It’s February, it’s cold and flu season, and by now you know the drill and you’ve got your go-to feeling-ick over-the-counter (OTC) medication. But what about supplements and herbal prevention remedies?
Monika Nuffer, PharmD, Certified Clinical Aromatherapist, is a clinical pharmacist with expertise in Whole Person Health. Dr. Nuffer holds faculty appointments at the University of Colorado in both the Skaggs School of Pharmacy and the School of Medicine, and is the course coordinator and instructor of the hybrid and online Integrative Health and Medicine electives. She is also a proud CU Pharmacy alumna.
Dr. Nuffer took five from her busy schedule to answer our questions on how to get through the rest of this winter.
First things first. What is the difference between prescription medication, and OTC medication, and what the FDA considers supplements, vitamins, or herbal remedies?
The Food and Drug Administration (FDA) stringently evaluates prescription medications for safety and efficacy before they are approved to be prescribed in the United States. OTC medications and vitamins do not have the same FDA oversight. With these supplements, the FDA generally only gets involved if there are safety concerns and potential harm with their use, in which case they will be reviewed and potentially removed from the market. OTC medications are generally considered safer to use, could be lower dosing than the same drug available by prescription, and allow patient empowerment to self-treat certain ailments. Herbal products are generally considered as dietary supplements, and as such, should not make claims to treat, prevent, or cure specific diseases.
Why is your area of study so important to pharmacotherapy and patient health?
Supplements and herbal products are highly utilized by U.S. consumers and there are large out-of-pocket costs for these treatments. Every one of these supplements is a chemical, and as such could produce drug-related problems when mixed with prescription medications and OTC items. Pharmacists are drug information experts and are best positioned to identify both the risks and benefits of using these therapies. Since they are widely available to the public, it is essential that someone is monitoring patient health and safety. We need to ensure that the complementary use of supplements and other whole-person modalities are safe in combination with conventional prescription and self-care treatments.
We know each patient is different, but if you had a patient who wanted to prevent or shorten colds, what would you recommend?
Well, if I had a perfect treatment option, I would patent that treatment and retire early. Honesty, the first steps in disease prevention are to practice good handwashing, be up to date on vaccinations including the annual flu shot, get plenty of rest, and have mind-body balance. As there are many supplement options, each person's health history needs to be a factor before recommending a product. We shouldn’t be in the business of recommending a supplement for a condition without evaluating the individual whole person for safety and interactions. That said, supplements such as Echinacea (Echinacea purpurea), zinc, and vitamin C all have some evidence for helping to prevent illness. Specific formulations, sources of the herb, and even how you take them can be very important for them to work properly. If people are looking for something to help them optimize their health, now is a great time to build a relationship with their local pharmacist, hopefully one that I’ve trained!
Are there any remedies you would stay away from, without first consulting your primary care provider?
If a patient Googles treatment options for cold or sickness remedies they will find dozens of expensive options. People would like to stay healthy and there is a robust market of remedies out there. Sadly, many of these are marketed as a 'cure-all.' Remember what your grandparents taught you… 'If something sounds too good to be true, most of the time it is.' A patient should consult their provider and or pharmacist to ensure what products they want to try are effective and safe for them. Generally, I recommend avoiding products that combine multiple different herbal products into one 'proprietary' formula. Keeping things as simple as possible helps to avoid bad outcomes, such as allergies, intolerances, or drug-related problems.
You have a very busy schedule. What do you take every day to feel your best?
I try to practice what I preach. I recently obtained some training in the use of essential oils, and I have incorporated some of these into my lifestyle. Oils that provide a fresh clean smell in my space like Lemon (Citrus limon), those that help suppress inflammation and prevent respiratory infections like Cypress (Cupressus sempervirens L.), Eucalyptus (Eucalyptus globulus Labill.), Frankincense (Boswellia sacra Flueck.), Bay Laurel (Laurus nobilis L.), Peppermint (Mentha × piperita L.), Rosemary (Rosmarinus officinalis L.) and the strong powerful action of Lavender (Lavandula angustifolia). Everyone responds slightly differently to oil scents, so it’s important to be selective. I also believe in the value of fresh air and forest bathing, so I try to get outside as much as possible. Traveling is great or just getting out in nature, walking the dog, or hanging outside on the deck with a beverage of choice!