Problems with nutritional supplements

2008 July 12

By David Annis
Article ID: 1239

Walk into any supermarket, drug store, or health food store and you will find a wide variety of nutritional supplements.  People use these as an alternative to “western” or “conventional” medicine.  Unfortunately, when taking nutritional supplements, you aren’t treating your disease or keeping yourself healthy. You are using yourself as a human guinea pig in a poorly designed experiment, the results of which will be thrown away.

There are two kinds of assumptions, those which can be proven to be true by experiment and those that are inherently not provable.  One can argue that God’s existence is not provable, and so we should just accept his existence on faith (an argument I disagree with. For more detail see the article If you can’t prove God doesn’t exist, why not believe?). However, the claim that a particular plant product can cure cancer is testable.  We can give the product to some people with cancer and give others an alternative treatment or a placebo.  We can see, objectively, whether the product works.  While no process is perfect, a drug needs to be shown to be safe and effective in a well controlled series of trials (usually double-blind placebo-controlled) to be approved by the FDA.  Nutritional supplements are rarely if ever tested in this manner.

Since a nutritional supplement’s active ingredients and its formulations haven’t been tested, you are using yourself as a guinea pig, though nobody is monitoring the result of that particular experiment.  However, that’s only the beginning. Unlike drugs, the FDA does not monitor or regulate the composition of nutritional supplements.  So, even if a nutritional supplement had been previously tested, the producer can reformulate the product at any time without testing, product safety constraints or warning.

The biggest concern is that of the unregulated nature of the supplement market. There is no guarantee that what the label says about those pills is actually what’s inside those pills.  Nor are there guarantees about ingredients or impurities not listed on the label.

Unfortunately, these concerns are not theoretical.  When independently tested, nutritional supplements are often found to be contaminated or not to contain the correct amount of the active ingredient. In some cases, they contain none of the active ingredient.  For example, a recent independent test of ten red yeast rice supplements by consumerlab.com found that “levels of cholesterol-lowering statin compounds vary by more than one-hundred-fold across products – with some containing large amounts but others having hardly any”. When testing twenty-three iron supplements they found “a potential toxin, citrinin, was found in four of the products.” They also found that “one ‘high potency’ iron supplement contained only 37% of its claimed iron. A second supplement was contaminated with lead.”  Even within a brand the level of the active ingredient often fluctuates wildly from batch to batch.

If you are taking a nutritional supplement to try to treat or manage a disease, you are taking something that could have been tested rigorously but probably wasn’t. If it was tested, it probably wasn’t in the formulation that you’re getting. If it was tested using the formulation that you are taking, there is nothing stopping the manufacturer from reformulating it. The product may contain more or less of the active ingredient than indicated on the label. It may be contaminated with toxins.  Nobody is systematically monitoring the effect of the supplement on you or on any other guinea pig.  Is it worth taking a pill with unknown contents that may or may not work better than a placebo?

Remember what you’re gambling with: your health.



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2 Comments
2008 October 5
matt the coolist permalink

If you walk into a hospital you are a guinea pig.The author says “a drug needs to be shown to be safe and effective in a well controlled series of trials (usually double-blind placebo-” yea like the ones you give your kids that have had zero studies! Not to mention that all bodies are not the same.

I read in a “news paper” where St. Johns warts does nothing for stopping a headaches and they where right. the problem is that St. Johns wart is not for headaches.

By the way check out any tv commerical selling the drugs and you will see that they all tell you to take a vit. supplyment with the drug.

From a secular view, the body and it’s earthlyness must have nutrition to live. If you beleive in that inane praddle of Dawinism than you must view nutrition suppliments as the only way to cure the body.

2009 March 20

David Annis you fear the “unregulated nature of the suppliment market”. But what’s your opinion on Dr. Joseph Biederman, who literally told Johnson and Johnson that he’d ensure his upcoming tests on an antipsychotic drug used on children would work in their favor if they’d give him money. (NY times article posted below)

http://www.nytimes.com/2009/03/20/us/20psych.html?_r=2&emc=eta1

Drug Maker Told Studies Would Aid It, Papers Say

Published: March 19, 2009

An influential Harvard child psychiatrist told the drug giant Johnson & Johnson that planned studies of its medicines in children would yield results benefiting the company, according to court documents dating over several years that the psychiatrist wants sealed.

Dr. Joseph Biederman

The psychiatrist, Dr. Joseph Biederman, outlined plans to test Johnson & Johnson’s drugs in presentations to company executives. One slide referred to a proposed trial in preschool children of risperidone, an antipsychotic drug made by the drug company. The trial, the slide stated, “will support the safety and effectiveness of risperidone in this age group.”

Dr. Biederman was the lead author of a trial published last year concluding that treatment with risperidone improved symptoms of attention deficit and hyperactivity disorder in bipolar children.

Dr. Biederman — who was director of the Johnson & Johnson Center for Pediatric Psychopathology Research at Massachusetts General Hospital, in Boston — is in the middle of two controversies: one involves the use of antipsychotic drugs in children, and the other relates to conflicts of interest in medicine.

He is the world’s most prominent advocate of diagnosing bipolar disorder in even the youngest children and of using antipsychotic medicines to treat the disease, but much of his work has been underwritten by drug makers for whom he privately consults. An inquiry by Senator Charles E. Grassley, Republican of Iowa, revealed last year that Dr. Biederman earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but failed to report all but about $200,000 of this income to university officials.

Harvard and the National Institutes of Health are investigating whether Dr. Biederman violated federal and university research rules. He has suspended his work with the drug industry during the investigations.

Dr. Biederman has become a key witness in a series of lawsuits filed by state attorneys general claiming that makers of antipsychotic drugs defrauded state Medicaid programs by improperly marketing their medicines. His work helped fuel a rapid rise in the use of these medicines in children.

In November, the lawyers for the states released e-mail messages and internal documents from Johnson & Johnson that showed the company had intended to use its connection with Dr. Biederman to increase sales. The documents became public in a motion filed by plaintiffs’ lawyers to compel him to be interviewed.

Dr. Biederman has not responded to messages seeking comment. An article in The Boston Globe in December quoted a letter to the newspaper in which he wrote that while Johnson & Johnson had sought commercial applications to his work, “any implication that J.&J.’s interests interfered with the center’s work is wrong.”

A spokeswoman for Massachusetts General Hospital said Thursday that she could not comment on pending litigation.

Judge Jamie D. Happas of New Jersey Superior Court, who is overseeing the multistate litigation, ruled last year that Dr. Biederman should be deposed. As part of that process, Dr. Biederman provided lawyers with documents relating to his interactions with Johnson & Johnson; the documents included presentations he made over several years summarizing the work of the center, financed by the company.

Peter Spivack, a lawyer representing Dr. Biederman, filed a motion seeking to keep these documents under seal. The New York Times received copies of the documents.

In a letter filed with the court on Thursday, Mr. Spivack said articles in The Times about Dr. Biederman had “publicly embarrassed Dr. Biederman and, in part, led to an agreement to forestall contact with pharmaceutical companies.”

One set of slides in the documents referred to “Key Projects for 2004” and listed a planned trial to compare Risperdal, also known as risperidone, with competitors in managing pediatric bipolar disorder. The trial “will clarify the competitive advantages of risperidone vs. other neuroleptics,” the slide stated. All of the slides were prepared by Dr. Biederman, according to his sworn statement.

In 2005, Dr. Biederman was the lead author of a study comparing Risperdal and Zyprexa, made by Eli Lilly. The study concluded that Risperdal improved subjects’ depressive symptoms but that Zyprexa did not.

A slide listing “Key Projects for 2005” mentioned a planned study in adolescents of Concerta, a stimulant manufactured by Johnson & Johnson. The study will “extend to adolescents positive findings with Concerta in A.D.H.D. N.O.S. in adults,” the slide said, referring to unusual cases of attention deficit hyperactivity disorder.

In 2006, Dr. Biederman was co-author of a study showing that children given Concerta for a prolonged period did not have reduced growth, allaying a significant concern about the medicine.

Josephine Johnston, a research scholar at the Hastings Center, a bioethics research institute, said the documents “raise questions about how well-designed Dr. Biederman’s trials were in that he promised a result to his funders.”

“It’s another shadow over his work,” Ms. Johnston said.

In a contentious Feb. 26 deposition between Dr. Biederman and lawyers for the states, he was asked what rank he held at Harvard. “Full professor,” he answered.

“What’s after that?” asked a lawyer, Fletch Trammell.

“God,” Dr. Biederman responded.

“Did you say God?” Mr. Trammell asked.

“Yeah,” Dr. Biederman said.

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