A Few Words on All-Natural Products

“What do you think about using a natural supplement on him?” It’s a simple question that might seem to have a simple answer, and veterinarians field this question several times a day. Nothing simple about it, though.
Supplements are products that came from nature (the FDA will tell you exactly what that means, if you would like—vitamin, mineral, herb, amino acid), which can be purchased right off the shelf and used in whatever way you choose. That puts you in the driver’s seat, which could be good or bad. We can utilize a supplement in the treatment of a medical condition, but there is comparatively little substantiated evidence to show us exactly how. If a supplement wants to graduate and become a “drug”, it must go before the FDA and prove it can treat the condition that it claims to treat. A safe dosage can then be provided, the compound will be under the full scrutiny of the FDA, doctors will know exactly what side effects to anticipate, and… wait for it… the price will go up. It costs money to run all those safety and efficacy studies. Until its graduation day, a supplement has very little responsibility to perform. It doesn’t have to actually improve your prostate health or brain function; it only needs to say that it is trying. It doesn’t even need to prove that it is trying its very best.

And, it doesn’t need to be safe. Now, don’t get me wrong: the FDA does care if you die after eating some natural thing you grabbed off the shelf of a big box store. Wait—these products came from Mother Nature, you say, not from a smoke-spewing factory that is filled with carcinogens and crawling with oxidants! Okay, let’s talk about that: when you go hiking, immersed in nature, do you assume that every mushroom along the path is safe to eat? You’d be better off eating the trash left behind by previous hikers than risk poisoning yourself with some of the more potent mushrooms… yet they are 100% natural (and organic!). In the news this week, several infants have died from an herbal teething remedy containing (all-natural) belladonna. The FDA is intervening, in a ponderous sort of way: they’ve apparently written some scathing letters over the past few months, but this product continues to be sold. Years ago, ephedra suffered an FDA crackdown (partial) following the death of several famous athletes. Yes, an herbal supplement can attract the attention of our federal agencies—eventually—if it poisons and efficiently kills people. Sub-lethal or delayed side effects (even bad ones) and any interactions with other pills are absolutely going to fall through the cracks.

Until and unless they graduate to drug status, supplements lead a privileged existence, unchaperoned by the adults and unpunished for their various bad behaviors, with little expectation to perform. Can they still have a place in the care of our animal patients? More next month…

Dr. M. S. Regan