Seniors and their friends and companions should consider reality versus magical thinking about the power of pills. The blunt truth: Over-the-counter dietary supplements can’t cure diseases. Not Alzheimer’s, not cancer, not diabetes, not any known disease. They don’t extend your lifespan either.
Scott Gottlieb, commissioner of the federal Food and Drug Administration, not only has warned a dozen companies to stop making reckless health claims about supplements, he also told Congress his agency needs greater authority to regulate what the New York Times reported has become a “$40 billion industry, which sells as many as 80,000 kinds of powders and pills with little federal scrutiny. These products range from benign substances like vitamin C or fish oil to more risky mineral, herbal and botanical concoctions that can be fatal.”
Gottlieb told the newspaper that regulators have been reluctant to rein in the wildfire spread of supplements and their wilder claims. But the public health is at such risk now that Congress must step in.
The FDA blasted supplement makers like TEK Naturals, Pure Nootropics and Sovereign Laboratories warning them in letters for making “unproven claims to prevent, treat or cure Alzheimer’s disease, as well as a number of other serious diseases and health conditions, including diabetes and cancer.”
Products intended to treat Alzheimer’s disease must gain FDA approval before they are sold in order to help ensure they are safe and effective for their intended medical use. Dietary supplements can, when substantiated, claim a number of potential benefits to consumer health, but they cannot claim to prevent, treat or cure diseases like Alzheimer’s. Such claims can harm patients by discouraging them from seeking FDA-approved medical products that have been demonstrated to be safe and effective for these medical conditions. In recent years, we’ve also taken action against companies and dietary supplements making similar claims regarding treatment of serious conditions such as cancer and opioid addiction.
For now, the FDA is constrained in its supplement oversight, forced by a 1994 law to regulate the manufacture and labeling of pills that 3 of 4 Americans pop regularly, and which are so trendy with seniors that 4 of 5 of them down some supplement daily. As the New York Times reported, the proliferation of supplements has challenged the agency:
In recent years, the FDA has cracked down on several sectors of the industry, including dietary supplements sold for weight loss, sexual function and energy enhancement. More recently, one of the biggest targets has been kratom, a botanical substance that is marketed as a safe alternative for opioids or to help opioid users’ withdrawal symptoms. The FDA has ordered that kratom imports be seized and told companies not to use it in supplements. The agency has linked several deaths to kratom.
Be skeptical of longevity boosting claims
But even as the agency was trumpeting its supplement actions, the independent, nonpartisan Kaiser Health News Service posted its deep dive into the hype of “longevity” pills, supplements that cost $60 a bottle and purport to boost users’ well-being with molecules known as “NAD boosters.”
Although hawking such claims dates back beyond Ponce de Leon and his Florida fountain of youth, the NAD hype is led by David Sinclair, 49, a geneticist who has built enough of a research reputation that he’s at Harvard. KHN reporter Marisa Taylor notes that Sinclair has taken full advantage of the Ivy aura:
Elysium, co-founded in 2014 by a prominent MIT scientist to commercialize the molecule nicotinamide riboside, a type of NAD booster, highlights its ‘exclusive’ licensing agreement with Harvard and the Mayo Clinic and Sinclair’s role as an inventor. According to the company’s press release, the agreement is aimed at supplements that slow ‘aging and age-related diseases.’ Further adding scientific gravitas to its brand, the website lists eight Nobel laureates and 19 other prominent scientists who sit on its scientific advisory board. The company also advertises research partnerships with Harvard and U.K. universities Cambridge and Oxford.
NAD boosters are clever enough to walk a careful line when promoting their products. Sinclair also has established a company that purports to take information users supply, crank it into models, and, voila, they get an estimation of their age — not in chronological but in supposed health and wellness terms. Sinclair uses this curvy approach to argue that his taking his NAD product, according to his other company, shows he is decades younger than the calendar calculates.
In scientific terms, NAD pills and other nostrums exploit a reality of rigorous research: It needs to be carefully done and it takes time. Savvy specialists, however, can jump ahead and bang the drum for products based on experiments, say, in lab mice. That happened with a product that enraptured some in California because it suggested that compounds in red wine could, maybe, possibly be beneficial to longevity. A Big Pharma firm swooped in, spent $720 million to try to commercialize the findings. They turned out to be “underwhelming,” and the potential product had side effects. This was a bust.
Taylor reported that Sinclair, who also was involved in this adventure, still made $8 million from the pharma firm’s purchase, plus $297,000 a year for consulting fees.
Nice work if you can get it. KHN also says his colleagues are furious at Sinclair and others who they contend are making a mockery and destroying the reputation of respected institutions that long have tried to protect and advance rigorous research.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, effective, and excellent medical care. This becomes more daunting to do by the day when prices skyrocket for therapies and prescription drugs, even as their complexity and uncertainty soar.
We all can get more savvy about health and medical news. But how are sick, injured, and older Americans supposed to wade into details of medical science to determine if they’re paying — oh, so dearly — for treatments to improve their health or if they’re just getting ripped off? And how are they supposed to determine if something they think will benefit them, instead turns out to be a defective and dangerous product or even, really, a dangerous drug?
Even if a product can be sold over-the-counter and hasn’t been FDA-approved, it should be taken with care and be viewed skeptically. Your doctors and pharmacists may be helpful in sorting gold from dross. But here’s one more suggestion: Put the $100 or more you might spend annually on dietary supplements — including vitamins and including Vitamin D — into your piggy bank or a nice meal. You’ll benefit by putting something tasty in your mouth, rather than supplements, at least until someone directly involved in your medical care says otherwise, with sound scientific evidence.