Publication Date 30/04/2012         Volume. 4 No. 4   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.

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No Deaths from Vitamins - America's Largest Database Confirms Supplement Safety

Staff Writer

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Editing and Researching news and stories about global and local Pharmacy Issues

The following news item from Orthomolecular.org adds one more dimension to the debate on nutritional supplements. It seems that safety is definitely not an issue where nutritional supplements are used.

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There was not even one death caused by a vitamin supplement in 2010, according to the most recent information collected by the U.S. National Poison Data System.

The new 203-page annual report of the American Association of Poison Control Centers, published online at http://www.aapcc.org/dnn/Portals/0/2010%20NPDS%20Annual%20Report.pdf, shows zero deaths from multiple vitamins; zero deaths from any of the B vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths from any other vitamin.

Additionally, there were no deaths whatsoever from any amino acid or dietary mineral supplement.

Three people died from non-supplement mineral poisoning: two from medical use of sodium and one from non-supplemental iron. On page 131, the AAPCC report specifically indicates that the iron fatality was not from a nutritional supplement.

Fifty-seven poison centers provide coast-to-coast data for the National Poison Data System, "one of the few real-time national surveillance systems in existence, providing a model public health surveillance system for all types of exposures, public health event identification, resilience response and situational awareness tracking."

Well over half of the U.S. population takes daily nutritional supplements. Even if each of those people took only one single tablet daily, that makes 165,000,000 individual doses per day, for a total of over 60 billion doses annually. Since many persons take far more than just one single vitamin or mineral tablet, actual consumption is considerably higher, and the safety of nutritional supplements is all the more remarkable.

Over 60 billion doses of vitamin and mineral supplements per year in the USA, and not a single fatality. Not one.

If vitamin and mineral supplements are allegedly so "dangerous," as the FDA and news media so often claim, then where are the bodies?

 

Reference:

Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Dart RC. 2010 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 28th Annual Report. The full text article is available for free download at http://www.aapcc.org/dnn/Portals/0/2010%20NPDS%20Annual%20Report.pdf

The data mentioned above are found in Table 22B. Mineral data on page 131; vitamin data on pages 137-139 .

 

Nutritional Medicine is Orthomolecular Medicine

Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org

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Submitted by Melissa Dorey on Sat, 07/01/2012 - 09:01.

Why is this article categorised under Preventative Medicine????

There is an old saying "Absence of evidence is not evidence of absence".

Just because they don't have a report of a death, doesn't mean one didn't happen.

Poison Control Centres are not the central repository for such things anyway.

It just means no-one rang a Poison control centre about this and that's all.

People ring about overdoses and accidental poisonings by children and who overdoses on vitamins anyway????

They are clearly getting pretty carried away with the data.

Submitted by Loretta Marron on Thu, 05/01/2012 - 19:21.

A better way to assess the risks of vitamins it to look at increases in mortality rates.
Here are quotes from some reputable studies
1. "This is the most comprehensive collection of data on antioxidant vitamins ever conducted, and we have shown that on the whole these agents have no benefit. Indeed, vitamin A, vitamin E, and beta-carotene are associated with an increase in mortality at the doses studied. Vitamin A and beta-carotene seem to have a dose-related effect, with mortality increasing as doses increase, whereas vitamin E does not appear to have a dose-related effect, with all doses associated with increased mortality."
www theheart.org/article/773375.do
2. "Vitamins Tied to Higher Death Rates in Older Women in Study"
www businessweek.com/news/2011-10-10/vitamins-tied-to-higher-death-rates-in-older-women-in-study.html
3. "Vitamin E supplements 'could cause up to 27 per cent increase in lung cancer'",
www medicalnewstoday.com/releases/99294.php
4. "Folic Acid, B12 May Increase Cancer Risk"
www webmd.com/cancer/news/20091117/folic-acid-b12-may-increase-cancer-risk

How many more would you like me to find?
Apart from a small group of people (including women wanting to fall pregnant and a small number of people with compromised immune systems or who have real vitamin deficiencies and some older people) if you have a reasonable diet, where is your evidence that wasting your money on these non-prescription drugs is doing any good (apart from lining the pockets of the vitamin suppliers and pharmacy owners who fail to tell patients that they DO NOT increase energy and DO NOT improve your immune system and they only help if you are deficient in specific vitamin- and all the other nonsense we hear on TV).
Where is the evidence that half of the Americans are going to live longer if they take vitamins? Forget the vitamin - save you money and go eat a banana!

Submitted by Mark Coleman on Sat, 07/01/2012 - 11:53.

Dear Loretta,
You do seem to have started the New Year in fine form!
However, it does you no credit when you quote reports that are based on “junk science” or incomplete science. Most of the information you have reported has since been refuted and discredited (particularly where a toxic isomer of Vitamin E has been used to skew results).

Coincidentally, I was asked to investigate some of the “evidence” surrounding some of the reports you note in your comments. Some of my comments were published in the Pharmedia section (go to http://www.i2p.com.au/article/pharmedia-academic-manipulation-growth-jun... ) of i2P in December 2011, and I have to say that I am appalled at how we collectively derive evidence for clinicians to arrive at decisions on behalf of patients.
The process even has a name - “flip-flop” science.
(More information re this process at http://www.i2p.com.au/article/truth-medicine-%E2%80%93-weighing-evidence ).

It would also seem that substantial amounts of data derived during the conduct of a clinical trial go missing in the final publication.
This significant problem was reported in an editorial in the BMJ published on the 3rd January 2012 and found at this link http://www.bmj.com/content/344/bmj.d8158 .

An investigation into missing data found about equal weighting for the negative aspects compared to positive aspects (46% for each weighting) with the remainder being of neutral impact.
I am wondering if the omission of the reported negative impacts was because “ghost writers” were utilised in the writing of the final report (follow the various links in my Pharmedia report for more information on ghost writing and the publication of evidence in mainstream journals).
The same might be said for the positive aspects if the subject of the trial was say, a complementary medicine not deemed to be in the best interests of Big Pharma.
It is interesting to note that the first reader comment to the BMJ editorial was a scientist who endeavoured to get some “missing data” published in a mainstream journal.
He states:
“The editorial about missing data is not only important for the advancement of medicine in general, but has made me consider the potential value of a dedicated, independent Ombudsman (BMJ 2012;344:d8158).
As a rather traditional scientist, I found it hard to understand why a letter of mine with 'missing data' was rejected by one of our mainstream journals, given that it would alert fellow readers that the published claims for the efficacy of graded exercise therapy (GET) in the management of chronic fatigue syndrome (CFS) might have been overstated.”
(Read the remainder of the commentary at http://www.bmj.com/content/344/bmj.d8158?tab=responses ).

The concept of an independent ombudsman has appeal with most of the pharmacists I have had the opportunity to contact to this date, and coupled with a suggested database (initiated by Dr Ken Harvey and others – see http://www.i2p.com.au/article/tga-managed-database-fully-evaluated-compl... ) of searchable fully evaluated material located on the TGA website.

Until we can eradicate the corrupt nature of published evidence and have a central and open process where clinical data can be ethically reviewed and altered, most pharmacists and other other health clinicians see little value in arguing over the “junk science” thrust at us.
Instead, in the cause of patients, we will continue to rely on our own clinical judgement derived from scientific training and personal experience, and from published information that has been independently and personally tested.

I respectfully request that you assist us in this endeavour through your own intellectual abilities and resources.

Mark Coleman

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