A modified model for understanding depression and anxiety ought to involve a whole person, integrative approach.
Public acts of violence seem to fill the news media streams these days and are typically followed by outcries for greater access to mental health care for those that need it most. And although almost all individuals with serious mental illness are not dangerous, many of the perpetrators of these heinous crimes later turn out to have a documented history of depression or mental illness, which often went untreated.
So, what can we do to stop the anguish? What is it that we are missing?
The Cost of Failure
Unfortunately, the number of Americans affected by serious depression and anxiety disorders is enormous, as are the costs to society due to failure to treat and/or treatment failure. Tens of millions of Americans suffer from depression, including chronic, low-grade depression (dysthymia) and anxiety. 21 million of those Americans have been diagnosed with major depressive disorder (MDD), the leading cause of disability for people ages 15 to 44.
The cost of failing to effectively treat these conditions is not just the individual’s inability to complete college, hold a job or cultivate positive relationships; it also includes the toll taken on an entire family and community when a despairing person takes their own life. And in other cases, the costs of acts of public violence – in terms of suffering, municipal expenses, personal medical and legal expenses, and lost human potential – are immeasurable.
Michael, a 17-year-old high school student, came to see me with a long history of hospitalizations after attempting to take his own life. Despite undergoing intensive psychiatric treatment, he remained depressed and suicidal. Like 40 percent of those who suffer from major depressive disorder, Michael was not responding to treatment.
When contemplating a situation like Michael’s, the question “What am I missing?” is never far from my mind. Statistics show that only about one-third of patients with MDD respond to antidepressant medication, with about the same number responding to psychotherapy alone. If we combine the two approaches the numbers improve slightly, but the fact remains that most people with MDD respond only partially to medical interventions, with almost half remaining entirely unresponsive.
A Central Nervous System in Turmoil
There is a mountain of scientific research demonstrating that neuropsychiatric conditions such as depression, anxiety disorders, and possibly bipolar disease are, in a very high percentage of cases, the result of inflammation occurring in the brain.
There is a great deal of research linking generalized inflammation to heart disease, chronic pain, and obesity. Inflammation in the body takes many forms: When we have an allergic response to pollen or food, our bodies’ inflammatory response includes the release of histamine, which makes our eyes itch and noses run; we see the inflammation associated with a skin wound when the white cells of our immune system respond to a bacterial infection. Inflammation in our brains, however, is unique in that it is mediated by tiny cells called microglia.
Microglia are the innate immune system of the central nervous system (CNS). Their job is to respond to trauma and damage to the brain. In response to brain injury, the microglia release a virtual symphony of chemical mediators that orchestrate the destruction of bacterial invaders, the elimination of damaged neuronal tissue, and the initiation of the repair process.
After responding to an assault on the brain, microglia typically return to a resting state. But ongoing and cumulative assaults to the brain will cause the microglia to remain chronically up-regulated, causing them to continuously spew out inflammatory, tissue-destroying chemicals. Examples of ongoing assaults include fever, physical assault, and emotional trauma. It can also be infections like Lyme disease or COVID-19.
Since the beginning of the COVID-19 pandemic, researchers have been studying how the SARS-CoV-2 virus affects the CNS as well as other body systems. What they are finding out is that it too heightens the activity of microglia leading to the release of inflammatory cytokines and a sequence of damaging events that can affect the brain and have other long-term effects on health.
Brain inflammation can produce a wide range of symptoms including depression, anxiety, chronic pain, difficulty focusing and concentrating, fatigue, and sleep disturbances.
Further compounding the issue is the fact that a solid understanding of the role of microglia in brain health is sadly lacking among most medical professionals, with the result that they continue to treat what are in fact “symptoms” as separate and unique “diseases.”
Looking Beyond the Symptoms
A better framework, where physicians look beyond the symptoms, involves giving priority to the discovery of the root causes of an individual’s depression or anxiety. This primarily requires an understanding of what caused the microglia to up-regulate.
Research has shown that anything that can damage neuronal tissue can be a trigger. So, an exploration of a patient’s depression may include asking them about possible traumatic head injuries, psychological traumas (acute events and chronic stress), infections (as mentioned above, tick-borne diseases, other bacteria, and viruses like Covid-19), and even biotoxins that may have entered the body from exposure to toxic molds, celiac disease, and hypoxia (usually related to sleep apnea). The list of triggers is long, and as such, the process of identifying the possible underlying causes of the disease requires putting together a thorough medical health timeline for each patient. By using this approach, treatment options expand due to the greater understanding of the origin of the illness, thereby increasing prospects for recovery.
As for Michael, my 17-year-old patient who was depressed and suicidal, it turned out that he has celiac disease. But how could a food allergy be related to his depression? Celiac disease is far more than an allergy to gluten – it is a very serious autoimmune disorder that’s triggered when even the smallest amount of gluten is ingested. As we know, with autoimmune disorders the immune system mistakenly attacks the body’s normal cells. In the case of celiac disease, when gluten is consumed the immune system goes into attack mode and causes damage to the healthy villi of the gut lining. Villi are responsible for absorbing nutrients and keeping food particles and toxins from entering the bloodstream. When the gut lining is compromised and toxins enter the bloodstream, widespread inflammation can occur, and this inflammatory response can affect more than the digestive system – it can cause inflammation in the brain. Research shows that people with celiac disease are at greater risk of neurological damage and mental health issues in addition to other serious chronic health conditions.
Michael, now gluten-free, is no longer depressed and he has re-engaged in life. He continued with antidepressant medications for a period of time, but slowly weaned himself from them under medical supervision (it takes time for the brain to heal after the assault is removed). His life has been changed, for the better, forever.
It is my hope that, with a modified model for understanding depression and anxiety, involving a “whole” person, integrative approach, more patients will be correctly diagnosed and treated, as Michael was. In his case, and I suspect in many more, we’re learning that all too often, depression is not just depression.
This article originally appeared in US News and World Reports, May 12, 2015. It was reviewed and updated in May 2023.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Additional references
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18].
Research shows that one-quarter of post-menopausal women eventually suffer from compression or collapsing of some vertebrae, the bones that comprise the spinal column. Compression fractures can not only increase one’s risk of future fractures, but they can also compromise one’s ability to function and may cause disabling chronic back pain.
Although these injuries are common, they can usually be prevented, delayed, or mitigated by adopting a healthy lifestyle that includes:
1. Engage in resistance training, such as weight training, yoga, or Qigong every other day, ideally for 30-60 minutes per workout.
There is good news for those who struggle to find those 30-60 minutes: a 10-year study that was completed in 2015 measured the bone mineral density (BMD) of 741 participants pre and post-yoga regimen. Participants who routinely engaged in 12 yoga poses each day for just 12 minutes showed a reversal of osteoporotic bone loss.
2. Do weight-bearing exercises like running, walking, or hiking, for at least 30 minutes each day.
Weight-bearing exercises work against gravity and stimulate bone cells to produce more bone.
3. Get your Vitamin-D levels tested to ensure that they’re between 50-70 ng/mL.
If your levels are low, consider getting more sunshine (exposing some of your skin for 15-30 minutes each day) and taking a supplement. Most people need between 3,000 to 5,000iu of supplementation, but some may need up to 10,000 international units. If you take Vitamin-D supplementation, your 25-hydroxy Vitamin-D level should be checked twice a year.
4. Check your calcium and magnesium intake.
Women should consume a total daily amount of calcium between 1200 and 1500 mg, with no more than 600 mg from supplemental calcium. Taking in more than this amount in supplemental form can lead to an increased risk of heart disease and kidney stones. Good sources of dietary calcium are sardines, white beans, almonds, oranges, leafy greens, and dairy.
Taking magnesium can increase bone mineral density and reduce fracture risk.
Before prescribing medications, we at Kaplan Center explore the possibility of using bioidentical estrogens and progesterone or estrogen analogues like Evista to prevent bone loss.
6. Talk with your doctor before using medications to treat bone loss.
Because most of these medications work by decreasing bone breakdown, this can potentially cause more brittle, unhealthy bone, and result in fractures of the femur and jaw necrosis. We generally reserve medication treatment for those with severe osteoporosis or a history of pathological fractures. Before considering bisphosphonates, like Fosomax, Actonel, Boniva, Reclast, or a newer injectable, Prolia, it is recommended to complete dental procedures before starting treatment for osteoporosis. Report any persistent jaw or thigh pain to your healthcare provider immediately.
Another treatment option is Miacalcin, a synthetic version of the hormone, calcitonin. It has been shown to build bone more in the spine than in the hip, offering users some pain relief. Two alternatives to the bisphosphonates and Miacalcin are Forteo and Tymlos, synthetic versions of a hormone called parathyroid hormone which also builds bone. Some of these drugs, however, carry warnings about an increased risk of bone tumors called osteosarcoma.
7. Consider Bone-Density Imaging
It’s important to evaluate the effectiveness of any medications or hormone replacement therapies you may use because each individual inevitably has their own unique response to a given treatment. A bone-density test can help measure the therapeutic benefits of any treatment path you have chosen.
8. Vitamin K supplementation.
Research on Vitamin K and postmenopausal bone loss has shown that it can have a positive effect on bone strength. This 2022 meta-analysis that looked at 16 randomized controlled trials and included 6,425 subjects concluded that “Vitamin K2 supplementation has a positive effect on the maintenance and improvement of [bone mass density lumbar spine] in postmenopausal women, and it can also reduce the fracture incidence”. Supplements are a great way to improve your health, but you should always discuss any new supplements or medications with your provider to ensure that it would be a good option for your unique health profile.
In sum, there’s a lot you can do to keep your bones strong! So, do it!
If you would like to talk to a Kaplan provider about any of the treatments above, please give us a call at 703-532-4892.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
This article was originally published online in May, 2018. Its content was reviewed and updated in May, 2023.
Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, Riva A, Petrangolini G, Peroni G. An update on magnesium and bone health. Biometals. 2021 Aug;34(4):715-736. doi: 10.1007/s10534-021-00305-0. Epub 2021 May 6. PMID: 33959846; PMCID: PMC8313472.
During the Covid-19 pandemic, many people turned to sleeping pills and supplements to improve disturbed sleep cycles either for themselves or for their children.
In 2022, prompted by a large increase in pediatric melatonin poisonings, particularly during the pandemic, researchers from the Cambridge [MA] Health Alliance and the University of Mississippi looked to assess several brands of the popular sleep supplement, melatonin. What they specifically wanted to examine was the quantity of melatonin as compared to its label and if any other non-labelled ingredients such as cannabidiol (CBD) were present.
The study, which was published in JAMA in April 2023, looked at 25 over-the-counter brands of melatonin gummies and found that most of them (88%) contained more melatonin than the labeled quantity, in some cases far more, and five brands even contained CBD! While the study only looked at a small sample of supplements, this is not very reassuring for the supplements industry.
To understand how this can happen you have to understand how the Federal Drug Administration (FDA) “regulates” supplements. The FDA does not approve dietary supplements before going to market; their role in regulating supplements begins after the product is available to consumers. According to the Dietary Supplement Health & Education Act of 1994 (DSHEA)
Manufacturers and distributors of dietary supplements and dietary ingredients are prohibited from marketing products that are adulterated or misbranded. That means that these firms are responsible for evaluating the safety and labeling of their products before marketing to ensure that they meet all the requirements of the Federal Food, Drug, and Cosmetic Act as amended by DSHEA and FDA regulations.(1)
FDA has the authority to take action against any adulterated or misbranded dietary supplement product after it reaches the market.(2)
Again, it is the manufacturer’s responsibility to provide a good, safe product that is effective and free of impurities and contaminants. The FDA will act only when an issue has been brought to their attention.
Now, are all sleeping aids bad? Do you have to stop buying supplements? Absolutely not. But we must work within the framework we are given, which means when it comes to buying supplements, making sure you’re buying from a trusted source.
Once restricted to just our patients, in 2021 we opened The Kaplan Center Store to the public. Now anyone looking to buy high-quality supplements can access our store. Our providers have taken the time to vet every one of the manufacturers we carry and can attest to the fact that they provide a quality product that’s been thoroughly tested and contains the ingredients it claims to contain.
Supplements are not a replacement for a healthy diet and lifestyle but can provide essential nutrients and support when deemed necessary. And remember, before you start taking any new supplement or medication, make sure to talk to your provider to avoid any possible drug interactions or adverse reactions.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Is Depression Ever Just Depression?
/in Inflammation, Long Covid, Mental Health/by Gary Kaplan, DOA modified model for understanding depression and anxiety ought to involve a whole person, integrative approach.
Public acts of violence seem to fill the news media streams these days and are typically followed by outcries for greater access to mental health care for those that need it most. And although almost all individuals with serious mental illness are not dangerous, many of the perpetrators of these heinous crimes later turn out to have a documented history of depression or mental illness, which often went untreated.
So, what can we do to stop the anguish? What is it that we are missing?
The Cost of Failure
Unfortunately, the number of Americans affected by serious depression and anxiety disorders is enormous, as are the costs to society due to failure to treat and/or treatment failure. Tens of millions of Americans suffer from depression, including chronic, low-grade depression (dysthymia) and anxiety. 21 million of those Americans have been diagnosed with major depressive disorder (MDD), the leading cause of disability for people ages 15 to 44.
The cost of failing to effectively treat these conditions is not just the individual’s inability to complete college, hold a job or cultivate positive relationships; it also includes the toll taken on an entire family and community when a despairing person takes their own life. And in other cases, the costs of acts of public violence – in terms of suffering, municipal expenses, personal medical and legal expenses, and lost human potential – are immeasurable.
Michael, a 17-year-old high school student, came to see me with a long history of hospitalizations after attempting to take his own life. Despite undergoing intensive psychiatric treatment, he remained depressed and suicidal. Like 40 percent of those who suffer from major depressive disorder, Michael was not responding to treatment.
When contemplating a situation like Michael’s, the question “What am I missing?” is never far from my mind. Statistics show that only about one-third of patients with MDD respond to antidepressant medication, with about the same number responding to psychotherapy alone. If we combine the two approaches the numbers improve slightly, but the fact remains that most people with MDD respond only partially to medical interventions, with almost half remaining entirely unresponsive.
A Central Nervous System in Turmoil
There is a mountain of scientific research demonstrating that neuropsychiatric conditions such as depression, anxiety disorders, and possibly bipolar disease are, in a very high percentage of cases, the result of inflammation occurring in the brain.
There is a great deal of research linking generalized inflammation to heart disease, chronic pain, and obesity. Inflammation in the body takes many forms: When we have an allergic response to pollen or food, our bodies’ inflammatory response includes the release of histamine, which makes our eyes itch and noses run; we see the inflammation associated with a skin wound when the white cells of our immune system respond to a bacterial infection. Inflammation in our brains, however, is unique in that it is mediated by tiny cells called microglia.
Microglia are the innate immune system of the central nervous system (CNS). Their job is to respond to trauma and damage to the brain. In response to brain injury, the microglia release a virtual symphony of chemical mediators that orchestrate the destruction of bacterial invaders, the elimination of damaged neuronal tissue, and the initiation of the repair process.
After responding to an assault on the brain, microglia typically return to a resting state. But ongoing and cumulative assaults to the brain will cause the microglia to remain chronically up-regulated, causing them to continuously spew out inflammatory, tissue-destroying chemicals. Examples of ongoing assaults include fever, physical assault, and emotional trauma. It can also be infections like Lyme disease or COVID-19.
Since the beginning of the COVID-19 pandemic, researchers have been studying how the SARS-CoV-2 virus affects the CNS as well as other body systems. What they are finding out is that it too heightens the activity of microglia leading to the release of inflammatory cytokines and a sequence of damaging events that can affect the brain and have other long-term effects on health.
Brain inflammation can produce a wide range of symptoms including depression, anxiety, chronic pain, difficulty focusing and concentrating, fatigue, and sleep disturbances.
Further compounding the issue is the fact that a solid understanding of the role of microglia in brain health is sadly lacking among most medical professionals, with the result that they continue to treat what are in fact “symptoms” as separate and unique “diseases.”
Looking Beyond the Symptoms
A better framework, where physicians look beyond the symptoms, involves giving priority to the discovery of the root causes of an individual’s depression or anxiety. This primarily requires an understanding of what caused the microglia to up-regulate.
Research has shown that anything that can damage neuronal tissue can be a trigger. So, an exploration of a patient’s depression may include asking them about possible traumatic head injuries, psychological traumas (acute events and chronic stress), infections (as mentioned above, tick-borne diseases, other bacteria, and viruses like Covid-19), and even biotoxins that may have entered the body from exposure to toxic molds, celiac disease, and hypoxia (usually related to sleep apnea). The list of triggers is long, and as such, the process of identifying the possible underlying causes of the disease requires putting together a thorough medical health timeline for each patient. By using this approach, treatment options expand due to the greater understanding of the origin of the illness, thereby increasing prospects for recovery.
As for Michael, my 17-year-old patient who was depressed and suicidal, it turned out that he has celiac disease. But how could a food allergy be related to his depression? Celiac disease is far more than an allergy to gluten – it is a very serious autoimmune disorder that’s triggered when even the smallest amount of gluten is ingested. As we know, with autoimmune disorders the immune system mistakenly attacks the body’s normal cells. In the case of celiac disease, when gluten is consumed the immune system goes into attack mode and causes damage to the healthy villi of the gut lining. Villi are responsible for absorbing nutrients and keeping food particles and toxins from entering the bloodstream. When the gut lining is compromised and toxins enter the bloodstream, widespread inflammation can occur, and this inflammatory response can affect more than the digestive system – it can cause inflammation in the brain. Research shows that people with celiac disease are at greater risk of neurological damage and mental health issues in addition to other serious chronic health conditions.
Michael, now gluten-free, is no longer depressed and he has re-engaged in life. He continued with antidepressant medications for a period of time, but slowly weaned himself from them under medical supervision (it takes time for the brain to heal after the assault is removed). His life has been changed, for the better, forever.
It is my hope that, with a modified model for understanding depression and anxiety, involving a “whole” person, integrative approach, more patients will be correctly diagnosed and treated, as Michael was. In his case, and I suspect in many more, we’re learning that all too often, depression is not just depression.
This article originally appeared in US News and World Reports, May 12, 2015. It was reviewed and updated in May 2023.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Additional references
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18].
Mohammadkhanizadeh A, Nikbakht F. Investigating the potential mechanisms of depression induced-by COVID-19 infection in patients. J Clin Neurosci. 2021 Sep;91:283-287. doi: 10.1016/j.jocn.2021.07.023. Epub 2021 Jul 20. PMID: 34373041; PMCID: PMC8289699.
8 Steps That Can Help You Prevent Painful Compression Fractures
/in Bone Health, Lifestyle/by Lisa Lilienfield, MDResearch shows that one-quarter of post-menopausal women eventually suffer from compression or collapsing of some vertebrae, the bones that comprise the spinal column. Compression fractures can not only increase one’s risk of future fractures, but they can also compromise one’s ability to function and may cause disabling chronic back pain.
Although these injuries are common, they can usually be prevented, delayed, or mitigated by adopting a healthy lifestyle that includes:
1. Engage in resistance training, such as weight training, yoga, or Qigong every other day, ideally for 30-60 minutes per workout.
There is good news for those who struggle to find those 30-60 minutes: a 10-year study that was completed in 2015 measured the bone mineral density (BMD) of 741 participants pre and post-yoga regimen. Participants who routinely engaged in 12 yoga poses each day for just 12 minutes showed a reversal of osteoporotic bone loss.
2. Do weight-bearing exercises like running, walking, or hiking, for at least 30 minutes each day.
Weight-bearing exercises work against gravity and stimulate bone cells to produce more bone.
3. Get your Vitamin-D levels tested to ensure that they’re between 50-70 ng/mL.
If your levels are low, consider getting more sunshine (exposing some of your skin for 15-30 minutes each day) and taking a supplement. Most people need between 3,000 to 5,000iu of supplementation, but some may need up to 10,000 international units. If you take Vitamin-D supplementation, your 25-hydroxy Vitamin-D level should be checked twice a year.
4. Check your calcium and magnesium intake.
Women should consume a total daily amount of calcium between 1200 and 1500 mg, with no more than 600 mg from supplemental calcium. Taking in more than this amount in supplemental form can lead to an increased risk of heart disease and kidney stones. Good sources of dietary calcium are sardines, white beans, almonds, oranges, leafy greens, and dairy.
Taking magnesium can increase bone mineral density and reduce fracture risk.
5. Consider bioidentical hormone replacement therapy.
Before prescribing medications, we at Kaplan Center explore the possibility of using bioidentical estrogens and progesterone or estrogen analogues like Evista to prevent bone loss.
6. Talk with your doctor before using medications to treat bone loss.
Because most of these medications work by decreasing bone breakdown, this can potentially cause more brittle, unhealthy bone, and result in fractures of the femur and jaw necrosis. We generally reserve medication treatment for those with severe osteoporosis or a history of pathological fractures. Before considering bisphosphonates, like Fosomax, Actonel, Boniva, Reclast, or a newer injectable, Prolia, it is recommended to complete dental procedures before starting treatment for osteoporosis. Report any persistent jaw or thigh pain to your healthcare provider immediately.
Another treatment option is Miacalcin, a synthetic version of the hormone, calcitonin. It has been shown to build bone more in the spine than in the hip, offering users some pain relief. Two alternatives to the bisphosphonates and Miacalcin are Forteo and Tymlos, synthetic versions of a hormone called parathyroid hormone which also builds bone. Some of these drugs, however, carry warnings about an increased risk of bone tumors called osteosarcoma.
7. Consider Bone-Density Imaging
It’s important to evaluate the effectiveness of any medications or hormone replacement therapies you may use because each individual inevitably has their own unique response to a given treatment. A bone-density test can help measure the therapeutic benefits of any treatment path you have chosen.
8. Vitamin K supplementation.
Research on Vitamin K and postmenopausal bone loss has shown that it can have a positive effect on bone strength. This 2022 meta-analysis that looked at 16 randomized controlled trials and included 6,425 subjects concluded that “Vitamin K2 supplementation has a positive effect on the maintenance and improvement of [bone mass density lumbar spine] in postmenopausal women, and it can also reduce the fracture incidence”. Supplements are a great way to improve your health, but you should always discuss any new supplements or medications with your provider to ensure that it would be a good option for your unique health profile.
In sum, there’s a lot you can do to keep your bones strong! So, do it!
If you would like to talk to a Kaplan provider about any of the treatments above, please give us a call at 703-532-4892.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
This article was originally published online in May, 2018. Its content was reviewed and updated in May, 2023.
Additional References
Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33. doi: 10.3390/nu5083022. PMID: 23912329; PMCID: PMC3775240.
Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, Riva A, Petrangolini G, Peroni G. An update on magnesium and bone health. Biometals. 2021 Aug;34(4):715-736. doi: 10.1007/s10534-021-00305-0. Epub 2021 May 6. PMID: 33959846; PMCID: PMC8313472.
Sleep Supplement Study Exposes Label Inaccuracies
/in News, Nutrition, Treatments/by Kaplan CenterDuring the Covid-19 pandemic, many people turned to sleeping pills and supplements to improve disturbed sleep cycles either for themselves or for their children.
In 2022, prompted by a large increase in pediatric melatonin poisonings, particularly during the pandemic, researchers from the Cambridge [MA] Health Alliance and the University of Mississippi looked to assess several brands of the popular sleep supplement, melatonin. What they specifically wanted to examine was the quantity of melatonin as compared to its label and if any other non-labelled ingredients such as cannabidiol (CBD) were present.
The study, which was published in JAMA in April 2023, looked at 25 over-the-counter brands of melatonin gummies and found that most of them (88%) contained more melatonin than the labeled quantity, in some cases far more, and five brands even contained CBD! While the study only looked at a small sample of supplements, this is not very reassuring for the supplements industry.
To understand how this can happen you have to understand how the Federal Drug Administration (FDA) “regulates” supplements. The FDA does not approve dietary supplements before going to market; their role in regulating supplements begins after the product is available to consumers. According to the Dietary Supplement Health & Education Act of 1994 (DSHEA)
Again, it is the manufacturer’s responsibility to provide a good, safe product that is effective and free of impurities and contaminants. The FDA will act only when an issue has been brought to their attention.
Now, are all sleeping aids bad? Do you have to stop buying supplements? Absolutely not. But we must work within the framework we are given, which means when it comes to buying supplements, making sure you’re buying from a trusted source.
Once restricted to just our patients, in 2021 we opened The Kaplan Center Store to the public. Now anyone looking to buy high-quality supplements can access our store. Our providers have taken the time to vet every one of the manufacturers we carry and can attest to the fact that they provide a quality product that’s been thoroughly tested and contains the ingredients it claims to contain.
Supplements are not a replacement for a healthy diet and lifestyle but can provide essential nutrients and support when deemed necessary. And remember, before you start taking any new supplement or medication, make sure to talk to your provider to avoid any possible drug interactions or adverse reactions.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
(1),(2) U.S. Food & Drug Administration / Dietary Supplements