2014-03-30

The Allure of the Pill- All Interventions Carry Risk- Even "Supplements"

The Allure of the Pill-  
All Interventions Carry Risk- Even "Supplements"

This coming week, the world's leading medical journal, The New England Journal of Medicine will be presenting a haunting reminder that every intervention needs to be weighed for possible harms.

The article tells the sad story of what once was thought to be a harmless dietary supplement, a protein pill to help build muscle called OxyElite Pro.   It turns out this substance actually can kill your liver.  In 2013, many cases of hepatitis, many hospitalizations, even 3 liver transplants and 1 death all were found to be due to use of this pill.

What's really troubling is that the United States, largely under pressure from those who sell these things, has created a whole category of pills that no one must study to know what harm they can cause, or ever prove if they work.  That category is called dietary supplements.  The products categorized as dietary supplements are typically not dietary or supplemental, they just are sold under this title, so that their manufacturers and sellers never have to prove if they work or find out if they might hurt you before they sell them to you.

What sort of products are sold under the legal category of dietary supplements?  Many.  They include essentially all vitamins, minerals, amino acids, botanicals, probiotics, and many more.  The combinations of such items total over 85,000 (that's right 85,000!) different pills and potions.  The law that protects them and exposes all of us to harm is called the Dietary Supplement Health and Education Act of 1994 which actually states that if a product is sold under the category of dietary supplement it is, by this law, assumed to be safe unless proven otherwise.

It turns out given this liberty, manufacturers fail to purify their products or add dangerous but popular items such as stimulants, anabolic steroids, novel antidepressants, and other untested drugs, without putting them on the label or finding out if they cause harm.

One sports supplement that looks very harmless turns out to have a novel form of methamphetamine (remember Breaking Bad?) in it.  The FDA recently found a new type of amphetamine in nine other supplements.

Untested substances in pills and potions can cause hearts to stop beating properly, damage livers, induce strokes, make guts bleed, and alter vision.

Bottom Line
New pills are all the rage.  The promise of something that sounds as harmless as a supplement is very enticing.   But keep in mind, every substance taken carries risk, whether it's a traditional medicine or a dietary supplement.  Most pills don't help very much, many may be harmless, but some can hurt.  We recommend not taking any pills unless truly necessary, and not taking anything that has not been studied and proved to be what it claims and safe.

Dr. Arthur Lavin





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