Are dietary supplements evil? What do doctors think about vitamins and attempts to regulate this market
Amidst statements about the potential tightening of control over the circulation of biologically active additives (BAAs), concern is growing among some medical professionals: instead of solving urgent problems of the healthcare system, the authorities are again trying to “reinvent the wheel.” UNN has gathered the opinions of doctors regarding the possible introduction of new regulation in the BAA market.
BAAs are not medicines, but they are not “harmful pills” either.
First of all, it is important to clearly understand: biologically active additives are not medicinal products, but they are not something dangerous either. In most cases, these are vitamins, microelements, and other substances that support the body during periods of increased stress, dietary restrictions, or for certain clinical indications. For example, vitamin D, magnesium, folic acid, Omega-3 – all these are common BAAs taken by a significant number of Ukrainians. In our country, as in the world, BAAs are considered part of nutrition. And therefore, both here and abroad, they are sold without a prescription.
Today, pharmacies, along with prescription drugs, offer patients a wide selection of health support products – including BAAs. This is a common global practice. And it is important to understand: the fact that a pharmacist offered a BAA does not mean coercion to buy. The decision is always made by the patient themselves.
Separate cash registers or prescriptions for BAAs?
Amidst discussions about regulating the sale of BAAs, proposals are being heard from individual MPs to “separate” these additives in pharmacies – for example, through special cash registers or shelves. However, doctors are convinced that such “innovation” will create confusion, has nothing to do with healthcare, and may have an inverse economic effect for businesses.
Even more destructive seem to be the ideas of making BAAs prescription-only, so that pharmacies would dispense them to patients exclusively with a doctor’s prescription.
“It’s like reinventing the wheel for oneself… This will hinder both patients and doctors,” notes obstetrician-gynecologist Olga Dubenko.
Doctors emphasize: the introduction of prescriptions for BAAs is not just an inconvenience for patients. It is a direct burden on the medical system, which is already working at its limit.
“I spend half a day, log into the system, write a prescription… I believe this is an unnecessary burden for everyone: for the pharmacy, for doctors, and for patients. Especially for BAAs,” says Dubenko.
Oncologist Serhiy Korovin shares a similar opinion. “BAAs are bought freely, that’s the first thing. And the second is that we don’t have many specialists who can navigate this problem… This is a burden on doctors, what you’re talking about is nonsense,” the doctor noted.
BAAs can be useful. But not for the regulator.
Despite the fact that biologically active additives are not medicines, in a number of cases their intake makes sense. For example, if it happens by doctor’s prescription, or if a person understands the needs of their body and decides to take them independently. A vivid example can be the intake of the same “Omega-3” if a person does not consume enough fish, or does not consume a certain type of food. For example, in case of vitamin D deficiency, or in the postoperative period, during diets, for athletes or in stressful conditions, doctors may recommend supplementing the diet with food additives. In any case, it is better to consult a specialist about this.
It should be noted that in some cases, doctors prescribe additional tests to patients to identify a particular deficiency and then recommend a course of vitamins or minerals.
“For example, if I, as a doctor, diagnose anemia, especially myeloblastic anemia, which can be the result of vitamin B12 deficiency, then – yes, I will refer for this analysis,” explained pediatrician Andriy Penkov.
He added that tests are not prescribed to everyone indiscriminately; they are necessary in exceptional cases. Then the body’s needs can be met with vitamin complexes.
The doctor also reminded that, for example, vitamin D is almost the only one that almost everyone needs to take, but for this, the doctor must determine the correct dosage. Often, doctors recommend taking vitamin D in minimal dosages for children.
The intake of biologically active additives is especially relevant for Ukrainian military personnel returning from Russian captivity, where they did not have access to quality nutrition.
“I can imagine how our guys return from captivity, with dystrophy, with a very critical weight loss, and maybe during rehabilitation, along with a diet, they will receive some preparations. Or, for example, people who play sports, they may need a higher level of, say, protein, and this is very difficult to achieve with ordinary food,” Penkov noted.
In general, he reminded that BAAs were created to support the body primarily of astronauts and military personnel who do not have access to quality nutrition during their work. Doctors emphasize that, with a good varied diet, the need for additional microelements may not arise.
The main thing is quality control
In any case, doctors are convinced that there is no need for a ban or additional regulation of BAAs; what is needed is strict quality control of products on the market.
“It is very important that garbage is not sold. Prescriptions will not help here at all,” Penkov directly states.
So BAAs are neither good nor evil. They are a separate category of means that can help support the body in certain situations. There is no need to demonize them, but reducing them to the status of “almost medicines” by introducing prescriptions or special cash registers is even worse. This is additional pressure on patients and doctors, without any proven benefit.
The issue lies in the awareness of patients who make a conscious choice. The Ukrainian healthcare system needs not fake reforms, but real work to improve patients’ lives: personnel, infrastructure, trust. And prescriptions for vitamin C, a separate cash register for magnesium, or a queue to the family doctor for folic acid – this is definitely not what will improve the situation.
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