At a recent check-up with my primary doctor, she asked a question about a vitamin/supplement I’m taking. “Why are you taking this?,” she said, with a skeptical look. I said that my gynecologist recommended it, and explained what for. My primary doctor used her face to express doubt/disagreement about this, and then said that recent studies have shown vitamins to be ineffective. Well, except for the vitamins/supplements she has recommended for me. Those are different.
I don’t know what I’m supposed to do, when two of my doctors disagree. A level further: I don’t know what my DOCTOR expects me to do, when two of my doctors disagree. Does she expect me to disregard the other doctor’s advice? Is that what she would want me to do with HER advice, if I were talking to the OTHER doctor? How about the two of THEM duke it out, and then get back to me?
A level further: I don’t know what ANYONE IN THE HEALTH AND MEDICAL COMMUNITY wants us to do when EVERY SINGLE THING they say, recommend, suggest, advise against, lecture about–EVERY SINGLE BLESSED THING–is contradicted by another faction of their community. Or, in fact, by the SAME faction, if we wait a little while.
Yes. *sigh* This is so frustrating. It seems like this with everything too. Eggs are good! Eggs are bad! Low fat is good! Low fat is bad! Butter will kill you! Butter is good for you! Put on sunscreen! You need vitamin D, don’t wear so much sunscreen!
Yes – haha! In my lifetime, eggs have been good for you, bad for you, good for you, bad for you, and I think we’re now back to good for you (for the moment).
I would continue taking the vitamin that Doctor A recommended. Doctor B didn’t say it was *bad* for you, right? Where I would find a problem is if Doctors A and B were both gynes working for the same practice!
Exactly. Unless it’s harming you, and if you feel your body is benefiting from it, keep taking it.
I like my doctor, but one time she tried to tell me that food doesn’t affect hormones, and I nodded my head while internally rolling my eyes. I take everything health professionals say with a grain of salt, then go home and do my own research (preferably peer-reviewed studies and medical articles, not, like Cosmo’s Guide to Health or Yahoo! Answers), experiment with my own self, and see what works best and feels right to me. I don’t think it’s wise to blind,y accept what doctors say; they’re just people, after all, and given how many doctors and health professionals I know personally, I can confidently say that they don’t know everything about health and certainly not about my own body.
Yes, right: Doctor B just said it wouldn’t do any good.
I’m dealing with a medical condition that required three different doctors to treat at various points. I am finally, finally feeling healthy again and starting to exercise, only to encounter a problem that Doctor A says is Doctor B’s fault and Doctor B says is Doctor A’s fault. Doctor C says it is probably a combination of both A and B, and she’s sorry that I have to deal with it. And suggested a possible solution via physical therapy or a specialized personal trainer. Doctor C is winning the “my favorite doctor” award. Not that I have time or money for physical therapy or a personal trainer, but at least she tried to help instead of blaming another part of my treatment.
On your clothes post, I’m not plus size, but I am short and not skinny, and finding clothes sucks for me too. What is the deal with the shirts that are so thin you have to wear something underneath them? Everyone is doing that now and I hate it. I only want to wear one shirt, thanks.
I’m always surprised when doctors attempt to say something authoritative related to nutrition, as studies are by and large inconclusive. We truly don’t know nearly as much as we’d like to think we do about all of the complicating factors involved. And here’s a good paradox: studies have shown that vitamins and supplements are not effective, but also that people who take them tend to be healthier. Mark Bittman says this means you should strive to “be the type of person who takes vitamins,” without wasting the money on them. ;)
And perhaps some supplements are separate somehow? I know quite clearly that iron supplements increase my hemoglobin, from seeing my results when I try to give blood when I have been taking them and when I haven’t!
I love this! Strive to be the type of person who takes vitamins. Ha!
FOLIC ACID.
we absolutely know that folic acid matters for women of childbearing age.
My favorite doctors are currently those who I can clearly see don’t agree with something another doctor (or I personally!) have said I want to do / should do, but they shrug and say “it certainly won’t HARM you; if you feel it’s working, don’t change what you’re doing.” (My ob/gyn is like this. He’s very frank about what he thinks people should/shouldn’t be doing, but is at the same time completely accepting if you feel differently, as long as he doesn’t think it is detrimental to your health. I appreciate his candor and his lack of judgement equally.)
I’m sorry you had to go through that–it’s anxiety-producing enough to have to go to the doctor, without feeling caught between two of them.
In addition to the other comments, the ethics of this situation bother me–what professional questions another professional in such an immature and indirect way? A physician never has the right to cause a patient to doubt another physician (unless of course there is blatent malpractice evident). And even if there is cause, words work better than childish face-making.
I know phone calling is hard for you, but I wonder if you would feel comfortable calling your primary care physician’s office and asking to speak with her nurse. Explain that you got a lot of nonverbal messages and now feel uncomfortable about what to do. Nurses are often quite good at running interference this way. It would help you, and it would be good for the physician to be approached about her unspoken message. I would offer to call for you, but of course privacy stands in the way (and I do highly respect that).
oopsie! BLATANT, not blatent
I could write for days on this. Literally. It would go on forever. But ,the short version is my pediatrician wrote IN HER NOTES but did not tell me to: “Try to feed less at night”. The child is breastfed. He doesn’t sleep through the night. He is a big child but not fat (so, like overfeeding – if it were possible from the boob, which it is not – isn’t happening). He eats, plus. it’s clearly comforting to him and he goes back to sleep quickly. So, what is her suggestion? Listen to him scream? Rock him for hours? Is she volunteering to do any of this? I”m fairly certain that no child has ever needed to breastfeed back to sleep for his entire childhood and into adulthood. LEAVE IT BE or have the guts to TELL me. So annoyed. My PCP, relatedly, wants me to lose weight, to which I’m like – a) I can walk over 3 miles with 30lbs on my back and I do this regularly (same baby + carrier). Can you do this? Does that make your thinner than me but definitely not thin self healthier or less healthy? I also mentioned that I lose weight when I wean – and she was like, when’s that going to happen? I’m pretty sure the health benefits of breastfeeding + the 30lb baby carrying outweigh any of her theoretical worries about the fact that I’m not thin. LEAVE IT BE. I get if I said I ate nothing but chocolate and mcdonald’s while sitting on the couch in front of the TV – the delivery sucked, but I get the concern. But, also BMI is not a very good method of measuring.
And I’m stopping because I could keep going. So annoying. So annoyed. I just do what I want while smiling and nodding but refusing to commit, which, then screws with everyone. It’s kind of like saying sleeping with your baby is SOOOO dangerous – because no one admits to it (but everyone does it) so the statistics are way off, therefore all of the conclusions drawn from those stats are wrong but all the doctors will spew them off like they’re written in stone on tablets from above.
+1 on the losing weight when weaning (and at least for me, not losing much without weaning)! And it made me so self conscious. Yes, I am 40 lbs overweight but I am currently running 3 miles a day, and I eat healthy food. And yes my baby is 20 months but no I’m not ready to wean. I get so frustrated when doctors get irritated at me because I want them to realize that it bothers ME more than it bothers them!
Not sure if this will be helpful, but often there are differences of opinion between groups of doctors (I trained as an internal medicine doctor), because there are a zillion studies to weed through, and as each doctor specializes, they tend to read certain journals. Also, it’s informed by the doctor’s personal experience with this or that. So many times during residency I just wanted someone to tell me how to interpret ALL the data! Alas, life and biology and science is complicated.
As a patient, I tend to stick with the advice that seems best informed. Is the supplement for perimenopausal symptoms? Then I might give more weight to the OB/GYN’s advice. Is it for general health? Then the primary doc might be more up on the literature. Or, does one of them have specific concerns about the supplement? Do you get the feeling one of the docs has studied up?
Work for you, I know! You are a smart lady, though. You definitely have the smarts to figure out whose logic is best (seen you do it many a time on the blog)! Hugs and good luck!
Here is a perfect example of this situation and what to do about it. In 2012 I had drastically high blood pressure. It’s genetic. My General practitioner told me I would need to go on a cholesterol medicine. I asked her for a chance to lower it myself. She said that was not possible. I told her I needed some time and left. Later I had my OB appointment, and his nurse practitioner is also a holistic midwife. While reviewing my file she saw my labs and asked about my cholesterol. I told her the GP wanted to put me on a medication. She said NO! She said those meds you have to stay on for life. Instead, go to Whole Foods and buy some Red yeast rice with COQ10, some spirulina pills, and one other thing (I forget now) and try that for 3 months, then get re tested. I did this and then made a follow up with my GP. She tested my blood and my cholesterol had dropped but not enough. I told her what I was taking and she said it wouldn’t work. I asked for three more months. I spent that three months religiously taking my herbs and adding in some exercise. At 6 months my cholesterol had dropped significantly. When I went back my GP said, “honestly, (shes eastern Indian) where I am from, taking an herb would be our first choice, however being a licensed doctor I am required to try and sell you on a medication. I am really shocked the herbal route has worked this well but I’m glad it has.” I stayed on them three more months and then stopped. I continued exercising and eating right and my cholesterol is now better then most normal healthy people. I have managed to beat my genetics.
What it came down to, is even though I had two doctors who said very different things, and who were both passionate about their way of doing things, ultimately I had to go with the person I trusted the most. My hippy dippy OB midwife has never once led me down the wrong path. She has always suggested a lower cost, short term, healthy organic fix before putting me on a life long pill. She has always been honest with me about my surgeries and options with other things (ie hysterectomy vs ablation), she had no financial gain from me taking the herbs, vs the doctor who got incentives for selling me on her medication.
I’m glad I trusted my gut and stayed on the herbs. In the end if the vitamin is working for you, and your GP had no VALID reason for you to NOT take it, then why would you stop taking it? If your OB had an actual reason for recommending it, and it’s doing the job then why wouldn’t you stay on it. I would stick with your instinct on this one.
i am APPALLED to learn that the GP actively preferred to recommend another route, but was REQUIRED to suggest the medication. OMG.
I am currently trying to avoid being on a statin for high cholesterol and employing the diet/exercise route. It’s good to keep in mind the whole thing of pharmaceutical companies advertising directly to the public and incentives to doctors. Especially the incentives!
Misguided Mommy, I am thrilled by your ability to beat your genetics at this. It gives me hope that I will see an improvement with my holistic efforts. The major thing about statins that scares me is that it increases your risk of developing adult onset diabetes which I have on BOTH sides of my family. I have a friend who is a doctor and she was like, “you’ve got to think about what’s going to get you first.” That would be the sugar in this case. Good luck everyone with untangling what to do! Great thread :)
Shannon,
Weird because that’s my name too. It took me almost a full year but I was able to drastically reduce my cholesterol with diet, exercise and herbs. My cholesterol now is like that over achiever kid in your sons classroom that you hate. I did all organic veggie caps (because I’m an annoying vegan, surprise a vegan who had insane high cholesterol, hello lays potato chips I love you), however you can actually buy almost all of this at CVS.
I took:
*Flush free red yeast rice with COQ10 (as a bonus it has niacin in it which kept me all warm and fuzzy in the winter)
Spirulina pills
*Artichoke Pills
*DHA
I took them daily for six months, then I dropped to every three days, and then I stopped entirely. It really worked for me. I also changed my eating major drastically. I switched to a 100% clean eating lifestyle and honestly everything changed for the better after that. I started reading the book 100 Days of Real Food. The introduction really helped me understand food so much better and it improved my triglycerides, my cholesterol, my weight, and my health.
I loved reading this: http://io9.com/i-fooled-millions-into-thinking-chocolate-helps-weight-1707251800
Studies show lots of things. Not always what anyone thinks they do.
That reminds me of this tongue in cheek piece in the British Medical Journal. I think the authors were saying that just because something can’t be proven in a trial doesn’t mean we can abandon common sense. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/
It drives me CRAZY when I am confronted with dueling views from professionals and I am in the middle, without sufficient knowledge or training to make a call about who could be right. I had this happen in a home maintenance context once, with my contractor and building super vehemently disagreeing about how our new radiators were going to be installed. I basically told them what you said, to duke it out amongst themselves and leave me out of it. I had ZERO qualifications for figuring out who was right. So maddening.
Doctors are lovely people, but science is complicated and it’s difficult to A) keep up, and B) synthesize seemingly conflicting studies that are outside your area of expertise. Plus doctors are really not trained well in some wellness topics like nutrition.
I have found this chart to be useful for deciding whether a vitamin/supplement is worth it: http://io9.com/how-many-of-your-health-supplements-are-actually-snake-1492960177 Obviously Dr. Google isn’t a licensed medical professional, but I like that this was developed based on many different peer-reviewed studies yet it’s still easy to use.
If it was something I felt was truely important I would request one physician consult the other in order to “facilitate coordination of care.”
Yeah, this. When I was at the hospital for stitches the other day, I got three different instructions regarding how to shower while the stitches were in, all within the span of FIVE MINUTES. The CNP said just shower, no worries. Then the nurse came in and said, Well, at least put a band aid over it. Discharge nurse said to wrap my whole foot in a plastic bag and seal it. So… great. Cleared that right up.
I have this problem too. My bariatric surgeon wants me taking 5,000 IU of vitamin D daily. My endocrinologist thinks that’s too much (even though my level has never gone over 50 and the normal range is about 30-80). I tend to defer to my bariatric surgeon because he specializes in my particular nutrition circumstances, but I did scale back on the vitamin D to a few times a week instead of daily. It’s so frustrating when there’s no consensus in the research.
I would just smile and nod and do what you feel good about. I mean, it’s a vitamin not treatment for angina or something, right? I hate doctors so much, the shitheads, unless I like them and then I want to see only them. I love my OB, and I think I’m just going to keep seeing her every year, that way I get a checkup, a breast exam, and it’s a pleasant exchange, even though I only have to see her every three years or whatever it is now.
In bad/confusing doctor stories, my husband had to get a sleep study a few weeks ago and during it, they came in and said you have sleep apnea so insurance says we have to give you a cpap. So they did and then he came home and then days and days went by and nothing! Then they called but they didn’t know anything and then finally, like one month later, they finally said someone would be calling from a home cpap place in the next few weeks. So they were in a huge rush to give him a cpap at the study so he didn’t DIE there but as soon as he walks out the door (and is charged SEVEN THOUSAND DOLLARS), he’s on his own! Whatevs. It’s all so annoying, I wish we didn’t need them at all.
Oh my gosh, that is exactly what happened to me! I had to call the home health place who then called the DR’s office and faxed an order for the Dr. to sign, weird. I wondered if I was imagining the whole thing or dreamed it or something
As a doctor, I agree with those who say, ask the doctors to talk it out amongst themselves and get back to you. Unfortunately, unless they’re all in the same practice (e.g. at a university), doctors don’t communicate with each other nearly as much as they should. It can be hard to say “Could you talk to Dr. X directly with your concerns?” but they ought to do so if they really have qualms about something you’re taking. No need for you to be the go-between!
As an aside, I notice some commenters have taken the approach of just nodding outwardly but having a different reaction inwardly. Obviously, it varies depending on the comfort level you have with your doctor, but it doesn’t really serve anybody well if you don’t speak up about your reactions. Ultimately, they are there to help you understand their rationale, and if they’re worth their salt, they *want* to hear your concerns. I confess, though, that when I’m a patient, I sometimes find it hard to speak up and ask questions or disagree, especially when the provider seems like they’re in a hurry (and they almost always do).
That’s almost exactly what I said, the 2nd part. About speaking up. It’s not very helpful not to BUT it’s not like doctors (as a rule) are super thrilled when you do. With mine, she was like, your weight. And I was like, I lose when I wean and she was like, THAT’S NOT TYPICAL…one, it’s more typical than is publicized – I have someone agreeing with me on here – and two, loads of things aren’t typical clearly I’m in an atypical group since you’re talking to me about losing weight and I’m telling you that I’m breastfeeding like a nut, if your contention is I should lose the weight while breastfeeding and I’m clearly not….
But, right, it’s not helpful to future patients or the world at large to smile and nod and go on with your life but it’s often easier and more helpful for the patient looking at the doctor right now.
This must be very frustrating. I am making a major side-eye at the 2nd doctor who made a face about your vitamin, by the way. So professional! So explanatory! So helpful to the patient!
Uuuuggggh. My daughters have had three different pediatricians (not to mention random doctors and NPs who see them for walk-ins) in four years, all at the same practice, and nothing is consistent. One doctor (my favorite) told me it was perfectly ok to wait out my daughter’s mild ear infections without antibiotics as long as she didn’t seem to be suffering. When he left the practice, the new doctor looked at me aghast because we should always, always treat ear infections in babies with antibiotics. (Guess which one of these doctors had four children and which had none.) New doctor put my daughter on x dose of iron, and told me an x month course would build up her reserves, strongly implying we could take her off the supplement as long as her numbers stayed up. 90 something doses later, new doctor is on maternity leave, and new-new doctor increases the dose to one I don’t even think is SAFE for her age/size, and gives me no deadline for when we might be able to stop supplements. But I think my favorite was having the new-new doctor, on being told that my older daughter is taking a multivitamin with iron (she was borderline, so I was told I could treat HER with mostly diet and OTC supplements), tell me “multivitamins don’t have iron.” Um … it says “iron, 18 mg” right on the label, so … do you want me to have Dr. Flinstone call you to prove it? My husband keeps telling me we should get a second opinion and I don’t know what to say, because my daughters have had tons of opinions, and that is part of the problem.
Oh, American medicine.
My mother—a physician—was once fired for prescribing vitamin D at a time when the research hospitals were begging rural family practice docs to prescribe vitamin D, because lack-of-D was having huge consequences, and it’s pretty hard to do damage by taking extra D because of how it’s absorbed. (You can get D poisoning, it’s just…genuinely difficult to accomplish. It’s easier to kill yourself drinking too much water.)
Yes, humans absorb vitamins better through food than pills, but also that doesn’t make all vitamins ineffective. It just means you need to take some on an empty stomach, and some with food, and some with fats like nuts or avocado, and some are better as a liquid or a skin cream instead of a pill…your body processes things differently. This is not magic or bologna.
There are supplements that are generally useful and hard to find arguements against (folic acid for all women of child-bearing age who could get pregnant, even accidentally; vitamin D for all of us who live far enough away from the equator that we get almost no sun on our skin half the year; iron for those who have been found to be deficient), and then there are a whole host of supplements that are in a more grey area. I agree with other commenters: if it’s not harmful (either the substance or the dose), why not take it if you want to?