Children’s use of alternative medicine has skyrocketed in recent years. In fact, a new study finds that kids’ use of herbal products and nutritional supplements nearly doubled between 2003 and 2014, but just because something is labeled natural, that doesn’t mean it’s safe. Joining us via Skype with a closer look is Pediatrician Dr. Aaron Carroll. Doctor Carroll, thank you so much for being with us. Hi Doctor Carroll!
Welcome back! Welcome. You know, on this show I feel like we’ve been very open minded, and we still are, regarding alternative medicines, but can you talk a little bit about your biggest concerns with the increased use of alternative medicines in kids? Yeah, let me say that I don’t have a problem with alternative medicine either, as long as it works, and part of the problem with supplements is that so much of the benefit is unproven, and we don’t think that most kids are getting any benefit at all. Given that, knowing that there’s a lot of safety issues, and that a lot of the alternative medicines and herbal supplements that people are using could have problems or cause harm, if you’re not getting a benefit and you could get a potential harm, it’s probably not something you should be doing. Doctor Carroll, why do you think there’s been such a surge in the use of alternative medicines in kids? Well, I think some of it has to do with marketing, and there’s also this belief sometimes that natural means safer, as you said, and therefore people think, well this is safe, and I might get a benefit so let’s go for it. And I think, Doctor Carroll, part of the problem is people are going to that internet, maybe they’re dealing with a child that has ADD or Autism or one of these prevalent conditions, obesity maybe, and they’re frustrated with what they’re doing, they hook into a group and say “Hey, if you use these supplements, your kid’s going to get better” I think there’s a lot of potential harm going on there. There is, some of it is as I said before, because there’s much less regulation with supplements than there are in pharmaceuticals, and so studies have shown that a lot of them contain substances which are not safe, or that people don’t know about. Another issue is that we need to be concerned about what we call “drug-drug interactions”. We’re pretty good these days with prescribed medications about checking to see if one will actually adversely interact with another when we prescribe it, but there’s a lot less checking with supplements and often doctors don’t even know that patients are on supplements when they prescribe them other medications, and that could lead to some pretty significant adverse events. Well, one of our biggest issues on this show with supplements has been that because they’re not regulated, the claims are also not regulated, and the claims always shoot for the moon, and if you wanna raise a happy, healthy child, why wouldn’t you take a supplement that says “for brain health!” I want my kid to be smart! But, the reason you shouldn’t jump for that is because again that’s a claim that has not been backed up, but let’s talk about that for a minute, because there are some kids who may have nutritional deficiencies who may even require a vitamin supplement for instance, can you talk a little bit about vitamin supplementation in kids and some of the dangers if you’re just going to the store and throwing vitamins at your kids that are not necessarily proven to be worthwhile? Sure, and of course there are kids who are deficient in vitamins, we worry about kids less than age one who have vitamin D deficiency, there are a significant number, although it’s still pretty small, of children under the age of five who have iron deficiency and this can lead to anemia or low levels of red blood cells but the vast, vast majority of children, certainly of adolescents and, you know, kids getting into school age, are not vitamin deficient, and yet, people are on vitamins, people take supplements all the time, because we’ve been led to believe that because a little of it is good, or necessary for some people, that more is better, but the body doesn’t work that way. You know, at some point, you’re just making expensive urine, your body doesn’t store the extra vitamins, it doesn’t use the extra vitamins, it doesn’t just make you smarter or better, you just wind up getting rid of it, in whatever way the body’s gonna do it. If you’re lucky, if it’s a fat soluble vitamin you may not just get rid of it in your urine, you can build up potentially toxic levels and the thing with kids is, you know, one of the things with supplements is at risk for kids is, as an ER doc I will say that a lot of supplements, they’re given in one size form, or a lot of supplements, it may be a pill. One dose. And, it’s the same dose whether you’re 250 pounds, or 50 pounds, and that is a big concern for me with kids, but the other big concern is, let’s just use an example of adults who decide to use melatonin for sleep. What about parents giving supplements like this to their kids? There are some studies that can show a statistically significant benefit for melatonin but we’re talking about kids that fall asleep a little bit earlier and maybe get an extra half hour of sleep, it’s not this mega change like people think for tiny sleep problems.