Michael Rosenthal

(12/2016) As I mentioned in an earlier article, several years ago I was filling a prescription in a local drug store; the pharmacist suggested that I start taking a non-prescription one-a-day vitamin supplement. I did just that until I mentioned it to my physician, and he told me that it was harmless but unnecessary. Americans spend more than $30 billion annually on dietary supplements. In 1994 an act called the Dietary Supplement Health and Education Act passed Congress, which allowed such products to reach the marketplace without any evidence that they were safe and effective. Under the law, the government can halt sales of an individual product only after it is on the market and is shown to be mislabeled or dangerous. A 2012 study by an epidemiologist at the Memorial Sloan Kettering Cancer Center in New York showed that 52 percent of Americans use supplements. Some supplements are useful or essential. My physician, a board-certified internist, has me taking Vitamin D3 to support bone health, consistent with my blood profile, and the medical profession agrees that certain supplements can be essential to treat vitamin and mineral deficiencies.

The September 2016 issue of Consumer Reports is devoted to a many page article entitled Supplements: A Complete Guide to Safety, and I strongly recommend this issue for those of you who want to learn more about the topic. I will discuss some of the points made in the Consumer Reports article.

The article emphasizes the important point that the fact that the FDA classifies supplements differently from drugs, and that they thus may not be safe. They may be not only ineffective, but may be contaminated with microbes or heavy metals and may have a dangerous interaction with prescription drugs. Once again, I advise consulting your physician before committing to supplements. Since retailers, even pharmacists, have no legal obligation to be knowledgeable about these supplements, they are most often not helpful in giving good advice.

How did all this start? In 1970 Linus Pauling, a brilliant chemist and two-time Nobel Laureate (and an idol of mine!), declared that 3000 mg of Vitamin C taken daily could abolish the common cold. The Vitamin C craze lasted nearly 20 years before studies showed it was simply not true. Even Nobel laureates can be wrong.

Clinical prescription drugs are held to very high standards. Before a company can sell a new drug, it must submit extensive clinical trial data to the FDA proving that it is both safe and effective. The process can take years and can cost as much as $2 billion per drug!

Dietary supplements are not held to the same standard. The claim is often that they are 100% safe, and they must meet identity, purity, strength, and composition standards, but they do not need to be approved by the FDA. Bad things can happen. In 2013 a weight-loss supplement containing a new ingredient named aegeline led to 47 hospitalizations, three liver transplants, and one death from a drug that was not certified by the FDA.

There are some 90,000 supplement products which generate $40 billion annually for the manufacturers. To remove a supplement from the market, the FDA must show it poses a danger to consumers once it’s already for sale. So what supplements may be dangerous? Consumer Reports lists "15 ingredients to always avoid." These ingredients include Aconite, Caffeine Powder, Chaparral, Coltsfoot, Comfrey. Germander, Greater Celandine, Green Tea Extract Powder. Kava, Lobelia, Methylsynephrine, Pennyroyal Oil, Red Yeast Rice, Usnic Acid, and Yohimbe. Take a close look at your supplement labels. The benefits and risks with these supplement ingredients can be found in the Consumer Reports article, in a survey compiled by independent doctors and dietary-supplement researchers.

So, most people don’t need a supplement, but there are situations where supplements are called for. Folic acid reduces the risk of brain and spinal-cord abnormalities in pregnancy and Vitamin D is important in pregnancy as well to help prevent pre-eclampsia. Vitamin B12 is important for vegans who consume no meat, fish, eggs, or dairy products. Vitamin D3 is important if you don’t get much sunlight. Vitamin B12 and magnesium supplements may be needed if you take heartburn drugs or diabetes medication. Vitamin D3 helps those individuals with osteoporosis. There is a drug that slows age-related macular degeneration in vision. And there are others that are safe and useful. Essential to safety and to good results, a knowledgeable physician should always be consulted. There is more material and are more subtleties in the Consumer Reports issue, and I highly recommend it.

I’ve stated before in this column, and the Consumer Reports article makes it very clear, that one should be highly skeptical of any product that has the statement, "This product has not been evaluated by the Food and Drug Administration," known as the FDA.

Now, let’s look at a more positive side. Many of the conditions that these supplements claim to help can be treated with other activities. Eating the right foods that contain necessary vitamins and minerals is important. Exercise is good. Keeping clean and away from bacteria is important. Counter medication pain killers are fine in suggested quantity. Eat a lot of fiber from whole grains, fruits, vegetable, and beans, and be modest with red meat and full-fat dairy products. Keep your weight down and don’t smoke. And consult a well-qualified physician regularly.

We will be seeing more controversy over the climate issue in coming months and years. The newly appointed advisor to President-Elect Trump is a "climate contrarian," a person who does not believe that we have a global warming problem. As reported in the New York Times, Myron Ebell of the Competitive Enterprise Institute will be Mr. Trump’s lead agent in choosing personnel and setting the direction of the federal agencies that address climate change and environmental policy. Mr. Ebell leads the Cooler Heads Coalition, a group that says it "is focused on dispelling the myths of global warming by exposing flawed economic, scientific, and risk analysis." In short, he does not believe we are on a path to climate change. That of course will raise the question of the role of the United States in the global coalition, the Paris Accord, to reduce greenhouse gases.

This year, greenhouse gas emissions in the United States are running at their lowest level since 1992. This trend began during the George W. Bush administration and reflects an increase in the use of renewables and the conversion from coal to cleaner natural gas. Natural gas when combusted is a carbon dioxide emitter that contributes to global warming, but not as effectively at it as is coal burning. The best sources of energy to reduce these emissions remain nuclear power, wind, water power, and solar, sources that do not produce carbon dioxide. Though there are those who refute the finding that carbon dioxide emission produces global warming, the great majority of responsible climate scientists believe in the principle. The United States Supreme Court has put a hold on President Obama’s Clean Power Plan pending completion of a federal lawsuit. This puts a hold on the effectiveness of the Paris Climate Agreement. Though I am not specifically a climate scientist, it seems obvious to me as an experienced PhD chemist, as it does to a great number of scientists, including climate scientists, that global warming is real, and that it is a significant factor in increases in wildfires, flooding, and other dangerous phenomena.

Michael is former chemistry professor at Mount. St. Marys

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