Do supplements and adaptogens truly work?

[Maximum7]

TL;DR Summary

Question on whether adaptogens and supplements work

I'm very skeptical of supplements and other products that supposedly boost testosterone and brain health. They are always on TV, and I wonder if they are just snake oil OR if there are any ones that actually do benefit the body. My mother takes Magnesium Glycinate every night to keep her migraines down but she still gets tons of them. I'm sure stuff like Neuriva and Nugenix Total T are fake but are there any studies that suggest some that actually work?

 

[berkeman]

Summary: Question on whether adaptogens and supplements work

I'm very skeptical of supplements and other products that supposedly boost testosterone and brain health. They are always on TV, and I wonder if they are just snake oil OR if there are any ones that actually do benefit the body. My mother takes Magnesium Glycinate every night to keep her migraines down but she still gets tons of them. I'm sure stuff like Neuriva and Nugenix Total T are fake but are there any studies that suggest some that actually work?

You've been here long enough to know the drill. Post links to the peer-reviewed journal articles that you have been reading about this question, or the thread will be closed and you will receive a warning or infraction. This is not Facebook.

 

[DaveE]

Vitamin C can prevent Scurvy. Vitamin D can prevent Rickets. Placebos can make you feel better, for a while. How are we supposed to answer this question?

Personally I prefer to ask questions like this to people that have studied medicine for many, many years. Experts who can focus on your specific concerns and your situation. We call them MDs here. I'd stick with the ones you pay for, not so much the ones on YouTube. I'm not sure I'd ask a bunch of physicists on a social media site.

 

[Frabjous]

I do not know of any supplement that has been proven to show benefits for the general population. Doctors will sometimes tell people to make up for a deficiency by taking a specific one. There is also the question of whether a specific individual will be able to process and absorb a specific supplement.

Water fluoridation might be an exception, but it is still debated.

 

[jim mcnamara]

One of the big problems with supplements is that there are no US labeling or research standards for these products. And if there are some research papers they are case studies, a relatively weak kind of science.
Why?

Sales of these products are on the order of 2 billion $US, so profit margins seem to be huge:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416287/

Sometimes, the US will ban a substance beforehand, example Yohimbe:
https://www.nccih.nih.gov/health/yohimbe This is the exception.

The US FDA intervenes in the aftermarket only when hospitals report what appears to be poisoning from one of the products, then they analyze what is actually in the product. If the FDA finds a toxin the product is recalled. This probably will not help the people who became ill.

Complex compounding -> supplements like 'brain stimulants' generally are very questionable to say the least.

Generally health professionals tend to avoid recommending these products.

Possible exceptions:
A. Products from Canada and New Zealand where labeling and testing is mandatory
B. a simple nutrient deficiency is observed - examples:

(1)scurvy,
(2)Vitamin A deficiency discussion:
https://www.ncbi.nlm.nih.gov/books/NBK567744/ - common in post-bariatric surgery patients.

`

 

[Vanadium 50]

Placebos

They're great. They can cure pretty much anything! They gave me these once and I made a full recovery - how can you argue with that?

 

[pinball1970]

Summary: Question on whether adaptogens and supplements work

I'm very skeptical of supplements and other products that supposedly boost testosterone and brain health. They are always on TV, and I wonder if they are just snake oil OR if there are any ones that actually do benefit the body. My mother takes Magnesium Glycinate every night to keep her migraines down but she still gets tons of them. I'm sure stuff like Neuriva and Nugenix Total T are fake but are there any studies that suggest some that actually work?

GP prescribes drugs if required, GP/Nutritionist if diet is part of the treatment.
Other examples that are valid but connected with a visit to GP, out patient care or in hospital.
Claims from a company pertaining to a particular product via the media should be regarded with skepticism.
Check with the Dr if you want a view on a product/supplement. They are the experts.

 

[phinds]

Claims from a company pertaining to a particular product via the media should be regarded with skepticism.

Make that EXTREME skepticism / disbelief

 

[gmax137]

I like the guy pitching the memory booster, who says, "I started taking xyz about 3 or 4 years ago, and..."

He should say, "I started taking xyz 3 years 4 months and 14 days ago. It was a rainy afternoon, and..."

 

[epenguin]

They're great. They can cure pretty much anything! They gave me these once and I made a full recovery - how can you argue with that?

If you know they are placebos they are not placebos are they?

 

[Laroxe]

Really I think we need to avoid being too evangelical about these things. There are several "alternative" therapies that make no sense whatsoever, like homeopathy or various energy therapies which we can dismiss out of hand but with some, particularly herbal supplements it gets more complicated. Remember that currently around 50% of all prescribed drugs have their origins in natural products, this goes to over 60% in cancer chemotherapy. Often whether things work or not is the wrong question, a few ideas to consider;

In the UK if you develop a chest infection doctors will prescribe antibiotics (natural products), we know they work, they do not prescribe expectorants because they don't alter the course of the illness. However, most of the population will buy OTC cough syrups usually based on herbal expectorants because they ease the symptoms and are safe.

Safety is a big issue both ways, a person receiving chemotherapy in which nausea is a real problem can be given powerful anti-emetics, but these carry their own side effect risks. It is common practice to recommend people try ginger which can help without adding problems. There are a great many herbs that have a local effect on the stomach that are used as apéritifs, they are common in stomach remedies (mint) and for grip in babies (fennel, anise).

There are a wide range of plant products that have well known physiological effects, often the main issue in using these products as treatments is getting the active ingredients to the site an effect is needed. An example might be Tumeric, which is simply not absorbed in sufficient quantities. So the product has the active ingredients concentrated, this gives you curcumin and you can try to alter gut permeability by adding black pepper (bioperine), this doesn't seem to be enough. However the anti inflammatory properties are sufficient to have companies trying to develop it as a new drug product.

The final issue is in the financial motives of drug companies, many of which seem to operate in a moral vacuum. The trials of a number of proven therapies have been exposed as corrupt, some leading to multiple drug related deaths.

So I think we need to be careful and be clear about what we are suggesting. There are lots of potential problems with using alternative treatments that can range from exploitation and serious harm to nothing really. People have the right to believe all sorts of things, but trying to control these beliefs can be counter productive in all sorts of ways, who would advocate the banning of prayer.? Sometimes we can only try to make people aware of the consequences of certain decisions, remember that giving control over the way we treat our own bodies to someone else is a relatively new one. Really, we need better information about the suggested harms and how common problems actually are.

 

[pinball1970]

If you know they are placebos they are not placebos are they?

Knowing they are placebos I don't think means they will not act like a placebo on a person.
Example.
There is enough negative stuff out there regarding homeopathy yet a patient (let's assume an educated patient who understands what the science community are saying)
They will go along to the session (journey) and meet the practitioner (nice vibe they like them)
Lie on the sofa/table (nice and relaxing)
The memory is chiming to the sounds sights and smells ONLY associated with this place. A place where people want to help.
The science says there is no evidence, some of practitioners even admit they don't know how it works.
Who cares? They feel better.
Journey, sights, smells, sounds, sofa, nice person who spends time talking to them. Oh yes some water too.

Placebo all the way.

 

[Rive]

Who cares? They feel better.

Sometimes (and I think this one is more solid than placebo) just care makes patients feel better.
I guess this kind of works with self-care (supplements and other products may belong there) too.

But I think the question should be about effects beyond that.

 

[pinball1970]

Sometimes (and I think this one is more solid than placebo) just care makes patients feel better.
I guess this kind of works with self-care (supplements and other products may belong there) too.

But I think the question should be about effects beyond that.

Hopefully you know I am not a fan of that and similar non evidence based medicine.
Extreme pain, anxiety, depression respond better than stage 4 cancer, diabetes and heart disease. Why is that?

My post was whether it would still work as placebo, I think it would.

However, there should be a campaign to advertise what these treatments for what they are.

So younger people can get a real view. It certainly should NOT be on the NHS as a treatment. (I think it is offered? If yes it should be stopped immediately)

 

[Rive]

My post was whether it would still work as placebo, I think it would.

... and I've just supported that, and added the caveats. That's all.

 

[Drakkith]

The science says there is no evidence, some of practitioners even admit they don't know how it works.
Who cares? They feel better.

The people who go there and waste lots of money for no relief care. When selling any product or service it is generally understood that they should have at least have a good chance of doing what they're advertised at doing. If 90% of the time the product simply breaks when used, it's a bad product and companies get sued over bad products all the time (just not usually at the level of the average person since the wasted cost is so low and legal costs so high). If 90% of the time a service provider's service did nothing, that's a bad service and companies get sued over bad service all the time.

But for some reason when it comes to health related services and products we let almost anything get through, no matter how ineffective. So you have an all-natural, herbal supplement that says in big, bold letters on the cover, "Gut Healtherizer 2000!" but has virtually no evidence that it makes your gut healthy? And your quality control is so poor that the active ingredient varies in each tablet by 2-3x or more and is often contaminated by a hundred other things? No problem! Just put on the back of the label, in really, really small text, "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." Problem solved! Rake in that money!

What an absolute joke.

However, there should be a campaign to advertise what these treatments for what they are.

No need! Just slap a little sticker under your acupuncture sign saying, "Not shown to be effective at anything except being a placebo" and then just explain to your customers that the sticker is just a stupid legal requirement and not to worry about it!

Sorry for the sarcasm, no disrespect intended, but my point is that anything short of outright banning of 'alternative treatments' is likely to be ineffective.

So I think we need to be careful and be clear about what we are suggesting. There are lots of potential problems with using alternative treatments that can range from exploitation and serious harm to nothing really. People have the right to believe all sorts of things, but trying to control these beliefs can be counter productive in all sorts of ways, who would advocate the banning of prayer.? Sometimes we can only try to make people aware of the consequences of certain decisions, remember that giving control over the way we treat our own bodies to someone else is a relatively new one. Really, we need better information about the suggested harms and how common problems actually are.

Prayer is not a product or a service. Usually. And the problem has little to do with more or better information, but about convincing people. Companies have almost always been better at convincing the public that their product was either safe and effective to use, or at least legal to sell, than science has at convincing people that it isn't. It is easier for them to make bad studies, hire professionals that will outright lie for them, and appeal to people's fear of authorities than it is for legitimate science to counter all of this. It has taken an enormous amount of time, work, and money to convince people that things like leaded gasoline or smoking really is incredibly unhealthy. Once something is established it is often incredibly difficult to abolish it.

No one can know everything. Especially about all the different health products and services available. If I go to the store to buy a product for my ear trouble, I should be able to expect that every product on the shelf has been shown to be reasonably effective at treating my ear. I shouldn't have to look at six different products before I find one that's actually not a scam (true story), where it was only through my intense personal interest in science and dislike of pseudoscience that gave me the knowledge to know that those six products were all scams.

Sometimes we can only try to make people aware of the consequences of certain decisions, remember that giving control over the way we treat our own bodies to someone else is a relatively new one.

I'm not sure I agree. 'Doctors' and other 'experts' have been around since prehistory, and I have to believe that the average person listened to them about as much as we listen to ours now.

 

[phinds]

But for some reason when it comes to health related services and products we let almost anything get through, no matter how ineffective

The reason is very simple, if stupid. Home remedies WAY preceded formal medications and certification bodies and lots of people stand by them for that reason. "Hey, if Grandma says it's good, it has to be good."

This is hardly the only way that many people refuse to come into the 21st century.

 

[Drakkith]

The reason is very simple, if stupid. Home remedies WAY preceded formal medications and certification bodies and lots of people stand by them for that reason. "Hey, if Grandma says it's good, it has to be good."

I'm no so certain. I don't think most of the questionable products on the shelves today were ever a home remedy for most people. I'm far more convinced that the average person goes into a store, looks for something whose label suggests it helps them with whatever issue they have, and then buys that product, without any regards as to what grandma used back in the day.

 

[phinds]

I'm no so certain. I don't think most of the questionable products on the shelves today were ever a home remedy for most people

I agree but you are taking me too literally. My point is that a lot of people believe in home remedies and over the counter junk and large part of the reason for that is that they are "natural". It's a point of view thing, not a logic / reasoning thing.

 

[Rive]

...my point is that anything short of outright banning of 'alternative treatments' is likely to be ineffective.

There is a little problem with that. People requires care, and care really works: and when related (supposedly harmless) products are banned people floods doctors and requires care from them even for the most trivial problems.
At the end what you get is the overuse of real medicine.

Here, in mid-Europe we tried that, you know. Does no good.

The 'alternative medicine' paired with advertising and lack of knowledge is also a big 'no good' thing, sure.
I'm also missing a big-big 'banhammer' in that field with actual years in jail (and more of such remedies ) dispensed so crooks could feel the care.

But when both sides of a question ends with 'no good' then a middle ground is needed.

 

[Drakkith]

At the end what you get is the overuse of real medicine.

Here, in mid-Europe we tried that, you know. Does no good.

The idea is to remove ineffective products and services, leaving effective ones available. If people legitimately have problems that they need to see a doctor for, what's wrong with that? And is it truly the banning of alternative treatments that has led to the 'overuse' of doctors? Or might it be a far more complicated issue with other major causes?

 

[Rive]

The idea is to remove ineffective products and services, leaving effective ones available.

I do understand that, but as I've said before even an ineffective product just by care still will be useful.
I think it's more important to remove harmful ones (and as 'harm', the false science it's sold with definitely should be considered).

And is it truly the banning of alternative treatments that has led to the 'overuse' of doctors?

Part of it, yes. There is a big set of problems which actually does not require medical attention, but without alternatives those problems still tends to end at at the next available level of care. Which is, in this case: doctors. Who then inevitably will do things to get rid of the unnecessary annoyance.

 

[Drakkith]

I do understand that, but as I've said before even an ineffective product just by care still will be useful.

I'm not sure I understand what you mean by this. Can you elaborate?

 

[Rive]

It's the broad and foggy topic of 'mental health'.
The feeling that your worries has been taken care of: something has been done, so you can sit down and properly rest for seven days for that cold which could took a whole week instead. And so you will feel better.

 

[Drakkith]

Unfortunately, I have little idea of what you're getting at. I'm talking about things like acupuncture, homeopathy, essential oils, poorly controlled supplements, supplements that have no known benefit, some forms of chiropractic, naturopathy, much of what's called 'traditional' medicine, the vast majority of herbal medicines, fringe medicine, etc.

 

[Rive]

In general, as voluntary choice all of those can and will provide the feeling of care.

 

[pinball1970]

The people who go there and waste lots of money for no relief care. When selling any product or service it is generally understood that they should have at least have a good chance of doing what they're advertised at doing. If 90% of the time the product simply breaks when used, it's a bad product and companies get sued over bad products all the time (just not usually at the level of the average person since the wasted cost is so low and legal costs so high). If 90% of the time a service provider's service did nothing, that's a bad service and companies get sued over bad service all the time.

But for some reason when it comes to health related services and products we let almost anything get through, no matter how ineffective.

I totally agree, my comment was slightly sarcastic BUT with a point also.

We all agree not only that Homeopathy does not work but it that it could not possibly work, not at those dilutions approaching zero for whatever they are using at the time.Same page.

I also think it is wrong charging for a placebo.

However what we can learn from this is that spending an 30 minutes in a session rather than the 1-2 minutes you get at your GP can have beneficial effect.

Especially for some chronic conditions, no cure just a respite.Patients claim they feel better so we could take positives from that, dispatch with the fake potions and make time to listen.

A pipe dream here in the NHS/UK granted, especially post COVID where actually getting to see a Dr is difficult, let alone getting 30 minutes to talk about the day and have a cup of tea.

I am not being facetious here that is the sort of thing they do.

Stance on Homeopathy https://www.nhs.uk/conditions/homeopathy/

 

[phinds]

We all agree not only that Homeopathy does not work but it that it could not possibly work, not at those dilutions approaching zero for whatever they are using at the time.

Also, homeopathic medicines should be paid for with homeopathic cash --- that is, an envelope that used to have money in it.

 

[gmax137]

The idea is to remove ineffective products and services, leaving effective ones available.

Are you suggesting some kind of government authority needs to test & certify effectiveness? Why don't we just let the market decide? If you take some cold "remedy" and it doesn't work for you, don't buy it again.

 

[jim mcnamara]

The past several posts have been about the placebo effect - in disguise. FWIW shamans "cure" people often.
The USDA & FDA funded research under the war on cancer. They got plants that were used by curanderas and shamans and tested them for pharmocologic effect. Some few had biological responses often negative and positive. In other words they may benefit one condition while causing other possiblly nasty side effects.
I cannot find a good link. from cancer.gov:

Taxol® (NSC 125973) Paclitaxel, the most well-known natural-source cancer drug in the United States, is derived from the bark of the Pacific yew tree (Taxus brevifolia) and is used in the treatment of breast, lung, and ovarian cancer, as well as Kaposi's sarcoma

@gmax137
The market in the US has been pretty much laissez-faire. Only when there is documented contamination or mislabelling and resulting pathology does the FDA/CDC step in. Generally most producers of these oopsies are very happy to recall them. Much cheaper and better for customer relations than law suits.

All recalls on any product - food, makeup, supplements, etc:
https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts

Note that given the fact Amazon must have 10⁶ supplements you can buy (if you have a
US shipping address) the supplement industry is going full bore... pretty much unfettered.

 

[gleem]

A good place to check the efficacy and safety of supplements is https://www.consumerlab.com/

They provide information on common/popular supplements such as the actual amount of active ingredients vs what the manufacturer put on the label and the presence and amount of any harmful contaminants such as heavy metals which is surprisingly in a lot of these natural (healthy?) products.

They report on past and current research and the side effects etc.

Recent Articles include:

Does Vitamin D Reduce Fracture Risk?​

​

Who Should Use Red Yeast Rice​

​

Cocoa Flavanols & Blood Pressure​

It's sort of a Consumer Report for supplements. The free website gives a summary of its findings for more things than one ever thought of taking.

You can also subscribe to a weekly newsletter and get access to all their studies.

 

[Drakkith]

Are you suggesting some kind of government authority needs to test & certify effectiveness? Why don't we just let the market decide? If you take some cold "remedy" and it doesn't work for you, don't buy it again.

I admit I don't know what a good solution would be. I just know that sifting through products on a shelf to find the one product that isn't a scam says something about the state of the industry and that it needs fixing.

 

[Laroxe]

I do agree that when people are ill they are often ripe for exploitation, and there are always large numbers of people and organisations ready to take advantage of this. I can think of some examples where I think the behaviour of some practitioners, is so disgraceful that they should be imprisoned, but the whole area is such a mess it does seem impossible to solve.

I think the first problem is that medicine is a messy subject, and the quality of biomedical "evidence" simply doesn't lend itself to black and white choices. While most people in medicine support the idea of it being evidence based, surprisingly little can be described as scientifically validated. The discussion around placebo effects highlights the fact that people are not the most predictable of research subjects.

All of the problems mentioned are indeed valid, but it can be an interesting exercise to compare the evidence of harms from both traditional and allopathic approaches to treatments. There are large numbers of drugs available, supported by research, that in reality were only developed to maintain company profits, antidepressants being a prime example. There is also the problem that drug development often involves increasing the potency of the active compounds, and this carries its own risks. Medicine is just as heavily influenced by fashion, fads and moral decision-making as other aspects of our culture, and in fact many of the approaches we describe as alternative are derived from and supported by medics. At the risk of triggering the moderators, I suspect that this is as much an issue of ethics and morality than it is about science and the public understanding of science, lies at its core.

This reviews some of the issues
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572812/