Supplement Media Attack: Another Case of Déjà Vu?

If a health product works, it’s cheap, and it isn’t made by a pharmaceutical company, it will come under attack by the mainstream scientific institutions, authorities, and the media. Scientific American’s latest attack is in a long line of hit-pieces against dietary supplements that, if taken seriously and implemented, would result in the supplement industry being wiped out. Action Alert!

The editorial in Scientific American (SA) not only calls for implementing Senator Dick Durbin’s (D-IL) supplement hit list that we successfully defeated last year; not only does it urge the FDA to regulate supplements more like drugs; it calls for supplements to be regulated more than drugs by requiring third-party testing for safety and efficacy. All this for a group of products that are safer than conventional foods, as shown by our sister organization, the Alliance for Natural Health International (ANH-Intl) using European data. Supporting these absurd recommendations are the same old, weak arguments that have been used to attack supplements for years; they were wrong then, and they’re wrong now. We have to push back against these baseless viewpoints, lest they be used by Congress to support passing Sen. Durbin’s anti-supplement policy in this Congress.

The FDA already has the power it needs to stop fraudulent products, or products spiked with illegal ingredients, from the market. In the past, we should remember that FDA leadership deliberately refused to enforce laws in the hope that something would occur which was so bad that the public would call for a drug-like regulatory scheme for supplements.

Like many of the other anti-supplement hit pieces we’ve rebutted in the past, the SA editorial starts by asserting that supplements are unregulated: “Right now no federal agency fully oversees the clinical testing and chemical verification of nutraceuticals in the U.S., and these products are often plagued by quality and safety problems.” In fact, current good manufacturing practices (cGMPs) for supplements could not be more stringent. Laws to guarantee safe products are already on the books, and it is up to the FDA to enforce those laws. If once in a great while some bad actors fail to meet current high standards, and the FDA fails to hold them accountable, this should not reflect on the entire industry. Every industry has its share of bad actors – and the supplement industry has actually had very few by comparison with others, especially when compared with the highly regulated pharmaceutical industry (see here and here).

The editorial moves on to cite a popular statistic drawn from a paper published in the New England Journal of Medicine back in 2015: “A study by the Centers for Disease Control and Prevention estimated that about 23,000 emergency department visits and more than 2,000 hospitalizations every year are attributed to adverse effects of dietary supplements.”

Let’s remind ourselves this was an estimate. An estimate that actually came from just 3667 cases found in 63 hospitals participating in the CDC’s National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project between 2004 and 2013. In that sense it’s not real data, on real people.  

When this statistic was released in 2015, we also noted that over 20% of the cases analyzed were the result of unsupervised children swallowing pills, while 40% of cases among those 65 and older were caused by choking. Many other cases were heart palpitations from ingesting too many diet pills, sexual enhancement pills, and energy drinks. But why let the facts get in the way of propaganda?

Even if we were to accept the 23,000 estimate, it actually demonstrates, in our view, the safety of supplements. Considering that more than half of US adults—about 200 million people—use dietary supplements regularly, 23,000 ER visits, assuming each visit involves a different person, represents only about 0.0115% of dietary supplement users.  Let’s remember that supplement related deaths are also negligible, unlike with foods, and especially not with drugs, that are the third leading cause of death in the USA.

Compared to the number of deaths from FDA-approved drugs, this is minuscule. Properly-prescribed drugs cause about 1.9 million hospitalizations and 128,000 deaths per year! According to National Poison Data System, dietary supplements cause zero deaths.

In fact, ANH-Intl also found that UK residents were about as likely to die from taking supplements as they were getting struck by lightning!

However you care to manipulate the data, what no one can get away from is the prevailing evidence from multiple sources that supplements are the safest substances we can put in our bodies, and to suggest they are both unsafe and unregulated is a perversion of the facts.

The assumption of the editors of SA seems to be that drug regulation is the model that should be applied to supplements and this will somehow protect the public. No consideration is given to the value supplements provide in supporting individual self-care, keeping people healthier longer, and reducing the burden on the mainstream healthcare system. The editors call for third-party testing to ensure supplements’ safety and efficacy. Ridiculously, this is an even higher bar than that required of drugs!

The FDA uses industry studies to determine if new drugs can come to market. No independent testing is done to check the industry’s results. This system presents many opportunities for manipulation. In the past, drug companies have withheld evidence that might lead a drug to be rejected, and the results have been disastrous (see, for example, the approval of Vioxx, which then killed 60,000 people). In other instances, FDA regulators ignore warnings from the agency’s own doctors in order to rush drugs through the approval process that are later found to be dangerous (see, for example, the case of Avandia). One of the reasons the system can be manipulated is the revolving door that is in full operation at the FDA that allows industry undue influence over the agency meant to regulate it.

Like the many hit pieces before it, the SA editorial warns us that “People might choose [supplements] products over medical interventions for serious illnesses or take one that interacts with their current medications.” Supplement critics making this point often add that supplements don’t have a benefit outside of treating nutritional deficiencies which are rare in the US. They have clearly failed to evaluate data from the clinics of the thousands of physicians practicing integrative, functional and other modalities of non-pharmaceutical medicine. They simply don’t know what they don’t (choose to) know.

Most consumers don’t take supplements to treat a disease. They take supplements to bolster their overall health in combination with diet, exercise, and lifestyle choices. The integrative community knows there’s no “magic pill” for health, it understands the complexity and multi-factorial nature of body systems and health conditions, and it therefore strives for holistic solutions. It’s the medical establishment that believes in the “one pill per symptom” approach to health.

And while there may not be many textbook cases of nutritional deficiency in the US, this is largely because the National Institutes for Health and the National Academy of Medicine consistently under-estimate optimal levels of nutrients required for peak health. In fact, large swaths of the American public are not getting the nutrients they need through diet. Poor diet is unquestionably a driver of chronic disease. Research has shown that micronutrient inadequacies can impact long-term health, increasing risk for diseases like cancer, cardiovascular disease, type 2 diabetes, and viruses.

All of these bad and misleading arguments, that in turn receive wide media attention, continue to be grist to the mill for Sen. Durbin’s anti-supplement policy, which we’ve written about at length over the last couple of years. You can read more about the policy here, and our analysis of the implications and potential consequences of this policy here and here.

We defeated Sen. Durbin’s policy last year. Let’s make sure it doesn’t progress this year too!

Action Alert! Write to Congress and oppose Sen. Durbin’s supplement “hit list.” Please send your message immediately.