The world of so-called nutritional supplements was briefly
back in the news last week when Dr. Oz was grilled by a Senate subcommittee.
Dr. Oz, if you aren’t aware (I wasn’t) has a popular television show where he regularly
touts nutritional supplements as magical cures for whatever ails you –
especially for weight loss products. The Senators questioned whether his
statements, “this is a magical product,” could be misleading. Are you kidding me?
This topic was addressed by John Oliver, on his HBO
television show over the weekend. For anyone who cares about the public health –
this show is a must – and it is available online here. Mr. Oliver takes us back to the L-trytophan
poisoning of 1993 when over 200 people died and about 16,000 reported illness after
having taken this product. And this is
just in the US.
There are two agencies in the US that could, under the right
circumstances, help protect us from dangerous supplements – the FDA and the
FTC. This was the subject of a previous blog.
Mr. Oliver correctly points out that the laws governing how these agencies can
handle supplements are designed to allow manufacturers to continue to sell us snake
oil unimpeded. The situation then and now is that the FDA can do nothing until
it detects some adverse event. Of
course, hundreds of people might be affected before the FDA can act and
hundreds more while they carry out their investigation. And it is more than
clear that these supplements can kill and that the supplement manufacturers are
unable to police themselves in this regard.
At the time of the L-tryptophan poisoning, the FDA proposed
that it be given new authority to regulate supplements requiring evidence of
safety and efficacy before they are
marketed and requested the authority to review advertising claims about such
products just as they do for drugs. The industry responded with a vigorous
advertising campaign spending millions. The FDA’s effort was soundly defeated
in congress. Apparently, according to
Mr. Oliver, congress received more letters defending the supplement industry
than they did over the entire Vietnam War.
All the FTC can do is to challenge the companies for making
false statements in advertising – but to do this, they rely on the FDA for
evidence that the statements are false.
If the FDA has not examined evidence of efficacy, the FTC’s hands are
usually tied.
Mr. Oliver points out that this situation is not likely to
change anytime soon. Why? The senate is in
the hands of the supplement manufacturers who assure their future with campaign
contributions – that’s why. The two
senators who receive the most money from this industry are Hatch and Harkin –
both of whom are the most outspoken defenders of the snake oil manufacturers.
This is a situation that affects all of us –from cardiologists
to ID specialists to surgeons to patients. Why do we let this continue?
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