Be very afraid … of vitamins!

June 8, 2010

Scary, huh?Seems every major media outlet has to have an obligatory ‘be afraid of vitamins’  article/editorial periodically. It’s almost as if the folks a PhRMA have a database to keep track of this stuff:

PhRMA Rep Dude: Hello newspaper/TV/radio Publisher Guy. We noticed that, even though our members have booked an obscene amount of direct-to-consumer pharmaceutical ads with your company, we notice you have not recently scared the electrolytes out of your readers/viewers by telling them the will die if they take vitamin C.

Publisher Guy: Oh, my apologies, PhRMA Rep Dude, we’ll get right on it. In fact, we have a set of stock editorials from which we pull this content to publish periodically. What with all the terror scares, economic re-meltdown, deadly earthquakes/aftermaths, mortgage crisis, undersea oil gushers and Jon & Kate news, it must have slipped off the queue momentarily. Rest, assured, we’ll get that one up right away.

PhRMA rep dude: You would do well to make good on this, Publisher Guy. You know we’re subsidizing the last two ‘real news’ reporters on staff. Hop to it.

So what’s got me spinning out on a random association tangent today? This ‘editorial’ in USA today:

Our view on pills and potions: Do you really know what’s in that dietary supplement?
http://www.usatoday.com/news/opinion/editorials/2010-06-07-editorial07_ST_N.htm

Here’s a fun little tidbit:

Researchers at an accredited lab working for Congress’ non-partisan Government Accountability Office recently found traces of potentially hazardous contaminants in almost all of the 40 supplement products tested.

“Mommy, Mommy, please protect me from that scary Vitamin E.”

It did not escape my notice that in this very same issue (6/8/2010), there were several ‘news’ articles extolling the virtues of the latest pharmaceutical drug that may extend life about four months if you (well, we mostly) spend about $30,000/month for the drug.

Let’s have a few numbers for perspective. Way back in 1999, the Institute of Medicine published a landmark book called To Err is Human. In it, among other things, it cited 98,000 deaths in the US caused by medical care. To be clear, this was not the total number of deaths from all causes, these were deaths directly attributable to contact with the medical care system. While the book did not tease out how many of these deaths were specifically related to adverse drug reactions (ADRs), it is well understood that ADRs are a significant contributor.

More recently (in 2008), in a study published in the British Journal of Clinical Pharmacology (note: not published in the US) It is estimated 3% of all deaths in the general population of industrialized countries are as a result of adverse drug reactions. In the US, the conservative estimate puts us at about 70,000 deaths per year directly related to legal pharmaceutical drugs (total of 2.4 mm deaths/year in US). Contrast this with the number of deaths from vitamins/supplements (namely, –0- in the typical year) and it’s not hard to see that we have our scary headlines misplaced.

What I find even more remarkable is how little information there is out there that probes the issue of the safety of pharmaceuticals in aggregate. You’d think that if the Institute of Medicine estimates some large number of people are killed by sanctioned, ‘on-label’ use of pharmaceuticals, we would have studied it more, here eleven years on. The silence is deafening, to borrow a shop worn cliché.

Here is your takeaway: the next time you see the “What about the health risks of vitamins” headline (and, make no mistake, you will see them popping up like clockwork), remember two numbers: *70,000* and *0*.

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