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Are Diet Supplements Dangerous?

The FDA cannot keep up.

by
Theodore Dalrymple

Bio

April 9, 2014 - 12:30 pm
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If something is either essential or good for the health, surely more of it must be good for you? Such at any rate is the reasoning of half the American population who, between them spend more than $30 billion on dietary supplements, that is to say $200 a head per annum. All things considered, these supplements must be pretty safe, unlike prescription drugs, for few people die or have serious side-effects from them. Whether they do any good, other than as placebos, is another question entirely of course.

According to an article in a recent edition of the New England Journal of Medicine there are 85,000 different supplements and combinations of supplements on the market, meaning that each of them sells, on average, approximately $375,000 worth per year. Given the popularity of some, this must mean that many are in a very small way of business indeed. It is the job of the Food and Drug Administration to monitor the safety of all these preparations: a task, one might have supposed, quite beyond the capacity of even the largest bureaucracy.

Not all the supplements are safe. One, called OxyElite Pro, caused hepatitis and even liver failure, first spotted by a liver transplant surgeon in Honolulu. It was used by body-builders to “burn off” fat, and it is isn’t difficult to find people on the internet who mourn the fact that the product has been withdrawn from the market, despite its potentially dangerous side-effects (one person died).

Dietary supplements do not undergo the rigorous testing, either as to efficacy or safety, that pharmaceuticals undergo. The author of the article points out that many supplements contain newly-devised amphetamine-like stimulants, anabolic steroids, untested chemical analogies of Viagra and various antidepressants, and weight-loss substances that have already been banned from the pharmaceutical market.

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All Comments   (16)
All Comments   (16)
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A classic example of something the FDA did and should have stepped on was 2,4-Dinitrophenol (DNP), a popular weight-loss aid (and industrial chemical) from 1933-1938 which worked like a charm by--crudely put--causing your body to burn up the blubber in the form of raised temperature. Actually, only a few people died of hyperthermia but there was a problem of rapidly forming cataracts and other sinister side-effects. It's still out there, available on the internet and from the same sort of sources the body-builders get their steroids. Although, in this case, it is anything but a "natural" substance.

Back in the 1990's I tried the then-popular caffeine/ephedra/aspirin "ECA-Stack) formula pills and they made me sleepless and psychotic. Maybe it was just my own "individual body chemistry" and everybody else used them with nary a bobble, but I doubt it. As far as weight-loss products go, anything that calls itself "thermogenic" or "metabolism-altering" is gonna mess with your head big-time. I can see how people who really went overboard with the stuff could aggravate underlying heart trouble or become susceptible to heatstroke.
25 weeks ago
25 weeks ago Link To Comment
My, its like the author insulted a religion or something. But then I guess he did...
27 weeks ago
27 weeks ago Link To Comment
It doesn't bother you at all that one of his prime examples of the "problem" turns out to be something completely different than what he's suggesting?

27 weeks ago
27 weeks ago Link To Comment
The whole concept of the FDA is wrongheaded. It is a massive impediment to research as since bureaucrats get in trouble if one person dies from a drug side effect, regardless of its utility, they ban it. My grandmother spent the last several years of her life in constant pain because they banned the only drug effective for her arthritis. Why? Because it really was dangerous to a small fraction of those it helped. It could give them a fatal heart attack.

So what? She was in her 90's! With it she could quilt, and go out with her friends, without it she was a shut in. She didn't get to choose to roll the dice. I would have. She would have, she said so. That would have been an informed risk, more than justified by the potential reward.

The FDA should rate level of safety and level of effectiveness on a scale of something like 1-6. A 6 would be known not to be effective or known to be unsafe. A 5 would be "untested". Everything else would be be a scale from evidence suggestive, to fully proven over time. You would rate safety and effectiveness separately. Then let people decide what they want to take.
28 weeks ago
28 weeks ago Link To Comment
What are you suggesting, that I shouldn't be able to buy some vitamin C and D at Trader Joes, or that neither one is really useful, or that we should put enough federal oversight on them so they cost ten times more?

I buy and use a number of supplements for better life today, not to "live forever". I also use some as treatments for medical conditions, for which they are helpful if not entirel currative. I am appalled that few medical doctors know much about these or recommend them, it's just about this far from a doctor not knowing about breathing oxygen or drinking water.

It is unfortunate that there are some things offered which are either ineffective or dangerous. And for most, neither their safety nor efficacy is actually well documented. I understand the concerns. I just don't want to lose the ones that ARE documented for efficacy and safety and that I use.

OTOH I try to have whole food sources for pretty much everything that I use as a supplement, but trying to do the equivalent means eating a LOT of oranges and salmon and whatnot, leaving no dietary slack at all.

How about a nice federal law that requires all doctors to get an education in the area so they can better advise patients?
28 weeks ago
28 weeks ago Link To Comment
"The FDA cant keep up"

I'm sorry... was there a time when they could?

Or did? Or even SHOULD?

Geez, I must have missed that period when The Federal Government guaranteed the entire universe was harmless…humph, what happened?

Look folks, its Caveat Emptor...if you’re willing to put unknown junk in your body based on slick advertising and pretty packaging, you’re a fool. Read the label, and expect the worst in anything that’s heavily packaged or processed. Be especially suspicious of any concoctions that aren’t recognizable as basic “food”…

Meat, Veggies, bread, cheese, milk...cook for yourself, eat in moderation, get some f*cking exercise, and Shut Up... Live in a City without Fresh Produce and Farmers markets? Too expensive? Too “difficult” to eat right because it doesn’t fit your “schedule?

Don’t expect The Government to ensure your diet of Dexitrim’s and Red Bull is “healthy” today, and don’t expect them to have infinite knowledge of the “safe daily allowance” of every OTHER possible tonic/poison these Supplemental Snake-Oil Salesmen will try hawking to you tomorrow.

Because SOME things in this universe, are actually YOUR responsibility, mmm kay?
28 weeks ago
28 weeks ago Link To Comment
They are a scam.
28 weeks ago
28 weeks ago Link To Comment
"It is the job of the Food and Drug Administration to monitor the safety of all these preparations: a task, one might have supposed, quite beyond the capacity of even the largest bureaucracy."

Given the FDA's track record on approval of prescription drugs, I wouldn't necessarily look to this bureaucracy to get it right on diet supplements.

I used to have a rather long list of FDA approved drugs that had to be withdrawn once they had gotten out into the general population. One in particular, the statin Baycol, was discovered to be a cause of muscle wastage/destruction.

The government has long been trying to infuse itself with more regulation into the supplement field in general, while our airwaves are still filled with sleazy lawyers soliciting your input for failed FDA approved medical devices and drugs.
28 weeks ago
28 weeks ago Link To Comment
Follow the money. If we were seeing these side effects with prescription drugs FDA would either say nothing or fine (forced bribe) the company.

Ephedra worked for centuries if not millennia for weight loss and is also a much gentler decongestant than any of the man made crap. Yet MaMa DC had to step in. That's what they're best at. . . stepping in it.
28 weeks ago
28 weeks ago Link To Comment
I don't think a person can have a desk job, eat like their grandparents take ephedra and expect everything to be alright. Dosage would be as important for a "supplement' as for a pharmaceutical. One woman overdosed on tea and tea is very natural. Her bones broke. She was an extreme case, but I bet ephedra is just as strong or stronger and people do not know the dose they are using.
28 weeks ago
28 weeks ago Link To Comment
So, your point is what exactly? That the people are too stupid to use naturally occurring substances without the government? Or that naturally occurring substances must be outlawed if a tiny fraction of percent of people are, in fact, too stupid to use them properly?
28 weeks ago
28 weeks ago Link To Comment
We all need faith in something but faith in the FDA is not the best course. That does leave us with the question of how to sort the good from the bad though.
28 weeks ago
28 weeks ago Link To Comment
"One, called OxyElite Pro, caused hepatitis and even liver failure, first spotted by a liver transplant surgeon in Honolulu. "

Never heard of it, so I did a search. SOME of the varieties were pulled from the market, and the FDA doesn't know if it's the product, or counterfeits of the product. Nothing in the FDA bulletins casts any suspicion on the product itself, but rather points to possible adulteration of the product.

Sloppy reporting, much? Big Pharma bias, maybe?

28 weeks ago
28 weeks ago Link To Comment
Don't forget that we also have slightly different body chemistries. I am convinced that certain supplements which have no effect on some people have an outsized effect on others.
28 weeks ago
28 weeks ago Link To Comment
"SOME of the varieties were pulled from the market, and the FDA doesn't know if it's the product, or counterfeits of the product. Nothing in the FDA bulletins casts any suspicion on the product itself, but rather points to possible adulteration of the product."

That part was interesting and worthy of consideration.
28 weeks ago
28 weeks ago Link To Comment
That was how the Feds pulled L-tryptophan (amino acid) off the market in 1991. An outbreak of eosinophilia-myalgia syndrome (EMS) in 1989 was later traced to impurities in a bad batch from a Japanese company. It wasn't the product itself but that didn't stop Big Brother.

The whole century-plus long supplements/alternative medicine/organic food vs. the Medical-industrial complex and Big Agribusiness is a saga comparable to the 2nd Amendment issue for Libertarians and Conservatives (and Lefties to boot, since they tend to like their vitamins, pontius pilates and acupuncture). Floridation, unpasteurized milk, artisanal, organic farming...the list goes on. Considering Obama's cozy relations with Big Ag this could be one hell of an issue for any Repubelican with both a brain and a pair.
25 weeks ago
25 weeks ago Link To Comment
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