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:Wed, 12 Mar 2003 12:30:00 -0500

HSI - Jenny Thompson

Icebergs Ahead

 

ICEBERGS AHEAD

 

Health Sciences Institute e-Alert

 

March 12, 2003

 

**************************************************************

 

Dear Reader,

 

Last week the FDA made what appeared to be one of its

boldest efforts to place tighter regulations on the herbal

and dietary supplement industry.

 

In presenting the publication of a " proposed rule " (in

reality, a large set of rules, designed to ensure accurate

labeling information and to put uniform controls on the

manufacturing of supplements), FDA representatives announced

it as if the cavalry had FINALLY arrived to rescue an

imperiled public from the evils that lurk in impure

supplements.

 

So...is it actually much ado about nothing? Or is there a

hidden agenda?

 

-----------------------------

How smooth is your ceiling?

-----------------------------

 

The proposed rule is referred to as CGMP, an acronym

for " Current Good Manufacturing Practice in Manufacturing,

Packing, or Holding Dietary Ingredients and Dietary

Supplements. "

 

Most of the 547-page CGMP is as dry as dust, including

mundane bureaucratic requirements such as " adequate lighting

in hand-washing areas, " and a very strict insistence that

manufacturing plants should have " floors, walls and ceilings

that are of smooth and hard surfaces. " If these rules become

formal regulations, we'll be able to finally take great

comfort in knowing that our daily supplements are produced

in facilities with smooth, hard ceilings.

 

The CGMP document is open to public comment for the next 90

days, so the tone of the wording is somewhat differential -

almost meek - as if to say, " These are just some ideas we

came up with. We guess they're okay. What do you think? " And

the FDA press release that accompanied the announcement

stated that the goal was to implement rules, " without

imposing unnecessary regulatory burdens. "

 

All that was missing was a blushing FDA rep kicking the dirt

with his toe while saying, " Aw shucks - we're just doin' our

job, folks. "

 

-----------------------------

Speaking with two voices

-----------------------------

 

But the hangdog tone of CGMP doesn't quite match the more

strident and accusatory public statements that accompanied

the publication of the document. One FDA spokesperson warned

that there were " many " cases in which pesticides, bacteria,

lead and even glass had been discovered in supplements. And

FDA commissioner Dr. Mark B. McClellan called the supplement

industry a " buyer beware market " - making it sound as if the

typical bottle of vitamin C is manufactured haphazardly in

open-air facilities with no ceilings or walls.

 

(As a side note, by the way: ALL markets are buyer beware

markets. Whether you're purchasing a bottle of diet soda or

a Concorde jet, a smart buyer should always beware, ask

questions and do research before making a purchase. In fact,

one of the functions of HSI e-Alerts, Members Alerts, and

the Forum is to offer a resource for those who desire to

make informed healthcare decisions.)

 

The curious reality of CGMP, however, is that this is an

attempt to create regulations where regulations already

exist. Robin Gellman (spokesperson for the American Herbal

Products Association) pointed out to the New York Times that

it's currently illegal to market a product that's

adulterated, noting that the FDA has removed such products

in the past. She adds that the FDA is being irresponsible

when they insinuate that supplements aren't regulated.

 

So if these 547 pages represent redundant regulations,

what's really going on here?

 

-----------------------------

New top dog

-----------------------------

 

Dr. McClellan took over as FDA commissioner only four months

ago. Perhaps this proposed rule reflects a new regime

asserting itself with the first of what may very well turn

into a barrage of regulations to be imposed on the

supplement industry. That's certainly reflected in a

statement in the introduction of the document that describes

the proposed rule as " one of many actions related to dietary

supplements that we (FDA) are taking to promote and protect

the public health. "

 

Commissioner McClellan also described the new set of

standards proposed in this rule as a tool to assist

researchers attempting to determine the health benefits of

supplements.

 

Ah! There we go! Now we're seeing what is perhaps the real

intent behind these new rules: To set the stage for a more

aggressive questioning of the health benefits of

supplements.

 

I hope I'm wrong, but if I were a betting woman, I'd bet the

farm that this somewhat mundane set of proposed rules is

just the tip of a very large iceberg.

 

....and another thing

 

As a side bar to today's e-Alert I want to take a quick look

at one of the barometers that measures the safety of herbal

and dietary supplements. After all, when the FDA starts

talking about impurities and protecting the public health,

what they're really talking about is safety. So let's look

at some numbers that will put safety into perspective.

 

Between 1989 and 1998 the number of deaths per year

associated with dietary supplements averaged a little more

than six per year. Let's round that up to seven per year,

for a total of 63 deaths over nine years. I don't mean to

make light of this. After all, that's 63 unfortunate

tragedies - good people who only wanted to improve their

health.

 

During that same period ('89-'98) those who attempted to

improve their health with pharmaceuticals fared quite a bit

worse, however. The average number of pharmaceutical related

deaths was approximately 227,000 per year. That places

deaths associated with pharmaceuticals as the third leading

cause of death in the U.S. - right behind heart disease and

cancer.

 

But of course, while the supplement industry is large, the

pharmaceutical industry is truly gigantic. So naturally we

would expect to see a higher rate of deaths. But 227,000 PER

YEAR!?

 

Previously, when I offered a similar sort of comparison,

someone pointed out that the numbers weren't comparable

because the pharmaceutical industry is easily 10 times

larger than the supplement industry. So let's imagine that

the supplement industry is not just 10, but 20 times larger

than it currently is. Then, if we extrapolate the numbers,

we would get a death toll from supplements of 140 per year.

 

140 avoidable deaths per year is unacceptable. 7 avoidable

deaths per year is unacceptable. 227,000 avoidable deaths

per year is an epidemic out of control - no matter how you

do the math.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

**************************************************************

**************************************************************

 

Sources:

" Current Good Manufacturing Practice in Manufacturing,

Packing, or Holding Dietary Ingredients and Dietary

Supplements " 21 Code of Federal Regulations Parts 111 and

112, Docket No. 96N-0417

" FDA Proposes Labeling and Manufacturing Standards For All

Dietary Supplements " FDA Press Release, 3/7/03

" F.D.A. to Put New Rules on Dietary Supplements " Donald G.

NcNeil, Jr. and Sherri Day, The New York Times, 3/8/03

" New FDA Regs to Ensure Supplement Purity " Steve Mitchell,

United Press International, 3/7/03

" Just Slightly More Than Six Deaths Per Year From

Supplements Between 1989 and 1998 " Wellness of Chicago

Newsletter, wellnessofchicago.com

 

Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C.

The e-Alert may not be posted on commercial sites without

written permission.

 

**************************************************************

Before you hit reply to send us a question or request, please

click here http://www.hsibaltimore.com/ealert/questions.html

 

**************************************************************

 

 

**************************************************************

If you'd like to participate in the HSI Forum, search past

e-Alerts and products or you're an HSI member and would like

to search past articles, visit http://www.hsibaltimore.com

 

**************************************************************

To learn more about HSI, call (203) 699-4416 or visit

http://www.agora-inc.com/reports/HSI/WHSIC313/home.cfm.

 

**************************************************************

 

 

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Or, go to our group site: Gettingwell

 

 

 

 

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