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A Matter of Perspective: Adverse Drug Reactions vs Supplement Dangers

A Matter of Perspective ...
by Dr. Michael Murray
It amazes me that adverse reactions to prescription drugs are estimated to kill over 106,000 Americans every year, yet all it seems that the media is interested in is inaccurately portraying the dietary supplement industry as dangerous and "unregulated." I think a little perspective is in order.
Consumer Reports "Dirty Dozen"
Recently, Consumer Reports came up with what they referred to as the "Dirty Dozen." Actually, this report is actually the stimulus of this editorial. While I agree that some of the compounds listed are potentially harmful, when you take a look at the list as a whole it is laughable compared to the dangers of even as something as simple as aspirin. What am I talking about? It is a well established fact that each year the use of aspirin and other NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.
While I agree that androstenedione (or andro, for short) is certainly not a dietary supplement and that aristolochic acid and pennyroyal oil are definitely hazardous, most of the health food stores that I have been in do not carry these products or others on the Consumer Reports list. For example, the natural product industry has been aware of the dangers of the pyrrolizidine alkaloids found in comfrey for almost 20 years. In fact, I haven't seen a comfrey product designed for oral use containing these compounds in a health food store in the last 15 years or so. Now, I could be wrong and there could be some loose comfrey being sold as a tea out there, but my point is that is comfrey really a public health hazard? My point here is if you really take a look at some of the other members of the 'dirty dozen," you will see that they pose little risk simply because they are not widely available.
The media keeps harping on the dangers of ephedra, but was ephedra really all that bad? My feeling is that it was the abuse of ephedra that was the primary issue. Used responsibly at appropriate dosages there is no question that ephedra is a safe and effective natural product. Granted, there was the tendency of abuse because of the typical American belief that if a little is good, a lot is even better. But, again let's try to keep things in perspective. In the worst case scenario, over the last 20 years ephedra was linked to approximately 150 deaths (virtually all of which were related to excessive dosage or abuse). In contrast, approximately 2,000,000 people in the United States died from adverse drug reactions including over 140,000 deaths caused by aspirin and other NSAIDs.
Taking anything by mouth, whether it is a food, drug, or supplement requires some personal responsibility. But, the relative risk of danger from taking a nutritional supplement or herbal product is substantially less than that seen with prescription and over-the-counter drugs. That fact is very clear.

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