Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools. On the other hand, Big Pharma has an entirely negative connotation within the walls of our profession, which makes it seem an almost insurmountable barrier for entry.
Manufacturing and Safety Issues
Although it is difficult to fathom for an industry that generates more than $40 billion a year, vitamin / supplement manufacturers have had a rough couple of years in the United States. The downturn started with Consumer Lab, which publishes test results on health, wellness and nutrition products, reporting that the Food and Drug Administration found problems at 58 percent of supplement manufacturing sites in U.S. and abroad.1 This was briefly picked up in the mainstream media, but quickly fell aside in the 24/7 news cycle of the 2016 presidential election.
The data for the Consumer Lab article was obtained through a Freedom of Information Act (FOIA) request because the FDA didn't want to release the damming statistics. Keep in mind the FDA is not a quality assurance agency; it is charged with basic food safety standards and labeling, and a majority of vitamin and supplement brands simply failed.
The FDA did publish which companies were cited, but did not publish specific infractions by each business. However, the more common infractions were disclosed:
- Not establishing product specifications for the identity, purity, strength, and/or composition of the finished dietary supplement
- Not conducting at least one appropriate test or examination to verify the identity of a dietary ingredient
- Not producing records which included the complete information relating to the production and control of each batch
In other words, the majority of vitamin / supplement manufacturers are out of compliance, which in no way guarantees you are getting what you pay for (and recommend / provide to your patients).
Even worse, in July of the same year, Consumer Reports published an article titled "Supplements Can Make You Sick,"2 stating that more than 1,000 supplements tested have been found to contain prescription or experimental drugs. You read that right: Some supplement manufacturers are putting experimental drugs or prescription medication in your supplements erroneously.
This is simply scary and responsible for 6,300 illnesses and 92 deaths from 2008 to 2011, according to the article. Consumer Reports also identified 15 supplement ingredients linked to organ damage, cancer and cardiac arrest, but somehow this list didn't catch enough mainstream attention, either.
Medical organizations have been using this data to restrict access to vitamins and supplements, even to the level of requiring supplements to be legend drugs.
Higher Regulatory Standards?
Dietary supplements are subject to far less stringent regulations than over-the-counter and prescription medication manufactured by drug manufacturers. Thus, Big Pharma can offer greater consistency and comfort that what is printed on the label is actually in the vitamin / supplement. This year when I've recommended to chiropractors that they may be better off sourcing vitamins and supplements from drug manufacturers, I often receive backlash. I have found chiropractors to have an emotional attachment to a brand or product, even though the company they buy from may be on the FDA-cited list for the above errors.
When a drug manufacturer makes anything from a statin medication to vitamin D, the manufacturing process is held to the same standard whether it is available over-the-counter or as a prescription. In my experience, many chiropractors possess an irrational fear of drug manufacturer-produced vitamins. Chiropractors rebut that it is not "whole food," or chime in with some anti-drug rhetoric as the rationale for never wanting to rely on a drug manufacturer for supplements.
But this is the only way, at least that I am aware of, to source a product held to the highest "gold standard" of manufacturing.
In my experience, we chiropractors have more passion for our patients than I've seen in other health disciplines. We always put our patients first, so if you offer vitamins and supplements, I challenge you to consider including vitamins and supplements from a drug manufacturer. Not just for the safety of your practice, but for the safety of your patients as well.
References
- "FDA Finds Problems at 58% of Supplement Manufacturing Sites in U.S. and Abroad." ConsumerLab.com, March 12, 2016.
- Interlandi J. "Supplements Can Make You Sick." Consumer Reports, July 27, 2016.
Dr. Edward Leonard, a 2006 graduate of Palmer College of Chiropractic - Florida, practices in Tampa Bay. He is also the founder and CEO of Florida Wellness Medical Group, a multi-clinic, multidisciplinary health care company; and the founder / CEO of DelivRxd, The Wellness Pharmacy (https://www.facebook.com/DelivRxd/).