Physician Select Vitamins are intended to be exclusively used with the referral and supervision of a health care provider. Just as physicians control access to, and supervise the use of, prescription medications, we believe, for reasons discussed below, that your patients will benefit dramatically from provider oversight of their use of nutritional supplements.

The Nutritional Supplement Industry: A Poor Reputation, Richly Deserved

While the FDA closely regulates the development, sales and marketing of pharmaceuticals, the Dietary Supplement Health and Education Act, passed by Congress in 1994, has tied the hands of the FDA, and left the nutritional supplement industry with minimal government oversight or scrutiny. As a result, the industry has become a virtually unregulated "free-for-all." Thousands of supplements are for sale on the internet, in supermarkets, drug stores, and via radio and television advertising. This absence of oversight has created 4 important areas of concern:

• Efficacy
  
  Although the FDA generally prohibits making specific health claims for nutritional supplements, the industry has succeeded in misleading consumers about the efficacy or benefits of many widely sold supplements. Ginkgo biloba, St. John's Wort, kava-kava, and many other supplements have proven worthless in blinded, placebo-controlled studies, yet still account for millions of dollars in sales each year.
  
  Despite the large number of worthless products being sold, a small but growing number of nutritional supplements have been studied in well-designed, placebo controlled scientific trials, and appear to offer real benefits - to specific patients. Recent peer reviewed studies have revealed potential applications of coenzyme Q10 in early Parkinson's patients, BPH symptom relief from saw palmetto extracts, prostate cancer risk reduction from a number of dietary agents, colon cancer risk reduction from calcium supplementation, and real benefits from folate supplementation in cardiac patients. However, these studies have utilized very specific dosages of supplement, with specific patient indications, and often cautioned about potential medication interactions. In short, the intelligent, effective use of nutritional supplements requires the same careful deliberation that is applied to the use of prescription medications.
  
  
• Safety
  
  Over the past several years, a number of nutritional supplements such as kava, ephedrine, lipokinex, and PC-SPES have been found to be either adulterated or unsafe. Often these problems were discovered only after widespread use was already underway. Just because a product is derived from "natural" or "herbal" sources does not assure safety. Many herbal products produce pharmacological effects. Additionally, proper dosage is often a key aspect of supplement safety. Unfortunately, many well meaning patients, believing that "if a little is good, more must be better," will take dangerously high doses of certain supplements. Numerous reports of hemorrhagic bleeding due to vitamin E overdosage have been published in the literature. Overuse of ephedra and other appetite suppressants may cause an increased risk of hypertension and stroke. Since no safety testing of nutritional supplements is required by the FDA, oversight by a health care provider becomes even more important.
  
  
• Product Content and Purity
  
  Prescription medications are produced under a rigid set of FDA guidelines known as "drug GMP's (good manufacturing practices)". Pharmaceutical production facilities are subject to careful inspection, assuring that proper steps are taken in formulation of the product, adequate quality control is in place, and batch testing is performed to certify that each "10 Milligram" pill of a prescription medication actually contains 10 milligrams of active ingredient. Unfortunately, no such oversight of nutritional supplement production exists. The FDA considers nutritional supplements to be "food," and so, regulates the production process in the same way as it would the manufacture of products such as potato chips, ketchup or breakfast cereal. So, while manufacturers are inspected for plant cleanliness, they are not held responsible for product quality. As a result, recently published studies using third party analysis have revealed wide variation in the content and purity of nutritional supplements.
  
  
• Medication/Treatment Interactions
  
  Interactions between nutritional supplements and prescription medications or other treatments are common. Vitamin E and ginkgo biloba can potentiate the effects of anticoagulants. Vitamin E and other antioxidants may interfere with the efficacy of the statins. Saw Palmetto interferes with iron absorption. Ginseng can change blood glucose levels, and should therefore be avoided by diabetics. Patients undergoing radiation therapy may reduce its efficacy if they take antioxidants at the same time. Unfortunately, such interactions may go unrecognized because the health care provider is unaware of the patient's use of a supplement. Alternatively, the provider may simply be unaware that a particular interaction is possible. Obviously, health care providers must develop a broader understanding of the relationship between nutritional supplements and other treatments they recommend or prescribe. They must also be aware of precisely what their patients are taking.
  
  

The Physician Select Vitamins Solution
Physician Select Vitamins was established to address the problems presented above.

• Physician Select Vitamins are created based on credible scientific evidence, formulated with the advice of a medical advisory board of practicing physicians representing various specialties.
  
  
• Physician Select Vitamins formulas and ingredients are constantly being reevaluated in light of the latest research trials.
  
  
• Physician Select Vitamins are manufactured at an FDA approved manufacturing facility located in California and are made with premium quality ingredients.
  
  
• Physician Select Vitamins are not mass-marketed, and are intended to be used under the supervision of a health care provider, as one component of a comprehensive health maintenance program