The Healthy Skeptic

I’ve written here on the blog about food, diet, and health many times. It’s not just that I love to cook, or that I view the ‘organic’ movement with a somewhat cynical eye (having been in the midst of it), or that I’m a mother trying to raise healthy kids. The reality is far from the narrative when it comes to food, medicine, supplements, and our perceptions of them. I hope if I keep talking about the science and truth hiding behind the obscuration of media and myths, others can learn to look for the man behind the curtain before they buy into claims lock, stock, and barrel.

Yesterday I shared a quote from Science Based Medicine on my blog about the supplement and natural medicine world, regarding their lack of ethics, and this roused questions about certain vitamin usage, so I thought I’d take the time to discuss vitamins and supplements more in-depth. First: there are definitely good vitamins we need and should make sure we get in our diets, or take in supplemental forms if that is impossible. However, note that the ideal form of consumption is dietary. Ofttimes vitamins taken in pill form cannot be fully processed by the body, and simply pass through, wasted. Among these are folate, for pregnant and nursing women, vitamin D supplementation for children and people who cannot be out in the sun (again a note that many foods are already supplemented with D, so be aware of your doses, which I’ll get back to shortly), vitamin K for newborns can prevent bleeding, and vitamin B12 is good for anemia.

However! Have you recently taken a stroll down the vitamin aisle in your local pharmacy or big-box store? I can remember when the vitamin and supplement section was maybe three feet of shelving. This has blossomed into, well, entire stores devoted to products of dubious claims and  suspicious provenance. These, specifically, are what I was referring to with my concern about a lack of ethics. Most of them do not do what they claim. Some do the exact opposite: look at this review of studies on antioxidants, which indicates they actually elevated mortality. Vitamin A, beta carotene, and Vitamin E are all indicated in that. I already knew that A was lethal if taken in high doses, but I was surprised to see beta carotene on the list.

The problem is that some things might be helpful, or at least neutral, taken in small doses. But as I wrote about a while back, the dose makes the poison. I showed that taken in enough quantity, even water is lethal. We are all familiar with the human tendency that ‘if a little is good, a lot is better’ and when it comes to taking your vitamins, this holds true. Science has not shown this to be helpful at all, and in some cases this may even be harmful. Scientists and doctors have repeatedly come out, saying that spending the money is a waste, but the public doesn’t hear these voices, drowned out in ad campaigns for the latest and greatest supplement. “After reviewing 3 trials of multivitamin supplements and 24 trials of single or paired vitamins that randomly assigned more than 400 000 participants, the authors concluded that there was no clear evidence of a beneficial effect of supplements on all-cause mortality, cardiovascular disease, or cancer.”

I wanted to make something else clear – I was not quoting the FDA, nor was it funding the studies I’ve been pulling data from for these articles. That’s not what the FDA does, first of all. Secondly, the perception of the FDA as a jealous dog in the manger keeping us from getting drugs that will help us all live happier, healthier lives is seriously warped. Does it slow down the process? Of course. Is it a gov’t bureaucracy with all the perils and pitfalls therein? Oh, my, yes. But the role is to ensure that the drugs we do take, and the supplements we buy, are what they say they are. Look, I’m all for natural foods and so forth. But the biggest problem I have is consistency. To rely on a drug (and face it, many supplements are being used as drugs: St. John’s Wort, Echinacea, and so on) you need to be sure you’re getting the same amount of active pharmaceutical ingredient each and every time you take it. To do otherwise is to risk overdosing, underdosing, and negative results.

I’ll suggest that if you’re concerned about the FDA’s role, you spend some time on their website reading the warning letters they send out. Like this one: “Some of your powder blend mixtures are manufactured from ingredients that pose potentially toxic effects. For example, your Infants’ Teething Tablet contains belladonna. Raritan uses this powder blend mixture to produce finished drug products for infants and children, a population vulnerable to the toxic effects of belladonna.”

First of all, who gives their kid belladonna!?

Sorry about the emotional reaction and punctuation. I don’t know how to fully express my mild horror at the idea. Secondly, if you read through that letter you’ll see that the FDA is primarily concerned with the toxic ingredient, yes, but also with the lack of methods for keeping production of their product uniform. So what does that lack of homogeneity mean? Well, with this product, it could mean enough belladonna in your teething baby’s mouth to put them to sleep… forever.

That, in a nutshell, is one of my biggest concerns over the use of ‘natural’ products. As I said in my earlier post about poisons and drugs, many natural drugs are plant poisons, produced by the plant to sicken or kill things that eat it. Do you really want to find out what happens when you take supplements or drugs that are variable in dose? Or would you rather there be some kind of a watchdog keeping an eye on the manufacturers, barking now and again to keep them ethical? I’m not a fan of overregulation. I am also not a fan of anarchy.

I’ll leave this here for now. The topic is monstrously large, and I could keep going for days, but I have work to do.  I’ll come back to it again next week if there is interest.


4 responses to “The Healthy Skeptic”

  1. “I already knew that A was lethal if taken in high doses”

    No kidding, and you don’t have to be a scientist to figure that out. Reading about Douglas Mawson’s Antarctic adventure put me off high doses of Vitamin A for life!

    OTOH, there are dye powders I keep on high shelves and behind closed doors, even though you’d have to ingest a pound of one to do yourself any harm, because I don’t put it past a visiting toddler to sit down in the work room and pig out on Mixing Red or Cerulean Blue.

    1. Well, if we’re talking dyeing, mordants can be fiercely toxic, too. Safe storage is just good practice.

      I think I first became aware of the dangers of vit. A when I was reading books on wild plants, and one warned that overconsumption of Dock (Rumex crispus) could be dangerous due to the high levels of A in it. On the other hand, if A really did help, that plant would be a great (and free!) way to consume it.

  2. Tammie Darden Avatar
    Tammie Darden

    This is the problem in a nutshell. Misleading advertising and an under educated public. Pharmaceuticals come with a big advisory sheet tell you all of the side effects and they also have quality controls in place (that get reviewed). I have to do some FDA related work. I’ll admit to giving them the stink eye. I have to remind myself that they do have a legitimate function. Belladonna is not for kids nope nope nope.

    1. My current job is largely done as though the FDA is looking over our shoulder. It’s both a PITA, and a nice feeling. As a consumer, I’m happy to know how closely they keep an eye on the drug production process.