Dear HealthSmart,

I’m a very picky eater with a small stomach so I take a lot of supplements to make sure I’m getting enough nutrients. I heard that not all supplements brands are created equal, and some can potentially be harmful. How can I know what supplements are best?

HealthSmart asked Dr. Sina Gallo, Ph.D., Assistant Professor of Food and Nutrition Studies at George Mason University. Here’s her response:

Supplements are not regulated in the United States, so it’s very likely the supplements you take aren’t providing you with nutritional benefit at all, and possibly contain added fillers that could be harmful. It’s important to protect yourself by only purchasing supplements from reputable brands. A rule of thumb is to look for the US Pharmacopeia Convention (USP) label on any supplement you’re buying. The USP label ensures that the supplement contains the ingredients listed on the label, in the declared strength and amount, does not contain harmful levels of specified contaminants, is made according to FDA and USP Good Manufacturing Practices, using sanitary and well-controlled processes, and will break down and dissolve within a specified amount of time so the active ingredients can be released and absorbed by the body. Another good resource is the National Institutes of Health Office of Dietary Supplements which provides fact sheets on what you need to know about dietary supplements on their website: https://ods.of.nih.gov/.

Dear HealthSmart,

What are the risk factors for developing Peripheral Artery Disease? What steps can individuals at risk take to avoid developing PAD?

HealthSmart asked Dr. Joseph Mills, M.D., Professor and Chief of the Division of Vascular Surgery and Endovascular Therapy at Baylor College of Medicine. Here’s his response:

The biggest risk factors for developing PAD are aging, cigarette smoking, diabetes, hypertension, obesity and lack of physical activities. There are many modifiable factors that individuals can actively change to avoid PAD. Quitting or decreasing tobacco smoking, increasing your physical activity level, and eating a Mediterranean diet all can help prevent or stabilize PAD. Your diet and exercise changes don’t have to be drastic and should be approachable so that they stick. Walking just three times a week and avoiding junk food can be significantly beneficial. Additionally, taking statins, which are typically a medication for known heart disease, can help prevent PAD.

Dear HeathSmart,

What treatment options are available for Restless Legs Syndrome? Are there any risk factors involved with medical treatment options?

HealthSmart asked Dr. John Winkelman, M.D./Ph.D., Chief of Sleep Disorders Clinical Research Program at Massachusetts General Hospital. Here’s his response:

There are four FDA approved treatments for Restless Legs Syndrome (RLS), three of which are dopamine drugs similar to the medication used to treat Parkinson’s Disease. The use of dopamine drugs for RLS has proven to work very well in the short term. The common side effects of these dopamine drugs are nausea and sleepiness. However, over time these drugs can worsen the RLS due to a process called augmentation, where the symptoms of RLS start earlier on in the day. Depending on the patient, this can occur after six months of taking the dopamine drugs, or it can take up to ten years. For example, a patient initially may not get RLS symptoms until 10:00 p.m. when they get in bed. After taken the dopamine drugs for a year, their symptoms may begin to start at 8:00 p.m. Their doctor may up their dosage and a vicious cycle ensues, causing the onset of their symptoms to start earlier an earlier. I have many patients who have symptoms much of the day even though they’re on high doses. The fourth medication is a Neurontin/gabapentin drug and isn’t a dopamine drug. It’s effective as well, but not particularly for the people with augmentation. It was approved for RLS that’s not augmented and is often times not potent enough for patients with augmented RLS. If a patient has a mild case of RLS, I may try to put them on a low dose of dopamine, but most of the time I try to get patients off of the dopamine drug or start out with the non-dopamine option.

Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to Editor@WashNews.com. HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021