Orthomolecular Medicine News Service, May 4, 2016 
In what is getting to be known as the anti-dietary supplement journal, JAMA Internal Medicine is at it yet again.
The journal recently reported on changes in prescription drug and dietary supplements from 2005 to 2011, with prescription drug use rising from 84.1% to 87.7% and dietary supplements from 51.8% to 63.7% over that time.[1]

The authors were quick to blame the increase that could result in serious side effects (a rise in risk from 8.4% to 15.1%) on the use of fish oil capsules when combined with blood thinners. This could pose bleeding problems.
Fish oil use rose from 4.7% to 18.6% during the study period.

“This is a major public health problem,” said the report’s lead author in the New York Times.[2] She added that she was stunned to discover that the use of omega-3 fish oil supplements had quadrupled over 5 years (about 1 in 5 Americans now take fish oil capsules) as they can cause bleeding in patients taking blood “thinners” like warfarin (Coumadin). However, there are few case reports and scant evidence.[3,4,5,6]

In fact, EPA (eicosapentaenoic acid), a component of fish oil, reduces arterial calcification (stiffness) induced by vitamin K depletion caused by the drug warfarin.[7] Furthermore, concomitant use of fish oil with blood thinning drugs also is documented to reduce the risk for drug-induced gastrointestinal injury.[8]

With use of blood thinning drugs rising from 32.8% to 43.0%, there certainly would be a massive number of adverse event reports if fish oil pills even resulted in 1% of patients taking blood thinners experiencing a bleeding episode.

JAMA Internal Medicine’s bias against dietary supplements

JAMA Internal Medicine published a scathing report on what it called valueless vitamin pills in its headline report published late in 2013 entitled 

“Enough is Enough: Stop Wasting Money On Vitamin and Mineral Supplements,”[9] which prompted this reporter to write a rebuttal entitled: “Vitamins: Enough of ‘Enough is Enough’.”[10]

JAMA Internal Medicine’s most recent report takes a similar swipe at supplements by saying “Despite no evidence of any clinical benefits, dietary supplement use is increasingly common among older adults, with almost a 50% increase in the use of multiple supplements.”

Before authors of this nonsense are allowed to go any further with their false claim that there is “no evidence” for the benefits of dietary supplements, let’s take a look at the strong need for dietary supplements among senior adults.

Researchers have recently done a meticulous job of documenting the progressive shrinkage (atrophy) of the human brain with advancing age, a process that is slowed by provision of vitamin B12 supplements.[11,12] By the way, the B12 vitamin cure for this problem does not work without co-consumption of fish oil or other excellent sources of omega-3 fatty acids such as walnuts, flax oil, and grass-fed beef.[13]

Brain shrinkage is a universal part of aging. No brain scans or diagnoses are needed before embarking upon a dietary supplement regimen that includes B12 and fish oil. Should one have to wait until brain shrinkage is noted to start taking B vitamins and fish oil? I think not. And why aren’t JAMA Internal Medicine editors unanimously urging their physician readers to prescribe fish oil and vitamin B12 for their senior patients?

The real problem: drug induced nutrient depletion

Statin drugs are the most used class of drugs, taken by half of senior Americans. I guess American doctors haven’t read the shocking report by investigators in Japan that claims, by virtue of statin drugs’ inhibition of vitamin K, coenzyme Q10 and the trace mineral selenium, they hasten heart failure.[14] This makes dupes (a victim of deception) out of every naive statin drug user.

The larger problem is the potential for prescription drugs to deplete essential nutrients from the body, which results in disease substitution rather than disease treatment. Pharmaceutical drugs are notorious for their ability to deplete patients of nutrients, meaning the patient will never get well. There is long-term profit there, and lots of it.

Thanks to the JAMA Internal Medicine report, we can get a rough idea what proportion of medication users are at risk for nutrient depletion because we can compare the data side-by-side. The chart below shows drug use (percent use by subjects in survey) that can be compared with a list of nutrients these drugs deplete and the percent of nutrient usage.

Nearly half of the subjects in the survey took statin drugs and only 3% of those surveyed take coenzyme Q10. That is a lot of people at unnecessary risk. For most individuals, proper doses of vitamins such as vitamins C,D, E, B-complex, and essential nutrients such as magnesium can obviate the need for statins. Nutrients are a far better way to prevent and reverse heart disease.

IN DRUG & DIETARY SUPPLEMENT USAGE 2005-2011 WITH COMPARSION LISTING OF NUTRIENTS DEPLETED BY DRUGS AND PERCENTAGE WHO SUPPLEMENT WITH THAT NUTRIENT
DRUG	Estimated Usage 2005-06	Estimated Usage 2010-11	Nutrients Depleted	Usage of Depleted Nutrient*
Statins Simvastatin (Zocor) Atorvastatin (Lipitor) Pravastatin (Pravachol) Rosuvastatin (Crestor) Zetia (ezetimibe)	37.3% 10.3% 13.8% 2.8% 1.1% 5.6%	50.1% 22.5% 9.7% 4.9% 4.9% 4.6%	Coenzyme Q10 Vitamin K Selenium	3.0% Nil Nil
Beta blockers Atenolol Metaprolol Carvedilol (Coreg)	27.1% 9.5% 11.7% 2.3%	31.2% 8.5% 14.9% 4.5%	Coenzyme Q10	3.0%
ACE inhibitors Lisinopril	24.5% 12.9%	30.4% 19.9%	Zinc	1.5%
Angiotensin antagonist (Diovan, Valsartan)	13.5%	13.2%	Potassium Magnesium Zinc	8.5% 2.9% 1.5%
Calcium blockers Norvasc	17.8%  8.5%	19.5% 13.4%	Potassium	8.5%
Anti-diabetic drugs Non-sulfonylureas Metformin	8.5 9.3%	7.9 12.6%	Vitamin B12	9.8-34.9%
Antiplatelet (blood thinners) Clopidogrel (Plavix) Warfarin (Coumadin)	32.8 4.5% 5.3%	43.0 7.1% 6.4%	Vitamin K	Nil
Acid blockers (proton pump inhibitors) Omeprazole (Prilosec)	15.7% 8.2%	18.5% 14.2%	Vitamin B12 Folic acid B9 Iron Zinc Calcium Vitamin C Vitamin D	9.8% 4.2% 1.8% 1.5% 24.1% 9.5% 15.6%
Anti-inflammatory NSAIDS Acetaminophen (Tylenol) Naproxen (Aleve)	10.1% 8.1% 3.5%	13.7% 8.7% 4.7%	Vitamin B6 Folic acid Iron Vitamin C	9.8% 4.2% 1.8% 9.5%
Aspirin	30.3%	40.4%	Iron Vitamin C Folic acid	1.8% 9.5% 4.2%
Diuretics Thiazide Furosemide	36.9% 17.1% 7.3%	47.6% 19.3% 8.2%	Potassium Magnesium Thiamin B1	8.5% 2.9% 9.8%
Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Internal Medicine April 1, 2016.				* not counting multivitamins

(Many other articles by journalist and radio host Bill Sardi will be found at his educational website,http://knowledgeofhealth.com . Copyright (c) 2016 Bill Sardi; permission given for exclusive use by Orthomolecular Medicine News Service.)

References:

1. Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC. MS Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med.(2016 Apr 1; 176:473-482. doi:10.1001/jamainternmed.2015.8581.http://www.ncbi.nlm.nih.gov/pubmed/26998708
2. Span P. The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile Of Pills, NY Times April 22, 2016 http://www.nytimes.com/2016/04/26/health/the-dangers-of-polypharmacy-the-ever-mounting-pile-of-pills.html
3. Stanger MJ, Thompson LA, Young AJ, Lieberman HR. Anticoagulant activity of select dietary supplements. Nutr Rev. 2012 Feb, 70:107-117. doi: 10.1111/j.1753-4887.2011.00444.x  http://www.ncbi.nlm.nih.gov/pubmed/22300597
4. Kepler CK, Huang RC, Meredith D et al. Omega-3 and fish oil supplements do not cause increased bleeding during spinal decompression surgery. J Spinal Disord Tech. 2012 May;25:129-132. doi: 10.1097/BSD.0b013e3182120227 .http://www.ncbi.nlm.nih.gov/pubmed/21423055
5. Eritsland J, Arnesen H, Seljeflot I, Kierulf P. Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Blood Coagul Fibrinolysis. 1995 Feb;6:17-22. http://www.ncbi.nlm.nih.gov/pubmed/7795149
6. Bender NK, Kraynak MA, Chiquette E et al. Effects of Marine Fish Oils on the Anticoagulation Status of Patients Receiving Chronic Warfarin Therapy. J Thromb Thrombolysis. 1998 Jul;5:257-261.  http://www.ncbi.nlm.nih.gov/pubmed/10767122
7. Kanai S, Uto K, Honda K et al. Eicosapentaenoic acid reduces warfarin-induced arterial calcification in rats. Atherosclerosis. 2011 Mar;215:43-51. doi: 10.1016/j.atherosclerosis.2010.12.001.  http://www.ncbi.nlm.nih.gov/pubmed/21193197
8. Tanaka M, Tanaka A, Suemaru K, Araki H. The assessment of risk for gastrointestinal injury with anticoagulant and antiplatelet drugs: the possible beneficial effect of eicosapentaenoic Acid for the risk of gastrointestinal injury. Biol Pharm Bull. 2013;36(2):222-7. doi: 10.1248/bpb.b12-00584. http://www.ncbi.nlm.nih.gov/pubmed/23207874
9. Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER 3rd. Enough is enough: Stop wasting money on vitamin and mineral supplements. Ann Intern Med. 2013 Dec 17;159:850-851. doi:10.7326/0003-4819-159-12-201312170-00011. http://www.ncbi.nlm.nih.gov/pubmed/24490268
10. Sardi W. “Vitamins: Enough of ‘Enough is Enough’.” Knowledge of Health, Feb 24, 2014.  http://knowledgeofhealth.com/vitamins-enough-of-enough-is-enough
11. Vogiatzoglou A, Refsum H, Johnston C et al. Vitamin B12 status and rate of brain volume loss in community-dwelling elderly. Neurology. 2008 Sep 9;71:826-832. doi: 10.1212/01.wnl.0000325581.26991.f2.  http://www.ncbi.nlm.nih.gov/pubmed/18779510
12. Smith AD, Smith SM, de Jager CA et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010 Sep 8;5(9):e12244. doi: 10.1371/journal.pone.0012244.  http://www.ncbi.nlm.nih.gov/pubmed/20838622
    Douaud G, Refsum H, de Jager CA et al. Preventing Alzheimer’s disease-related gray matter atrophy by B-vitamin treatment. Proc Natl Acad Sci USA. 2013 Jun 4;110:9523-9528. doi: 10.1073/pnas.1301816110. http://www.ncbi.nlm.nih.gov/pubmed/23690582

13. Jernerén F, Elshorbagy AK, Oulhaj A et al. Brain atrophy in cognitively impaired elderly: the importance of long-chain ?-3 fatty acids and B vitamin status in a randomized controlled trial. Am J Clin Nutr. 2015 Jul;102:215-221. doi: 10.3945/ajcn.114.103283.  http://www.ncbi.nlm.nih.gov/pubmed/25877495
14. Okuyama H, Langsjoen PH, Hamazaki T et al. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol. 2015 Mar;8:189-199. doi: 10.1586/17512433.2015.1011125. http://www.ncbi.nlm.nih.gov/pubmed/25655639
15. Roberts H, Hickey S. The Vitamin Cure for Heart Disease: How to Prevent and Treat Heart Disease Using Nutrition and Vitamin Supplementation. Basic Health Pub. (2011) ISBN-13: 978-1591202646

   16. Levy TE. Primal Panacea. Medfox Pub. (2011) ISBN-13: 978-0983772804 Reviewed at       https://www.thenhf.com/book-review-primal-panacea/

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