White Coat Underground

Too much of a bad thing

I’ve never liked Gary Null. Early in my blogging “career” I wasted thousands of words expressing my incredulity at his horrible health advice, his paranoid rants, and his shameless hucksterism. Then I saw something shiny and forgot about him for a while. But now blog bud Orac has ruined my reverie. He informs me that Gary Null took a dose of his own medicine—and nearly died.

As a compassionate human being, I can only hope he recovers quickly with no serious sequelae. As a physician, educator, and writer, I hope we can use this as an object lesson in the dangers of idiotic medical advice.

What happened?

From the news reports, it appears that Null suffered the toxic effects of too much vitamin D, a condition known as “hypervitaminosis D”. Vitamin D has multiple, complex effects on our physiology. One of the primary affects of vitamin D is on blood concentrations of calcium and phosphorus. Excessive amounts of vitamin D cause calcium to be released from bone into the blood, which can lead to constipation, kidney stones, and other more serious problems. When the both phosphorus and calcium levels are sufficiently elevated, they can precipitate in the skin leading to a condition called “calciphylaxis” which looks and behaves like a serious (often deadly) burn injury.

Gary Null, the famous guru of fake medicine, said that after starting a supplement called “Gary Null’s Ultimate Power Meal” he developed extreme fatigue, pain, blood in the urine, and was in pretty bad shape. A work up revealed him to have vitamin D toxicity. Apparently, he wasn’t the only one.

Hypervitaminosis D does not occur naturally. Most cases in the literature are due to errors in food manufacturing. A study in the 1950′s followed a group of monkeys who received feed accidentally over-supplemented with vitamin D. An outbreak in humans in the 1990s was linked to a dairy which accidentally over-fortified its milk. The new outbreak that nearly did in Mr. Null seems to follow the same pattern.

How did this happen?

Gary Null’s Ultimate Power Meal was apparently manufactured and distributed with an erroneously high vitamin D content. He ironically noted that:

All my other products are fine. It would seem that the media’s angle was not to show concern for my health but rather as per its normal pro-Big Pharma approach to try to bring criticism towards any natural product that may have an error in formulation.

How does he know all of his other products are “fine”?  The (unintentional) irony is that dietary supplements are not subject to the same regulations as “Big PhARMA” products.  As regulated by the  Dietary Supplement Health and Education Act of 1994 (DSHEA):

[T]he dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed… Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements. Manufacturers must make sure that product label information is truthful and not misleading.

It was Mr. Null’s promotion of untested, unregulated dietary supplements led inevitably to the probable poisoning of him and his customers.  Null and other poison peddlers need to be held to account for their actions.  DSHEA, the statute that enriches supplement hucksters, is the tool that allows medicine men like Null to thrive.  If we get rid of DSHEA, we at least have a chance to prevent more poisonings such as this, and to make supplement hucksters find honest work.

Comments

  1. #1 mxh
    April 29, 2010

    What really pisses me off about this guy is that, rather than acknowledge that large amounts of Vitamin D can be deadly, on his website, he shrugs it off saying that he’s fine and that Vitamin D is rapidly cleared by the body. For someone who has a PhD in (granted it’s a fake PhD) and has spent his life working with nutritional supplements you’d think that he might have (even accidentally) heard that Vitamin D is fat soluble and can build up in the body for a long time. Either he’s a complete idiot or he’s lying to his customers in order to keep on selling his crap (I’d bet on a combination of the two).

  2. #2 BB
    April 30, 2010

    Holy hypervitaminosis D, Batman!

    My elderly mother is on something like 5x RDA Vitamin D. I told the nurse to cut her down to one Vit D pill = 1 RDA per day. The excess Vit D was prescribed by a regular MD too, not a woo-meister.

  3. #3 Dianne
    April 30, 2010

    BB: Higher doses of vit D are sometimes given in cases of deficiency to bring the level back to what is considered the healthy range. I can’t say for sure whether that was what was happening in your mother’s case, not knowing the details, but it might be. If so, the intake of excess vit D should be time limited and monitored.

  4. #4 Vicki
    April 30, 2010

    BB–

    I gather (our host will know more about this) that a lot of people think the RDA for vitamin D may be too low–that RDA will prevent rickets, certainly, but vitamin D does other things. There’s a fairly wide range between RDA and dangerous levels, and 5 times the RDA is likely safe even if she doesn’t need it.

    Also, if you’re going to be telling the nurse to be changing your mother’s medication, including vitamins, make sure the doctor knows: s/he may be making decisions based on what s/he prescribed and thinks your mother is getting. If your mother was somewhat vitamin D deficient, next time her blood is tested, the doctor might look at the lab results and think “5 times RDA isn’t enough to relieve this deficiency, something serious is wrong” (or just put her on 10x) rather than “the RDA isn’t enough here, go back to 5x.”

  5. #5 James Sweet
    April 30, 2010

    Re: #2 #3 and #4… I know my wife takes vitamin D supplements, so when I first heard the news about Null it had me kind of worried. No big deal though. While there’s no reason to believe a healthy young person like my wife is actually benefiting from the extra vitamin D, you need to be far more than 5x RDA before you start into the danger zone. If I recall, the maximum safe dosage is something like 20 or even 100 times RDA. Don’t quote me on that, look it up yourself if you are concerned… but my point is, 5x RDA is not a health risk for vitamin D. It turns out that the safe range for daily vitamin D intake is quite broad.

  6. #6 nitramnaed
    April 30, 2010

    O-oh. My doc just put me on a regiment of 2000 iu vitD per day because my vitD was at 9 ng/mL. I live in the “Great White North” so I guess this is not unusual. I just hope I don’t “CACK!” before I get re-tested in 6 months.

  7. #7 PalMD
    April 30, 2010

    Vitamin D deficiency is common in the north, and aggressive replacement is considered reasonable. Null was receiving several orders of magnitude above normal replacement values.

  8. #8 James Sweet
    April 30, 2010

    Okay, since it keeps coming up and nobody quoted a number, I re-looked it up.

    The maximum “safe” level is 10,000 IU/day, which is 50x the RDA. Overdose hasn’t really been observed in adults below about 70,000+ IU/day.

    (Since Scienceblogs only allows me one link, excuse my citation of Wikipedia… this particular article is extremely well-cited so if you are one of those “DERP you cited Wikipedia so you automatically fail! I’m so smrt!” people, then just pretend that Scienceblogs allowed you to post 57 links and that I had actually posted the references in the Wikipedia article.)

  9. #9 PalMD
    April 30, 2010

    Our commenting reg system might allow me to fix something about that. I’m going to change you to a “trusted customer” and see if that allows mult links.

  10. #10 Julie Stahlhut
    May 1, 2010

    In what way is Gary Null’s business NOT “Big Pharma”?

  11. #11 marty
    May 2, 2010

    Your 100 % wrong and probably 100 % porterhouse Animal Cruelty

    Go on his Show or watch Gary Null Trenton Rally Video

  12. #12 PalMD
    May 2, 2010

    I’d like some dressing with that word salad, please.

  13. #13 E
    May 2, 2010

    Wonder if it was he who taught the clerk at my local health food store to proclaim, “Well, you can never get too much vitimain D?” That’s one that when I attempted to correct had her respond by turning and walking away in a huff. (I now boycott that health food store for that and a number of other reasons.)

    I’m one of the ones who admittedly stared out the window during science class, but even I know that too much vitamin D is dangerous. I’m only forced to consider it because I have low blood-calcium post thyroid surgery, etc., etc….

    I hope whatever physical issue Gary Null is going through comes to an end. I also hope his experience causes this latest health trend du jour of obsessing about vitamin D to come to an end as well. (Can we dig up the cholesterol one and bring it back to the forefront – I love oatmeal!!)

  14. #14 stripey_cat
    May 2, 2010

    What really matters in this case is the difference between the quality control for supplements and for pharmaceuticals. We hear about prescription errors a lot, but I can’t think of a patient getting three orders of magnitude more of a drug because of a manufacturing mistake.

    On the Vit D thing – not all supplementation is bad (here in 51 degrees north, it’s a good idea in the winter months). It’s easy to oversimplify “supplements = bad” and forget that it’s a matter of individual cases.

  15. #15 JuliaAnn
    May 2, 2010

    #6, your D is way low at 9 ng/mol and supplementing at 2,000 IU is more than reasonable, not to mention safe. See http://ods.od.nih.gov/factsheets/vitamind.asp re: latest NIH statement on Vitamin D and supplementation of same.

  16. #16 JuliaAnn
    May 2, 2010

    Oops, 9 ng/mL

    Sorry, everyone, and especially #6. Distracted by the talk at home in NYC re: a just-missed car bomb explosion last night.

  17. #17 Gareth Rees
    May 3, 2010

    Gary Null? Is he the gentleman who came up with the Null hypothesis?

  18. #18 JayZee
    May 3, 2010

    it could have been worse, stopping the overdose resolved the issue…He could have OD’d on Viox – how many tens of thousands of Americans died when their Dr’s prescribed 80mg instead of the approved 40mg dose? How many tens of thousands die every year from the smoke and mirrors we call standard medical disease treatment.

    I’m not a customer or a fan of Gary but I say thanks Gary.Thanks for showing how safe vitamins are even with a mega overdose, you lived to fight another day.

  19. #19 PalMD
    May 3, 2010

    1) It’s called “Vioxx”

    2) It doesn’t come in either 40mg or 80mg

    3) Thanks to the stubborn truth of data, the perfidity of the manufacturer was eventually revealed.

    4) It’s not clear, despite the bad actions of the company, how harmful vioxx may actually have been, compared to similar drugs.

    5) If you ignore all of the above, your entire comment is still nonsensical.