Meds & Supplements, News & Research

Dietary Supplements: Does the Bottle Contain What the Label Says?

Do store brands of dietary supplements contain the ingredients the labels claim?, asked scientists from The New York attorney general’s office. In analysis of supplements from Walmart, Target, GNC, and Walgreens, they found that only 21% of the supplements did contain the ingredients listed and that “most” contained ingredients not included on the label. The resulting response has included furor over the attorney general’s testing methods as well as people claiming that these results support what they knew all along. Amid all the outrage, some interesting points have caught my eye. Here’s what I found most interesting:

How Not to Test a Dietary Supplement in The New Yorker examines whether DNA barcode testing is an accurate way to assess the ingredients of supplements. (Tammy Rome, an herbalist and writer for, argues that it is not.)

Your Vitamins May Be Lying to You: Why Big Herba is Out of Control, in Salon, carries important information far beyond the sensational headline: “The very same mega-companies with gigantic chemical labs that make drugs are cooking up vitamin and herbal supplements labeled with sunny terms like ‘natural’ and ‘wholesome.’ Pfizer, Unilever, Novartis, GlaxoSmithKline and other big pharmaceutical firms make or sell supplements. Procter & Gamble Co. and Arm & Hammer are also in on the action. Wall Street is getting in on the game, too: the Carlyle Group, a private-equity titan, owns NBTY (formerly Nature’s Bounty), whose brands include Nature’s Bounty, Sundown Naturals, Puritan’s Pride, and Vitamin World.”

People take herbs and supplements for a variety of reasons, only one of which is distrust of the pharmaceutical industry. Still, if that’s important to you, then you’ll want to do careful research to find out if you’re supporting Big Pharma when purchasing supplements. Other people will seek out supplements sold by pharmaceutical companies, assuming that they have more rigorous scientific and safety standards than smaller, less known companies.

In Be Careful Where You Buy Your Herbal Products!, headache specialist Alexander Mauskop, M.D., discusses the supplements he recommends and says that his preferred brand is Nature’s Way.

As so often happens, I’m left with no answers, just more questions. First, what about non-store brands? Does Nature’s Way, for example, contain the DNA of the listed ingredients? If so, it supports the idea that store brands could be lacking, though even that raises additional questions. If not, we’re still left to wonder if the testing methods were inaccurate or if all supplements or bogus or something in between. Also, if the pharmaceutical industry plays a large role in the supplement industry, does that make supplements more or less reliable, or does it make no difference? From my reading today, it appears that how you answer that question depends on your beliefs about Big Pharma. Finally, does this even matter? Will it change consumers’ purchasing behaviors? Will it just increase the divide between those who think supplements are the best and those who believe they’re hogwash? Will people become even more invested in their existing opinions, as studies have found happens when people who are anti-vaccination are shown pictures of children with the disease they aren’t vaccinating for?

What’s your reaction to the news? Will it change the way you think about supplements or where you buy them?

Patient Education, Society, Treatment

Education & Advertising Revisited

Yesterday I received the first mailing of Pfizer’s “Be Stronger Than Your Migraine” campaign. Disguised as a letter welcoming me to the program, the mailing was all about how the drug will change my life. The main points:

  • Don’t give up – Even if it didn’t work last time, Relpax may work in the future
  • Partner with your doctor – Your doctor needs to know how you’re doing on the drug and should give you refills before you run out

I also got the patient info sheet that’s included with every prescription. More pieces of the toolkit are supposedly on the way. Maybe they’ll even address tools other than Relpax.

Coincidentally, an e-mail message from an Ortho-McNeil employee also arrived yesterday, asking my opinion of the Topamax and Axert educational and advertising sites. Before I had a chance to look at the sites, I wondered if my response to the Relpax campaign was too harsh or not well thought out.

The answer is no.

I’m a fan of western medicine and don’t think all drug companies are bad or that “natural” treatments are better. Quite simply, I think that advertising that feeds false hope is disgusting. It’s unethical for a company that stands to profit to play into the vulnerabilities of someone with illness.

In contrast to my beef with the Pfizer site, Ortho-McNeil’s sites provide comprehensive information about migraines and possible treatments. Topamax and Axert are mentioned as what the company can offer for a preventative or abortive, but aren’t hyped. Even the drug specific websites don’t use absolutes.

My biggest complaint is the name of the site “Mind Over Migraine,” which encourages patients to be involved in their treatment and gives specific tips on how to gain some control. But there’s even a statement on the site that while you can’t think your migraines away, “you do have the power to decide whether you’ll take control of your migraines, or let them take control of you.”

What can I say? I’m impressed.

I’m not shilling for Ortho-McNeil. I don’t know if one drug is better than another – and the answer to that will depend on your body – but I’ll always support honest educational materials and a realistic approach to a medication’s results over an ad that’s framed as outreach.

(The sites I looked at:,,,,


Drug Lobby Spending and Influence

Too tired to write much, but want to share this story: Drug Lobby Second to None. The Center for Public Integrity today shared findings from its study on the drug industry’s lobbying efforts. The first paragraph of the press release sums up the findings well:

“The pharmaceutical and health products industry has spent more than $800 million in federal lobbying and campaign donations at the federal and state levels in the past seven years, a Center for Public Integrity investigation has found. Its lobbying operation, on which it reports spending more than $675 million, is the biggest in the nation. No other industry has spent more money to sway public policy in that period. Its combined political outlays on lobbying and campaign contributions is topped only by the insurance industry.”

Meds & Supplements, Patient Education, Society

Education or Advertising?

Pfizer, the maker of Relpax, announced a new migraine education – and advertising – campaign today. Called “Be Stronger Than Your Migraine,” the company says the campaign provides migraine patients with tools to identify how migraine affects their lives, recognize how they interfere with their own treatment and ways to have a better relationship with their doctors.

There’s not much information available on it yet, but I’ve requested the “toolkit.” At the surface, it appears to be little more than a direct-to-consumer drug ad. You know the line: If you tell your doctor to prescribe Relpax, you’ll be in control and your pain will go away.

Am I being cynical? Yes. Volatile? Certainly. I’m tired of drug companies and media outlets telling me that I just have to be strong and my headaches will go away. Yes, it’s important to be assertive with your doc and to think about ways to become more involved in your treatment. It’s also important to grieve the losses that you’ve had because of your headaches. And to think critically about who is giving you such advice.

Mostly I’m angry because Pfizer, like many other drug companies, is promoting the idea of the miracle cure for migraine. Relpax might be the drug that improves migraine pain. But it isn’t going to work for everyone. It’s dangerous to believe in a miracle cure, because you’ll be crushed if it doesn’t exist for you.

This might turn out to be a great and empowering campaign and I’ll have egg on my face. I’ll share the information with you when I receive the materials. You can also look into it for yourself. Yahoo! has the press release, the campaign site has an overview and the Relpax website has more detailed information.

I have a Relpax prescription waiting for me at the pharmacy. Who knows, maybe it’ll be my miracle drug. In any case, you should know that one of the reasons I started this blog is because so much migraine information online is from advertisements thinly disguised as education campaigns. You can be sure that I’ll never push one medication or treatment over another.