Recent studies reporting supplement "failures"
03-31-2006 06:56 AM
Recent studies reporting supplement "failures"
This is preaching to the choir, but I thought it was a timely reminder for those of us who do believe there are effective, non-pharmaceutical products on the market.
Supplements Under Siege – Going Beyond the Headlines
It's been a rough couple of months for the public relations departments within the dietary supplement industry. Headlines around the country have been screaming the “failure” of supplements to provide any benefits for a wide range of chronic conditions including arthritis ( glucosamine and chondroitin ), colds ( echinacea ), heart disease ( vitamin E and omega-3s ), depression ( St. John's wort ), prostate enlargement ( saw palmetto ), and osteoporosis ( calcium and vitamin D ).
Perhaps the most interesting aspect of the doom and gloom stories about ineffective supplements is the fact that while the headlines decry “failure” – the actual studies themselves actually show a great deal of benefit. Once you read beyond the headlines (as too few consumers and journalists do these days), you actually see a wonderful story evolving to solidify what we at SupplementWatch have been saying for years – that there is ample scientific evidence showing supplements to be highly effective, safe, and more affordable when compared to synthetic drugs. Unfortunately, pharmaceutical marketing dollars often trump good reporting and inaccurate headlines carry the day.
One of the best recent examples is the reporting of two very well done trials of glucosamine supplementation in patients with arthritis. The two studies, GAIT (The Glucosamine/Chondroitin Arthritis Intervention Trial) and GUIDE (The Glucosamine Unum in Die Efficacy Trial) were presented at the American College of Rheumatology meeting on November 14, 2005. Both studies ran for 6 months, included large numbers of patients, and evaluated the safety and effectiveness of 1500mg/day of glucosamine in cases of knee arthritis. Researchers from both studies concluded in their own presentations that results showed that the supplements were “effective in treating moderate to severe knee pain” (GAIT) and should be considered the “preferred symptomatic medication in knee osteoarthritis” (GUIDE). Both studies also showed equivalent effects of the supplements when compared to drugs such as Celebrex (GAIT) and Tylenol (GUIDE).
Following the presentation of these important results at the ACR meeting, news headlines carried appropriate and accurate announcements of the findings – indicating effectiveness, safety, and affordability of the supplements versus the drugs. However, in February 2006, all of that positive reporting took an interesting change in direction. On February 23, the New England Journal of Medicine (NEJM) – a long-time foe and opponent of dietary supplements and natural alternatives to prescription and over-the-counter drugs – published the results of the GAIT study. Interestingly, headlines from the Associated Press and other news outlets around the country on February 22 (the day before the NEJM article was published), screamed “Supplements Fail to Ease Arthritis.” How could these February “failure” headlines be describing the very same data reported as “effective” only 3 months prior? We're not sure either – but we have some suspicions.
We find it interesting that the author of the NEJM editorial accompanying the GAIT study, as well as 11 of the 16 researchers involved in the study, have disclosed receiving consulting fees, grants, or other financial incentives from the drug industry, including Pfizer (which makes Celebrex), Merck (which makes Vioxx), and McNeil (which makes Tylenol).
We also find it interesting that when the 1,543 patients with knee arthritis pain in the GAIT study were asked via questionnaire whether or not they had experienced a 20% reduction in pain over the 6 month intervention period, there was not much difference in pain reduction between the groups:
In patients with moderate to severe knee pain (354 patients), those reporting 20% pain relief looked like this:
- Placebo = 60%
- Glucosamine = 64%
- Chondroitin = 65%
- Glucosamine + Chondroitin = 67%
- Celebrex = 70%
Rather than reading headline of supplements “failing” to ease arthritis pain, why did we not instead read “Celebrex barely better than placebo!” or perhaps “At 7-times the cost of supplements, is Celebrex worth the heart attack risk?” If these supplements are just about as effective as the most powerful, expensive, and dangerous pain drugs available, why not reach for the safe, affordable, and equally effective supplements (which can rebuild healthy tissue when the drugs cannot).
- Placebo = 54%
- Supplements = 79%
- Celebrex = 69%
Unfortunately, it's not just glucosamine and chondroitin that are getting a bad rap in the journals and the news headlines – it's a growing list of other safe and effective natural remedies that are being unfairly characterized as ineffective. But, we ask, “ineffective” against what? In most of the recent “no effect” studies, we see saw palmetto declared “ineffective” against advanced stage prostate hyperplasia (against which expensive and dangerous drugs often fail as well) – we see St. John's wort declared “ineffective” against major depression (even as the prescription drug used in the same study was equally ineffective) – we see vitamin C and echinacea declared “ineffective” in preventing cold symptoms (but we see that both are effective in populations under the most immune system stress) – we see vitamin E and B-complex declared “ineffective” in preventing heart disease (but only when studied in populations with long-term severe illness) – we see calcium and vitamin D declared “ineffective” in preventing osteoporosis (but only in women who were already receiving adequate amounts of both nutrients, were taking postmenopausal hormone therapy, and had no risk factors for osteoporosis).
When consumers and journalists take the time to read beyond the pharmaceutical public relations juggernaut, a different picture emerges. As outlined above, the glucosamine supplements DO work to reduce pain and stiffness associated with arthritis (as GAIT and GUIDE and dozens of previous studies have already told us) – the calcium and vitamin D supplements DO work to build healthy bone and reduce the risk of osteoporosis (again, as the Women's Health Initiative study and numerous previous studies have shown) – and the numerous other supplements from B-complex to vitamins E and C actually DO have well-documented health benefits.
As recent articles in the New York Times, Los Angeles Times, Seattle Post-Intelligencer, and MSNBC, have indicated, it's difficult to find reliable answers and guidance regarding dietary supplements. Standing in the drugstore aisle or surfing the Internet, you often have no idea of which supplements to look for or which brands to buy. Given the fact that 20-70% of all Americans regularly use one or more dietary supplements on a daily basis, this confusion is a big problem. Self-care requires a certain amount of self-education – and that education often takes a helping hand to guide you through these very confusing and conflicting waters.
But, where do you get that education and helpful guidance? When you get your information from pharma-PR masquerading as headlines, you're getting scammed toward expensive and often dangerous drugs. We laughed out loud when we read a recent newspaper article on the “ineffectiveness” of calcium and vitamin D for bone health (a report on the Women's Health Initiative study published in the same NEJM that claimed the “ineffectiveness” of glucosamine) when it concluded with, “many doctors are telling their patients to consider osteoporosis medications to prevent bone loss.” Well, OF COURSE this is the recommendation when all your “education” is delivered by big pharma.
On the other hand, the supplement industry is often guilty of the very same techniques and tactics (although on a smaller budget) – with “spin” reigning supreme in an effort to promote and sell their products. It is important for us to note that we fault neither the pharmaceutical industry nor the supplement industry for taking the (justified) initiative to put their own spin on a given set of data. There is nothing wrong with promoting your product – whether natural supplement or synthetic drug – and portraying it in the best light to potential buyers. BUT, it is equally important for consumers and health professionals alike to view any and all such presentations of “the facts” (including this one) with what we like to call “open-minded skepticism.” Knowing the messenger behind the message, and getting both sides of the story in the proper context can help you make the best health decisions for you and your loved ones.
Supplement decisions made easy – that's SupplementWatch – and we're here to lend you that helping hand in determining which supplements are right for your unique needs.
Thanks for joining us this month. As always, please feel free to share this edition of the SupplementWatch Newsletter with friends, family, and colleagues – and let us know how we're doing and how we can do it better for you.
SupplementWatch Technical Staff
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