Dietary supplements are banned in Nepal but they are still a fad among peopleThe drug regulator says it will hold a meeting with Nepal Medical Council to discuss ways to discourage doctors from prescribing such supplements.
Last month, the Medical Oncology Department at BP Koirala Memorial Cancer Hospital in Chitwan prohibited doctors from prescribing food and dietary supplements to patients. Doctors serving at the department said such supplements neither cure ailments nor improve health conditions.
"Regular healthy diet can provide all necessary vitamins, minerals and other nutrients our body needs," said Dr Jaya Shrestha, chief of the Medical Oncology Department at the hospital. "Food and dietary supplements are unnecessary and costly and they can sometimes involve health risks."
Even though the Department of Drug Administration, the drug regulatory body, has banned the import and sale of such dietary supplements, doctors have been found to be prescribing them.
In a bid to stop doctors from unnecessarily prescribing such supplements, the department is planning a meeting with Nepal Medical Council, the national regulatory authority of medical practitioners.
"We will discuss the matter with the council as doctors are generously prescribing such supplements and pharmacies are selling them abundantly,” said Pan Bahadur Chhetri, director general at the Department of Drug Administration.
Both doctors and patients need to exercise prudence while taking such supplements which come in various forms—pill, capsule, powder or liquid.
“There is a tendency among doctors to prescribe dietary and food supplements to patients. When patients indeed need additional supplements, such dietary supplements do not work,” said Dr Aruna Upreti, a nutritionist. "Capsules or injections are needed in exceptional cases. Regular healthy food is sufficient in most cases to get the required vitamins and minerals for our body."
On Tuesday, the department issued a public notice, directing medical practitioners to refrain from prescribing dietary supplements. The department has also warned suppliers and pharmacists against selling the banned supplements.
According to the department, it is also concerned about the quality of such dietary supplements that are sold in the market.
"We do not conduct quality tests on such supplements. The department put a ban on such supplements 27 years ago,” said Santosh KC, spokesperson for the department.
Such dietary supplements available in the market are regulated by the Department of Food Technology and Quality Control as food items, not drugs. KC said he wondered why the Department of Food Technology and Quality Control has been allowing the import of such supplements which are banned.
Mohan Krishna Maharjan, spokesperson for the Food Quality Control Department, said that his office has given permission to import dietary supplements, as they come under the food category.
“We first register the product and go through the documents of the companies that produce such supplements before allowing their import,” said Maharjan.
On the drug department’s objection to the import of such supplements, Maharjan said it should focus on ensuring the quality of medicines. “We look after the food products,” he said. “The food department looks after food products and supplements all over the world including in India and the United States of America.”
If what the Department of Food Technology and Quality Control says is anything to go by, it just conducts quality tests on such dietary supplements and does not guarantee whether the products work. Labels on such dietary supplements usually claim certain health benefits. Experts, however, say there is little evidence that they have any curative benefits, nor do they treat and prevent disease.
“They can sometimes cause harm to patients’ health. Antioxidants like vitamin C and vitamin E can reduce the effectiveness of some cancer chemotherapy drugs,” said Shrestha. “A high dose of vitamin B6 for a long time can cause nerve damage. Likewise, vitamin E, when used excessively, can cause bleeding.”
In its notice issued on Tuesday, the department has also put out a list of supplements— vitamins A, B1, B2, B6, B12, C, D, E, niacinamide, d-Pantothenic acid or its salt and Panthenol and folic acid—that can be sold in prescribed doses. The department has also decided to take action against pharmacies if they are found selling banned supplements.
According to experts, if people want to take any kind of supplements, they should discuss their dietary plan with their doctors. Upreti, however, laid emphasis on acquiring vitamins, minerals and other nutrients primarily from food.
According to Upreti, doctors should advise patients to eat a variety of healthy foods instead of prescribing dietary supplements.
“Actually, medicines cost very little,” said Upreti. “By prescribing dietary supplements, doctors, who are often prompted by suppliers, are forcing people to fork out more money.”