Friday, September 20, 2013

Vitamins Even Fly!

The primary differences between prescriptions medicines and vitamins or other supplements are that prescription drugs must be thoroughly tested for effectiveness and side effects before they are sold, and they can legally claim to cure or alleviate diseases and conditions.  Even if they are known to be helpful for problems that they weren’t approved for, on the other hand, drug companies cannot legally market them for these off label uses.  The market is very controlled.

Vitamins and supplements must make no claims to cure, but rely on their reputation of just generally being good for you, a reputation often spread by non-professionals:  neighbors, friends, relatives and talk show hosts.  Notice that in ads and packaging material that all claims are very general, often padded with cue words like natural and organic.  They can be sold to anyone before they are tested for safety and effectiveness.  Testing may or may not come later.  Common and long-standing advice on vitamins and minerals is that they are best acquired from the food we eat rather than from supplements.

This has been a regular topic here, but was brought to mind again by a recent example from Johns Hopkins Health Alert regarding alternative therapies for hot flashes related to prostate treatment.  “In general, neither soy nor black cohosh was shown to be any better than placebo in reducing hot flashes. Studies of vitamin E show that it was only marginally effective in reducing hot flash frequency and severity. Research has shown that high doses may have negative effects on cardiovascular health, and a 400-IU dose is associated with an increased risk of prostate cancer.”  Instead they recommend “common keep-cool strategies” like fans and loose clothing.

The second example is personal.  On a recent Southwest Airlines flight, I heard the announcement that vitamin water could be purchased for $3.  I first thought that it was Karma – people who didn’t read my blog (July 5, 2013) or otherwise find out about the latest science deserved to throw away money.  Kids believe in the tooth fairy and the Easter bunny, but grow out of it when they get better evidence.  Some adults continue to believe in magic pills and elixirs by resisting and denying the evidence, but it’s really not funny.

The reason I consistently address this issue is that Americans spend over $20 billion annually on these unproven supplements, and now the government is trying to make it easier.  Move over NRA.  New legislation supported by the Natural Products Association (NPA) and Council for Responsible Nutrition has been introduced to allow those with health savings accounts or flexible spending accounts to use that money to buy supplements.  While the median household income is falling and many people are struggling, we should have a government more concerned about this kind of unwise expenditure.  It’s clear that the government is more interested in pleasing the lobbyists than protecting citizens from poor spending decisions.

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