Patients walk in primed with information from an Internet search and want an official answer. Three experts tackle the questions they hear most.
CHICAGO — Physicians hear it daily: Internet search results prompting questions. Patients walk in primed with information they've gleaned from "Dr Google" and they're looking for the official answer. Three experts summarized their answers to the top questions that patients have after their scrolling sessions. Erin D. Michos, MD, MHS, cardiologist and professor at the Johns Hopkins School of Medicine in Baltimore, said here at the American College of Cardiology Scientific Session 2025 that she gets a lot of questions about dietary supplements. "Should I Take Calcium or Other Supplements?" Thebottom line: "Stop wasting money," Michos said. "Half of US adults take a supplement," but "there is no evidence that taking a daily multivitamin helps cardiovascular outcomes." In a meta-analysis of 18 studies that she coauthored, which included more than 2 million patients taking multivitamin or mineral supplements, "it was essentially a wash," she reported. "We didn't see harm, we didn't see benefit." As for calcium, several studies have suggested that calcium supplements might actually increase the risk for cardiovascular disease, she said. In postmenopausal women, calcium supplements were associated with a 15% increase in the risk for cardiovascular disease and a 16% increase in coronary disease, according to a meta-analysis of 13 randomized controlled trials. And a combination of calcium plus vitamin D supplements "didn't show a reduction in fractures, cardiovascular disease, or cancer" in a study that was part of the Women's Health Initiative. "Almost every outcome was null, except there was a 17% increased risk of kidney stones with calcium plus vitamin D supplements," Michos said. The largest vitamin D trial was the VITAL trial, in which more than 25,000 people got a high dose of vitamin D — 2000 IUs a day — or placebo. The hazard ratio for cardiovascular outcomes and cancer was null. She suggested pointing patients instead toward moderate sun exposure and…