You might think that we at MedShadow are big proponents of the use of vitamins and supplements as preventative medicine. After all, our message is to avoid possible side effects by using the lowest effective dose of medicine for the shortest necessary period of time. And not needing to use medicine is the best way to avoid side effects. But we don’t encourage vitamin and supplement use by healthy people. Why? We advocate for evidence-based medicine and there is very little proof that vitamins and supplements work as well as they claim.
The evidence does not support the belief that use of supplements can improve or lengthen life for healthy people. In fact (not in belief), many supplements have been proven ineffective and, worse, dangerous in some cases.
Pieter A. Cohen, MD, one of the 3 major writers of the website Updates in Slow Medicine (which I consider a must-read), published an editorial in a recent issue of JAMA. In it, he summarizes and outlines the confounding issue of why do smart people ignore good research? The information that many supplements don’t work, he points out, is available with very little digging.
Let me hasten to point out that for people who are low in key nutrients, appropriate supplements and vitamins can restore health. I take a compounded formulation of B6 and B12 because my body can’t seem to absorb it naturally.
More than 50% of US adults take some sort of vitamin or supplement on a regular basis. This number hasn’t really changed even when various supplement claims are debunked. The public either keeps taking it or moves along to the next hot supplement. For example, a large study published in JAMA in 2006 on the arthritis “remedy” glucosamine/chondroitin had negative results. Yet, years after the article was published, the same number of people were taking it.
Cohen notes, “In response to research findings showing no substantial benefit for garlic and glucosamine, for example, manufacturers may have turned to preliminary findings to promote coenzyme Q10 for heart health or methylsulfonylmethane for joint health.”
Cohen reports on a review of studies of health effects of supplements from 1999 to 2012. The National Institutes of Health spent between $250 and $300 million studying supplements. In general, the results failed to show any benefit. Some might say, it may not do anything, but what’s the harm in trying? Wasted money, risk of ingesting pills that may not actually have the ingredients on the label, (and in many cases, substances NOT on the label), and risk of supplements or vitamins interacting with medicines that are effective.
Why doesn’t the FDA protect us from dangerous or useless products? They don’t have the power to. Cohen points out that, “Ginko biloba continues to be sold ‘to support mental sharpness’ despite a large, high-quality NIH-funded study that found evidence to the contrary.” The law allows supplements to advertise benefits based on “structure/function” claims.
Furthermore, supplements do not have to go through the extensive testing prescription drugs do to demonstrate its safety and efficacy. A company can slap almost any claim they want on the label. And the FDA typically only gets involved if there are complaints about a product or a pattern of serious side effects or adverse events appears.
Here is my advice: If you see the following claim on any product, believe it. “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.”