Sure are. The real crux of the issue for me is the wild lack of quality control.
I'm broadly in favor of the FDA and other regulatory agencies, if for no other reason than they have the power to require that you're really selling what you claim you are, and enormous power to punish you if you don't.
That this is not the case for supplements is largely the fault of Orrin Hatch.
The FDA's mandates are safety and efficacy, in that order. It's still bad, but I'm way more OK with people taking sham pills that contain exactly binder and nothing else, instead of taking sham pills that contain lead and mold.
no. But for makers of actual pharmaceuticals, etc., the FDA can appear at your plant and they have the legal authority to close the site and halt manufacture until they're done auditing you. That particular power is not granted to them for supplement makers. I think it ought to be.
Perhaps, but that does seem disruptive to business. There probably needs to be better anti-fraud enforcement, but maybe there is a way to do it without shutting down facilities just to conduct an audit. Woudn't testing product samples to ensure that they are what they claim to ve (and nothing else) be enough?
>Perhaps, but that does seem disruptive to business.
It's sure supposed to be!
> Woudn't testing product samples to ensure that they are what they claim to ve (and nothing else) be enough?
Experience has shown otherwise. Though random product QA testing is absolutely the first and normal line of defense, you need the fist, too. Actual plant shutdowns are rare, very costly, and normally get people's attention.
This topic tends to be flamebait unfortunately, and the title of this article doubly so. A better title might be "Harvard releases vitamin and mineral supplements guide for clinicians".
Thank you. And if you compare the recommendations to supplement sales, it is probably much more aligned than the headline would suggest. Sales of vitamin D, B12, folic acid, etc would total in the billions of dollars, and thus make up a large percent of the industry.
But this guide isn't comprehensive at all, and doesn't go into the evidence for the multitude of vitamins, whereas other researchers have tried to synthesize more of that data. [1]
It's taken me a lifetime to figure out the combination of vitamins, enzymes, amino acids and other compounds that I need to compensate for what I lack in a diet. If I followed any one websites advise, I would have serious health problems. I have also learned over time that doctors actually learn very little about this in school. They know even less about the gut. I believe that each person needs to review and study what they eat vs. what they need and use trial and error. You will find side effects to different combinations of supplements. Some supplements also affect medication you may be taking, so study that as well. Don't stop when you find some wordpress site. Look for multiple government studies that explain testing methods, numbers of participants, human vs. animal testing, etc. I found several studies that directly conflicted with each other on some compounds.
The idea that the lack of a rigorous specific study indicates supplementation doesn't work is flawed. The entire Eastern system of medicine evolved based on shared experience and knowledge, and ample experience exists with many supplements to support their use, even if not the sort of rigorous evidence we might like. Sure this opens the gate to fraud and self-deception, however the level of personal experience shared on the internet is unprecedented in human history and certainly worth referring to when deciding on the efficacy of supplements.
Further, scientific studies are very often flawed. I trust how I feel at least as much as I trust a study.
Bits and pieces of Chinese medicine have been appropriated by Western medicine in piecemeal ways that often miss the point. There are large universities to teach this stuff. To believe that Western medicine has studied and adopted all that works is colonial arrogance.
>The entire Eastern system of medicine evolved based on shared experience and knowledge, and ample experience exists with many supplements to support their use...
Oh -- you don't tell me the entire Western system of medicine evolved isn't based on shared experience and knowledge!
The difference is the Western system has a systematic way of filtering noises from anecdotal experiences. It's called science: One of the most important pillars is reproducibility. You need to know what the chances that something will work, how statistically significant the result of the method you propose is. Any of the ideas such as "eating roots and leaves," "expose it to X-rays," "pray to the Gods," "spit on it," "take supplements," "open it up and cut it with a sterile knife," "drinking rhino horn powder," method, at the beginning, can equally seem like great ideas -- and we should test them all.
But so far, some of the "take supplements" routes, as pointed out by the article, don't work way too well. The Eastern system, in general, doesn't work too well either. If it did, Eastern people with cancer wouldn't have to go through chemo.
Yes we do. That's very valuable sometimes. Often those studies are flawed or biased. In fact much of the time they are not even reproducible, or studies that don't support a patent holder's interests are discarded.
Also thousands of years of knowledge and experience has yielded a lot fruit. Some of it is wrong for sure. Much of it too subtle and long term to fit into western trials.
I suspect the error rate is comparable. Science is not the only path to knowledge and medical science is deeply flawed.
> the level of personal experience shared on the internet is unprecedented in human history and certainly worth referring to when deciding on the efficacy of supplements
Similarly, we can safely conclude that vaccines cause autism, ghosts are real, and the moon landings didn't happen.
How many of our colleagues troll the internet for anecdotal evidence about recreational drugs or nootropics or Rsi cures. Not all knowledge has been established by science. In fact, I'd say less than 1% of knowledge, and much of medical science is wrong or misleading.
Medical science has brought both cures and devastating harms and lies. Just like other forms of knowledge, it must be taken with scepticism. Human knowledge has so much more to offer.
Further, scientific studies are very often flawed. I trust how I feel at least as much as I trust a study.
Hey, you know, if supplements make you feel better and there's no evidence that a particular one does any harm, then go for it!
But you have to acknowledge that "feeling better" in the absence of any evidence that a particular supplement has a detectible impact is more likely to be some complex placebo effect than anything else. Which is still valuable, but important to think about.
"Totes in your mind dude. Feeling better could not possibly be evidence of improved physical health."
This line of thinking makes me crazy and I don't understand why it is considered acceptable in any environment that remotely considers itself to be a space that values logic and science and the like.
We've ample evidence of the existence of the placebo effect.
Supplements are frequently studied. Some have scientific evidence of efficacy. Others don't, and it's reasonable to point out that claims of their efficacy that can't be successfully shown via studies may be the placebo effect at work.
Yes. Also it's called then placebo effect for a reason. Because the effect is real. Placebo effects can cure cancer. Feeling better is important if not the ultimate goal. Some medicine may be a combination of placebo and effects we don't understand.
A couple of random thoughts and then I should probably just bow out of this discussion:
1. I get dismissed a whole lot as my experiences being placebo effect or hallucination or whatever. My kids and I mockingly say "If just believing I will get well will cure us, I will take that. That must mean we have some of the most powerful minds on the planet."
2. When they do studies, they often use sugar pills as a placebo. I find this questionable. Sugar is an actual chemical. I use it at times for things like pain reduction. It doesn't work the same as a pain killer, but it does a good job of taking the edge off. Presuming that sugar is inert and has no impact on the body is a flawed mental model.
People that do things professionally where the science isn't fully vetted out usually have some things to teach in this regard.
My favorite example is body builders. There is still a lot of quackery, but I wouldn't throw everything they say out the window. These dudes are competitive and the sport is decades old, they have a good idea of what works, and that includes supplements.
To crib a bit from The Simpsons: I am currently not being attacked by tigers, but that doesn't mean my anti-tiger rock works, and it would be potentially dangerous to believe it does.
Bad analogy. There is a real effect from taking the drug, even if not related to it's pharmacology. There is no effect of the tiger rock on the tigers.
"There’s just no clear evidence to prove that they have any benefit."
Then...
"One large, randomized, double-blind, placebo-controlled US trial in men found that some who took multivitamins had a slight reduction in total cancer risk (particularly those with previous nutritional deficiencies and cancer diagnoses). But the trial needs to be repeated with women and more baseline data of nutrition status."
This is some really confusing writing but it sure sounds like there's some evidence that the multivitamin is helpful.
I use examine.com when choosing which supplements to take (which are very few). I had hoped that the underlying article would discuss fish oil but it appears to be out of scope.
Nah, it's the usual excuse for using homeopathy - as it works for those that believe it works.. Maybe! I dunno... I'm just very skeptical (without any proof)
The title is misleading - the article covers the fact that some supplements are useful. Yes, there is a ton of crap, but that doesn't make the entire industry a racket, just as fast food doesn't make the food industry a racket.
Fast food is still food, tasty, safe and nutritious - albeit with a macronutrient profile that is unsuitable for modern life styles when eaten in quantity. Fast food is not the problem, lack of awareness of how to use food is the problem.
Unlike food (or fast food) most supplements are not fulfilling any biologically useful function when consumed by otherwise healthy people - unless we consider placebo effects as biologically useful. They are unnecessary for the functioning of the human body, unregulated, untested and driven by often unscientific claims that don't have to be proven clinically.
When the majority or large portion of the sales are related to deceptive marketing of useless products, it's fair to say a market is a "racket" as a way to alarm the public, notwithstanding the many honest producers and effective products.
This sounds interesting. Can you break down your embedded assumptions, claims and conclusions in bullet-form? No matter how many times I re-read this, I am not able to follow it front-to-back.
EDIT: I love this line -- "lack of awareness of how to use food is the problem."
That's not a good analogy, though -- even if fast food is not healthy per se, it is provably food and suffices to supply people with calories in order to live.
Most supplements don't pass muster with the basic premise that they do what people claim they do.
So you are saying that food has calories, and therefore, based on caloric content, keeps you energetic or fat (depending on) fulfulling it's "food function", and that supplements are not macro- devices, so not only do they lack caloric benefit, they may (or may not) lack the micro-nutrient content claimed? (In other words - a Vitamind D supplement may not contain Vitamin D?)
I'm broadly in favor of the FDA and other regulatory agencies, if for no other reason than they have the power to require that you're really selling what you claim you are, and enormous power to punish you if you don't.
That this is not the case for supplements is largely the fault of Orrin Hatch.