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Member Advisory

American Botanical Council Sends New York Times Letter to Editor on “Skip the Supplements” Opinion Piece

(AUSTIN, Texas, Jan. 6, 2014) On Monday, Dec. 16, 2013, American Botanical Council (ABC) Founder and Executive Director Mark Blumenthal sent a letter to the editor of The New York Times in response to an opinion article written by Paul A. Offit, MD, and Sarah Erush, PharmD, BCPS. The piece, titled "Skip the Supplements," was published online Dec. 14 and printed on Dec. 15, and is the latest of Dr. Offit’s apparent efforts to discredit the general science and clinically documented benefits of numerous herbal and other dietary supplements.

Dr. Offit recently wrote a book that presents his case against the use of dietary supplements and integrative medicine titled Do You Believe in Magic: The Sense and Nonsense of Alternative Medicine. It is possible that the relatively high degree of media coverage he received in the past year may be related to his efforts to promote his book, as well as the media’s general tendency to publish negative articles. Regardless of potential book sales (the proceeds of which are said to be donated to the Children’s Hospital of Philadelphia, where he is Chief of the Division of Infectious Diseases and Director of the Vaccine Education Center), Dr. Offit appears to be on a sustained campaign against integrative, complementary, and alternative medicine. He is also a leader in educational and media activities in support of childhood immunization and fighting the assertion that childhood autism may be caused by or otherwise associated with vaccination.

Owing to the Times’ policy of not publishing letters to the editor that have been circulated by email or on the Internet, ABC did not release the contents of its letter until it became apparent that the Times was not publishing it. The Times did publish several other letters on the issue of dietary supplements and safety, including a letter from Michael McGuffin, president of the American Herbal Products Association.

The full text of the ABC letter, and the four references cited in the letter, follows:

December 16, 2013

Letter to the Editor
New York Times

Re: Paul A. Offit & Sara Erush, Skip the Supplements. New York Times, Sunday, December 15, 2013 

To the Editor:

We appreciate the authors’ concerns about the identity, quality, and safety of some herbal dietary supplements. For the past three years, as an independent nonprofit research and education organization, we have led an international consortium of independent laboratories and other parties investigating the accidental and intentional adulteration of herbal raw materials and extracts. [1] We have reported on herbal materials that are adulterated with undisclosed, lower-cost ingredients. Inasmuch as we agree that such practices are deplorable and require increased regulatory enforcement by the FDA to help ensure proper identity of raw materials, we disagree with many of these authors’ statements.

They confound regulatory distinctions among foods, drugs, and supplements (legally, the latter is a class of foods, not drugs). Further, the authors consider herbs to be “drugs” because they have “pharmacological effects.” So do coffee and prunes, but they are not regulated as drugs nor would any reasonable person recommend such. Our recent report on the top-selling herbal dietary supplements in the US market reveals that many popular herbal supplements are based on conventional foods or common spices. [2] These include barley, bilberry, cranberry, cayenne pepper, garlic, ginger, green tea, and soy, among others. They have been used in human nutrition for thousands of years. To suggest that such foods or spices, when put into a gelatin capsule and used for a potential or clinically documented health benefit, should meet the pre-approval regulatory requirements of synthetically made pharmaceutical drugs stretches the bounds of reason, and could result in hundreds of safe ingredients being unavailable in the market.

The authors also cite an outdated, erroneous statistic that the FDA “estimates 50,000 adverse reactions” are reported each year for dietary supplements, but that figure is based on a report from 2000 that estimates prescription drug and vaccine-related adverse event data, not dietary supplement data. [3] In contrast, FDA officials reported that 3,247 serious adverse events were associated with supplements in 2012. [4]

In various instances, the authors uncritically embrace flawed, uncontrolled studies with negative findings on herb supplement quality while ignoring or dismissing entire bodies of controlled clinical trials that demonstrate health benefits of many herbal supplements. Their statement that “doctors … are on their own” when it comes to dietary supplements indicates not only an apparent lack of education about dietary supplements in the physicians’ training curriculum but also an unfamiliarity with scientific literature on clinically tested dietary supplement products – information that patients expect from their health professionals. 

Sincerely,

Mark Blumenthal
Founder & Executive Director
American Botanical Council
Editor-in-Chief, HerbalGram & HerbClip

References

1. ABC-AHP-NCNPR Botanical Adulterants Program. American Botanical Council website. Available at: http://abc.herbalgram.org/site/PageServer?pagename=Adulterants.

2. Lindstrom A, Ooyen C, Lynch ME, Blumenthal M. Herb supplement sales increase 5.5% in 2012. HerbalGram. 2013;99:60-64. Available at: http://cms.herbalgram.org/herbalgram/issue99/hg99-mktrpt.html.

3. Walker A. The Relation between Voluntary Notification and Material Risk in Dietary Supplement Safety. US Food and Drug Administration Commissioned Paper, March 9, 2000.

4. Fabricant DS. Post-Market Surveillance and Risk Assessment of Dietary Supplements. Presentation at the International Conference on the Science of Botanicals, University of Mississippi, Oxford, MS. April, 2013.