Letter in Response to the New York Times Article "Potential for Harm in Dietary Supplements" by Jane Brody, April 8, 2008

As part of our ongoing look at health care reform, it is helpful to look at the misinformation often disseminated through the media. Much of this often simply parrots the misleading biases against Natural Medicine taught in medical schools. Sadly, The New York Times, hot on the heels of its article suggesting that Fibromyalgia is not a real disease, has done another piece suggesting that natural medicine is dangerous relative to prescriptions. The article ignores the over 200,000 U.S. deaths from prescriptions each year (no longer newsworthy) and that harm from natural remedies is so rare that it is news. I know that "dog bites man" (like news that a medication kills someone) is so common that it is not news and "man bites dog" (like an herbal hurting someone) is. It would be nice, though, to see The New York Times actually offer the truth instead of only the sensational—especially when so many lives are at stake. Though I am certain their writer meant well, she seems to have forgotten what investigative journalism in support of the public is. Below is the "letter to the editor" I wrote in response.

Dear Ms. Brody,

As a physician and researcher with over 30 years experience in helping tens of thousands of desperately ill patients, I am constantly amazed how sensationalism—often/usually promoted by money—devastates our patients. Having reviewed tens of thousands of studies examining the safety and effectiveness of both natural and prescription therapies, it is clear that both offer significant benefits, costs, and risks. The risks and costs of the prescription therapies, however, DRAMATICALLY outweigh those of the natural therapies—and may do this while being less effective. For example, there are likely well over 200,000 deaths a year in the U.S. from medications, with deaths from natural remedies (excluding ephedra, where deaths are often from lack of proper education and dosing) being very rare. This key piece of information and perspective seems to have been overlooked in your article—an oversight that can cause many deaths.

As an investigative reporter with your readers' best interests at heart, I invite you to look past drug company "propaganda" to what the science and statistics actually show. To maintain objectivity, I would note that I accept no money from either pharmaceutical or natural product companies (enormous amounts are offered), and use both medications and natural products in helping patients. Therefore, I have no ax to grind beyond what works best, is safest, and is the best value. Conversely, almost all of our journals, medical conferences, and certainly drug reps are geared to PUSHING the use of what is most expensive. As Professor Jerome P. Kassirer, M.D., Distinguished Professor at Tufts University School of Medicine in Boston, Visiting Professor at Stanford University, former Editor-in-Chief of the New England Journal of Medicine, and author of the Oxford University Press book, On The Take: How Medicine's Complicity with Big Business Can Endanger Your Health has noted, these conferences are often "advertisements masquerading as educational activities!" Let's look at a few examples from your article and some common medical issues (I could easily offer dozens more):

1. Let's begin with migraine headaches. How many physicians have had tens of millions of dollars in advertising spent to show them the research showing that Imitrex (expensive) is no more effective for migraines than caffeine, aspirin, and Tylenol (e.g., Excedrin migraine-cheap). Placebo-controlled studies show Vitamin B2 decreases migraines an average of 67% after 6 weeks—much more effective than many of the toxic and expensive medications used. Basically, if it is cheap, no one makes sure physicians hear about a therapy. Five cents of IV magnesium will eliminate over 85% of acute migraines within 15 minutes (again in placebo-controlled research)—and is quite safe.
2. Motrin family medications (NSAIDS) unnecessarily kill well over 16,500 Americans a year (though as you note, the FDA considers them to be "safe"). We spend ~ $3-4 billion/year to buy these NSAID drugs and a similar amount for hospitalizations to address their complications. Glucosamine and chondroiten are safe, cheap, and in the NIH study was as or MORE effective than Celebrex. Of course since 11 of that study's authors were on the payroll of drug companies making the pain medications, you got the opposite impression and actually wrote that the natural remedies were not effective. I would be happy to walk you through what the data actually showed. This misimpression given by the study authors simply reflects the JAMA study showing that if drug company money is involved in a study, it is 400-2000% more likely to favor that companies' drug in the write up. As an investigative journalist, and with hundreds of thousands of lives at stake, I implore you to be responsible and actually look at what the research data shows (I am happy to help you do this) and not only what the paid schills (I'm sorry—the esteemed professors) on the drug company payrolls say. Sorry to be harsh, but there are too many lives at stake with the misinformation you give for me to be subtle. Especially when numerous safe natural remedies (willow bark, boswellia, fish oil, glucosamine, chondroitin, etc.) have been shown to be more effective than Motrin in addressing arthritis and other types of pain.

Unfortunately, the FDA has neither the training nor the open-mindedness to regulate natural remedies (they would simply eliminate them). What is needed is to have a separate group of experts in natural medicine be in charge of assessing the safety, effectiveness, and proper manufacturing processes for natural products. The experts should not be able to take money from natural or pharmaceutical companies (as should also be the case at the FDA) and should be a separate agency. Consumers should also be allowed accurate, scientifically based information on natural remedies as well (this is currently often forbidden under FDA rules).

My goal as a patient advocate, who is expert in both natural and pharmaceutical medicine and the economic forces driving both, is to make things as safe, effective, and cost-effective as possible, while supplying accurate information to the public so that they can make informed choices. Your article does not give accurate perspective by any means—but sensationalism seems to sell. I know you from your writings to be a caring person, and would be happy to give you perspective to help you better help the public.

As we enter a time of health care reform, if decisions are totally controlled by the large moneyed interests, many people will unnecessarily die as the system moves to bankruptcy. By reporting the science objectively and honestly, though, we can save our health care system and hundreds of thousands of lives.

I would be happy to speak with you if you'd like the experience of an insider who has refused to be bought off by either side. Interested?

Best wishes,

Jacob Teitelbaum, M.D.