Supplements talk sparks controversy

As soon as my column extolling the benefits of omega-3s hit the front porches, Dr. Tim Rodgers galloped into my e-mail inbox on his self-proclaimed "high horse." He took exception to the whole notion of unregulated supplements being touted as beneficial.

"I'd love to believe that folk remedies and supplements cure all ills and avoid the toxicity of pharmaceuticals," wrote the doctor. "I'd love to believe in the tooth fairy also."

Since I know Dr. Tim, a well-respected internist and a frequent adviser to my column, I thought I would let him have his say.

Besides, a good controversy is always helpful in breaking us out of our post-holiday doldrums, don't you agree?

The man is serious. He believes that a major problem has resulted from Congress making food supplements exempt from testing and FDA regulation.

"When you buy a supplement over-the-counter you really don't know what you get," he claimed. "There have been independent tests of products that turn out to contain not one single molecule of what the label says is in them. Frequently, product testing has revealed 18 percent to 250 percent of what is stated on the label is actually in the product.

"How can one possibly know which product to purchase in this situation? How could you get the proper recommended dosage? Some products have shown contaminants which are toxic. Others have lead in them."

He cited one reported case of a man who had experienced heart arrhythmia and was determined to be digitalis toxic. "It turned out that he was receiving herbal enemas that, on analysis, contained digitalis! He damned near died because of this."

Dr. Rodgers referred me to an article from the Journal of the American Medical Association (from July 2005) that does support his argument.

The title of the article, authored by Drs. Lichtenstein and Russell, poses the questions: "Essential Nutrients: Food or Supplements? Where Should the Emphasis Be?"

The authors claim that most of the support for nutritional supplements has come from what are called "epidemiological observations", but that these results rarely hold up when the more serious "intervention studies" are conducted. The authors cite the initial excitement over vitamin E and C and its purported beneficial impact on coronary heart disease. After reviewing more controlled tests, the American Heart Association concluded there was no basis for recommending these supplements for the treatment of prevention of coronary heart disease. There is a similar story about beta carotene, which initially was thought to lower the risk of developing lung cancer, only to be later discredited by the more reputable "intervention trials" as possibly increasing this cancer risk among cigarette smokers when taken in large doses.

This raises another concern articulated in that same article: The issue of -- love the term -- "nutritional intoxication."

Vitamin E is an example. There has been recent concern voiced about how the chronic stimulation of the immune system from that supplement can raise the incidence of auto-immune disorders. A meta-analysis of studies further suggests that daily vitamin E supplements in excess of 400 IUs "increased all-cause mortality."

The article concludes that focusing on a food-based diet -- not nutritional supplementation -- is the best way to go.

After his "high horse" was sufficiently exercised, Dr. Rodgers softened a bit. Referring to my positive report on omega-3 fatty acids, he conceded that these nutritional sources did "have some science behind them."

~ Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives and works in Santa Barbara, Calif. Contact him at mseabaugh@semissourian.com.