Supplement Regulation and Side Effects: Efforts to Suppress the Truth

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In a video I did a few years ago, I talked about how press releases about the latest science coming out of even top medical centers were filled with overstatements and omissions. Medical journal press releases suffered from similar problems, and press releases from the drug companies were no different, filled with hype and exaggeration. What about press releases issued by the supplements industry? Not even the companies that published the studies, but like trade organizations for the multi-billion dollar dietary supplement industry.

Researchers found that 100 percent of supplements industry press releases contained “spin,” meaning strategies to hype or denigrate findings to distort the results of clinical studies. And here’s the crazy part: industry press releases advocated supplement use in response to >90 percent of even the studies that reported no benefit or harm. Here are the harm studies. A study comes out showing a supplement is actually bad for you, and the vast majority of independent institutions, like the National Institutes of Health or mainstream media stories, are like “don’t take it.” Duh. But the industry trade organizations are like, “Harm? Go for it! Buy an extra bottle.”

It is, therefore, likely that the propagation of the ‘spin’-enriched industry press releases contributes to the ongoing, and even burgeoning, enthusiasm for use of supplements in the face of accumulating evidence of most of their ineffectiveness and, in some cases, harm. In some cases, people are paying to make themselves sick. Sadly, the science may not even matter to many supplement users. Most dietary supplement users said that they would be minimally influenced by independent, taxpayer-funded studies contradicting the efficacy claims of supplement manufacturers. Only a minority of users said they would stop taking a supplement if public health authorities stated that it was just a waste of money.

The iconic image of the snake oil salesman was actually a real dude: Clark “the Rattlesnake King” Stanley, in 1916. Turns out that Stanley’s snake oil, in fact, contained no snake oil at all, but rather just like spicy mothballs and turpentine, prosecuted under the newly enacted Pure Food and Drug Act, and ultimately fined a lofty sum of 20 bucks. And a century later, here we are with snake oil coming out our ears, a vast number of supplements marketed and sold without routine oversight. Now, the supplement industry bristles at such talk, saying that the supplement industry is regulated to protect consumers. And it’s true there are definitely laws on the books, but the ability of regulators to successfully carry out this mission is hampered by the sheer number of products.

The FDA estimates that there are more than 85,000 dietary supplement products currently available in the U.S. alone. So, there’s the sheer number, the underreporting of adverse side effects, the difficulty of successfully prosecuting cases against offenders, and the ease with which suppliers can rebrand products removed from the shelves have led to a largely unregulated environment. In the real world, there is little guarantee that a supplement will even contain what is advertised on the packaging and not contain unlisted ingredients, potentially leading to significant harms, resulting in an estimated 23,000 ER visits every year. Now, of course, prescription drugs don’t just sicken but kill many more, making them perhaps the third leading cause of death, wiping out more than 100,000 Americans. But still, the less death and disability, the better.

Dietary supplements are often adulterated with undeclared pharmaceuticals, which could represent an enormous risk to consumers, most often found in erectile dysfunction, weight loss, diabetes, and high blood pressure supplements. But wait a second, what about supplement manufacturers who say they have independent, 3rd party certification of purity? There is a practice called dry labbing, a dirty little secret of the supplements industry, where quality assurance labs just rubber stamp fake documents. And if you think that’s outrageous, check out the story of BMPEA.

A researcher at Harvard published a paper replicating prior research from the FDA detecting a designer amphetamine-like stimulant, β-methylphenylethylamine in various U.S. supplements sold in the United States. In response, one of the offenders, Hi-Tech Pharmaceuticals, manufacturers of weight loss supplements like Black Widow and Yellow Scorpion, sued the Harvard researcher for libel, slander, and product disparagement, originally to the tune of $200 million in damages.

This was all documented in a piece by STAT, which is an excellent source of medical journalism that I recommend. The head of Hi-Tech openly admitted that he was “hoping that we were able to silence this guy,” and while ultimately unsuccessful in court, Hi-Tech’s lawsuit effectively sent a warning to other researchers. In fact, Hi-Tech’s CEO is attributed as saying, he “hope[s] that the long and costly legal battle will scare away other academics from investigating the supplement industry.”

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Motion graphics by Avo Media

• FDA
• Harvard
• industry influence
• medical profession
• mortality
• supplements