Knowledge is Spreading

Knowledge is Spreading

There have been a flurry of studies the last several years that demonstrate that herbs and supplements are not only a waste of time, but potentially harmful. As the Annals of Internal Medicine editorial noted in 2013

In conclusion, β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful. Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases. Although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe that the case is closed— supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough.

Herbs like St. Johns Wort have the potential for important drug-drug interactions

SJW was mentioned in 2,230,000 visits (120,000 visits/year). On average, visits mentioning SJW had 3.1 other drugs mentioned. Of the visits at which SJW was listed, 28% (620,000 visits over the 18-year study period) also listed a drug that is unsafe to use with SJW. Leading medications that could interact with SJW and that were listed at SJW visits included SSRIs (13.7%), benzodiazepines (9.8%), warfarin (4.2%), statins (3.3%), verapamil (1.0%), digoxin (1.0%), and oral contraceptives (0.6%, Table 1).

A quick Pubmed of “herbal complications” finds hepatitis, kidney failure, hypertension, bleeding, and priapism that lasted 120 hours among others.

 

No proven efficacy and potentially fatal side effects. That is what supplements and herbs offer.

One of my unsubstantiated beliefs is that the truth will out. Eventually. It appears that in the US consumers were getting the message:

An estimated 40.6 million US adults reported herb and supplement use in 2012. However, the rate of herb and supplement use dropped from 18.9% in 2002 to 17.9% in 2007 and 2012 (P < 0.05). This decline in use was more pronounced among women, racial or ethnic minorities, and adults with low incomes. Conclusion. Herb and supplements use remains common in the USA, but adult use rates are on the decline. It is still important for health care providers to ask patients about herb and supplement use.

and that was before the devastating verdict of the Annals.

The industry is worth 68 billion dollars and predicted to grow:

Consumer demand for nutritional supplements should remain high as health-conscious customers seek optimal health in a bid to prevent or treat chronic conditions.

I doubt Big Supplement will go quietly into that good night. Too much money to be made. But it is nice to know that perhaps people are indeed paying attention to some of the science-based medical information. With the rapid growth of integrative medical clinics, it is nice to start the new year with one bit of good news.

Points of Interest 01/14/2015
Points of Interest 01/13/2015

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