“An error does not become truth by reason of multiplied propagation, nor does truth become error because nobody sees it.”
Mahatma Gandhi

On January 16, the New York Times published an essay by author Dan Hurley entitled “Dietary Supplements and Safety: Some Disquieting Data.” The essay makes for unsettling reading.

Hurley writes:

“Since 1983, the American Association of Poison Control Centers has kept statistics on reports of poisonings for every type of substance, including dietary supplements. That first year, there were 14,006 reports related to the use of vitamins, minerals, essential oils – which are not classified as a dietary supplement but are widely sold in supplement stores for a variety of uses – and homeopathic remedies. Herbs were not categorized that year, because they were rarely used then.

“By 2005, the number had grown ninefold: 125,595 incidents were reported related to vitamins, minerals, essential oils, herbs and other supplements. In all, over the 23-year span, the association – a national organization of state and local poison centers – has received more than 1.6 million reports of adverse reactions to such products, including 251,799 that were serious enough to require hospitalization. From 1983 to 2004 there were 230 reported deaths from supplements, with the yearly numbers rising from 4 in 1994, the year the supplement bill passed, to a record 27 in 2005.”

He goes on to elaborate, breaking down the statistics according to the number of reported adverse reactions, hospitalisations and deaths linked to vitamins, minerals, herbs, homeopathic remedies, etc. “Homeopathic products, often marketed as being safe because the doses are very low, were linked to 7,049 reactions, including 564 hospitalizations and 2 deaths.”

To any complementary medical practitioner and user, and anyone who purchases and uses dietary supplements, this article is worrying. But not necessarily for the obvious reasons.

At the end of the essay we read “Dan Hurley is the author of the new book ”Natural Causes: Death, Lies and Politics in America’s Vitamin and Herbal Supplement Industry” (Broadway Books), from which this essay is adapted.” In his research for the book, Hurley (a regular contributor to the “Science Times” section of the New York Times with 15 years’ experience as a medical reporter for publications ranging from Medical Tribune to Family Circle and Psychology Today), claims to have spent nearly two years reviewing studies and court cases, speaking with politicians and public-policy experts and interviewing physicians, pharmacists, nurses, toxicologists, epidemiologists and public health officials, as well as victims and their families. His analysis of 23 years of data from the US Poison Control Centers was what was extracted from the book to form the basis of the NYT article.

However Michael Levin, a healthcare consultant who has served in executive positions in both pharmaceutical and dietary supplement businesses, was suspicious of the figures. Levin immediately researched Hurley’s claims and promptly wrote to the New York Times. His letter has not been published but the full text of it is available here on John Weeks’ The Integrator Blog.

He writes:

“Mr. Hurley’s essay regarding the safety of vitamins and dietary supplements was, indeed, disquieting. He referred to “a national database accumulating strong evidence that some supplements carry risks of injury and death, and that children may be particularly vulnerable.”

“In examining that database (“2005 Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database”, Lai, et al, Clinical Toxicology, 44:803-932, 2006), it became clear that Mr. Hurley’s “disquieting data” is wholly misleading and utterly unfounded. His bias is reflected in the fact that he did not disclose to his readers that the statistics he cited included suicide attempts, multiple drug use and events related to children’s misadventures in the household medicine cabinet.

Hurley, in his NYT essay, attempts to pre-empt the obvious riposte from the dietary supplement industry by arguing:

“Advocates of the products correctly point out that the poison centers’ figures do not prove a causal link between a product and a reaction and that, in any case, far more people are injured and killed by drugs. Painkillers alone were associated with 283,253 adverse reactions in 2005, according to the poison centers, more than twice as many as with supplements. But only 3.5 percent of those reactions occurred when people took the prescribed amount of painkiller; most were from overdoses, either accidental or intentional. The same was true of asthma drugs (3.6 percent of reactions were associated with the prescribed dose) and cough and cold drugs (3.1 percent).

but apparently fails to apply the same logic to his own analysis of the data on supplements and alternative treatments. Levin writes:

“Regarding deaths from all causes: Dr. Lai, et. al. reports “of the 1,261 human poisoning fatalities reported, 89.6% of adolescent deaths and 76.6% of adult deaths (older than 19 years) were intentional” (page 811). Clearly, the vast majority of deaths were deliberate acts which have absolutely no reflection whatsoever on the safety of the products involved when they are used as directed or prescribed.”

and goes on to break the data down further, showing in each instance the extent of Hurley’s manipulation of the figures.

While it would be ludicrous to suggest that alternative medical techniques and treatments and dietary supplements are incapable of causing adverse reactions, or that those participating in the dietary supplement industry and alternative medical practice are all as pure as the driven snow – every area of life, without exception, has its ethical and unethical representatives and practices – sensationalist articles such as Hurley’s do nothing to advance the cause of evidence-based medicine. The New York Times (not to mention The Lancet), once regarded as a publication of integrity and reliability, has clearly been co-opted into promoting agendas which have nothing whatsoever to do with reliable, robust science.

Yet the attempts of the medical mainstream to discredit alternative and complementary treatments are beginning to look more and more desperate. It’s heartening to see that for all the extensive resources being thrown at these exercises, the truth still manages to find its way out somehow.

“There are two ways to be fooled. One is to believe what isn’t true; the other is to refuse to believe what is true.”
Søren Kierkegaard