Stop Supplement Confusion and Other Secrets

Q. I get totally overwhelmed when I need to buy supplements. There are so many brands, and I have no idea which to trust. What do you recommend?
-- April, via e-mail

A. You're smart not to just buy any old product. Supplements are classified as food products, not medicines, and aren't regulated by the strict standards used for other over-the-counter meds, like pain relievers and cold remedies. From brand to brand, quality control is, as we like to say, "eclectic." Buy two bottles of an herb such as saw palmetto from two manufacturers; even if the labels say all the ingredients are identical, they may not be -- and there may not even be much saw palmetto in either bottle.

Luckily, there's one precaution you can take. When we buy supplements, we look for the "USP-verified" mark on the label. This means the United States Pharmacopeia, a reliable nonprofit science organization, has tested and verified the contents of the supplement. Of course, that doesn't mean it works! But it's the best evidence you'll get that the pills actually contain what the manufacturer claims they do.

Q. Can I exercise if I have a cold? It's taken a while to work my way up from walking 1 mile to 4, and I'm worried that stopping when I'm sick will make me have to start over again at 1 mile.
-- Raymond, Toronto

A. First, keep walking regularly -- it may prevent you from catching a cold in the first place. But if you do get one, the general rule is that if your symptoms are from the neck up -- runny nose, sore throat -- you can still do moderate exercise, such as walking. Just save more demanding workouts until those symptoms are gone. If you have a fever or muscle aches, rest up until they go away. A few days off will not set you back to square one; it takes longer than that! In one study, it took 3 months of doing nothing for people who worked out to lose most of their fitness gains. That said, get back out there as soon as you can.

Q. Do I need to worry about the safety of Botox? I've heard it can cause allergic reactions in the brain or paralyze your diaphragm, keeping you from breathing.
-- Joyce, Pasadena, CA

A. Botox is a brand name for a purified form of botulinum toxin, a product that stops muscles from contracting and creating wrinkles. Botox injections used for cosmetic purposes don't carry the risks you mention. If you get them done by a trained physician, he or she will use a very thin needle, so the toxin can't get into the veins. However, noncosmetic forms of botulinum toxin are increasingly used for muscle problems in other parts of the body. Those forms can be very strong and can have contaminants.

But the cosmetic form is safe if used properly and in the right places. Don't get Botox injected around your mouth (there are other products for that area). You could wind up with a droopy lip and drool for a few months until it wears off, and we're pretty sure that's not the look you're going for.

Q. My dad passed his eye test, but he still doesn't seem to see well when he drives. Did the eye doctor miss something?
-- Abraham, via e-mail

A. Vision isn't just about sight -- it's about neurological functioning. So your dad may be able to see everything well in isolation, but have trouble pulling it together and focusing on what's important. Add that to the fact that older eyes have a harder time seeing when the light is dim, and a harder time recovering from the bright lights of oncoming traffic, and you've got a perfect storm for driving problems. Since it's also harder to judge objects moving toward you, and because left-hand turns account for the biggest incidence of car accidents, we often tell older patients that three right turns really do make a left.