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Neary, a naturopathic physician and chairman of the physical medicine department at Bastyr University in Kenmore wants dietary supplements come as prescriptions. "People need someone qualified to help them manage what supplements they take," Neary said.//

The management has become even more complex in recent weeks as new research casts doubts on supplements such as calcium for bone health, saw palmetto to prevent prostate cancer and glucosamine to alleviate arthritis pain.

Some nutritionists have embraced the supplement adviser role, which seems logical enough. As it turns out, naturopathic physicians, or N.D.s. like Neary are indeed qualified to guide patients on the use of dietary supplements. There is a formidable body of research produced in England, Italy, and especially Germany evaluates all sorts of dietary supplements.

"I don't know if it's our American ego but almost literally when most mainstream professionals (meaning most M.D.s and medical researchers) see "herbs" and "European" they assume the study doesn't hold water," said Neary.

Neary said he has patients who see results in "four, six, eight weeks" and he is always happy to hear the success stories. One of his concerns is that some early results -- good news, no matter how you attribute it -- can be chalked up to placebo effect. He sees six months as proving the overall results (or lack of benefits).

"My question is, what is placebo?" said Neary. "We hear the word and think it means 'fake.' Well, the placebo effect works. The more I think about supplements, the more I think it is in part about me supporting the patient."

In the case of glucosamine, it translates to patients relying on instinct rather than a doctor's view that the New England Journal of Medicine study proves no value.

Many glucosamine consumers are more than willing to spend the $25 to $30 per month to maintain an improved quality of life. In the past t wo weeks alone, I have heard from people who don't plan to stop using glucosamine for joint pain, stiffness or mobility. And that was without even bringing up the subject.

"The scientist in me makes it my preference that you try one variable or supplement at a time for each medical problem," said Neary. "The exception is taking a multiple vitamin-mineral supplement. That's always a good idea."


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