Social Media Prescriptions Replace Medical Consultation

Social media has today become one of the sources of health information, but there is a line between medical information and product promotion that is sometimes overlooked amid the clamor of likes, views and comments.

According to Ambassador Arjan Aghaz, he wrote: "If your vitamin D is low, comment on the word dose", "Take this supplement to strengthen your eyes", "To prevent hair loss, buy this shampoo" and "If you want to prevent diseases, comment the name of the supplement." We see these sentences among the multitude of posts, stories and videos on social networks. Recommendations that are expressed in a confident tone and are sometimes so simple and tempting that the audience imagines that with a few pills and capsules, they can prevent disease, improve the health of their eyes and skin, or delay the aging process.

Today, social networks have become one of the sources of receiving health information, but there is a boundary between medical information and product promotion, which is sometimes ignored in the frenzy of likes, views, and comments. The audience buys and consumes a product with the impression that a recommendation has been made for their health, without knowing whether they really need it or not, whether the recommended dosage is suitable for them, and whether combining it with other drugs can pose a risk to them. This is how a seemingly simple recommendation about a vitamin or supplement may lead to complications and visits to medical centers instead of helping health.

Have doctors become bloggers or are bloggers doctors?

This question is one of the most important ambiguities of virtual space in the field of health. On the one hand, there are doctors who inform about diseases, warning signs, and prevention methods with the aim of public education, and on the other hand, there are pages where the border between scientific education, prescribing, advertising, and product sales is not easily discernible.

Having a medical degree by itself does not mean that all of a person's advice is correct. Just as a blogger's high number of followers, the professional appearance of his page, or his assertive tone does not guarantee the scientific validity of his statements. Most importantly, even a valid scientific recommendation may not be suitable for everyone. The question is why on many pages, the recommendation to consume a product is accompanied by emphasis and repetition, but the need to check the physical condition, the possibility of side effects, restrictions on consumption and the need to consult a doctor is less talked about? Why do phrases like "take this supplement" or "comment on the product name" appear more often, but explaining who shouldn't take it has a smaller share of content?

Part of the answer should be found in the economy of attention and attraction of advertisements. For some pages, introducing the product can be a source of income. As the number of visitors, interaction and audience increases, the possibility of earning money from advertising increases. In such a situation, introducing a supplement with the promise of strengthening the body or preventing disease may be more attractive than an elaborate explanation of its scientific limitations. This does not mean, of course, that all doctors active on social networks or all advertisements for health products are misleading. The problem is the lack of transparency in some content and the difficulty of distinguishing advertising from education for the general audience.

Saving people from doctors or from advertisements?

On one of the virtual pages, a blogger had written with the theme that people should be saved from the hands of doctors. According to him, doctors do not tell people what supplements to take to prevent diseases, because their income is provided by people's diseases.

In response to this article, one of the audience responded with a critical tone that people should be saved from bloggers who introduce any product to receive advertising money. Regardless of the harsh tone of both sides, this debate raises an important question: what criterion does the audience need to distinguish scientific advice from advertising claims?

Evidence-based medicine does not mean that everyone should take drugs or supplements to prevent disease. In many cases, proper nutrition, physical activity, adequate sleep, age-appropriate screening and control of underlying diseases are the main measures to maintain health. Supplements are also valuable when the need for them is identified or their use is recommended in certain conditions.

The fact that a doctor does not prescribe a supplement for a person does not necessarily mean concealment. That person may not have a deficiency, there is not enough evidence to use the supplement in question, or the risks of taking it may outweigh the possible benefits. On the other hand, criticizing the unnecessary prescription of medicine or the improper performance of some doctors should not lead to absolute distrust of medical knowledge. Replacing a qualified expert with a person who publishes their information in the form of short videos and advertisements does not necessarily mean a more informed choice.

A few days ago, a colleague mentioned someone at work. This person has set up a page on social networks and explained about the properties of herbal medicines and their use for various problems. He introduced himself as a traditional medicine doctor and gave advice to the audience. While his main job was a servant and he always dreamed of becoming a doctor! Now everyone calls him doctor in the company!

Such an example raises an important issue: how should the audience evaluate the professional competence of someone who is commenting on their health? Of course, based on this narration alone, it is not possible to give a definitive verdict about the competence or lack of competence of that person. But in cyberspace, titles such as "specialist", "health consultant" or "therapist" may be used without a clear explanation of education, licensure and limits of professional competence.

The audience usually does not have the possibility to immediately review all these claims. He might trust the credibility of what he says by seeing a few trending videos, positive comments from followers, or a product endorsement by a celebrity. Meanwhile, the responsibility is not only on the shoulders of the audience. Transparency about the promotional nature of the content, the possibility of checking the professional qualification of people and monitoring treatment claims are among the issues that should be considered in the policy and monitoring of health content. However, until the client is certain of the validity of a recommendation, it should not be used as a basis for starting, stopping, or changing the dosage of the drug.

One of the common beliefs is that because vitamins and supplements are good for the body, there is no harm in consuming them. This idea is not correct. Supplements can be helpful under the right conditions, but dosage, product composition, individual health status, and concomitant medications play a role in their safety. For example, consider a person who decides to take iron pills because of anemia or fatigue. If the cause of his symptoms is not iron deficiency, taking this supplement will not necessarily help improve his condition. In a person whose body's iron reserves are high or suffering from disorders such as iron overload, iron consumption for no reason can even be harmful.

Diagnosing the need for iron is also not possible based on feeling tired or pale. The doctor decides on the need for treatment based on the history and appropriate tests, including blood cell counts and indicators of iron stores. The same applies to vitamin D. If the test result shows a low level of this vitamin, the doctor may prescribe a supplement, but the choice of dosage and duration of use depends on the deficiency, physical condition, underlying diseases and other factors. It is not possible to prescribe the same intake plan for all people whose vitamin D levels are below a certain number.

For example, a general recommendation to take two tablets of 50,000 units per week, without knowing the test result, medical history and condition of the person, can be dangerous. Excessive consumption of vitamin D may increase calcium in the blood and damage the kidneys. If the deficiency is not resolved with appropriate treatment, the doctor can investigate possible causes such as malabsorption or some underlying diseases based on the individual's condition.

From strengthening the eyes to the risk of unnecessary consumption

Supplements related to eye health are among the products that are introduced in cyberspace with promises about improving vision, maintaining retinal health, and preventing eye problems. But the name of a product or the phrase "eye health support" does not mean the treatment of all diseases of this organ.

For example, some PreserVision supplement formulas are based on compounds investigated in studies of age-related macular degeneration, or macular degeneration. Some of these formulas can play a role in reducing the risk of developing this disease for a specific group of patients; But they do not mean treating cataracts, correcting refractive errors or preventing all eye diseases. Product formulations vary, and even two products of the same brand may not have the same formula. Old formulas containing beta-carotene are also not suitable for smokers and those who have a history of smoking, due to the increased risk of lung cancer in related studies. Therefore, it is important to know the ingredients of the product.

Regarding other supplements, such as Eye Vision Foruaro, just putting the title "eye health" on the packaging or promoting it on a popular page does not prove the necessity of its use or its effectiveness for a particular disease. Ingredients, dosages, scientific evidence, and user conditions should be reviewed.

Interferences that remain in the captions

One of the most important risks of arbitrary use of supplements is their interaction with other drugs. A person who chooses a supplement regardless of their medication may inadvertently increase the risk of complications or reduce the effectiveness of their treatment.

For example, taking iron and calcium supplements at the same time can reduce iron absorption. Some supplements containing zinc and magnesium may also affect the absorption of drugs or other minerals in certain conditions. The issue is not limited to supplements. Omega 3 should also be checked according to the dosage and the condition of the person. Regular use of this supplement does not necessarily pose a high risk in many people, but high doses or simultaneous use with drugs such as warfarin and other drugs that affect blood coagulation require more careful consideration. Aspirin can also affect the risk of bleeding in some situations. On the other hand, diclofenac alone may cause gastrointestinal complications and bleeding; Therefore, the history of gastric ulcer, underlying diseases and concomitant medications should be considered. This does not mean that anyone who takes omega-3s should completely stop taking them or that they cannot take any other medication. The right decision depends on the dosage, the reason for the prescription, the individual's condition and the type of concomitant medications. The problem is that in a short video or advertising caption, there is usually not enough opportunity and motivation to explain all these exceptions. The phrase "this supplement is useful for the health of the body" does not take the place of answering these questions: for whom, at what dose, under what conditions and with what drugs?

Future seniors and concerned parents

Among the audience of supplement advertisements, two groups may be exposed to tempting advice more than others: people who are worried about their physical strength and eyesight declining as they age, and parents who want to strengthen their children's health from the very first years of life.

As we age, it is normal to worry about memory, vision, bones, mobility, and chronic diseases. Advertisements that promise a supplement can prevent premature aging or dramatically increase physical performance capitalize on this concern.

But the nutritional needs of people at different ages are not the same. A supplement that is useful for a person with a certain deficiency is not necessarily necessary for another person with proper nutrition and without that deficiency. Even in the elderly, underlying diseases, kidney and liver function, and medications taken should be considered in decision-making. Parents may also see the advertisement of a multivitamin or nutritional supplement and think that its consumption will prevent physical weakness or illness of their child. While children's need for supplements depends on age, diet, growth, health status and medical recommendations. Excessive use of some vitamins and minerals in children can be harmful, and some supplements in large amounts even cause the risk of poisoning. It is understandable to worry about the health of loved ones, but the answer to this concern should not lead to the continuous purchase and consumption of supplements whose necessity is not clear.

In cyberspace, users are usually asked to check the authenticity of the content before trusting it. This advice is necessary, but not sufficient. The average audience does not necessarily have the necessary medical knowledge to distinguish a valid claim from a false recommendation. He cannot be expected to review all the scientific evidence, dosages, interactions and limitations of a product on his own. Therefore, the responsibility of providing information is on the shoulders of content producers, doctors, advertising companies, sellers of health products and regulatory bodies. Advertising must be distinguishable from medical education, and therapeutic claims must not be made without valid support. In recent years, the follow-up committee of the protocol for combating drug, supplement and edible drink smuggling was held, and in it, Abolfazl Najarian, the deputy adviser of food and drug, emphasized that any buying, selling and advertising of drugs in the cyber space is prohibited and is a crime, and said: "Doctors should also have a license from the Food and Drug Organization for their advertising in the cyber space.