1 Acting on Good Information

Question common assumptions about products

Using certain products without really knowing what is in them, what they actually have been proved to do, or how they can affect you can be a dangerous mistake, especially if you are taking other medications.

Before you take action, question common assumptions. Here are some examples:

Questionable Assumption #1
"Even if a product may not help me, at least it won't hurt me." This is almost never true. When consumed in large enough amounts, for a long enough time, or in combination with certain other substances, anything can be toxic, including nutrients, vitamins, plant components, and other biologically active ingredients.

Questionable Assumption #2
"When I see the term 'natural,' it means that the product is healthful and safe." It's a bad idea to assume that "natural" food-like substances are safer than prescription drugs. The term "natural" on labels is not well defined. In many cases, the benefits and safety of the product are not known. For example, many weight-loss products claim to be "natural" or "herbal" but this doesn't necessarily make them safe. In addition, their ingredients may interact with drugs or may be dangerous for people with certain medical conditions.

Questionable Assumption #3
"A product is safe when there is no warning information on the product label." Manufacturers of vitamins and dietary supplements are not required to include warnings on their product labels. If you want to learn more about the safety of a particular product, you should contact the manufacturer directly. The manufacturer is responsible for determining that their products are safe and that the label claims are truthful and not misleading.

Questionable Assumption #4
"When a company recalls a harmful product, it guarantees that all such harmful products will be immediately and completely removed from the marketplace." Dietary supplement recalls are voluntary. While most manufacturers do their best to remove harmful products from the marketplace, their efforts may not be entirely successful.

Often, making the best possible decisions about a particular product requires contacting the manufacturer for more information. Ask the manufacturer or distributor to answer the following questions:

  • What information does the company have to back up the claims made about the product? (Note: Some firms will provide undocumented information from satisfied consumers, or "internal" reports, containing graphs and charts, as "proof" of their claims. These materials are not the same as sound scientific research on the product.
  • Has the company conducted tests on the safety or efficacy of the ingredients in the product?
  • Does the company have a quality control system that determines if the product actually contains what is stated on the label and is free of contaminants?
  • Has the company received any adverse eventsClick here for a definition of this term reports from consumers using their products?

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Health Compass Tip:

For more information on how the US Food and Drug Administration (FDA) regulates dietary supplements and on the manufacturers' responsibilities for the products they market, see "Questions and Answers." http://www.cfsan.fda.gov/~dms/ds-faq.html

Health Compass Tip:

For more information on making informed decisions and evaluating information, including "Tips for the Savvy Supplement User," go to the Web site of the FDA Center for Food Safety and Applied Nutrition, Dietary Supplements (The information is also available in Spanish on the Web site.). http://www.cfsan.fda.gov/~dms/ds-savvy.html

Making medical/treatment decisions: important issues to consider

If you, or a family member or friend, are diagnosed with a serious condition, you should try to learn as much as possible before you and your doctor make a decision about treatment. The following issues should be important considerations in your decision-making process. 1

  1. Diagnosis. Do you understand the diagnosis? If it requires complicated or expensive treatment, you may want to get a second opinion. Note that some managed care organizations insist on a second opinion before approving surgery or other expensive or ongoing treatments. If you need to learn more about the diagnosis, look at trustworthy sources of health information (eg, Web sites ending in .gov, .edu, or .org), as explained in the FIND and EVALUATE sections.
  2. Treatment recommendations. What treatment does your doctor recommend? Does the second opinion agree or disagree with his/her recommendation? It's important that you and your doctor believe the treatment you've chosen is the right one for you and that it will be effective. Some treatments are difficult to tolerate because of side effects (e.g. chemotherapy). Get as much information as you can in advance (see FIND) so that you're prepared to speak with your doctor.
  3. Personal style and preferences. Since you're the one who must live with the side effects and/or results of the treatment, you need to decide if it's right for you. Some treatments are difficult to tolerate because of side effects (eg, chemotherapy). You may need to consider which is more important to you - a better quality of life or more time with your family? Find out as much as you can about the different treatment options and how they'll affect your everyday life. That way you'll be able to ask better questions and make more informed decisions.
  4. Participating in a clinical trial. In clinical trials done to find treatments that work to improve health in people, human volunteers participate as study subjects. Participants in clinical trials:
    • Play a more active role in their health care
    • May receive new research treatments before they are widely available
    • Contribute to medical research
    All clinical trials have guidelines about who can participate. These guidelines take into consideration factors such as age, sex, type of disease, previous treatment history, other medical conditions, etc.

    Choosing to participate in a clinical trial is an important personal decision. If you qualify for and are considering participating in a trial, you should talk to your physician, family members, and friends. You should also contact the research staff of the clinical trial to get more specific information about the trial and to ask any questions you may have.

    For more information on participating in clinical trials, go to http://www.clinicaltrials.gov, a Web site of the National Institutes of Health.
  5. Complementary/alternative treatments. The field of complementary/alternative medicine (CAM)Click here for a definition of this term is large and continuing to grow. Many of the Web sites and search engines mentioned in the FIND section have special segments on complementary medicine, such as the National Institutes of Health (http://www.nih.gov) and the US Department of Health and Human Services Web sites (http://www.dhhs.gov)
    You may want to search for medical publications about the possibility of using CAM treatments (see FIND). Always discuss your ideas with at least one doctor, including the physician whose treatment you decide to follow, because CAM treatments can have side effects of their own, as well as interfere with more traditional treatments (both prescription and nonprescription) you may also be receiving.
  6. Trade-offs, choices, and potential results. Compare your treatment options (eg, surgery, radiation therapy, or "watchful waiting") and consider the effects and possible outcomes of each. If what seems like the most "direct" route to the outcome you want is surgery or another major procedure, what is the chance that the treatment will be successful? Do you have time to try other treatments first? Or is time a critical factor?
  7. Risks vs. rewards. As we have seen throughout the Health Compass program, there is no such thing as absolute certainty in medicine. Do you know the risks associated with your choice of treatment? Do you know what the uncertainties might be? Is there anything you can do to minimize the risks of treatment, such as stopping smoking and/or losing weight before surgery? If all the available treatment options carry a high degree of risk or failure, are there ongoing clinical trialsClick here for a definition of this term that offer a new, as yet unproven treatment, with the possibility of a better outcome?
  8. Respecting your decisions. Will your doctor continue to work with you even if you choose a course of treatment with which he/she disagrees? Is your doctor willing to support your decision to try something that is still in the experimental stages? If you decide on a nontraditional course of treatment, be sure you have the cooperation and assistance of a trusted healthcare professional.

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Health Compass Tip: Your Legal Rights

You have a legal right to the information in your medical records. You have the right to request a copy of the information in your medical record from any doctor you have seen. You must make the request in writing, and some offices will charge a fee for copies. For more information on the ever-changing world of medical records legislation, two Web sites in particular offer up-to-date information: The American Medical Informatics Association (http://www.amia.org) and the US Department of Health and Human Services (http://www.dhhs.gov)

Advance directives: Having your choices carried out if you are unable to communicate

"Advance directive"Click here for a definition of this term is a general term that refers to your oral or written instructions about your future medical care, in the event that you become unable to communicate those instructions yourself. Forms of advance directives vary from state to state, but they typically include the living will, the durable power of attorney for health care, and the Health Care Proxy. Here are just a few of many information sources:

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