Let’s face it…
Much of what you see on your news feed is click-bait, designed to get your click so the poster gets paid. Each of us is more likely to “click” if an emotion is triggered. Fear, Anxiety, Anger, Hope, Joy – these are what titles and opening photos are designed to do.
Agree with me so far?
My news feed (because the all-knowing-techno-brain-in-the-sky knows my interests) is filled with articles about healthcare, innovation, neuroscience, metabolomics and, yes, supplements. Many of these are pure click-bait sensationalism – BUT, the emotion can’t be triggered unless there is some reasonable problem or solution presented in the title.
There are many reasons anti-supplement fear-mongering is a favorite topic for click-bait articles, and it is this:
There ARE many problems with the sale of nutritional supplements in the US.
Why can I say this reliably?
For those of you that don’t know me, I am an MD, trained at Vanderbilt and the Mayo Clinic. I have Board Certifications for Integrative Medicine, Family Medicine, Neurofeedback, and am a Certified Nutrition Specialist. I have recommended particular supplements to my patients for 20+ years, and have been inside the nutritional supplement industry for the last 15 years as a formulator of products, expert consultant, quality control evaluator, and scientific advisory board member. and I am currently the Medical and Innovation Director for XYMOGEN, the largest and fastest-growing medical-professional-authorized nutritional supplement company in the US.
Suffice it to say I have seen both the light side and the dark side of the nutritional supplement industry.
Let’s take a look at some of the real problems with nutritional supplements in the US and why this makes for a good soil from which to grow click-bait articles.
Problems With Supplement Marketing
Potency and Purity
With most supplements you do not know what is REALLY in them, because potency (what is actually in the formula, and PURITY (what is truly NOT in the formula) is rarely disclosed. Terms like “Proprietary Formula” abound to hide the actual quantities. Lack of detail is commonly used to hide the fact that inferior raw materials were used, and the actual manufacturer is hidden from consumer knowledge behind a brand name.
- Of note, in 2015 the New York Attorney General’s office examined the common herb “Devil’s Claw” and found that of the 18 products tested – 2 had no DNA for Devil’s Claw present, and the other 16 for which DNA could be identified, all contained zeyheri [the inferior, less potent variety] rather than procumbens [used in most studies and more potent]. The attorney General’s office issued cease-and-desist letters to several manufacturers due to these quality control issues – several brands you may recognize if you know your supplements: Solaray, The Kroger Co., as parent of Vitacost.com, DaVinci Labs, Thorne Research Inc., Puritan’s Pride, Prescribed Choice, Now Foods, Nature’s Sunshine Products, and Vital Nutrients. Many of these companies market heavily, and promote deep discounts.
- In that same year, the New York Attorney General sent cease-and-desist letters to GNC, Walgreens, Walmart and Target, calling them to stop selling some of their store-brand herbal supplements in New York. They include ginseng, St. John’s Wort, echinacea and ginkgo biloba. It turns out almost 80 percent of the pills officials tested did not contain the key plant ingredient listed on the label, and included fillers like rice and beans, and additional ingredients such as wheat, mustard or radish.
Suppose the label IS clear – you still don’t know if the company is ignorant or lying. Many manufacturers do not test beyond the bare minimum for raw-material authenticity, bacterial contamination, toxins, or adulterated materials.
Aside from some very basic minimum standards most potency and purity testing is self-monitored by the company itself according to the standards the company sets with little FDA oversight.
Is it even good for you?
Lets say you feel sure that the contents of your bottles are potent and pure. You are not sure if a pill or potion – at a specific time and this dose – is even good for you. That’s because supplements are generally not patent-protected, so the large investments necessary for thorough trials are hard to come by. Research funders know they will be unable to recoup their investment.
Still, there are many unregulated voices that will tell you their magic pill is good for whatever ails you, and this creates reasonable skepticism and even cynicism.
- Add to this the problem of Amazon where mass competition is driving down supplement profit margins to the extent that smaller companies that are trying to sell their products on this platform have already and will continue to cut corners elsewhere in raw material selection, purity testing, and expiration date games. Amazon’s warehouses may not be air-conditioned, and products may be returned for resale. Not ideal conditions for something that will be brought into the body on a regular basis.
Anti-supplement Posts Don’t Make Enemies
Chemicals (small molecule drugs) have WAY better profit margins than Natural compounds.
This has several effects:
Beating up on supplements in a blog is not going to anger big advertisers.
Compare this to writing about how Omeprazole (better known as the Purple Pill) increases all-cause death, dementia, pneumonia, etc. You’ll risk lawyers from AstraZeneca and Proctor and Gamble after you. You’ll also have fewer large internet venues desiring to pick you up because those companies will not want to advertise next to articles critical to their products.
- Ironically, Big Pharma and big business owns most supplement companies:
- Pure Encapsulations and Garden of Life are owned by Nestle, the same company that brings you Nesquik, Tombstone Pizza, Alpo and Carnation Instant Breakfast.
- Centrum is owned by Pfizer, maker of Viagra and Lipitor.
- Metagenics and Herbalife are owned by Amway,
- Etc, etc, etc.
- While these companies know this strategy diversifies their health care offerings, they are keenly aware that there is not a drug-like profit margin available when one is selling a natural product that takes land, sunshine, and living organisms to produce. Not to mention the protection from humidity, heat, light, and radiation it needs to stay usable to the human body.
Heart > Head = $
Oftentimes, the science is covered up in the headline.
After all, emotion makes us click. Describing the nuances of study design, population selection, and clinical or statistical significance, while incredibly important are not sexy.
“Science” Is Often Misleading
*WARNING* Science Language Ahead
- Natural compounds, unlike drugs, are NOT designed to override, block, stimulate, or inhibit bodily processes. Therefore, when studied, they seldom show dramatic short-term effects on established disease. But just because an effect takes time does not mean it has is no effect.
- Nobody can deny that the quality of our diet in the long-term greatly influences the quality of our health. For this reason, good studies on nutritional compounds need to be appropriately dosed (most are horribly under-dosed) and long enough (years) to show effect that is meaningful. To illustrate this, SAMe given at high dose for two years decreased the need for liver transplant and all-cause mortality in individuals with moderate alcoholic liver disease by nearly 50%! CoQ10 for heart failure was examined in the Q-SYMBIO trial which took place over 2 years and 16 countries using high-dose CoQ10 and it showed a statistically significant improvement in all-cause mortality, hospitalization for heart failure, endurance, and an improvement in heart failure class. It should be part of the standard of care in conventional medicine for certain. Oh, and the placebo had more side effects than the study supplement because the individuals randomized to the supplement were healthier in more ways than just less heart failure.
- Compare these studies with some of the fish-oil drivel that frequents the blogosphere. Most fish oil studies under-dose, do not track blood levels, and are for very short periods of time. Long-term data is clear that those with the highest levels of omega 3 over 15 to 20 yrs have markedly decreased all-cause mortality, but studies expecting to find a drug-like effect are setting the supplement up for failure. It is like comparing a speed-boat and a race-car to a match of speed. The track you choose will make a big difference on who wins. The track supplements need to show off is a long-term measurement of health outcomes, not short-term drag race to decrease symptoms.
- We need more, longer, and better conducted studies that is for certain, and we all need to be able to change our mind given better data on any subject – that goes for advocates for and detractors against the use of nutritional supplements.
Wolves Among The Sheep
A “supplement” can come from a broad range of substances and molecules that are marketed to the public. They can be nutritional agents, minerals, vitamins, plant extracts, or particular food and food concentrates. When recommended by somebody knowledgeable of the product and the person into whom it will go, they are incredibly safe. INCREDIBLY SAFE.
But when body-hackers and bio-hackers practicing bro-science are using the term “supplement” to market strong stimulants, illegal hormone-like substances, drug-like high concentrates of mood-altering raw materials, and drug-laced franken-supplements using raw materials coming from China being produced in who-knows-who’s garage, yes, there will be bad outcomes.
This is why regulation and transparency are so key in this field.
Most all of the negative outcomes attributable to supplements come from the muscle-building gym-rat set of materials. A good example of this is from an article that prompted the writing of this blog:
Honestly, before reading this article, I had never heard of such an ingredient – largely because it is essentially a drug in supplement clothing and I would never consider using it or another of it’s stimulant cousins in a product let, alone recommend them to patients.
Look at the product names that contain this ingredient in the quoted study and see if any of them sound like a product to improve fundamental health and well being…
“The 24 products tested in the study were: Adrenal Pump, Apidren, Beta-Stim, Burn-HC, Defcon1 Second Strike, Diablo, DyNO, Gnar Pump, Higenamine, High Definition, HyperMax, iBurn2, Liporidex Max, Liporidex PLUS, LipoRUSH DS2, N.O. Vate, OxyShred, Prostun-Advanced Thermogenic, Pyroxamine, Razor8, Ritual, Stim Shot, ThermoVate, and Uplift.”
Not only did only 5 of the 24 actually list an exact quantity of this stimulant, those 5 were not correct.
But note the title of the article: “These supplements may actually harm your health.”
The article wants clicks so it did not include the name “Higentamine” in the title. If the article was to inform or protect, then it should have read “Higenamine may harm your health,” but then not as many people would click and they would lose ad revenue. Besides, even if the author does primarily want to inform and protect, he can’t very well do that if no one opens it up.
The problem is that many people will see the title but not read the article.
If all they read is “These supplements may actually harm your health,” they grow in their wariness of all things natural and supplemental. This is a meaningful win for big Pharma and big Ag and big HealthCare.
What We Are Doing About This
- Our clinic does its best to recommend products for our patients that have been thoroughly vetted for PURITY and POTENCY, with great documentation.
- The supplements we recommend are produced by a family owned company that is personally accountable to the end customer.
- These products are produced in a facility which applies standards at or above those used for pharmaceuticals.
- Substances used are same ones used in studies, at appropriate doses for maximum effectiveness.
One final thought: Supplements are Supplemental. An excellent diet, exercise, adequate restful sleep, stress management, and wholesome relationships are the core of health. Nutritional supplements are not manna, they are not the elixir of the gods. They are useful concentrated foods and natural substances. At their best they support health in ways that could not be attained without their use. I encourage use with discernment.