Why your bottles of supplements and vitamins are a prescription for trouble.

MY MOST RATIONAL FRIENDS AND PATIENTS, the kind of people who would have wanted irrefutable evidence of WMDs before we went into Iraq, do not require such proof when it comes to taking kava, comfrey, Xango juice, or blue cohosh. Walking down the supplements section of my local Walgreens, I worry. I am convinced that there are enough vitamins and supplements being peed out into sewers and emptying into the Gulf of Mexico each day to provide for the world’s daily requirements for the next century—and to keep whales and every other marine animal from going extinct. A reasonable person seeing shelf after shelf of these bottles in a reputable pharmacy chain might believe that the leaf or tablet contains what it is said to contain, in the quantity it is meant to contain, and that it produces the effect it is meant to produce—all without adulterants. Of all of these, the last belief is what concerns me the most. My health-conscious friends who buy their drinking water at the grocery store because they do not trust tap water will swallow something labeled “all natural” or “herbal” without knowing how much lead, mercury, or cow poop they are consuming, though I must concede that all three—particularly the last—are perfectly natural.

That can’t be,” you will say. “This is Texas, not Guangdong or Bombay. Surely some agency is regulating what is in there.” The government was regulating until 1994, when Congress passed the Dietary Supplement Health and Education Act. It absolved the Food and Drug Administration from having to monitor anything that supplements the diet, including vitamins, minerals, herbs, botanicals, or amino acids. Which is why, if you recall, it was about that time when your friendly pharmacy chain began to have a full aisle dedicated to herbals and supplements. Regardless of what the product actually contains—cow poop, for example—as long as it is labeled a dietary supplement, then the manufacturer isn’t required to demonstrate efficacy or safety or even report adverse events. The FDA does require a disclaimer: You can say your cow poop promotes tonsorial growth on the scalp of men and women and even furniture; you can say that it enhances sexual vigor; you can say that it stimulates growth receptors in the male sex organ. The only thing you cannot say is that it is “intended to diagnose, treat, cure or prevent any disease.” And yet, most of us will take these supplements to do just that. I looked at the saw palmetto bottle in my medicine cabinet just to be sure. It claims only to “promote prostate health.”

Strangely, I am as guilty of this “magical” thinking as anybody. I want to believe that a pill made from some mysterious substance found in the Amazon or Africa will do all the wonderful things it claims it will do, and I would hate for it not to work from lack of belief. Indeed, the truest altar to our faith in America is our medicine cabinet. Next to the boring, white-capped, childproof amber prescription bottles that hold our blood pressure, cholesterol, and other pills (those workhorses of American medicine that have undoubtedly made us live longer) sit the flashier containers of lycopene, CoQ10, ginseng, ginkgo, shark cartilage, milk thistle, and other sacred offerings we make to the temple of the body. Don’t ask us how or why those work. We know. Have faith.

As a young medical student in India, I detected in myself the early signs of a thinning scalp. The dermatology professor I went to see, a sound scientist, gave me the cold, hard facts: Genetics and testosterone were working against me. Only eunuchs were guaranteed a full head of hair. Enjoy it while you have it, he said. This capable dermatologist took away my last hope. Short of castration, which I thought was excessive, my destiny was predetermined. I had all the facts. My quest should have ended, but the wish for magic never dies. A friend who was an airline pilot and a yoga teacher (a balance of inner and outer space that I envied) recommended I see an ayurvedic physician, a man whom his family swore by. “Just see him. Have faith. You never know.” Words to that effect.

I went. I took a bus to Parry’s Corner, in Madras (a city now called Chennai), a bustling part of town where the redbrick Indo-Saracenic High Court building dating to 1892 dominates and where lawyers in black robes over white cotton shirts carried files with shoelace bindings that kept the papers from falling out. I walked down back alleys to find the good doctor’s residence. He turned out to be a septuagenarian with a reassuring, down-to-earth manner, a man with an interest in astronomy and astrology, as well as ayurveda. His office was the front room of his modest house, just inside the street, but shaded by a porch. His dark, cozy space had shelves on one side containing a few specimen jars of the kind that in medical museums hold Cyclops babies and Siamese twins, but his had leaves, tubers, powders, and seeds. Next to those were many smaller bottles of oils and various liquid distillations. Books, both English and Sanskrit, filled another wall, and a Sanskrit tome the size of the Gutenberg Bible lay open on a table. From the titles of the English books I could tell this was a well-read and well-educated man with a broad interest in science. The place had the redolence of an herbarium, the mystery of a sorcerer’s den, yet it was as warm and inviting as my grandmother’s kitchen. I told myself that when I became a licensed physician, this was what I wanted my office to look like. The dermatologist’s office with its plain walls and dull certificates in duller frames inspired no such passion.

He sat in a cane-bottomed rocking chair, in front of an old teak desk, and waited, smiling, as if he had all the time in the

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