WGBH Frontline Slams Supplements

 

There are many ongoing controversies about the use of supplements and their effects on people’s health. The supplement industry in the United States could best be described as a bazaar with various companies hawking their goods based on either carefully worded statements, such as “supports immune function” or testimonials by individuals. What is noticeable is that a $36 billion a year industry does not fund research on its own products.  The industry is protected by a bill that exempts it from regulation by the FDA.

 

There are many supplements with overstated claims, supplements mislabeled as to the contents, and some are just plain bad for you.

 

However, there is also medical evidence that supplements, taken in the proper amounts, and with proper manufacturing, are beneficial to health. The bark of the willow tree was the origin of aspirin, the leaf of the French Lilac was the origin of Metformin, and penicillin comes from a species of mold. And the poison strychnine comes from a seed. There is no guarantee of benefit or harm.

 

The WGBH broadcast criticized the consumption of both multivitamins and megadose vitamins. Megadose vitamins, especially fat-soluble ones like vitamin E, are clearly bad for health. However, a daily multivitamin is recommended by the Linus Pauling Institute at the University of Oregon to compensate for the depleted nutrition in the American food supply and in the average American diet.

 

Herbal products, like St. John’s wort or ginkgo biloba are rarely pure, frequently have fillers, and their labels do not reflect the contents. The broadcast was correct that DNA testing demonstrated that the vast majority of herbals are a crapshoot as to contents. More enlightened manufacturers are turning to DNA barcode testing to improve their products.

 

The section on omega-3 fish oils was outright misleading. There are studies in which fish oil is amazingly effective for changing lipid profiles and reducing cardiac death. However, equal numbers of studies show no effect. In 2014, a review article pointed out that almost no researchers tested fish oil products for oxidation; the author suspected that oxidized fish oil produces negative results, while fresh fish oil is beneficial. As an amusing aside, the pharmacist who pointed out the problems with fish oil did not mention that, in his most recent conflict of interest filing, he receives support from seven pharmaceutical firms. The point that fish oil from fish may be more effective than fish oil capsules does have some scientific merit; however fish oil capsules have less mercury in them than the fish they came from.

 

The section on vitamin D is critical of anyone taking more than 2000 units a day. It did not mention the relationship between dosage recommendations and vitamin D deficiency. The idea, unstated in the broadcast, is that if one has adequate levels of vitamin D, 2000 units a day is more than adequate. However, in conditions of vitamin D deficiency, the American Journal of clinical nutrition recommends dosages up to 20,000 units a day. The definition of vitamin D deficiency 30 years ago was a level of 14; today it is a level of 32. Similarly, the level of toxicity 30 years ago was 50; today it is 100. The changing target levels are grudging acknowledgment by the medical establishment that vitamin D is beneficial.

 

In point of fact, at Age Management Boston, we subscribe to databases and testing agencies in order to evaluate all supplements we recommend. Like many things in medicine, there are open questions, and I encourage people to keep an open mind. In this case however, I thought Frontline missed the educational opportunities that educational television strives for.

James Katz MD

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