pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Huge Variability In Dietary Suppliments – Vitamin D

It has long been known, or at least felt, by the medical community that the “dietary supplement” industry used widely varied but fairly dubious practices in their dealing with people. That comes from the majority of them realizing they can pretty much obtain the equivalent of winning the lottery if they can just use the right advertising slogan or methodology to dupe unknowing individuals.

If you can take a 100,000 percent profit on selling anything (especially something readily available and inexpensive) the economies of scale are enormous and make a select few very, very wealthy. At this date it is only with difficulty that I can remember anything from my college days; but, I do remember an economy teacher once telling the class that if we wanted to become wealthy we needed to figure out how to sell water or air.

The industry as a whole is pretty much without regulation. The most wild of claims are almost never authenticated or challenged. And, even production standards are only directed by the most vague and loose of regulations. Sometimes the package design and construction has more regulations than the product inside the bottles.

Such is the current state of those companies making huge profits on selling vitamin D3–cholecalciferol. We know that without it we get RICKETS–not good. We’ve seen astronauts sweating with exercise to prevent bone loss from weightlessness–tough duty. And, know that Vitamin-D3 plays a role in tough and strong bones. And we’ve been taught from kindergarten days that Vitamin D comes from our skin seeing the sun, food and milk (because they add it.)

The dangerous problem is that we truly need it for our long term health and happiness, these days we can’t depend on the sun to not give us cancer and need to obtain the compound from other food sources. And what about the increasing numbers of milk intolerant people, what do we do? Especially now that we know we can’t trust the manufacturers to truly deliver what they claim on the label.

The medical journal JAMA (Feb 11) reported a study done in the Kaiser Permanente system which exposed the true problem. The researchers bought over-the-counter (OTC) vitamin D tablets from 12 different manufacturers, in different strengths and having different lot numbers then meticulously analyzed them for how much they “really” contained.

It turns out that no matter what brand you spend your hard earned cash for, you actually have no clue what concentration you are going to get. In fact the true level ranged from 52% to 132% of what the manufacturer claimed on the label– keeping in mind that in the U.S. the USB “convention” standards call for 90% – 120% truth in labeling. Did you notice that it’s a “convention” NOT a requirement because the industry as a whole is poorly regulated. It seems that if they don’t HAVE to do it correctly, they don’t.

Even if they averaged five pills out of the bottle 33% failed to meet the “convention.” Amazingly, when they analyzed a single pill from 5 bottles with different lot numbers. Those pills ranged from 9% to 140% of the stated dose! Basically you can’t even count on getting any vitamin-D at all in any one pill!

The researchers concluded “In our test, just over one-half of the OTC pills and only one-third of compounded pills met USP Convention standards.” They called for the increased regulation of the industry. I agree (for many more reasons than this) but am disillusioned that the what the government would actually do would actually turn out to be a benefit for us.

What can we do? Well… liver, veal, beef, eggs, and some fish are still available in the market and as long as we can still afford to eat them they would be a safer and more reliable source. Besides they taste a whole lot better.

[JAMA Intern Med. Published online February 11, 2013]

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