WHERE ARE THE
BODIES? THE SAFETY OF VITAMINS AND FOOD SUPPLEMENTS
(A presentation
by Andrew W. Saul to the Government of Canada, House of Commons Standing
Committee on Health, specifically in reference to C-420, on May 12, 2005,
Ottawa, Canada.)
Honorable Ladies and
Gentlemen:
Natural health products, such as amino acids, herbs, vitamins
and other nutritional supplements, have an extraordinarily safe usage history.
In the USA, close to half of the population takes herbal or nutritional
supplements every day. That is over 145,000,000 individual doses daily, for a
total of over 53 billion doses annually.
The most elementary of
forensic arguments is, where are the bodies?
To try to answer this
question, we may turn to the 2003 Annual Report of the American Association of
Poison Control Centers Toxic Exposures Surveillance System, published in the
American Journal of Emergency Medicine, Vol. 22, No. 5, September
2004.
This report states that there
have been four deaths attributed to vitamin/mineral supplements in the year
2003. Two of those deaths were due to iron poisoning. That means there have been
two deaths allegedly caused by vitamins, out of over 53 billion doses. That is a
product safety record without equal.
Pharmaceutical drugs, on the other
hand, caused over 2,000 poison control-reported deaths,
including:
Antibiotics: 13 deaths
Antidepressants: 274
deaths
Antihistamines: 64 deaths
Cardiovascular drugs: 162
deaths
It would be incorrect to state that only prescription drugs kill
people. In 2003, there were 59 deaths from aspirin alone. That is a death rate
nearly thirty times higher than that of iron supplements. Furthermore, there
were still more deaths from aspirin in combination with other
products.
Fatalities are by no means limited to drug products. In the USA
in the year 2003, there was a death from "Cream/lotion/makeup," a death from
"Granular laundry detergent," one death from "Gun bluing," one death from plain
soap, one death from baking soda, and one death from table salt.
Other
deaths reported by the American Association of Poison Control Centers
included:
aerosol air fresheners: 2 deaths
nailpolish remover: 2
deaths
perfume/cologne/aftershave: 2 deaths
charcoal: 3
deaths
dishwashing detergent: 3 deaths
(and interestingly, weapons
of mass destruction: 0 deaths)
In America in 2003, there were 28 deaths
from heroin, and yet acetaminophen ("Tylenol") alone killed 147. Though
acetaminophen killed over five times as many, few would say that we should make
this generally-regarded-as-safe, over-the-counter pain reliever require
prescription. Even caffeine killed two people in 2003, a number equal to the two
fatalities attributed to non-iron vitamin/mineral supplements. Tea, coffee and
cola soft drinks are not sold with restriction, prescription, or in childproof
bottles, and rather few would maintain that they need to be.
A CLOSER
LOOK AT ALLEGATIONS OF VITAMIN FATALITIES
Nutritional supplements are
exceptionally safe. In 2003, there were no deaths from multiple vitamins without
iron. There were no deaths from amino acids. There were no deaths from B-complex
vitamin supplements. There were no deaths from niacin. There were no deaths from
vitamin A. There were no deaths from vitamin D. There were no deaths from
vitamin E.
There was, supposedly, one alleged death from C and one
alleged death from B-6.
The accuracy of such attribution is questionable,
as water-soluble vitamins such as B-6 (pyridoxine) and vitamin C (ascorbate)
have excellent safety records stretching back for many decades. "Vitamin
problem" allegations are routinely overstated and unconfirmed. The latest (2003)
Toxic Exposures Surveillance System report indicates that reported deaths are
"probably or undoubtedly related to the exposure," a clear admission of
uncertainty in the reporting. (p 340)
Even if true, such events are
aberrations. For example, In 1998, the American Association of Poison Control
Centers' Toxic Exposure Surveillance System reported no fatalities from either
vitamin C or from B-6. In fact, that year there were no vitamin fatalities
whatsoever. For decades I have asked my readers, colleagues, and students to
provide me with any and all scientific evidence of a confirmed death from either
of these two vitamins, or from any other vitamin. I have seen none to
date.
HERBAL SUPPLEMENTS
The 2003 Report of the American
Association of Poison Control Centers Toxic Exposures Surveillance System
(http://www.aapcc.org/Annual%20Reports/03report/Annual%20Report%202003.pdf) indicates a total of 13
deaths attributed to herbal preparations. Three of these are from ephedra, two
from yohimbe, and two from ma-huang. I have worked extensively in the
alternative health field for nearly 30 years, and I have known of virtually no
one who has taken ephedra, yohimbe, or ma-huang, and certainly not in the
deliberately abusive high quantities that it takes to kill someone.
Nevertheless, accepting all seven deaths attributed to these products, we still
find that there were 30 times as many deaths from aspirin and
acetaminophen.
Only three deaths are attributable to other "single
ingredient botanicals," and oddly enough, their identity remains unnamed in the
Toxic Exposures report.
Millions of persons take herbal remedies, and
have done so for generations. Indigenous and Westernized peoples alike have
found them to be safe and effective, and the 2003 Report of the American
Association of Poison Control Centers Toxic Exposures Surveillance System
confirms this (p 388-389). There have been no deaths at all from "cultural
medicines," including ayurvedic, Asian, Hispanic, and in fact, from all
others.
Additionally, we find:
Blue cohosh: 0 deaths
Ginko
biloba: 0 deaths
Echinacea: 0 deaths
Ginseng: 0 deaths
Kava
kava: 0 deaths
St John's wort: 0 deaths
Valerian: 0
deaths
Furthermore, there have been no deaths from phytoestrogens,
glandulars, blue-green algae, or homeopathic remedies.
MINERAL
SUPPLEMENTS
Of the eight deaths in the category, five of them are from
non-supplement sources rightly termed "electrolytes": two from sodium and three
from potassium (p 389). Two deaths were allegedly due to iron overdose. Since
1986, there has been an average of two deaths per year "associated with" iron
supplements. The sole remaining death was from calcium, a mineral that is
employed medically for its antidote properties. In fact, in 2003, calcium was
used as a lifesaving antidote in 5,228 cases (p 344). There is no evidence that
the single listed calcium death was from a supplement, and the odds are
overwhelming that it was not.
AMINO ACID SUPPLEMENTS
In 2003,
poison control centers reported no deaths whatsoever from amino acids. This is
in itself a strong safety statement.
IN
PERSPECTIVE
Supplementation's harshest critics have traditionally railed
against vitamins (especially in large doses) as being outright "dangerous" and
at the very least "a waste of money." Yet nutritional supplements are very safe,
and for much of the population, very necessary. . . To illustrate how
extraordinarily important supplements are to persons with a questionable diet,
consider this: Children who eat hot dogs once a week double their risk of a
brain tumor. Kids eating more than twelve hot dogs a month (that's barely three
hot dogs a week) have nearly ten times the risk of leukemia as children who ate
none. (Peters JM, Preston-Martin S, London SJ, Bowman JD, Buckley JD, Thomas DC.
Processed meats and risk of childhood leukemia. Cancer Causes Control. 1994 Mar;
5(2):195-202.)
However, hot-dog eating children taking supplemental
vitamins were shown to have a reduced risk of cancer. (Sarasua S, Savitz DA.
Cured and broiled meat consumption in relation to childhood cancer. Cancer
Causes Control. 1994 Mar; 5(2):141-8.)
It is curious that, while
theorizing many "potential" dangers of vitamins, the media often choose to
ignore the very real cancer-prevention benefits of supplementation. . . Media
supplement-scare-stories notwithstanding, taking supplements is not the problem;
it is a solution. Malnutrition is the problem.
The number one side effect
of vitamins is failure to take enough of them. Vitamins are extraordinarily safe
substances. Drugs are not. There are over 106,000 deaths from pharmaceutical
drugs each year in the USA, even when prescribed correctly and taken as
prescribed. (Lucian Leape, Error in medicine. Journal of the American Medical
Association, 1994, 272:23, p 1851. Also: Leape LL. Institute of Medicine medical
error figures are not exaggerated. JAMA. 2000 Jul 5;284(1):95-7.)
Public
supplementation should be encouraged, not discouraged. Supplements are a
cost-effective means of preventing and ameliorating illness. Supplement safety
is outstandingly high. Natural health products should be classified as foods,
not drugs.
(end)
You can read the full text of Andrew Saul's
Parliamentary presentation at