Prescribed medicines are somewhat resistant to fads. Marketing can certainly drive demand and use, but long-term use tends to be driven by effectiveness. Some medicines used routinely today are decades old (e.g., penicillin for strep throat), because nothing better has been identified. Other drugs may be used for decades, only to largely disappear as newer, more effective treatments are introduced (I’m thinking of drugs like theophylline for airway disease, largely replaced by safer and more effective treatments).
The opposite is often the case with dietary supplements. With some exceptions, supplements tend not to be supported by convincing scientific evidence. Their use is driven by marketing, word-of-mouth, and hype. In the pharmacy we used to call it the Oprah effect or the Dr. Oz effect – remember green coffee bean? Or red palm oil? These supplements surged in popularity only to disappear – because they were ineffective. Effective products have the best sales pitch of all – they work.
My usual first response to a request about the effectiveness of a new supplement is to look at the evidence base. I may go to PubMed and search directly, but I’ll more commonly look at a trustworthy tertiary reference like UpToDate, NatMed, or Examine.com for their take on the product and the evidence. In a lot of cases, there’s little to no evidence worth reviewing, which makes for a boring blog post. I was asked about a product recently that was actually assessed in multiple randomized controlled trials – which makes for better blog fodder, as there’s some science to actually consider.
Maritime Pine Bark
Maritime Pine Bark is a extract from the Pinus pinaster tree, often marketed with the trade name Pycnogenol. The maritime pine is a tree native to Mediterranean countries like Spain, France, Portugal, Italy, Croatia, and Morocco. Its bark is used in supplements for various conditions. Pycnogenol, a patented extract from French maritime pine (pictured above), comes from trees grown only in Landes de Gascogne, in southwest France.
One of the biggest challenges with evaluating clinical trials related to herbal remedies is that products will differ in terms of their chemical constituents. If you think of a herbal remedy as essentially an unrefined drug, the individual compounds in it will vary based on the variety of the plant, when it was harvested, what part of the plant was harvested, and how the supplements was actually prepared. Standardization
What are some reasons why dietary supplements might experience sudden surges in popularity followed by a decline in interest?
## The Supplement Surge and Fade: Why Effectiveness Trumps Hype
**Host:** Welcome back to the show! Today, we’re tackling the world of dietary supplements, something that often seems more driven by trends than scientific evidence. Joining us to shed light on this topic is Dr. Sarah Jones, a pharmacist with extensive experience in navigating the complex landscape of medications and supplements.
Dr. Jones, thanks for being here.
**Dr. Jones:** Thanks for inviting me.
**Host:** Let’s start with the basics. Why do you think dietary supplements seem so prone to sudden popularity leaps, followed by relative obscurity?
**Dr. Jones:** I think it comes down to a question of rigorous testing. Unlike pharmaceuticals, which undergo extensive clinical trials to prove their effectiveness and safety, dietary supplements can be sold without this evidence. This leaves the door open for marketing hype and word-of-mouth to heavily influence consumer choices. We saw this with products like green coffee bean and red palm oil, which experienced a surge in popularity thanks to celebrity endorsements, only to fade once scientific evidence failed to support their claims [[1](https://www.health.harvard.edu/heart-health/dietary-supplements-sorting-out-the-science)].
**Host:** That’s fascinating. So, what’s your advice to someone who’s curious about trying a new supplement?
**Dr. Jones:** My first piece of advice is always to look for scientific evidence. Don’t just rely on marketing claims or anecdotal stories. Reputable sources like PubMed can provide access to clinical trials and research studies. Remember, effective products speak for themselves. If a supplement truly works, the evidence will be there.
**Host:** That’s great advice. Dr. Jones, thank you so much for sharing your expertise with us today.
**Dr. Jones:** You’re welcome.
**Host:** And to our viewers, remember to prioritize evidence-based information when making decisions about your health.
