Full Disclosure: I don’t watch professional basketball. There is something about the strategic foul that leads to the last two minutes of the game that I don’t think. I feel like shouting “PLAY GAMES !!!” But in fact, that’s exactly what they do, but not the way I like it.

So a few weeks ago, I had never heard of Lamar Odom, former NBA star and husband of Kardashianka. Now I hear his name several times a day from many of my patients. As a urologist specializing in sexual medicine, I receive questions which all relate to the so-called “natural” Viagra that I used before I found myself in a coma.

When I read the reports I found out that he was taking cocaine and consuming a number of over the counter (OTC) pills along with supplements designed to support erections. I will not focus on cocaine because the danger is clear and well established. Questions that all of my patients focus on when taking supplements.

Can buying an accessory at a local general store hurt? 

The short answer is: absolutely!

I am going to explain. I believe that judicious use of high quality supplements can improve erectile response. The problem is that many supplements are contaminated with counterfeit Viagra, Cialis or Levitra.

If it works I’ll take it

Now, for $ 40-50 a pill for these drugs, several of my patients have asked me why it is so bad that these over-the-counter supplements are “tainted” with prescription drugs. As one of my patients put it, “If it works, it works. And if it works and it’s affordable, I accept it.

There is a problem. Medications for erectile dysfunction (ED) cause immediate and significant physiological changes. These changes, when done in moderation and under the supervision of a physician, are beneficial.

Unfortunately, if you buy them from 7-Eleven and make them yourself, they can be dangerous. This is because (i) we don’t know the strength of the active drug in the supplement, (ii) we don’t know the quality of the ingredients (remember these are often counterfeit drugs made by laboratories non-regulated from abroad) and (iii)) The physician does not monitor for pre-existing conditions that would put individuals at increased risk as a result of treatment.

So what should the consumer do? How do you distinguish quality supplements from those contaminated with drugs? Unfortunately, this can be difficult. The FDA maintains a list of known authors, which they call “spoiled products” because they are supplements containing the drug. But the market is moving so fast that I doubt the list is quite correct.

The Washington Post reports that Lamar Odom has taken Reload and Libmax Plus. The FDA has labeled Reload with a warning that it contains sildenafil, the active ingredient in Viagar. The FDA announced in 2009 that the manufacturer had withdrawn Libmax from the market because it contained tadalafil, another component of an approved erectile dysfunction drug. But a (legal) brothel in Nevada, where Odom was having trouble, sold him a product from their store.

I advise my patients to listen to their instincts rather than getting into trouble, as long as the natural erection supplement is safe. I explain that drugs like Viagra are taken as needed and are often taken 1 hour before sex. On the contrary, high quality supplements work over time and require a daily dose.

With that in mind, I would avoid all supplements that promise fast action, all supplements sold in small quantities (1-5 tablets are taken in a single dose), and all supplements that make outrageous claims of success. Erectile dysfunction is a condition that often requires specialist attention. I offer a full range of treatment options, from medication to injection therapy and, if necessary, surgery.

Remember, if the statements are too good to be true, they are not.

The latest news regarding Lamar is worrying. There appears to have been significant and lasting brain damage. He has a long way to go. I can only assume that it wasn’t the cost that motivated him to take the specific supplements he was consuming. I feel like you’ve been swayed in part by the desired results, but also in part by the widespread perception that something you buy without a prescription cannot harm you. It’s not like that.