Supplements and sales pitches

Dr. Blonz is away this week. This column originally appeared on Nov. 16, 2021.)

DEAR DR. BLONZ >> I have paid the price for researching health products online — my mailbox is constantly loaded with promotions to help everything from heart disease and digestive disorders to stress issues and cognitive decline. The advertisements are usually accompanied with customer stories raving about the products.

I am 71 and in generally good health (with some arthritis), but I do like to follow developments.

My question for you is, how can products that are nonsense advertise like this? — M.M., Scottsdale,

Arizona

DEAR M.M. >> It can be challenging to distinguish between legitimate research and the unscientific assembly of self-serving puffery and testimonials. You hear or read what appear to be true-to-life stories in support of these products, and they all seem so straightforward: It worked for them, so why not you?

Before food additives, prescription or over-the-counter (OTC) drugs or medical devices can be sold, they must be approved by the Food and Drug Administration (FDA). This requires extensive testing, with results being submitted and given the green light.

A foundational tenet of our legal system is “innocent until proven guilty.” But this approach can have an uncertain impact in areas involving dietary supplements. Our laws have shifted the burden to the FDA to prove supplements cause harm, rather than the companies needing to prove they work.

With no need to establish efficacy before making the sale, it becomes the responsibility of the FDA to disprove benefits or show harm. The Federal Trade Commission (FTC) has the responsibility to go after dubious advertising claims. A better system would be one where product promoters shoulder the burden of substantiation before they begin to seek customers, but that is not the system we have. The problem is made worse because the extent of questionable products and unproven claims is overwhelming — far beyond the ability of regulatory agencies to patrol.

The American public has proven quite vulnerable to health frauds and quackery. Some, perhaps like yourself, are naturally curious. But to those frightened in the face of discomfort, pain and disease, the temptation to try something new is sometimes irresistible. To individuals dissatisfied with the medical establishment, the allure of “alternative medicine,” with its open arms and carefully worded messages, can be too much to disregard.

In some cases, bogus products go beyond a mere waste of money. When someone opts for an untried treatment rather than seeking reputable, effective medical therapy from the start, that delay can allow a condition to progress to a more severe state — even an untreatable one.

Where health is concerned, the concept of “let the buyer beware” takes on particular importance.