Supplement Truths: Caught between Offit and Oz

Offit:Oz 3

On June 8th, this article appeared in the New York Times, spoiling an otherwise beautiful morning: NY Times article PIC cropped For some reason, the Times gave Paul Offit, an infectious disease doctor from Philadelphia, free reign to plug his just-published book: DoYouBelieve The article (written by Offit himself) painted a pretty bleak picture of the supplement industry, and I’ll wager that the book does the same. Many patients asked me about the article– and in particular, wanted to know whether they should stop taking their supplements. So, I decided it was worth writing to a rebuttal to at least the Times’ article, if not the entire book. Dr. Offit isn’t entirely wrong– there are some unscrupulous players in the supplement industry. But does anyone out there really think that Big Pharma exists simply for the betterment of humankind? Or that the FDA is infallible? Anyone remember Bextra? In the past two months during shifts in the E.R. I have seen two people bleed to death after starting the new drug Pradaxa; it’s pretty clear that someone dropped the ball when that was approved. (Dear lawyers for Boehringer-Ingelheim: no, I cannot prove that Pradaxa killed them.)

In the U.S. about 165,000,000 people (half our population!) take supplements, yet the number of deaths attributed to supplements in 2010 was… wait for it… zero. By comparison, every 19 minutes someone dies from an accidental overdose of prescription medications. In total, prescription drugs are thought to cause about 125,000 U.S. deaths a year. On top of which, when I did a web search on Paul Offit, I learned that he is a long, long way from unbiased, as he has gotten tens of millions of dollars from his partnership with Merck Pharmaceuticals.

So, that gives a little perspective. Having said that, it is certainly true that most people taking supplements have no idea what the data actually shows about the pills they are popping. Heck, most doctors don’t know either, so at least we are all in the same boat. In an effort to steady that boat, a few weeks ago I gave a lecture to a group of doctors. I went over the Offit article, and what the papers he refers to really say about multivitamins. Then I went on to cover some other topics:

(If that embed link doesn't work in your browser, click here for another version)

The webinar is divided into three sections, and you can fast forward to the section you want.

  • The first 25mins is about multivitamins.
  • Minutes 26-40 are about curcumin, with an update on the prior post I wrote about Longvida
  • and from minute 41 onward I talk about Vitamin D, and why I don’t like to see blood levels above 40.

The webinar is aimed at doctors, so there is a little bit of med-speak to wade through, but I think it’s pretty understandable even for those not in the medical field. However, if you prefer something a bit lighter/ geared toward laypeople, I also did a radio show on much the same material:

Part 1: What you need to know about Multivitamins

Part 2: Vitamin D— where should your levels be?

Part 3: The lowdown on Curcumin

If you prefer to have more control over fast-forwarding the mp3, click here.

The entire radio show can be found at this link: Radio 7-29-13 Dr Josh Trutt – Multivitamins – Vit D – More .mp3

  • My section of the show starts at minute 30 with a discussion of multivitamins;
  • I talk about Vitamin D starting at 1:02,
  • and Curcumin starting at 1:33.
My goal in creating the webinar was to give you some useful do’s-and-don’ts for your vitamins and supplements– but I also wanted to do something else: I wanted to convey a sense of how much effort is required to sift through data on supplements and arrive at a reasonably informed conclusion. It’s a lot of work. Which brings us to the opposite end of the supplement equation: The Dr. Oz Show. In my opinion, it’s essentially impossible to have a daily radio or TV show about supplements or nutrition and still convey much in the way of novel useful information. A weekly show is barely possible if you have a staff working for you to do research and book guests, etc… and even so it is quite a challenge to book 52 knowledgeable guest speakers a year. There aren’t 52 supplements that people should be taking, so what are your guests really talking about? At some point, the pressure of constantly finding something fresh to discuss exceeds the amount of actionable information available. So you talk about things with less-good data behind them, or find eighty different ways to tell people to eat right, or kill time talking about Rick Springfield’s battle with depression. I have never seen a full episode of Dr Oz, so I logged onto his site today to see what I’ve been missing. Frankly, the guy is a genius (via terry). His show has been on for years and yet there I was watching 20 minutes of Dean Ornish talking about eating more fruits and vegetables. Really?? That’s the groundbreaking info people are tuning in for?? Of course not. They watch because Dr. Oz is a dynamic, engaging personality and they feel comforted by his advice. And truth be told, that’s more than half the battle of being a good doctor: all of us already KNOW we are supposed to eat less fried food… but perhaps the best doctors can motivate you to actually do it. That’s where Oz is massively successful. I was easily drawn in to the game-show aspect of his delivery, watching women choose “door number two” to learn more about omega-three fatty acids. Watching Dr. Oz work the crowd, I almost completely forgot that; why worry about that when you’re having so much fun? Between Offit and Oz, I’ll take Oz any day.


  • Rian says:

    As I mentioned earlier, I am very familiar with turmeric. Been consuming it since I was a toddler, so I found the following in the FAQ section of the Longvida site. They claim that the “safety” of the volatile oils in turmeric root has not been established. This is so inaccurate, since the empirical consumption of turmeric root by the people of South East Asia does not bear this out. Turmeric root volatile oils are SAFE to consume, albeit, strong. The entire root is used in recipes in moderation and as a spice, not as the main ingredient. Ridiculous to claim that the volatile oils in our sacred turmeric root may be unsafe or not efficacious. Marketing hype, I say.

    “Does Longvida contain any essential oils from the turmeric root? NO. Longvida® does not contain essential oils from turmeric, since these components have not been evaluated for safety or efficacy, and currently do not have accurate testing methodology available for their quantitative measurement.”

    • Josh Trutt says:

      I agree with you, I have not seen anything to suggest that the oils are dangerous. I think BCM-95 uses the oils to enhance absorption…. Luckily, I don’t work for Longvida and don’t have to defend this…

  • John says:

    Dr Trutt, in your video you mention you’re aware of a handful of supplements that cross the blood brain barrier.

    May I ask you which ones besides Longvida?

    Also, what supplement did you say treats Vascular Dementia?

    • Josh Trutt says:

      Vinpocetine crosses the BBB and improves cerebral blood flow and metabolism. See this post for more on that.
      Alpha Lipoic Acid also crosses the BBB, and there are a number of other so called “nootropics” that we believe do as well, but few with as much clear evidence as vinpocetine and Longvida.

  • DJ says:

    Dr. Trutt,
    That was an interesting discussion in your video about vitamin D3. Many people who take high dosages of vitamin D3, e.g., 3000-5000 IU/day, experience magnesium depletion resulting in muscle spasticity. Could it be magnesium depletion that is influencing the slight increase in all cause mortality found at higher D3 levels?

    • Josh Trutt says:

      That’s interesting David, I hadn’t heard that. Some studies I saw did “cross reference” with calcium levels, but not with magnesium. I’m starting to get a lot more liberal with magnesium dosing on my patients, and I’m going to add IV magnesium to my practice in the next couple of months. Giving 400mg Magnesium a day to migraine patients is now becoming mainstream even in the “non-Integrative” Western medicine community. So, I suspect many patients could benefit from more Mag. I test RBC Mag. I’d like to start using the ExaTest for intracellular Magnesium.

  • Mike H says:

    Such a disappointing assessment about Vitamin D. It’s what got me into supplements in the first place. Namely, the work of Dr. Gominak on sleep and migraines.

    The data on all cause mortality are discouraging, but until someone can come up with a plausible mechanism by which Vitamin D causes mortality, I want to hold out hope that levels around 65 are generally healthy.

    I also recommend Dr. Hollis’s work on prostate cancer and breastfeeding with Vitamin D supplementation.

    Dr. Gominak’s evidence is purely anecdotal at this point, though compelling. Dr Hollis has many real studies you can look up.

    • Josh Trutt says:

      The studies I commented on are all human studies but none are pregnancy/ lactation studies. I have seen studies in the past showing that infants do better if the mom supplements with Vitamin D during pregnancy. Supplementing with higher doses during the limited time that you are pregnant (or breastfeeding) to insure that adequate amounts cross over to your baby is a different story… in that case one is saying “I don’t know if this is good for the mom, but it’s good for the baby– whose levels won’t be as high as the mothers’.”

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