Doctor’s Tip: Concern about supplements
I’m aware I will probably get some flack by writing about this subject, because people love their supplements. But my task with these columns is to present to my readers the latest scientific evidence related to nutrition and health.
There’s no question that pharmaceuticals have their problems, although if you get pneumonia, depression, heart failure or many other conditions, you will be glad we have them. Big Pharma is easy to dislike, because among other things the companies’ main motive is profits rather than our health, and they indeed rip people off when they can (Viagra $40 a pill in the U.S. when the generic is a few dollars elsewhere?).
Some 106,000 people die from adverse reactions to drugs in the U.S. every year, making that the fourth-leading cause of death. On the other hand, the FDA closely controls pharmaceuticals, which must be proven to be effective and to be relatively safe before they can be sold, and literature on possible adverse reactions must accompany each prescription that leaves the pharmacy.
Supplements have their problems as well. When a patient makes an appointment to see me, I ask them to bring in everything they’re taking. I’m always amazed when they start out by telling me they are against taking any medications, but they bring in a bag of multiple supplements, some of them often expensive. Here are the problems:
1 The supplement industry is a $36 billion industry, and whenever money is involved, dishonesty and corruption often occur.
2In spite of what the supplement manufacturers would like you to believe, there is minimal oversight. The January issue of the American Family Physician journal points out that “the Dietary Supplement Health and Education Act of 1994 made supplement manufacturers responsible for ensuring that their products are safe, essentially using an honor system” and “that manufacturers do not need FDA approval before selling their product.” Would you trust the pharmaceutical industry to use the honor system?
3 Therefore, supplements don’t have to be proven to be safe, often don’t contain what the label says and sometimes have dangerous contaminants. For example, Consumer’s Report found heavy metals including lead and arsenic in several powered protein supplements and noted that “you don’t need the extra protein or the heavy metals” in these products.
A recent article in the New England Journal pointed out that there are some 23,000 ER visits a year related to dietary supplements, with more than 2,000 hospitalizations.
Liver toxicity which can lead to liver failure and even death can rarely occur with certain pharmaceuticals but also from certain supplements, either from the supplements themselves or from contaminants. People who eat a diet high in antioxidant vitamins (fruits and vegetables and whole grains) have better health and longer lives, but vitamin A and E in pill form raise risk for early death. Calcium in vegetables such as kale, and fruit such as figs and oranges, promotes strong bones, but calcium supplements increase heart attack danger, per the book “Beat the Heart Attack Gene.” Folate in vegetables helps prevent cancer, while folic acid pills increase cancer risk.
4Due to lack of oversight, false claims are often made by supplement manufacturers. In his book “How Not to Die,” Michael Greger notes that pyramid-like multilevel supplement companies “espouse all sorts of health claims” and that the a public health review found that such studies often seemed “deliberately created for marketing purposes” and were bogus.
5Many dietary supplements interact with other supplements and with pharmaceuticals, including Coumadin.
People often tell me they don’t want to take a statin but would rather take “something natural like red yeast rice.” I tell them that just because something is natural doesn’t mean it’s healthy (arsenic and lead for example). Also, toxic contaminants were found in red yeast rice from China. Furthermore, the only reason this product lowers cholesterol a little is that it contains a natural statin, lovastatin, the first statin that came on the market 25 or so years ago (brand name Mevacor).
So I suggest that they take the latter, which we can be sure has in it what’s on the label and doesn’t have impurities. But I also tell them even better is to go on a plant-based, whole foods diet which we know is the most effective and for sure the safest way to prevent and reverse cardiovascular disease and to prevent cancer.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at email@example.com.