We hear bad stories about supplement quality too often.
To the uninitiated, a January collection of headlines like this might look like a New Year’s roundup of the rough year we just left behind.
In the supplement industry, it’s business as usual—a brand new year off to a rough start.
Some—like the upcoming Frontline expose—are familiar generalized rhetoric, and some are new findings, variations on painful dosage or spiking themes. But one piece of journalism stands out among these: Vox’s “UNREGULATED: The hidden drugs in your favorite supplements.” A familiar headline, but this time, an impressive piece of journalism far beyond the usual.
Julia Belluz and Soo Oh assembled a comprehensive database of 850 supplements that have been ‘flagged’ by authorities.
“This database is by no means exhaustive,” they write, “it only includes products that have been studied or were the subject of safety complaints.” To create the list, they compiled data from the FDA and, they say, the Department of Defense, as well as published studies from scientific journals and court documents.
“Some products in the database may have also been reformulated since they were flagged,” they concede. On the other hand, “Others that are dangerous may never have been tested. Still, it’s the most comprehensive look so far at what may lurk in your supplement bottle.”
The searchable database is also sortable by product, manufacturer, ingredient and data source, as well as groupings within ten claim categories, like appetite suppressants, muscle relaxants or sexual enhancers—with broad summaries of the drugs likely found in each category.
The database is both useful for concerned consumers, and yet another call for the industry to get out from under the “unregulated” label and move beyond voluntary transparency. The upgrade of the FDA supplement enforcement division to “office” is a move in the right direction. The CRN registry aimed at informing regulators of what is in the marketplace will be helpful too, but for now is not consumer facing.
While self-policing is not enough, it’s still better than no policing. Maybe there’s an opportunity for industry transparency efforts to be combined on a single searchable platform—the good news antithesis to the Vox database.
Until then, a good deal of industry transparency will remain in the hands of critics. A sad indictment of the supplement industry and its motives.
What if millions of medical diagnoses, procedures, and treatments were based on, at best, questionable scientific evidence, but still performed daily, the world over, in the name of saving patients lives or reducing their suffering? A new JAMA review indicates this may be exactly what is happening.
A disturbing new review published in JAMA online about overuse of medical care, i.e., health care where “risk of harm exceeds its potential for benefit,” concludes that many common medical procedures, given to millions are subjected to each year, have questionable or even non-existent evidence.
According to the review, co-authored by researchers from some of the country’s most respected medical institutions, medical overuse can also be defined as ‘a health care practice, about which when patients are fully informed, they would choose to forego care’. They go further:
Medical Overuse encompasses over diagnosis, which occurs when “individuals are diagnosed with conditions that will never cause symptoms,” and over treatment, which is treatment targeting over diagnosed disease or from which there is minimal or no benefit.”
Obviously when information is withheld on the real risks and benefits of a procedure, the whole principle of informed consent is violated. It’s a far too common occurrence in today’s medicine where money competes with scientific evidence to drive the doctor’s consensus that determines standard of care. It appears published biomedical literature is so corrupted by industry influence, and bias, that the entire ideal of ‘Evidence-Based Medicine” is in reality based on no more than a coin’s flip worth of certainty.
There’s also the more insidious problem of the mis-classification or misunderstanding of disease. This can mislead health care professionals and their patients into performing or undergoing harmful procedures without anyone understanding and accepting the harm and even lethal result they have wrought.
Over the past eight years, a vast, submerged iceberg of overdiagnosed and overtreated medical conditions, with the worst examples being common forms of breast, prostate, thyroid, and ovarian cancer has been identified. It wasn’t till 2013 that the issue broke open.
A National Cancer Institute commissioned expert panel acknowledged that early-stage or ‘stage zero’ breast (DCIS) and prostate (HGPIN) “cancers” are actually benign or indolent lesions of epithelial origin and should never have been, and should never be, termed “carcinomas.”
Summarizing, the report revealed that millions have been wrongly diagnosed and treated for breast and prostate cancers over the past few decades that they never had. In the case of stage zero breast ‘cancer’, some 1.3 million American women were subjected to sa combination of either mastectomy, lumpectomy, radiation, and chemotherapy over the past 30 years, even though their screen-detected condition had no symptoms. Left untreated this would likely never have caused them any harm. It doesn’t even account for the radiobiological harm caused by x-ray mammography. This could well have planted the seeds of malignancy into the healthy breasts of millions of women in the name of “prevention through early detection.”
The study, titled “Update on Medical Practices That Should Be Questioned in 2015,” reviewed 910 articles published in 2014, of which 440 directly addressed medical overuse. 104 of these were selected as “most relevant,” with the 10 most influential articles selected by author consensus, and forming the basis for their 10-topic critique, which is divided into three sections: overdiagnosis, overtreatment, and methods to avoid medical overuse.
- Asymptomatic Carotid Stenosis: Colloquially known as “blocked or restricted arteries in the neck,” carotid artery stenosis often presents with no symptoms (asymptomatic), and yet is routinely treated with carotid angioplasty and stenting (placing a balloon or stent within the artery to open it) or surgical endarterectomy (removal of the inner lining of the artery and obstructive deposits found there) as “precautionary measures.” The review referenced a systematic review and meta-analysis by the US Preventive Services Task Force that found no studies providing data on whether screening for carotid stenosis reduced stroke. What was found is that carotid ultrasonography screening leads to many false-positives; a finding that I believe, contributes to increased morbidity and mortality in screened populations. This is especially apparent when you consider that safe and effective non-surgical alternatives exist: pomegranate juice has been found to reverse carotid artery stenosis within only months!
- Screening Pelvic Examinations Are Inaccurate in Asymptomatic Women and Are Associated With Harms That Exceed Clinical Benefits.
Pelvic examination is often included in annual preventive visits for women and usually consists of both visual examination and the insertion of the hand and instruments like a speculum in the vagina. This soft-tissue evaluation includes the upper genital tracts, as well as urethra, bladder, and rectum. Amazingly, a cited review found no studies assessing the effect of pelvic examinations on morbidity or mortality from cancers (including ovarian cancers) or benign gynecological conditions. Moreover, it was found that the harms of screening include “discomfort, anxiety, psychological effects, embarrassment, and unnecessary procedures, including surgery (1.4% [29 of 2000] of women in one study).” The review opined strongly about the study implications: “Do not perform screening pelvic examinations. Clinicians should educate female patients about the low value of the examination. This review informed a new guideline from the American College of Physicians recommending against routine pelvic examinations for screening asymptomatic women.” [emphasis added] Given the lack of evidence supporting pelvic examinations, could the practice be considered just another form of the violation of women by medical care providers, not unlike unnecessary C-sections?
- Head Computed Tomography Is Often Ordered but Is Rarely Helpful:
Computer tomography uses ionizing radiation and sometimes a contrasting agent in diagnosis, both of which have significant potential to cause adverse health effects. Often CT scans produce incidental, and clinically unimportant findings, and will lead to additional CT scans being ordered. The review concluded, “A second head CT scan rarely affects patient management. Clinicians should be judicious in ordering multiple CT scans in the same patient.” Consider also, that a study published in the NEJM in 2007 estimated that .4% of all cancers in the US may be attributable to CT scans!
- Thyroid Cancer Is Massively Overdiagnosed, Leading to Concrete Harms:
In the past 30 years, there has been a global increase in the implementation of thyroid cancer screening programs which have lead to dramatically increased rates of diagnosis of “thyroid cancer,”mostly due to papillary carcinomas, which are non-fatal. Thyroid cancer mortality rates remained the same throughout this period, a clear indication of overdiagnosis, i.e. the thyroid lesions were non-cancerous insofar as they would have never caused harm if left untreated. The review cited a new study that reviewed the 15-fold increase in thyroid cancer in South Korean, from 1993 to 2011, concluding that, “Overdiagnosis of thyroid cancer is extremely common. The harms associated with this overtreatment include lifelong thyroid replacement, hypoparathyroidism, and vocal cord paralysis.” Learn more by reading my article, “Thyroid Cancer Epidemic Caused by Misinformation, Not Cancer.”Ian: Is it any wonder we as ordinary mortals are resorting to alternative methods? While the efficacy and medical veracity may often be in question, it’s, to my mind, healthy in that whatever the form, people are taking responsibility for future health away from the medical establishment.
Full report here
Author Sayer Ji is founder of Greenmedinfo.com, where this article first appeared. He is on the Board of Governors for the National Health Federation, and Fearless Parent, Steering Committee Member of the Global GMO Free Coalition (GGFC), a reviewer at the International Journal of Human Nutrition and Functional Medicine. Like on Facebook – Follow on Twitter
The Telegraph reports that the Japanese firm Takeda and Eli Lilly have been fined $9 billion dollars over claims they concealed cancer risks associated with a diabetes drug.
The case centred on diabetes patient Terrence Allen, who developed bladder cancer in 2011 and had been taking Takeda’s drug since 2004.
Mr Allen claimed Takeda knew of the link between the drug and bladder cancer for years before disclosing it to the healthcare industry. The drug’s label was updated in 2011 to warn of an “increased risk of bladder cancer”.
Ian: I have been reading reports of concealment and malpractice by Big Pharma for as long as I have been in the business here, but never something with a result as big as this. The fact that diabetes can be ameliorated or healed with correct diet and water just doesn’t get the press it deserves, yet the proof is out there. We have been talking about the caves at Nordenau in West Germany where people have been coming to partake for years. A Japanses resarch team found that the effect of the water from the caves on diabetes came from the infused hydrogen in the water.