I frequently recommend supplements that don’t have large, randomized, double-blind placebo studies to back them up as long as they are inexpensive and safe; they have preliminary research for the condition in question and minimal side effects; and there are few other options (or those options are costly).
For example, the research on vitamin B2 for migraine prevention is still preliminary, but it’s impressive. The vitamin is dirt cheap and the side effects are negligible, so it’s worth a try. The prescription options for migraines are expensive, have side effects, and don’t always work. Plus, up to 50 percent of users have trouble functioning after taking them, so better alternatives are needed. This is the essence of benefit versus risk.
I would love to live in a world where every supplement fulfills all my research criteria (see the Appendix), but even conventional drugs don’t work this way; it’s part of the art of medicine. Few things in medicine come with a 100 percent assurance of effectiveness, so it comes down to probability and your willingness to accept a certain amount of risk to gain certain benefits.
“Are quality-control testing organizations useful?”
They can be. Both Consumer Reports and ConsumerLab.com tend to watch the supplement industry. ConsumerLab.com gets criticized for not being a “real” lab—they send out samples to reputable testing facilities—but I think they’re providing a decent service.
The only problem I have with some of the quality-control testing labs in the United States, which will remain nameless, is that they are discriminatory. For example, these labs will not test sexual enhancement products, either because they have to do with sex (gasp!) or because of the sordid, negative associations they anticipate for getting in bed (pun intended) with these products.
This is one of the largest categories within supplements! And they should all be allowed equal testing. Erectile dysfunction and female sexual dysfunction are real medical conditions that should be handled like any other, but instead the testing labs see them as stereotypes. I look forward to these labs being exposed for their at times discriminatory behavior.
The Supplement Handbook - Mark Moyad
