By Alec Denes, MD Sports Orthopedic Surgeon

One issue that commonly arises when I see patients in the office is that of nutritional supplements. A walk through Rite-Aid or GNC would have you believe that there are a multitude of pills, powders, and creams that can alleviate the pain from arthritis or muscle cramps or even transient joint aches, and it’s easy to understand why patients turn to their doctors for answers. In “What You Don’t Know Might Kill You”, published in Sports Illustrated this week, authors David Epstein & George Dohrmann expose some of the hidden realities in the business of performance-enhancing supplements. Unfortunately, many of these truths apply to all supplements, including things like prenatal vitamins.

Pharmaceutical companies often take years developing, researching, and ultimately getting FDA approval for new medications. This commitment is necessary to ensure that their products are both safe and effective, and it also helps explain the high cost of many new medications. As the SI article points out, supplement manufacturers can often turn an idea into a new product, ready for the shelves at GNC, in as little as two months. This difference is a result of 1994 legislation that abolished much of the regulatory oversight for these substances. The last 15 years have seen astonishing growth of the nutritional supplement industry, with sales of $20 billion in 2007, and manufacturers are quickly learning the game of creative product development, marketing, and sales that is more business than science.

The industry has largely abandoned the pursuit of rigorous scientific testing of its products, with many supplements offering little or no proven effect in human subjects, and several vitamin pills containing less than the advertised amount of active ingredients. Worse yet, some are even dangerous, such as “fat-burning” supplements that can increase metabolic rates, but have caused life-threatening problems in athletes during summer training camps.

The take-home point is that nutritional supplements can be just as powerful as prescribed medications, both in beneficial results and adverse effects. They are manufactured and sold, largely without much scientific testing and regulation. While millions of supplement-takers have experienced pain relief, gained strength, and even broken Major League home run records, there are many who have had side effects, and even a few who have died. The Sports Illustrated article points out that the industry is doing very little to protect consumers, and that puts the responsibility on you to research the ingredients, and use them with caution, just as you would with prescribed medications.

http://vault.sportsillustrated.cnn.com/vault/article/magazine/MAG1155395/index.htm