The Supplement Threat

The New York Times has recently published two articles on the use of so called nutritional supplements. Nutritional supplements are not regulated as drugs, but physicians and hospitals should, and usually do, treat them as drugs.  What does this mean? Supplements do not have to prove that they are efficacious and safe before they are sold.  The FDA can only regulate them in a retrospective way – when they find that there may be a problem. It’s like the FDA and food safety, at least until recently.  Only after the problem occurred, when it was too late, could the FDA crack down on a malfeasant food supplier. Same deal for supplements.

The FDA is now spending a great deal of its enforcement time dealing with supplements that have unlabeled active ingredients like steroids or Viagra-like drugs or amphetamines. Some have high quantities of things like arsenic or heavy metals like lead and selenium.  Some are just mislabeled so instead of getting gingko, you’re getting green tea or just twigs and leaves. All of these can be harmful to your health.  And – you don’t know that you’re taking them because you think that the supplement you are taking for your joint health or whatever is safe and effective.  You believe all those advertisements on TV.  Or you mistakenly believe that somehow the FDA has your back here.  You’re wrong on all counts. By the way – the FDA is not alone here – same problems in Europe.  My impression is that supplements are even more popular there than in the US.

Steroids in supplements can lead to masculine traits in women like beard, mustache or chest hair.  They can lead to breast enlargement in men.  But, in the worst case, they can lead to liver failure as noted in the second article in the Times. Liver failure can sometimes be treated with medication and watchful waiting, but sometimes a liver transplant on an emergent basis is the only alternative.  Sometimes, you die.

Another recent study looked at the utility of those vitamin pills many of us take every day.  Guess what!  They don’t do anything. But, in some cases, like the other supplements, they can be harmful or contain unlabeled contaminants.  Admittedly, the problem of unlabeled or mislabeled ingredients seems to be less urgent for vitamins – at least our risk of dying from taking them seems to be less than for other supplements – but they don’t seem to do anything to benefit us either.

What does all this have to do with antibiotics and why is this topic appearing in this blog? Well, supplements have always been a pet peeve for me and the latest spate of lay news articles has given me the opportunity to vent a little. But, some “natural” practitioners are recommending that one way to cut down on inappropriate antibiotic use – a noble goal – is to use nutritional supplements of various sorts instead. Obviously – I think this is a very bad idea.  If you don’t need an antibiotic because you have a viral infection that antibiotics won’t treat – don’t take them.  But if you have a potentially serious bacterial infection and you try to treat it with some supplement – you’re playing Russian roulette.