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Posted September 9, 2014: by Bill Sardi
I should have guessed it was another hit piece on dietary supplements the moment I learned its author is panned as a political reporter with 30 years of experience (so his bio says, but his photo must have been taken when he was 20 years old). [ConsumerAffairs.com]
Like so many online journalists these days, they read a press release issued by a health agency or a medical group but not the actual published scientific study referred to in the news report.
If this journalist had read the entire published report his headline might have said something like “Liver toxicity study group unfairly blames dietary supplements for transplants and deaths attributed to alcohol.” Instead the headline reads: “Supplements now more likely than medications to cause death.” [ConsumerAffairs.com Sept 8, 2014]
Of course, the study that provoked that news headline was not a population study and has no bearing on whether dietary supplements cause more harm among Americans than drugs. (The study’s authors say their report “is not a population-based study…..and it cannot be concluded that the problem is actually on the rise in the United States.”)
In fact, there was no way of knowing whether the users of these supplements took them in doses recommended on the label or even intentionally overdosed.
Furthermore, there was one caveat the reporter missed. The group commissioned to do the study, The Drug Induced Liver Injury Network, was not commissioned to study all drugs. They conveniently excluded acetaminophen (Tylenol), the pain reliever linked by Pro Publica to more deaths, hospitalizations and liver transplants than any other over-the-counter medication. [Pro Publica Sept 30, 2013]
It turns out that the watchdog group of liver specialists selected from 1219 reports cases of liver toxicity which was reduced to 839 for various reasons, with 709 involving drugs and 130 involving dietary supplements (45 were bodybuilding supplements and 85 non-bodybuilding supplements).
Thirteen of the 45 subjects taking non-bodybuilding supplements either underwent liver transplantation or died (two of these deaths were actually attributed to complications from endoscopic procedures). So we are down to 11 in need of transplant or died. But 54% of this group were alcohol abusers. Of the 13 reported cases of death or transplantation, three used products were foreign made or were raw unlabeled Chinese herbs. So now we are down to just 8 cases.
Among the remaining eight cases, one patient used four different supplements for colon cleansing and another used three herbal products to boost sexual performance, obvious examples of misuse. So now we are down to just six highly suspect cases.
It would be unjust to characterize the remaining six dietary supplements as unsafe based upon a single case of liver failure needing transplantation or that resulted in death.
This is not like the herbal product OxyElite Pro produced by USPLabs that was linked with 97 cases of hepatitis (47 of whom were hospitalized with one death) reported earlier this year. [FoxNews.com April 3, 2014] The problem here is that OxyElite Pro was a weight loss supplement. That class of dietary supplements tends to be overdosed by crash dieters who don’t follow label directions.
Based upon this manipulated data, the recent news report claimed “death or liver transplantation occurred more frequently among cases of injury from non-bodybuilding supplements, 13%, than from conventional medications, 3%.” That makes it sound like dietary supplements expose consumers to more than four times greater risk for severe liver disease or death than dietary supplements. But 6% more of the supplement users consumed alcohol than the medication users, narrowing the difference a bit more.
ProPublica had a difficult time estimating the number of deaths caused by acetaminophen. Deaths from accidental or intentional misuse of acetaminophen were estimated at 321 in 2010 with 78,000 visits to the emergency room and 33,000 hospitalizations. [ProPublica.com Sept 20, 2013] One wonders how many binge drinkers use a known liver toxin like acetaminophen to recover from a hangover and end up in the ER.
Over a decade ago the U.S. Acute Liver Failure Study Group reported 458 deaths due to acetaminophen poisoning. [Hepatology July 2004] All these deaths are needless. Liver toxicity is attributed to acetaminophen’s ability to deplete a key antioxidant, glutathione (glu-ta-thigh-on), from the liver. It has been suggested the antidote to acetaminophen poisoning, a sulfur-based dietary supplement (N-acetyl cysteine, nor NAC) that replenishes glutathione, be included in over-the-counter Tylenol. [Toxicology Applied Pharmacology June 2014] Acetaminophen’s manufacturer opposes that or any suggestion consumers take NAC when repeatedly using Tylenol.
Bottom line: liver-toxic drugs get an undeserved free pass while semi-questionable dietary supplements are put under such suspicion that consumers unjustifiably fear using them. — © Bill Sardi, Knowledge of Health, Inc.