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Posted October 31, 2011: by Bill Sardi
I’ve been given a peek of a data report showing the annual sales of dietary supplements ranked by dollar sales. The rank of the top 500 selling supplements may surprise you. It is a list of raw ingredients rather than branded products and it doesn’t include all sales of supplements (Wal Mart, Whole Foods, other big box stores and online sales were not tabulated in this list). However many thoughts come to mind as I review it. I’ll share some of those thoughts with you as I read through the report.
So what do you think is the top-selling dietary supplement today? Vitamin C? Vitamin D? Well actually it isn’t on the list. It is Lovaza, a prescription fish oil concentrate prescribed by doctors to reduce high triglycerides, a blood fat. Annual sales are about $1.5 billion. Once this dietary product became a drug and covered by insurance ($25 co-payment), its sales soared beyond imagination. So consumers play a role in the gouging of pooled funds in insurance plans.
Consumers want someone else to pay. Imagine if insurance paid for dietary supplements, sales would go through the roof. Of course I don’t relish the idea of having government choose the supplements that get covered along with the dosage.
I thought dietary supplements were “not intended to prevent, treat or cure” any disease, as the FDA’s required disclaimer states. But in this case, a supplement is masquerading as a drug and is prescribed to lower elevated triglycerides, a blood fat. That certainly IS a disease process. So once a dietary supplement gets declared a drug this gives its maker the opportunity to raise its price.
A price comparison between a supplement that masquerades as a drug and a true dietary supplement (fish oil concentrate) will give Americans an idea how much supplements will cost if the FDA’s New Dietary Ingredient (NDI) proposal is adopted. NDI is a newly proposed list of testing requirements that will raise the price of supplements beyond affordability.
The retail price range for Lovaza is around $2.00 per pill and you may have to take 4 pills a day – costing up to $8.00 X 30 days = $240.00 per month. Consumers can purchase Lovaza online with a doctor’s Rx at the discount price of $1.59 per capsule and a 4-capsule daily regimen would cost $6.36/day or $190.80/month.
Each 1-gram capsule of Lovaza provides around 900 mg of fish-oil derived omega-3 fatty acids which have passed through the fish’s liver and have already been converted into biologically ready EPA and DHA. One capsule of Lovaza provides 465 mg of EPA (eicosapentaenoic acid) and 375 mg DHA (docosahexaenoic acid). DHA is the primary ingredient in fish oil that lowers triglycerides.
Let’s compare that to a leading fish oil concentrate provided as a dietary supplement, not a drug.
A leading brand DHA fish oil concentrate provides 300 mg more DHA than the same number of capsules (4) of Lovaza and sells for $1.17 per pill for $4.66 per day for 4 capsules/ $139.80 per month. That is a $51.00 difference (27% savings), not counting the doctor’s bill for an office exam. (See comparison chart below)
|Comparison Chart: Fish Oil Concentrate As A Drug & Dietary Supplement
For Treatment of High Triglycerides (a blood fat)
|Product||Total Omega-3 per cap||DHA per capsule||EPA per capsule||Pills per bottle||Retail price||Cost per pill/per day/month|
|Lovaza Rx||900 mg||375 mg X4 = 1500 mg/day||465 mg||60||$240.00/30||$1.59* X 4 per day = $6.36/day X 30 days = $190.80/month|
|Leading brand** DHA fish oil concentrate||500 mg||450 mg X4 = 1800 mg/day||45 mg||30||$34.95/30||$1.17 per pill X 4 = $4.66/day X 30 days
|* Price at Drugstore.com ** DHA Super Boost Formula Purity Products|
So let’s get back to the original question. What is the best selling dietary supplement ingredient in the USA? The unexpected answer is probiotics, such as acidophilus and bifidus ($227 million in annual sales). While the friendly non-pathogenic acid-forming bacteria in probiotics do not survive long in the digestive tract, its acidity cleanses the digestive system and it provokes a white blood cell response that raises immunity.
A contradiction among natural medicine enthusiasts is they frequently advocate alkaline diets and the use of acid-forming bacteria (acidophilus). Acidophilus increases absorption of nutrients from the diet. Drugs which create alkalinity are associated with growth of unfriendly bacteria in the digestive tract.
The number two-ranked supplement is soy foods – burgers, cereal and milk ($207 million, rank #2). However, this isn’t what the long-living Japanese consume. They eat fermented sources of soy such as miso and tempeh and benefit from the concentrated isoflavones and other molecules in soy.
A study was conducted in Japan a while back. Soy protein was given to women with no effect in reducing the risk for breast cancer. But a single serving of miso soup reduced the risk for breast cancer, and two servings dropped the risk even more, three servings more again. Fermented soy concentrates the weak plant estrogens so they can do their job in countering estrogen dominance in menopausal females that breeds breast cancer. And don’t overlook the fact that soy provides a heaping dose of IP6, a potent metal chelator.
Big business is behind soy in America and most of the soy is genetically modified (GMO) which can provoke allergic reactions. The FDA dispenses with these soy allergies by adding a warning on soy product labels. In Japan there are no warnings on soy products because they do not use GMO soy.
The number 3 supplement is not sold in high volume in health food stores or pharmacies. I’ll give you a hint – it’s sold in roadside convenience stores. It is taurine, an amino acid that is laced into energy drinks ($843 million annual sales).
Multivitamins and omega-3 fish and flaxseed oils comprise the largest categories. Multi’s for men, women and adults total over $1.190 billion in sales. Omega-3 oil generates $1.289 billion of sales. For adults, multivitamins should be iron and copper-free and fish oil concentrates can reduce the number of pills that need to be swallowed compared to plain fish oil pills.
The top selling lettered vitamin is still vitamin C ($489 million, rank #6) with vitamin D following ($189 million, rank #19). Still $489 and $189 million equals $1.59 and 62-cents per year per capita in the US. Greater intake of both of these supplemental vitamins would predictably improve the health and life expectancy of Americans. There would be far less doctoring for sure. Vitamins C and D represent the kind of health insurance that we can all afford – offering 10-cent cures and real prevention. For the much ballyhooed uninsured, they should be taking vitamin C and D supplements. Is it a not surprising that modern medicine games the population and steers people away from these vitamins. Few Americans consistently achieve adequacy for these two essential vitamins except supplement users.
A lettered vitamin that ranks low on the list is thiamin (vitamin B1, rank #178) — the vitamin that prevents beri beri. The prevalent consumption of alcohol and refined sugars along with the use of many drugs (diuretics, digitalis) which block B1 absorption creates a hidden B1 deficiency epidemic in America that is misdiagnosed as irritable bowel, dermatitis, fibromyalgia and heart failure. Believe it or not, modern medicine has an outbreak of beri beri on its hands but has blinders on when it comes to nutritional medicine so it completely misses this nutrient deficiency disease. Benfotiamine, the fat-soluble form of B1, a hard-to-find supplement, is the antidote to the above problems.
The most popular herbal supplement is not garlic or Echinacea which were leaders in the herbal category for years. Ginseng ($231 million, rank #17) now outsells garlic ($22 million, rank #76) and Echinacea ($41 million, rank #58). Ginseng is recording many scientific advances.
A note about garlic pills: most do not provide the primary active ingredient allicin whose activating enzyme, alliinase, is destroyed by acid as it enters the stomach. Enteric-coated garlic capsules may or may not slide past the acidic stomach and then open up in the intestines to create allicin. By the way, allicin just bested the most commonly prescribed drug in the treatment of yeast overgrowth (Candida albicans).
Only one type of garlic powder made by NutraProducts, which is buffered against acid and has been tested for allicin, is worthy of purchase. This is not to say aged garlic and other garlic pills are of no benefit. Also, manufacturers test their garlic pills for allicin potential in a dish of neutral pH water rather than acetic acid. So many garlic pills are labeled there is potential to produce allicin when there is none. See www.garlicbreakthrough.com
There is a long list of dietary supplements with nebulous or questionable health benefits. For example Kombucha mushroom could be lethal ($58 million, (rank #49). red yeast rice may be a natural alterative to statin cholesterol-lowering drugs but still can produce undesirable liver toxicity like statins do. Red yeast rice ($16 million, rank #87) far outsells resveratrol, one of the most promising science-backed nutrients to ever enter the dietary supplement arena ($9.4 million, ranked 109th in a survey of 500 top supplements).
In recent years there have been so many bogus supplements promoted that have become popular in health food stores. Noni juice (it may be safe, but is it effective?; coral calcium; hoodia; colloidal silver (it kills germs but is a heavy metal); shark cartilage; policosanol; coconut oil; and colloidal minerals have fortunately declined in sales. Unsung supplements such as milk thistle (liver cleanser, rank #74), lipoic acid (antioxidant, rank #97), oregano (natural antibiotic, rank #141), vitamin K (natural anti-calcifying agent, rank #117), sulfphurophane from broccoli (rank # 225) should be promoted more widely at the store level by clerks who advise customers.
Recognize resveratrol (rez-vair-ah-troll) works better than aspirin at preventing mortal heart attacks (baby aspirin doesn’t work at all), thins the blood, counters all manner of germs (bacteria, viruses, fungi) and stops cancer at all three stages of development (initiation, growth and spread), something no cancer drug can claim, and yet it remains ignored in the long list of dietary supplements. Even though there are 345 brands of resveratrol pills offered today, consumer demand is poor. I’ve never seen such a crowded market for a dietary supplement that so few Americans buy.
Ditto for two other dietary supplements – pine bark extract (Pycnogenol; rank #191) and astaxanthin (rank #249), two supplements with strong scientific backing that are largely unused. Pycnogenol currently has 233 published scientific reports, all positive, listed at the National Library of Medicine. Obviously, science doesn’t equate with sales.
Another perplexity is the sales of glucosamine/chondroitin combinations ($246 million, rank #16) or glucosamine ($43 million, rank #54)) or chondroitin ($1.4 million), all which biologically but weakly stimulate the production of a water-holding space-filling/nerve cushioning molecule in connective tissue called Hyaluronic acid ($3.9 million, rank #156).
For comparison, about $4 billion of Hyaluronic acid products are reportedly sold in Japan annually. It has been said that Hyaluronic acid (HA) is not well absorbed. However recent data dispels that falsehood. Hyaluronic acid (HA) works far better and faster than glucosamine, chondroitin or a combination of both yet it languishes as the 156th seller. For people with joint problems, skin wrinkles, thinning hair, nerve pain, Hyaluronic acid is a god-send. A little secret about HA is when given orally to women who are having difficulty starting a pregnancy it works miracles.
The supplement industry is in denial over the fact one of its top sellers, calcium supplements ($349 million, rank #10), are problematic, yet it is obvious as women begin to lose calcium from bone (osteoporosis) as their estrogen production declines that that calcium is being deposited into arteries and causing arterial disease. Therefore, calcium supplements are problematic. Osteoporosis is not a calcium shortage it is a hormone shortage. Estrogen sends a signal to hold calcium in bone. Women approaching menopause may want to investigate phytoestrogens, the safest being resveratrol which activates osteocalcin, the hormone that holds calcium in bones.
Calcium ($349 million, rank #10) far outsells magnesium ($36 million, rank #61) yet few Americans (who live in a dairy country) are truly calcium deficient while an estimated 40% of American adults have a shortage of magnesium and pay a steep price for it (migraines, fatigue, muscle cramps, blood clotting, sleeplessness).
There are $73 million of iron pills being sold (rank #40), most likely to young women who are anemic from menstrual flow, but the only safe form of iron is carbonyl iron (trade name Ferronyl). No other form of iron pills should be in American homes. Carbonyl iron is toddler safe and does not cause nausea like other iron pills. Ditto for copper supplements (cupric acid) – unsafe in any hands; obtain copper in stable form from the diet (nuts, cocoa). People playing with fire when they take iron or copper supplements.
Digestive enzymes ($45 million) are also another over-promoted category (if you were enzyme deficient you would have a genetic disorder), while most senior Americans don’t produce a sufficient amount of stomach acid to properly digest food and absorb nutrients. For comparison, only $889,000 of betaine hydrochloride (acid) pills were sold in 2010. Betaine taken with meals improves digestion, calms heartburn, increases absorption of B vitamins, vitamin C, iron and calcium.
There is growing science that tocotrienols, the overshadowed family of vitamin E molecules (tocopherols dominate multivitamins), are one of the best science-based nutrients that nature has to offer. Hundreds of millions of dollars of vitamin E is sold, largely as alpha tocopherol, whereas only $268,000 of tocotrienols are reportedly sold. Yet scientific studies reveal tocotrienols may be equally as promising as resveratrol.
While there is much talk about antioxidants, there is no daily requirement for sulfur published by health authorities, yet this mineral is critical for human health and sulfur-bearing supplements such as lipoic acid (rank #97), N-acetyl cysteine (NAC, rank #166) should rank much higher as they help produce the master endogenous antioxidant in the body – glutathione. (Note: vitamin C also boosts glutathione levels.)
Iron and copper-binding supplements will offer strong anti-aging effects. These include IP6 rice bran extract (rank #300), elderberry (rank #103, resveratrol (rank #109), pomegranate (rank #65), acai berry (rank #29), cranberry (rank #57), milk thistle (rank #74), cinnamon extract (rank #85), grape seed extract (rank #95), lipoic acid (rank #97), bilberry (rank #167), tart cherry (rank #187). These metal-controlling molecules are largely identified as bioflavonoids or polyphenols. These supplements should be used in low doses (175-350 mg) and work better in combinations than by themselves. Mega doses turn these antioxidants in molecules that promote oxidation. Be aware.
For unexplained reasons natural medicine is missing out on the growing science behind the concept of hormesis, roughly defined as a little bit of a toxin (below lethal dose) that will activate defenses in the body and produce profound health. There are numerous dietary and herbal-derived molecules that actually trigger biological stress which in turn activates internal antioxidant defenses in the body. The gene involved is the NRF2 gene, which activates glutathione. This is not homeopathy, it requires a low-dose toxin. One well studied molecule which send a toxic signal in low doses is resveratrol, known as a red wine molecule.
Sales of dietary supplements are brisk and there are dynamic changes underway. While the pipeline of new drug molecules is drying up, nature continues to provide seemingly endless molecules that exhibit profound biological action. The dietary supplement of today represents the medicine of tomorrow. – Copyright 2011 Bill Sardi, Knowledge of Health, Inc.
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