More supplement hysteria

Here we go again. Sanity seems once again to have fled the playing field. Some “scientists” have declared supplements are all worthless at best or dangerous at worst. This is as ridiculous as those who would say all “drugs” are worthless or dangerous.

First, we have an article published on 12/22/13 in the New York Times. (Note: link embedding seems to be broken on WordPress: ).  Once again, an article that purports to be informative distorts knowledge in pernicious ways. Let’s unpack it a bit.

The article notes that some people have reported liver damage due to supplements. Here they conflate the effects of supplements themselves with the notion that some supplement manufacturers are crooks who spike their products with drugs. And then they trot out the usual lie that the FDA is helpless because of the Dietary Supplement Health Education Act (DSHEA). Eventually, they note that the FDA DOES indeed have the power to go after companies that have a corrupt product; it’s just they only recently started to actually do this work, in a very limited way. Why? Because they don’t have the budget (thank you, horrible Congress) to do their job of assuring that dietary supplements AND drugs AND food are pure and contain what the label says.

More critically, they go on to the topic of the potential of some supplements to harm the liver. Here, there IS truth–though a bit of context may help. The specific example they go after is the potential for the catechins found in green tea to be hepatotoxic (liver damaging). Indeed, this can happen but is extremely rare; some cases of presumptive damage by green tea was again due to a contaminant by the herb, germander. (Other cases of young people using it to get “cut” in bodybuilding one may expect liver toxic steroid use or supplements again so adulterated.) However, some few cases have been reported and consumers using Green Tea supplements should be on the alert for liver trouble. We have amended our entry on Green Tea to reflect this. But overall, the benefits of green tea supplements or drinking green tea outweigh this potential risk.

The case of the young man facing a liver transplant is indeed horrible. What remains unclear is whether this was directly due to the supplement or whether there was a contaminant in the supplement. Such an anecdote of harm, however, is no more valid than an anecdote of benefit.

We need a robustly funded FDA to assure that products are what they say they are.

Coming up–a review of the Annals of Internal Medicine–bits of truth lost in more hysteria.

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