May - June 2016

Written by Steven Burns
From his column To Your Health

"I’m feeling really good," she said, sitting in my exam room. "I stopped all my medicines, and started taking this supplement. My pain has improved. I just feel a little tired, and kind of nauseated."

My patient had severe rheumatoid arthritis, and had refused standard treatment because of her fear of medications. I was happy she was feeling better, but concerned about her symptoms. "What have you been taking?" I asked.

She told me about her new herbal supplement, Chaparral. At the time, I had not heard of the herb. When I examined her, I noticed she had abdominal pain and her liver edge was tender and swollen. "We need to check a few lab tests, and see why you feel nauseated," I said.

Imagine my surprise when her liver enzymes showed levels in the 2000-3000 U/L range, about 40 to 50 times the upper limits of normal. She had acute chemical hepatitis, and, unchecked, she could have gone into complete liver failure. During that time, in the early 1990s, many people suffered liver failure and several died, all from taking this unproven supplement, now known to cause severe liver toxicity. Fortunately, my patient stopped the supplement, and over the next few weeks her liver functions returned to normal.

What would you think about a medicine that sends an average of 23,000 people to the emergency room every year, with more than 2,100 hospitalizations? What if that number was shown to be valid year after year, from 2004 through 2013? How about the fact that many of those injuries occurred in children? What if that medicine was for “prevention,” not to treat a disease? And what if it had a label reading: "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease"?

What if I added that the industry that produces these substances earns $28 billion per year and has successfully lobbied Congress to prevent requiring FDA approval and closer oversight?

Of course, I am speaking about the vitamin and supplement industry.

Over 30 years of practice, I have seen many patients who took supplements. In fact, one in five Americans takes herbal supplements, and half of all Americans take vitamins and/or supplements. I had one elderly couple bring all their pills to my office to make sure there were no interactions with their medications. They appeared with two large Rubbermaid bins, both so full of pills the lids would not fit.

The problem is that these supplements contain chemical substances that are not well-controlled or proven effective by anyone outside the company making them. Many herbal mixtures contain plant substances such as guarana, ginseng, green tea or green coffee extracts, and various other plant stimulants. As a result, some of my patients taking these supplements have suffered dangerously high levels of blood pressure.

Currently, there is a lawsuit, filed by the New York state attorney general against Walgreens, Walmart, and Target, among others. The suit alleges the companies’ supplements, as tested by DNA methods, do not contain what they say they do. In fact, only 1 in 20 of the pill bottles tested contained the material listed on the labels.

The phrase “clinically proven” is frequently used to imply that a substance has been tested in a scientific setting and shown to do what the manufacturer claims. But this statement means only that somewhere, someone used the supplement and felt better. Medications that meet FDA requirement do not use this phrase, as it is meaningless. Instead, pharmaceutical companies say what the medication is for and give the efficacy as shown in double-blind studies, meaning that neither the physician nor the patient knew whether they were getting a drug or a sugar pill. FDA-approved drugs have to show that they are better than a sugar pill. Supplements don’t.

So, the next time someone approaches you to buy a miracle cure, here is my advice: figure out the costs, including shipping and handling, and take out that much cash. Place it in an envelope where you will see it every day. Then, next Sunday, drop it in the offering plate at church. That way you know it will be helping someone and will never make anyone, including you, sick. Also, you will experience the added joy of worshipful giving.

Note that these warnings apply only to herbal supplements, not vitamins. Next time: "So, What Should I Take?”

Dr. Steven C. Burns is board-certified in family medicine and has been in practice for almost 30 years.

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