Terra Sigillata

Dan Hurley’s new book, “Natural Causes: Death, Lies and Politics in America’s Vitamin and Herbal Supplement Industry,” has the industry on the defensive.

Cited by Katie Couric’s two-part CBS News series on dietary supplements and excerpted today in the New York Times, Hurley seems to have created a buzz reminiscent of Marcia Angell’s similar indictment of the prescription pharmaceutical industry.

Hurley’s book is already #953 on Amazon and had been picking up heat from supplement advocate bloggers since before it was even released on 26 December.

Unfortunately, I was not privy to the advance book promo back in November but certainly look forward to reading it after a reader pointed out today’s NYT essay by Hurley based on his book:

Since 1983, the American Association of Poison Control Centers has kept statistics on reports of poisonings for every type of substance, including dietary supplements. That first year, there were 14,006 reports related to the use of vitamins, minerals, essential oils — which are not classified as a dietary supplement but are widely sold in supplement stores for a variety of uses — and homeopathic remedies. Herbs were not categorized that year, because they were rarely used then.

By 2005, the number had grown ninefold: 125,595 incidents were reported related to vitamins, minerals, essential oils, herbs and other supplements. In all, over the 23-year span, the association — a national organization of state and local poison centers — has received more than 1.6 million reports of adverse reactions to such products, including 251,799 that were serious enough to require hospitalization. From 1983 to 2004 there were 230 reported deaths from supplements, with the yearly numbers rising from 4 in 1994, the year the supplement bill passed, to a record 27 in 2005.

Of course, these numbers pale in comparison with the number of adverse events and deaths associated with the use of prescription drugs. But, then again, prescription drugs are tested for efficacy as well as safety, allowing risk-benefit analyses to be done and revised as new safety data comes in. I also wrote last week on how the herbal industry got behind new adverse event reporting legislation passed in December, largely to combat the perception that the industry is not regulated.

The inevitable popularity of Hurley’s book leads me to think there will be active and heated discussions of its thesis and supporting data. With accumulating failures in herbal efficacy trials while evidence also comes to light on prescription drug side effect cover-ups, we’re likely to end up with a flurry of fingerpointing and flame wars.