Every so often, a whole lot of noise is made about the “health risks” of nutritional supplements. And how risky are they? Here’s one chart:
Most deadly? Serving in the Middle Eastern wars, preventable medical injuries and reactions to pharmaceutical drugs. Least? Food supplements and herbal remedies. The risk, as calculated by the Alliance for Natural Health for their recent report, is 1 death per 10 million people who take them. (For more on this report, see Dr. Mercola’s article.)
Now Consumer Reports has published yet another be-careful-with-those-supplements article (previously) – the subject of the following opinion piece by Bill Sardi (via the Orthomolecular Medicine News Service)…
Does Anybody Still Believe
Slam Pieces On Dietary Supplements?
The news media is operating in lock step with the FDA to create a groundswell of public opinion that dietary supplements are deadly and must be regulated beyond existing law. The goal is to demonize dietary supplements to the point where they become over-priced drugs, captured by pharmaceutical companies to profiteer from. It’s all part of the modern American marketplace, that un-free enterprise system where industry buys off government to do its bidding. The impetus for guillotining dietary supplements is that patents on blockbuster prescription drugs are expiring and the supplement industry is a growing market in a dying economy. A major takeover of the supplement industry by pharmaceutical companies is underway.
The latest attempt to slander the dietary supplement industry is the September 2012 issue of Consumer Reports entitled “10 Surprising Dangers of Vitamins and Supplements.” 
Good with the Bad
I favor dietary supplements over the really deadly FDA-approved prescription drugs, but I’m not a bought-off announcer for the home team. Some criticism of the dietary supplement industry is justified on scientific grounds, but no new legislation is going to make food supplements much safer than they already are (safer than table salt, aspirin and even tap water). What criticism is justified will be described below.
One has to be careful in blaming either supplements or drugs for deaths or serious side effects based solely upon associations. That is, for example, it might be found that most of the consumers who experienced side effects from dietary supplements were wearing tennis shoes at the time of consumption. But tennis shoes are only associated with the side effects; they obviously didn’t cause adverse reactions. And that is a major criticism of the evidence Consumer Reports (CR) uses to prop up its contention that supplements are unsafe.
Raw numbers don’t explain if consumers overdosed on these products and failed to take the recommended dose or just happened to choke on them as they swallowed them down, a problem Consumer Reports says is surprisingly common. Obviously, horse-sized pills could pose problems, but the most likely cause of choking is dry mouth induced by commonly used drugs such as antihistamines, antidepressants, sedatives and decongestants. CR is pinning the tail on the wrong donkey.
For comparison, some years ago a study was published in the Journal of the American Medical Association showing that properly prescribed drugs, ordered by a physician and administered by a nurse in hospitals result in over 100,000 needless deaths per year.  That kind of data suggests drugs are causal, not just associated with mortality.
Of course, there are bad players in every industry. There seem to be many pretenders on the internet who violate every regulation the Food & Drug Administration and the Federal Trade Commission have outlined for Good Manufacturing Practices and advertising guidelines. You can find them easily by browsing the internet. Some of these renegade outfits are brazenly advertising their products bearing home-made labels, failing to provide a “supplement facts” panel, and shipping them from who knows where. Even phony dietary supplement rating websites can be found on the internet.
CR says the Federal Trade Commission has taken action in more than 100 instances against false advertising claims made by supplement makers over the past decade. That amounts to only about 10 a year. This certainly sounds like regulatory agencies are dragging their feet, allowing outlaw supplement companies to exist so as to perpetuate the myth that the dietary supplement industry cannot be trusted. Like the banking industry whose regulators have overlooked the wrongdoing of lenders, the FDA and FTC are intentionally allowing renegade supplement makers to exist to exemplify the idea that the entire supplement industry needs to be cleaned up.
Does the Diet Alone Provide Sufficient Nutrients to Maintain Health?
Critics of dietary supplements, particularly old-school dieticians who typically promote foods over supplements and doctors who typically prescribe drugs, launch into their tired claim that a varied diet provides all the nutrients needed to maintain health. However, the only Americans who are year-round sufficient in vitamin C, omega-3 oils, vitamin D, magnesium, vitamin B1, and vitamin E are those who take supplements. The best diet couldn’t possibly meet the need for essential nutrients, particularly among the elderly who have absorption problems, and smokers, alcohol imbibers and prescription drug users who typically suffer from substance-related nutrient depletion.
But CR said “many people can get enough omega-3s by eating fatty fish (salmon, cod, tuna) at least twice a week.” CR appears ignorant of the fact most fresh fish sold in grocery stores today is farm raised and provides very little omega-3 oil.  Fish from cold northern waters eat phytoplankton that results in their rich omega-3 content. The simple fact is, until fish oil supplements became popular in the U.S., most Americans were deficient in this essential nutrient.
Readers of the CR report on supplements are shown a photo of a doctor talking to a patient, with the caption below: “Doctor with a patient who had a heart attack while on supplements.” Here again, about 65% of Americans take supplements.  This is guilt by sensationalism. It would never be admissible evidence in a court of law, or even a high-school debate.
And while it has recently been disclosed that a baby aspirin does not prevent mortal heart attacks as first believed,  leaving no proven medicine to prevent sudden-death heart attacks, the FDA says nothing about the red wine molecule resveratrol which has been shown to prevent mortal heart attacks in laboratory animals. The FDA rules say resveratrol pills can’t be advertised they prevent heart attacks until they undergo human trials. Such a study would require half the patients at high-risk for a mortal heart attack to take, at least for a while, an inactive placebo tablet, which would be unethical. You can’t let half the patients die to prove resveratrol pills are effective.
Supplements Don’t Cure Diseases: Really?
Another unfair criticism of dietary supplements floated by CR and others is that “none are proven to cure major diseases.” If a dietary supplement is proven to cure a disease then FDA declares it a drug. So by definition, supplements can never cure a disease, when in fact almost everyone acknowledges that they do cure many diseases: scurvy, rickets, pellagra, beriberi and anemia, just to name a traditional few. Furthermore, the biological action of most prescription drugs can be duplicated with dietary supplements at far less cost and side effects, a fact the FDA doesn’t want the public to know. CR goes on to say: “When healthy consumers use supplements, there’s rarely, if ever, a powerful life- saving effect.” But the FDA approved cholesterol-lowering statin drugs which are pandered as a life saver but have never been shown to reduce mortality rates from coronary artery disease. There’s nothing like the pot trying to call the kettle black.
Supplement Industry Doesn’t Have Completely Clean Hands
So what does the dietary supplement industry do wrong? Come on, there has to be some dirt I can dig up in order to maintain my integrity.
OK, CR correctly offers criticism of iron and calcium supplements. Ironically, these are the very supplements that doctors prescribe most. And CR asks its readers to consult with your “health care provider” when they have questions about supplements as if they are knowledgeable and unbiased. Everyone knows that most doctors know very little about nutritional therapeutics. It is not surprising to find many patients who know considerably more than their doctors about dietary supplements.
The problem with iron supplements is that toddlers, or others who might unintentionally or intentionally overdose, might suffer mortal consequences from taking iron pills. Primarily due to child-resistant caps, this happens rarely, once or twice per year, and usually not at all.  The safest form of iron is carbonyl iron, which has never been reported to cause a death even after overdose.  This is an example of supplement companies not following the best science.
Another topic CR got right was that women are overloading on calcium supplements. While over $1 billion of calcium pills are sold annually, the supplement industry has come to their defense in light of multiple studies showing they increase the risk for heart attacks among postmenopausal women who commonly take them.  Confusion over calcium lies in the false assumption that postmenopausal women losing bone are deficient in calcium. Actually, they are deficient in estrogen which sends the signal to hold calcium in bone, and deficient in vitamin D that is well established as necessary to put calcium into bone.
Many products on store shelves are simply outdated scientifically. Some recent studies have reported that as the supplemental intake of vitamin E rose, health benefits seemed to decline. The common form of vitamin E in dietary supplements (mostly multivitamins) is alpha tocopherol, and not the more potent family of vitamin E molecules: tocotrienols. Tocotrienols have hundreds of times better antioxidant power compared to tocopherols, and work more effectively in laboratory studies.  Research now suggests including tocotrienols in supplements, something the industry has largely ignored so far.
What About “Too Much”?
As for dietary supplements that exceed the recommended daily intake levels and even the so-called “safe upper limit”, thank heavens they do. Supplement makers ignore covert efforts by the Food and Nutrition Board to limit nutrients in fortified foods and supplements. For example, the recommended daily intake level of vitamin C for adults is 75-90 milligrams. The so-called “safe upper limit” is 2,000 mg per day. But 75-90 mg will not raise a person’s blood level of vitamin C, a water-soluble vitamin that is rapidly excreted. Fortunately, at least in the USA, it is difficult to find a vitamin C supplement today that doesn’t provide 500 mg per pill.
The 2,000 mg “safe-upper limit” has been parlayed into a “toxic upper limit.” Actually, 2,000 mg is perfectly safe and may be on the low side. Vitamin C expert Dr. Steve Hickey says taking 500 mg of vitamin C five times a day at equal intervals would produce optimal blood levels of this essential vitamin.  The RDA won’t.
The “safe upper limit” for vitamin D is 4,000 international units (IU; 100 micrograms), which is the amount required to even measure an appreciable rise in blood concentration. The newly increased RDA for vitamin D is 600 IU, ridiculously low.
Consumer Reports, do your homework. You are supposed to be on the side of the consumer, not government agencies and drug companies.
Some “iron poisoning” is attributed to but not caused by iron supplements: http://orthomolecular.org/resources/omns/v07n16.shtml
- Hickey S, Saul AW. Vitamin C: The Real Story. Basic Health Pub, 2008. Reviewed at http://www.townsendletter.com/June2009/bc_vitc0609.htm