Yes, the AMA — that organization consisting now of < 12% of licensed MDs or DOs in this country — has sought to go after that life and death question in one of their latest editorials: The Supplement Paradox — Negligible Benefits, Robust Consumption (). Why, we Americans must be downright stupid, no?
This is the kind of position that begs a query. Why on earth would the most commercialized of all so-called “peer-reviewed” medical journals go after something like this? It is well known that drugs — even when prescribed properly — kill > 100,000 Americans a year, and that, by any measure, is likely a gross underestimate. Supplements, on the other hand and despite intense scrutiny by the medical minions in various regulatory agencies, are among the safest of interventions. According to the American Association of Poison Control Centers there were more than 60 million doses of dietary supplements consumed in 2012 with not a single reported death. More recent data is likely going to be available soon, but this might drop a hint that any panic attacks re supplement safety is probably misdirected. But I digress.
The AMA, the organization that supports itself on the profits of those funny little codes that are used for each and every single medical procedure or encounter (without which physicians cannot get paid by their employers, ie, insurers), also is laying down the gauntlet that these innocent substances are not effective for anything.
Dietary supplements encompass a wide variety of products from vitamins, minerals, and botanicals to probiotics, protein powders, and fish oils.1 During the past 2 decades, a steady stream of high-quality studies evaluating dietary supplements has yielded predominantly disappointing results about potential health benefits, whereas evidence of harm has continued to accumulate. How consumers have responded to these scientific developments is not known. In this issue of JAMA,2 the report by Kantor and colleagues sheds light on this important question.
Prominent examples of high-quality studies published during this era and showing no benefits of supplements include an evaluation of multivitamins to prevent cancer and heart disease, echinacea to treat the common cold, St. John’s Wort to treat major depression, and vitamin E to prevent prostate cancer.
Well indeed they do intend to trivialize vitamins and other supplements. Where do I start. The number of referenced “studies” that seem to indicate lack of efficacy are few and far between. One study actually published in their very own Journal of the American Medical Association in 2012 showed an 8% reduction in all cancers in a randomized, placebo controlled 10 year trial of retired physicians. This study was not cited nor were numerous other studies (see below for just a small sample) that show both safety and efficacy of the intelligent and skilled application of nutraceuticals (the preferable word for “supplements”) and/or botanicals. In other words today it is highly unlikely that the average MD not trained in the specific application of these substances would have a wild clue as to how to use them properly. The testing — standard, functional medicine, and genotypic — now used to decide who would benefit and by how much in the use of nutraceuticals or botanicals is a mystery to most MDs unless they have attended a graduate level course in their use. It would be equally as unlikely that a psychiatrist would be comfortable as to how to prescribe a retroviral drug to a patient with HIV.
So our friends at the AMA have actually done us all a favor by illustrating their ignorance. A JAMA editorial denouncing the American patient public in their ignorant use of “supplements” reminds me of how the AMA advised us on another product Americans consumed, only this time they encouraged it.
Probiotics lower blood pressure: de Brito Alves JL, de Sousa VP, Cavalcanti Neto MP, Magnani M, Braga VA, da Costa-Silva JH, Leandro CG, Vidal H, Pirola L. New Insights on the Use of Dietary Polyphenols or Probiotics for the Management of Arterial Hypertension. Front Physiol. 2016 Oct 6;7:448. Review. PubMed PMID: 27766081.
Grapeseed extract lowers prostate cancer riosk by 40%: Brasky TM, Kristal AR, Navarro SL, Lampe JW, Peters U, Patterson RE, White E. Specialty supplements and prostate cancer risk in the VITamins and Lifestyle (VITAL) cohort. Nutr Cancer. 2011;63(4):573-82. doi: 10.1080/01635581.2011.553022. PubMed PMID: 21598177; PubMed Central PMCID: PMC3100666. Low vitamin D associated with depression: Parker GB, Brotchie H, Graham RK. Vitamin D and depression. J Affect Disord. 2016 Oct 11;208:56-61. doi: 10.1016/j.jad.2016.08.082. Review. PubMed PMID: 27750060. There are hundreds more, but I need to have a smoke.