNA from the original Omicron strain (not BA.4 or BA.5 subvariants).

Should I get one?

Yes.  I plan to get mine and will give it to my 87-year-old mother.  I’ve encouraged my children (in their 20’s) to get it as well.

When should I get it?

Although you can get it as early as 2 months after your previous booster, I recommend waiting 4 months after your last booster.  That’s the point where the vaccine efficacy seems to drop. 

Another consideration is the current amount of COVID infections.  Currently cases are relatively low.  We are anticipating a surge in December/January, like what we’ve had for the past two years.  So, you might want to get the booster in October or November to have good immunity in December and January.

Does the new booster have side effects?

They are expected to be similar to the original vaccine – soreness in arm, body aches, fever, etc.

COVID Vaccine Boosters

Don't let perfect be the enemy of the good.

I have to admit, I’m tired of the whole issue of COVID vaccines.  That does not mean I’ve not had mine – I have.  I had my two shot initial series and BOTH boosters. 

But it’s hard to keep up with all the recommendations.  And it’s frustrating the vaccine doesn’t give us long term immunity.  But it’s all we have right now.  So… Is it better to go without because it’s not a perfect vaccine?  NO – don’t let PERFECT be the enemy of GOOD!

Our current COVID vaccines (Pfizer and Moderna) are very good vaccines – they reduce serious illness, hospitalization and death by around 90%.  And they’re still effective against the latest variants.  But they’re not perfect:

  • Can cause flu like symptoms for few days after administration
  • Don’t stop you from getting COVID
  • Immunity only lasts 4-6 months

Pharmaceutical companies are working diligently on a vaccine that will solve these issues, but we’re not there yet.

  1.  What Happened to Johnson & Johnson Vaccine?

It wasn’t as effective as Pfizer or Moderna so isn’t being given anymore in the US.

  • Who Can Get A First Booster? 

Everyone ages 12 and up can get 1 booster 5 months after completing the primary series with either Pfizer or Moderna.  If your primary shot was with Johnson and Johnson, you’re eligible for a booster after 2 months.

  •  Who Is Eligible For A 2nd Booster?
    • Adults aged 50 and over. 
    • People aged 12 and older who are moderately or severely immunocompromised – active cancer treatment, organ transplant recipients, stem cell transplant in last 2 years, primary immunodeficiency syndromes, HIV infection, high dose oral steroids or other immunosuppressive medications
    • People who got 2 doses of Johnson & Johnson vaccine
  •  When should I get the 2nd booster?

At least 4 months after the first booster.  This is my opinion:  you might want to wait until cases are rising or you’re planning air travel.

  •  Do I need a booster if I’ve had COVID?

Yes.  We know natural immunity lasts at least 90 days.  But after that, it varies significantly by individual.  We’ve seen re-infections at 90 days in some but 6-9 months in others.  Appears we have little natural immunity after 1 year.

  •  Should I “Mix and Match” the vaccine boosters?

There is some data that shows benefit from getting a booster that is DIFFERENT than your original vaccine series.  For example, I had 3 Moderna vaccines (2 initial and 1 booster), so for my 2nd booster I got Pfizer.  It’s a harder question to answer if you had Pfizer as your primary series….that’s because the Moderna booster is only a half dose and I worry it may not provide enough protection.

  •  Where can I get a booster?

I am no longer giving vaccine in my office, but it’s readily available at many pharmacies and some County locations.  You can find locations and schedule appointments or see if they talk walks ins here.

Omicron: What’s In A Name?

OMICRON was named as a concerning variant of COVID-19 in November 2021.

Because it’s so new, we don’t know very much at this point.

· Is it more infectious/transmissible?

· Does it cause less severe disease?

· Can you be asymptomatic like the other variants?

· Will the vaccines be effective against Omicron?

Since we don’t know very much, I thought we should look at where the name Omicron came from.

In May 2021, the World Health Organization announced a simple method for naming COVID variants. They would name them after letters of the Greek alphabet. This system makes public communication about variants easier and less confusing. The older naming convention was unfair to the people where the virus emerged. The agency called the practice of describing variants by the places they were detected “stigmatizing and discriminatory.” (https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/)

We better get familiar with the Greek alphabet: alpha, beta, gamma, delta, epsilon, zeta, eta, theta, iota, kappa, lambda, mu, nu1, xi, omicron, pi1, rho, sigma, tau, upsilon, phi, chi1, psi1, omega.

Omicron, the 15th letter of the Greek Alphabet, was assigned to the 13th strain of COVID. Wait….13th? Not the 15th strain? Yes. The W.H.O. skipped two letters just before Omicron — “Nu” and “Xi”. “‘Nu’ is too easily confounded with ‘new,’” Tarik Jasarevic, a W.H.O. spokesman, said. “And ‘Xi’ was not used because it is a common last name.”

You may be thinking “I didn’t know there were 13 strains of COVID? That’s because we generally only hear about strains of “interest” or “concern”. There were some strains assigned a letter from the Greek alphabet that didn’t reach that classification level. For more information, check out this article in the New York Times.