One Star Rating
They’re baaaack!
“They” are the editors of Consumer Reports (CR), and it seems like every six months or so they come up with a feature that seems specifically designed to get me all riled up. Well they’ve got me all riled up again with a misguided cover story (May issue) that’s loaded with what seems to be reasonably good advice. And while this advice does serve a purpose, it’s also seriously off the mark in several important details that everyone who takes supplements should be aware of.
Hamstringing
The May CR cover headline blares: “Dangerous Supplements: 6 Could Cause Cancer, Kidney Failure, Liver Disease or Death.”
Sounds dire, doesn’t it? Inside, the lead article gets things underway with this headline: “Dangerous Supplements: Still at Large.” In other words, the editors are equating certain supplements with criminals roaming the countryside, searching for someone to harm. And that basic mindset runs through the entire feature.
Much of the article is devoted to a review of the FDA’s relationship to the supplement industry. This is a topic that I’ve covered in great detail in several e-Alerts (see “The Fix Is In” 7/22/03), so I’m not going to open that large can of worms again here. But there is one quote that stands out, and makes CR’s position clear: “The agency continues to be hamstrung by the 1994 Dietary Supplement Health and Education Act (DSHEA).”
What they don’t mention (or, more likely, just don’t get) is that the FDA is SUPPOSED to be hamstrung by DSHEA! The whole point of DSHEA is to keep the FDA from meddling too deeply with the dietary supplements that give consumers the freedom to make their own healthcare choices. Saying the FDA is hamstrung by DSHEA is like saying the Federal Aviation Administration is hamstrung by the public’s desire to fly.
The sky is falling
After outlining the reasons why the poor FDA is in such a bind, the article gets to work detailing what they call the “dirty dozen” supplements that are reputed to cause a variety of health problems. I’m not going to defend the use of these supplements, and I would recommend that they be used with caution and only after consultation with a doctor. But the inflammatory style CR uses to tick off the negative aspects borders on a kind of hysteria. Run for your lives! Dangerous supplements are at large!
The effect of course is to portray the entire supplement industry as irresponsible and the products unsafe when the fact is that only a very small percentage of supplements ever cause any problems at all.
In a chart that describes the drawbacks with each one of these dozen, you won’t find any mention of the benefits of any of the supplements. But you will find a listing of reported hazards, such as “kidney failure” and “deaths reported.” The sources of these details are not listed, so we don’t know any of the circumstances surrounding a patient with a failed kidney – could the patient have had other health problems that contributed? And “deaths reported” does not mean “deaths confirmed.” And again, were there other contributing factors? Were the supplements misused? Were they combined with another supplement or a drug that made them more potent? CR doesn’t say. But the clear implication is that we should simply trust the editors that these supplements are apparently equal to poison.
Not so fast
The worst offender on the list is Aristolochic acid (AA), extracted from vines of a species of plant called Aristolochia. CR calls this supplement a “powerful kidney toxin” and notes that it may be carcinogenic when taken in high doses. The dangers of AA are highlighted with reference to a well-known incident in the early 1990s. More than 100 patrons in a Belgian weight-loss clinic suffered kidney failure “after consuming Chinese herbs adulterated with Aristolochia.”
What CR doesn’t note is that this concoction of “Chinese herbs” also contained drugs such as the stimulants fenfluramine and diethylpropion. So was Aristolochia responsible for these kidney problems, or was it simply an unfortunate mix of herbs and drugs? In the several reports I found about this incident, the conclusions are inconsistent.
CR notes that, in spite of an FDA warning about Aristolochia, their editors were able to purchase Aristolochic acid easily on the Internet, and I’m sure they were. But I was curious about what sort of availability such a notorious product might have. So I Googled “Aristolochic acid” and you know what I got? Warning after warning after warning. No advertisements, just warnings. This is what you might call “ground level regulation.” Anyone searching for an AA product or looking for information about it before taking such a product (which they certainly should do), would clearly be forewarned by browsing through just the top 6 hits on the Google list.
Upside down
At the top of their article, the editors of CR state that, “Most supplements are probably fairly benign.” But that’s a ridiculous understatement. Many supplements help people live healthier lives by helping prevent chronic diseases, healing joints, managing pain, and relieving depression, to name just a few benefits. That’s far from benign. But when it comes to potential problems, CR doesn’t want you to believe supplements are benign at all. When discussing the danger, supplements suddenly become potentially “potent” toxins.
The obvious message here is that the benefits of supplements are weak, but the dangers are powerful. Which is the truth turned on its head.
Rating the raters
At HSI we support responsible supplement labeling and we endorse only those manufacturers that label their products accurately. We also urge anyone who is about to embark on a new supplement regimen to consult with their doctor and then do their own background research – ask questions, look for testimonials and read available studies.
When you go to the Consumer Reports web site, at the bottom of many of the pages you’ll see this quote: “For complete Rating and Recommendations of appliances, cars & trucks, electronic gear, and much more “
As always, I wish CR would stick to rating appliances, cars & trucks, electronic gear because when it comes to healthcare, they continue to rate unsatisfactory in my book.
Sources:
“Dangerous Supplements: Still at Large” Consumer Reports, May 2004, consumerreports.org
“Twelve Supplements You should Avoid” Consumer Reports, May 2004, consumerreports.org
“The Art and Law of Supplement Labels” Consumer Reports, May 2004, consumerreports.org
“What You Can Do” Consumer Reports, May 2004, consumerreports.org
“Aristolochic Acid and Chinese Herbs” John K. Chen, Ph.D., acupuncture.com
