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Think Like a Pharmacist

Let’s say you’ve been feeling a little down lately. Maybe more than a little, or maybe for longer than you’d like. A friend mentions something they read on social media. The post said that magnesium can be used instead of a prescription medicine to treat depression and anxiety.

Should you try it?

“Patients get the idea that supplements like magnesium are OK to use because they’re over-the-counter and “natural’’ but we tell them to talk first to a physician and their pharmacist to see if there are any interactions with other medicines they are taking,’’ says Jennifer Toth, Pharm.D., a 2018 graduate of the College of Pharmacy.

Thinking like a scientist about the effects and interactions of every product we eat or drink takes training—like the evidence-based medicine classes that College of Pharmacy students take in their first year, right alongside College of Medicine students. From Dr. Toth’s classroom training and her experience serving patients at community pharmacy locations, she can offer a few key points to keep in mind when we read the latest claim that a product can make us calmer (or faster, or smarter—you can fill in the blanks).

Questioning the latest media cure

As consumers in the U.S., we’re used to prescription medicines being highly regulated. That is, we can rest assured that a prescription contains what it says it does. But Dr. Toth notes that the Food and Drug Administration (FDA) does not approve supplements and so-called natural products such as vitamins and minerals before they are brought to market.

Wait, really?

It’s true. Although familiar brand names can be reassuring, and possibly more reliable, there’s no guarantee from the FDA or any other government body that a supplement labeled as, say, magnesium, actually contains that product or the amount stated on the label, agrees Daniel Krinsky, R.Ph., professor of pharmacy practice.

And all supplements are not created equal. Consumers need to consider the other ingredients with which a product may be mixed. Magnesium citrate (a salt form of magnesium) is used as a laxative, for example. If you mistakenly purchase this product with hopes of improving your mood, you will likely be surprised by some very different results. And there’s another potential side effect, says Dr. Toth: Because magnesium is an electrolyte, which is important for normal body function, you could end up with a slower heart rate and lower blood pressure.

Sizing up the research

Evaluating through fact-finding just makes sense to Dr. Toth, who was a math major as an undergraduate and is now pursuing a Ph.D. in pharmacy administration. At NEOMED, in a pharmacy elective taught  by professor Krinsky, Dr. Toth and her classmates looked at product claims made in advertorials (paid content designed to blend in, so it could be mistaken for objective content written by reporters employed by the publication). They learned to check out the studies cited in the ads and compare them with the actual evidence, if that even existed —and the students often discovered that the claims were about as substantial as using cotton candy to treat cancer.

While we consumers can feel confident that prescription medications have been put through rigorous safety and efficacy tests by the FDA, Dr. Toth learned in class that such clinical studies may not have been conducted to demonstrate that natural remedies actually work.

The students dug deep, asking manufacturers for details about control groups and sample sizes. But answers came slowly or not at all. Sometimes the results showed that studies were flawed; for example, they might have had too few participants to be considered significant. NEOMED training taught Toth to consider such information gaps as red flags.

The assignment of researching a product that’s not FDA-approved but is promoted in an advertorial was eye-opening, says Toth. What’s the takeaway for consumers? Maybe we can’t help hoping that the latest claims buzzing around in the media are true. But teaming up with a pharmacist who has a scientist’s insistence on evidence? That’s a good way to check them out.

This article was first published in the Fall 2018 issue of Ignite magazine.