S2 E10: Caveat Beware

Speaker 1 Why choose a sleep number smart bed?

Speaker 2 Can I make my site softer?

Speaker 3 Can I make my site firmer? Can we sleep cooler?

Speaker 1 SleepNumber does that, cools up to eight times faster, and lets you choose your ideal comfort on either side. Your sleep number setting.
Enjoy personalized comfort for better sleep night after night.

Speaker 1 It's our Black Friday sale, recharged this season with a bundle of cozy, soothing comfort. Now only $17.99 for our C2 mattress and base plus free premium delivery.

Speaker 1 Price is higher in Alaska and Hawaii. Check it out at a SleepNumber store or sleepnumber.com today.

Speaker 6 Rediscover skin that looks as vibrant as you feel.

Speaker 7 Medicate is a British clinical skincare brand trusted by dermatologists for visible age-defying results without compromise.

Speaker 9 And right now is the best time of the year to try it.

Speaker 10 Medicate's 30% off during their Black Friday sale.

Speaker 13 If you've been curious about retinol, start with Medicaid's Crystal Retinol Night Serum.

Speaker 19 It's award-winning, ultra-gentle, and proven to work 11 times faster than traditional retinol, smoothing wrinkles, brightening dark spots, and firming skin without irritation.

Speaker 22 Or try the fan-favorite liquid peptide serum, clinically proven to smooth fine lines in just seven days.

Speaker 28 And if you want that lifted, deeply hydrated feel, Medicaid's newest innovation, Advanced Pro Collagen Plus Peptide Cream, delivers visibly rejuvenated skin while reducing wrinkles.

Speaker 32 This is the moment to elevate your routine.

Speaker 12 Medicate's 30% off Black Friday sale is is happening now through Tuesday, December 2nd.

Speaker 35 Visit medicaid.us.

Speaker 37 That's M-E-D-I-K-8.us and save 30% on age-defying skincare.

Speaker 38 Previously, on the dream.

Speaker 39 The health freedom movement, broadly anti-vaxxers, they all say that the government is hiding the cure for cancer or autism or what have you because they make more money off of us when we're sick.

Speaker 39 I do tend to point out that at all these conferences, they leave the lecture hall and they literally enter a marketplace immediately.

Speaker 39 That's how all of them are set up, so that you are funneled directly into the place where you buy things.

Speaker 39 You will hear people with, you know, a scientific specialty in one field claiming expertise in another.

Speaker 38 Remember early on in this season when we were talking about the origins of the vitamin and supplement industry?

Speaker 38 In a nutshell, all of these products we ingest or rub on ourselves or whatever, they came about because right around the Industrial Revolution we started messing with our food in ways that took vital nutrients out of it.

Speaker 38 Most of that messing around was done in an effort to preserve food or make it safer.

Speaker 38 Around the same time, trains started moving food and drinks and drugs around the country faster than ever before, so folks up north could suddenly have salad at Christmastime.

Speaker 38 It was thrilling for salad eaters, probably.

Speaker 38 But as with any new technology or big trend away from old practices, along with all this progress came the con men. Take bread, for example.

Speaker 38 You used to have to bake it yourself, or go to your baker and buy it and eat it that day before it went bad.

Speaker 38 But then with preservatives and faster shipping, bread factories came along, and with them, money-hungry industry types, who decided to put things in bread like copper copper sulfate to make it seem heavier.

Speaker 38 They watered down our milk and then added chalk to it to make it look like they hadn't. And they, okay, now this one's really gross.
They mixed ground-up lice into sugar. And that's just the food.

Speaker 38 Drugs were getting adulterated as well. Just about any cough syrup you gave your kid at that time had some sort of opiate in it.
Cocaine was everywhere, famously inspiring the name of Coca-Cola.

Speaker 38 Arsenic and beauty products, lead in everything.

Speaker 38 It was a mess. As these dangers became more well known, the government began to do its job to protect the public interest.

Speaker 38 Beginning in the 1870s, Congress took up like a hundred bills trying to regulate this stuff until finally the Federal Food and Drug Act was passed in 1906, which basically said, you can't sell food or drugs that can hurt or kill people.

Speaker 3 We're making that illegal now.

Speaker 38 You can't cover up food additives. You have to tell people if what you're selling them contains heroin.

Speaker 38 The guidebook for what was okay for people and what wasn't was the U.S. Pharmacopoeia, or USP.
You've seen that on bottles.

Speaker 38 And it's a book kind of like the DSM, the one that they use for mental health, but it's for food and drugs.

Speaker 38 A lot of folks in the supplement industry try to make it sound like the USP has some sort of governing power, but they don't. They're an encyclopedia.

Speaker 38 And if you're playing by the rules, it's pretty useful in making sure you don't hurt anyone with your products. But that's it.

Speaker 38 But if you didn't care and you were just trying to make money, you could ignore the USP and the FDA at the time was mostly focused on all that food nonsense, not so much on the drugs.

Speaker 38 So people still got away with murder, literally, until a new version of the law was passed in 1938 called the Federal Food, Drug, and Cosmetic Act.

Speaker 38 This is the one that said you had to prove the safety of your products before you sold them to people. And that's the idea the supplement industry has been fighting against ever since.

Speaker 38 The fight basically boils down to this. Who do you trust more with your health and safety? Government or industry? Are you a fan of the jungle or Atlas shrugged? Bernie or Trump?

Speaker 38 The problem complicating this at this particular moment in time is that it's hard to tell the difference between industry scions like Bezos and government scions like Trump.

Speaker 38 But the bottom line is that protecting our own health and safety requires information. And right now, no one has to provide it.

Speaker 38 Today, you're going to hear from two people at the front lines of this fight that is still raging.

Speaker 38 The first, David Kessler, was the FDA commissioner when Deshea, the Dietary Supplement Health and Education Act, passed in 1994.

Speaker 38 That's the one that basically stopped the FDA from ever regulating vitamins and supplements.

Speaker 38 It wasn't his fault that the supplement industry bill got passed, but we wanted to know how the hell it happened.

Speaker 38 How did the organization that we think of as the one who keeps us safe, how did they lose control here? Our other guest, Steve Mister, yes, Mr.

Speaker 38 Mister is his name, is the president of the Council for Responsible Nutrition, which sounds like a food safety board or something, but is actually just the cleverly named largest lobbying organization for the supplement industry.

Speaker 38 Here's David Kessler, formerly of the FDA.

Speaker 3 So I was commissioner of FDA under two presidents,

Speaker 3 appointed by the first President Bush, reappointed by President Clinton, and was there for a little under seven years.

Speaker 3 I'm a physician. I'm a pediatrician.

Speaker 3 I ran a hospital in the Bronx and was dean of two

Speaker 3 medical schools.

Speaker 38 And here is Steve Mister from CRN.

Speaker 40 I'm Steve Mister. I'm the president and CEO of the Council for Responsible Nutrition.

Speaker 40 The Council for Responsible Nutrition, or we call it CRN, is the industry's trade association for dietary supplements.

Speaker 40 So we are a member organization and our members are the companies that make both the finished products that you would see on the shelf, as well as all of the ingredients that are in the supply chain.

Speaker 40 So we represent about 190 companies between those companies that are making products and those that are providing services to the industry.

Speaker 38 I looked up who some of those companies are on their hilarious stock photo-filled website, so many smiling faces in business attire. And they include, wait for it,

Speaker 38 Amway,

Speaker 38 Avon, doTERRA, Herbalife, The Honest Company, Mary Kay for some reason, even though they have nutrition in their name, so it's like, what?

Speaker 38 And then some names you'd expect to see, like Bayer and Archer's Daniel Midland. Just keep those names in mind as you listen to Mr.
Mister talk about this conglomeration of conglomerates.

Speaker 38 Dan asked David Kessler what his thoughts were on CRN.

Speaker 41 What was your impression of the Council for Responsible Nutrition?

Speaker 3 I think that they were sort of middle of the road.

Speaker 3 They were not

Speaker 3 just a fly-by-night organization. But make no mistake, I mean, their members are

Speaker 3 industry

Speaker 3 manufacturers who sell these products, who have an obligation to their shareholders to make money.

Speaker 3 Nothing wrong with that, but you can't hold them out as a public health group.

Speaker 41 Can you tell me a little bit about the background why Deschea came about?

Speaker 3 In 1990, Congress passed the Nutrition Labeling Education Act.

Speaker 3 That required nutrition facts on all packaged foods

Speaker 3 and required certain standards if companies were going to make claims about their food products. So, if you wanted to, say, prevent heart disease, you have to meet certain scientific standards.

Speaker 3 You couldn't just say,

Speaker 3 go have a focus group and say, that's what consumers want, reduces the risk of heart disease, and slap that on your label. You had to have certain science

Speaker 3 to back up that claim. And Congress set that for food substances.

Speaker 3 But Congress could not agree among themselves on what should be the standard for that claim on dietary supplements. And basically turfed the issue to FDA and said, FDA, you go decide.

Speaker 3 what the standard should be if a dietary supplement manufacturer wants to make a claim.

Speaker 3 So what we did was we

Speaker 3 adopted the same standard as the standard for foods. If you want to make a claim, there should be significant scientific agreement.

Speaker 3 Not absolute science, not perfect science, but there'd be scientific agreement that backs up that claim.

Speaker 38 Okay, so what the FDA meant by significant scientific agreement was repeatable scientific studies done by impartial scientists and doctors.

Speaker 3 The The dietary supplement industry didn't like that.

Speaker 3 They didn't want to have that kind of scientific rigor to support the claims that they made.

Speaker 3 And they lobbied Congress very hard.

Speaker 3 Lawmakers got more mail on that during those years

Speaker 3 than almost any other issue. And that led to the passage of Deschea.

Speaker 38 Dan asked Steve Mister, what his organization, the Council for Responsible Nutrition, what their role was in the passage of Deshea.

Speaker 40 CRN was one of many organizations that was at the table back in 1993 and 94 that led to the passage of Deshea.

Speaker 40 And we're really very proud of it. Looking back, now it's 25 years old and the impact that it has had for both the industry and for consumers, it's been remarkable.

Speaker 41 And what are some of those impacts?

Speaker 40 The real key to Deschea was that it balanced consumer access, and that was very important.

Speaker 40 You know, there were millions of consumers that came out and urged their members of Congress to pass this law.

Speaker 38 I just want to pause for a second to remind you, those millions of consumers who wrote to Congress in favor of Deshea, those were the people influenced by ads.

Speaker 38 Ads funded and widely distributed by folks from the supplement business. Ads that use scare tactics, like that the government wanted to take away your freedom of choice.

Speaker 38 Like that one that Mel Gibson starred in, where a SWAT team busted into his home to take away his vitamin C.

Speaker 40 So it balanced their right to have access to these products, but at the same time created a framework that allowed the FDA to regulate them and to oversee the safety without creating the kinds of pre-market obstacles that would have shut down the industry.

Speaker 41 What do you think about that?

Speaker 3 I don't think it's accurate.

Speaker 41 Why not?

Speaker 3 Because I don't think that the fact is that it ever was a question about access. The issue was whether there had to be a scientific basis to support its claims.

Speaker 3 I would walk into a health food store and there would be big signs say FDA wants to take your vitamins away or FDA wanted to make your vitamins by prescription.

Speaker 3 Those were just lobbying gimmicks to gin up the base to get them to write to their congressmen.

Speaker 3 The real issue was whether there had to be significant scientific agreement to support the claims that the industry wanted.

Speaker 41 Aaron Ross Powell, what would be the standard for significant scientific agreement? Aaron Ross Powell,

Speaker 3 significant scientific agreement would be, in essence, the weight of the evidence.

Speaker 3 Not just a paper here or a paper there or a paper you pay someone to publish. But when you look at the evidence,

Speaker 3 the weight of it, the totality of the evidence, supports that claim.

Speaker 38 By claim, David means what the company claims their products can do.

Speaker 41 So what happened with the passage of Deschea? What were you left with as far as your ability to regulate or enforce the industry?

Speaker 3 Aaron Powell,

Speaker 3 basically, Deschea,

Speaker 3 in a significant way, deregulated dietary supplements, certainly compared to food. Congress just wanted to get it off its plate and said that as long as you're not making a disease claim,

Speaker 3 you can't say something that this cures Alzheimer's or cures cancer. But if you said that the product increases memory or builds the immune system, if it were a structure or a function claim,

Speaker 3 the industry could get away with that because the FDA would have to bear the burden of showing that that was false rather than the industry having to determine that that was true.

Speaker 38 I think it's important to remind everyone what happened when Deshea was passed in regards to these claims.

Speaker 38 These claims are what manufacturers put on dietary supplement bottles to tell people what the supplement is supposed to do.

Speaker 38 David Kessler and the FDA had been pushing for their claims to be backed by what he refers to as significant scientific agreement.

Speaker 38 In other words, they had to have science to back up claims on the bottle. The industry didn't want that at all.
So they came up with something something kind of like a compromise.

Speaker 38 Because of Deschea, the industry was not allowed to say that their products could prevent or cure a disease, but what they could say was that the product could help your body in its efforts to ward off a disease.

Speaker 38 This new type of language was called a structure function claim. There are structure function claims all over those moon juice powders I was taking.

Speaker 38 Restores balance on a cellular level, whatever that means, addresses the effects of stress, ignites energy energy in and out of the bedroom. Those are structure function claims.

Speaker 38 So by agreeing to no longer tell people that their products could cure or prevent, say, cancer with no scientific evidence to back that claim up, they're now able to say that their products can help your body's immune system in its own efforts to fight cancer.

Speaker 38 And all of this is why when David from the FDA talks about the passage of Deshea, he sounds like he just got beat up. But when Steve from the industry does, he sounds like he just fell in love.

Speaker 41 Can we talk about structure function claims?

Speaker 40 Sure.

Speaker 41 Can you describe what a structure function claim is?

Speaker 40 A structure function claim is a claim for the product that links the product to some sort of beneficial effect on the structure and function of the body.

Speaker 40 They were very important to the negotiations of Deschea all the way through because it was important that companies be able to make representations about their products that did not rise to the level of treating a disease.

Speaker 41 Say I had a product that was being marketed as something that could benefit the body's already existing ways of fending off a certain type of disease or disease in general.

Speaker 41 How would I say that on the bottle?

Speaker 40 So we know that there are many both herbals as well as some of the essential nutrients that help build your body's defenses and build a stronger immune system.

Speaker 40 So you could put something out if you had evidence of that that says that it helps to, you know,

Speaker 40 support a stronger immune function or, you know, supports immunity. Those are legitimate structure function claims.

Speaker 3 I stood for, if you want to make a claim, make sure there's some science to support that claim and make sure it's good science. Industry didn't want that.

Speaker 3 There were millions and millions of dollars at stake and they readily admitted that. Congress said, you know, these substances,

Speaker 3 let's not put that burden on the industry. Let them sell their substances.
So, you know, Congress gets to make those laws, but consumers should understand what those laws are.

Speaker 3 And the industry, because

Speaker 3 it may got the benefits of, in essence, deregulation,

Speaker 3 shouldn't be able to then say, oh, that law does more than it does.

Speaker 3 That law assures that their products are safe and their claims are supported. That just isn't the case.

Speaker 3 But in the end, the American people get what they want through their elected representatives, and what they get on dietary supplements is consumer beware.

Speaker 3 There is no pre-market notification with regard to claims or any substantiation of the claims. The consumer is left to determine for themselves whether the claims are, in fact, true.

Speaker 40 I can tell you, if you're talking about anything that would resemble the requirements for a pharmaceutical, we would absolutely oppose that kind of pre-market

Speaker 40 approval process.

Speaker 40 If they were to impose those kinds of standards on these products that are essentially natural products, herbs, botanicals, vitamins, minerals, amino acids, and things like that, if they were to impose that level of pre-market review, it would drive the cost up.

Speaker 40 It would make them unaffordable and it would really hurt access to these products.

Speaker 41 Were you proposing pharmaceutical level pre-market testing be required?

Speaker 3 No, there was not a requirement for adequate and well-controlled clinical trials, which is what the drug standard was. But there was a requirement for significant scientific basis for that claim.

Speaker 3 They would much rather not invest in that science, be able to make the claims that they make, but just the problem is we don't know whether they're true or not.

Speaker 3 I think they would sell a lot more product and be able to charge more for their product if we, if it really had an effect. Right now,

Speaker 3 these products are sold, and

Speaker 3 maybe they work, maybe they don't.

Speaker 3 Good luck.

Speaker 41 Somewhere between 80 and 85,000 supplements are on the market right now. Does that work with the figures you have?

Speaker 40 Well, you know, that leads us to another problem that I think is one of the areas that Deshea didn't take care of. We really don't know how many products are in the U.S.
marketplace.

Speaker 40 FDA has estimated it could be anywhere between 50 and 80,000.

Speaker 40 And the fact that you have this 30,000 product delta is a good illustration that despite many of the things Deschea did, it did not allow FDA to really see into the industry and see what the marketplace looks like.

Speaker 40 And that's one of the reasons that CRN is advocating for something that we call a mandatory product listing, which would be, you know, every product that would be in the marketplace would have to notify FDA and give FDA a copy of the label as the entry price of getting into the market.

Speaker 40 And that would finally give FDA that last piece of authority to know what's in the industry.

Speaker 40 And then they could say with certainty there are 75,000 products or there are 80,000 products because then they would know.

Speaker 38 That all sounds good in theory and sounds like the industry regulating itself. But if you stop for a second and think about it, it's just a database of products.

Speaker 38 So things could be made up or wrong, right?

Speaker 38 We asked David.

Speaker 41 That seems like something that could be helpful to the FDA. Does that seem like something that would realistically could get passed?

Speaker 3 And it's subject to some scrutiny and evaluation

Speaker 3 and there's independent judgment, or is it just the industry having the say of what's in this database? I'm not familiar with it.

Speaker 3 I mean, the general rule when it comes to drugs, go read the information about that drug, and you've had an independent evaluation that you can trust.

Speaker 41 And so that would make it illegal for a company to enter the market if they hadn't given prior notice to the FDA.

Speaker 40 Aaron Powell, Jr.: That's right. And it would be an administrative violation.
It would be very easy for FDA to enforce that.

Speaker 40 If they found products on Amazon or found products in your local drugstore and they were not properly listed, that would be an automatic violation.

Speaker 3 But that's the whole thing. If FDA has to go after each product and make a case, assemble the science, bring in the experts, go to court, spend hundreds and hundreds of thousands of dollars.

Speaker 3 You can do that here or there, and the FDA does it. Maybe the FDA can do a handful of those cases a year, but it certainly can't have a marketplace that has truthful and non-misleading labels.

Speaker 42 You know how every family has those holiday traditions that make the season the season? For me, it's my entire family singing along to holiday music.

Speaker 42 It's doing a giant Christmas-themed jigsaw puzzle with my family, or drinking out of our old Christmas mugs and slutting in the yard.

Speaker 42 All of those memories are perfect for an Aura frame, because now, instead of scrolling through a thousand random photos on my phone, I can actually see those moments, my family, my friends, snow, right there.

Speaker 42 glowing in my living room like a nostalgic little time portal. With Aura, you get unlimited photo and video storage totally free.

Speaker 42 You just download the Aura app, connect to Wi-Fi, and start adding your favorite shots. And if it's a gift, you can even preload photos and add a personalized message before it ships.

Speaker 42 So it's ready to go the moment they open it. Aura Frames, you can't wrap togetherness, but you can frame it.

Speaker 42 For a limited time, visit auraframes.com and get $45 off Aura's best-selling Carver Matte Frames, named number one by Wirecutter, by using promo code DREAM at checkout. That's a-ur-a-frames.com.

Speaker 42 Promo code DREAM for $45 off. This exclusive Black Friday Cyber Monday deal is their best of the year, so order now before it ends.
Support the show by mentioning us at checkout.

Speaker 42 Terms and conditions apply.

Speaker 43 This holiday season, connection with the kids we love is the best gift of all.

Speaker 43 Right now, kids on average are spending between five to nine hours a day on screens, and studies link heavy use to rising anxiety and depression, with social media being at the center of it all.

Speaker 43 That's why Gab makes kids-safe phones and watches. No internet, no social media, just the right features for their age.
With Gab's Tech and Steps approach, kids get the right tech at the right time.

Speaker 43 So if a phone is on your child's wish list, make it a Gab, the gift of safe connection.

Speaker 11 And right now, get 50% off all phones and watches.

Speaker 4 That's up to $100 in savings.

Speaker 29 Act fast while supplies last.

Speaker 35 For this exclusive holiday offer, visit gab.com/slash get gab and use code get gab.

Speaker 13 That's g-abb.com/slash get gab.

Speaker 36 Gab.

Speaker 23 Tech in steps, independence for them, peace of mind for you.

Speaker 6 Rediscover skin that looks as vibrant as you feel.

Speaker 8 Medicate is a British clinical skincare brand trusted by dermatologists for visible, age-defying results without compromise.

Speaker 9 And right now is the best time of the year to try it.

Speaker 11 Medicate's 30% off during their Black Friday sale.

Speaker 13 If you've been curious about retinol, start with Medicaid's Crystal Retinol Night Serum.

Speaker 19 It's award-winning, ultra-gentle, and proven to work 11 times faster than traditional retinol, smoothing wrinkles, brightening dark spots, and firming skin without irritation.

Speaker 22 Or try the fan-favorite liquid peptide serum, clinically proven to smooth fine lines in just seven days.

Speaker 28 And if you want that lifted, deeply hydrated feel, Medicate's newest innovation, Advanced Pro Collagen Plus Peptide Cream, delivers visibly rejuvenated skin while reducing wrinkles.

Speaker 32 This is the moment to elevate your routine.

Speaker 12 Medicate's 30% off Black Friday sale is happening now through Tuesday, December 2nd.

Speaker 35 Visit medicate.us.

Speaker 37 That's M-E-D-I-K-8.us and save 30% on age-defying skincare.

Speaker 45 Feeling the AI anxiety? From questions to job security to cybersecurity and everything in between, it's easy to feel overwhelmed with the rate of AI innovation.

Speaker 45 Enter ARIA, the enterprise AI orchestration and security platform built to boost your confidence. With ARIA, you don't have to compromise between speed and innovation or security and governance.

Speaker 45 Quickly deploy AI without cutting corners on compliance. Give your teams the confidence to adopt AI with ARIA.
Ready to eliminate your AI anxiety? Visit ARIA.com to get started for free today.

Speaker 45 That's AIRIA.com.

Speaker 38 Something that came up a lot in our reporting was safety. Are supplements safe? And how would we know?

Speaker 38 A few weeks after I started taking all that moon juice stuff at whatever quantity I wanted because the label wasn't clear about what was appropriate, I began puking.

Speaker 38 Like about an hour after I'd take it, I'd puke anywhere from two to ten times.

Speaker 38 Took me a few days to figure out what was wrong because honestly, my first instinct was not that it was the super trendy health powder that they sell at the cafe down the street from my house.

Speaker 38 I thought maybe I had a virus, but I didn't have a fever, so maybe food poisoning from the salads I'd started eating.

Speaker 38 And we all know about the great menace of tainted lettuce because they do lettuce recalls. So who knows? Eventually, I decided to stop taking the stuff.
And coincidentally, the puking stopped.

Speaker 38 I didn't call Moon Juice or the grocery store where I bought the lettuce. I doubted myself.
The fact that I didn't make a complaint, it's kind of a win for the industry.

Speaker 40 Our products are one of the safest products out there.

Speaker 40 I mean, if you look at the number of recalls, even on the food side of the marketplace, I mean, every week there are recalls around food, salmonella, E. coli, Listeria, one thing after another.

Speaker 41 But aren't there recalls around food because the regulation is more robust?

Speaker 40 No, actually, it's less. If you look at the regulation of supplements, it lies somewhere between the regulation of food and the regulation of drugs.

Speaker 40 For instance, they don't have an adverse event reporting requirement.

Speaker 38 We do.

Speaker 3 That would be incorrect. Food is much more heavily regulated.
There has to be significant scientific agreement. That's not the case with dietary supplements.

Speaker 41 Should supplements have a warning label if there are possible side effects or drug interactions.

Speaker 40 I think that is a question that's best left to the individual ingredient.

Speaker 40 And if you notice, many supplements on the market do have advisory statements on them because the manufacturer makes a conscious decision to alert consumers.

Speaker 40 For instance, if they're on a certain medication that might interact with it,

Speaker 40 or, you know, for instance, if it's a product that contains a lot of caffeine, they'll warn pregnant and lactating women to avoid the product.

Speaker 40 But that's really a decision that's best made on a product and ingredient basis.

Speaker 3 I certainly don't think that

Speaker 3 there is a rigorous system of warning

Speaker 3 labels. There may be

Speaker 3 some,

Speaker 3 but again, there's very little scientific basis

Speaker 3 or or oversight. So you may see

Speaker 3 in some

Speaker 3 instances when there are allergies,

Speaker 3 you may see certain warning labels.

Speaker 41 So St. John's Wart.

Speaker 41 What we know about St. John's Wart is it can interfere with drugs that prevent things like transplant rejection or drugs that are used to treat heart disease, seizures, certain cancers.

Speaker 41 Do you believe that St. John's Wart should be required to have some sort sort of warning label on its bottle?

Speaker 40 Again, at least if you're talking about my members, I think I can't speak for every one of them, but I think most of my members who sell St.

Speaker 40 John's wort do include some kind of cautionary statement on the label.

Speaker 40 I would say that consumers ought to know about that if they're taking medications that could interfere, you know, where supplements could interact with them. But, you know, that's a two-way street.

Speaker 40 We know that grapefruits, for instance,

Speaker 40 interact with a lot of prescription drugs. And we don't require warning labels on grapefruits.

Speaker 40 What we do is we require doctors to ask their patients before they prescribe that medication, tell me about the products that you, what do you eat?

Speaker 40 And

Speaker 40 the burden that is on the physician prescribing that product to caution the person not to eat grapefruit while they're on that medication. So I think it goes both ways.

Speaker 40 Doctors also have an obligation to understand that consumers, as I said, three quarters of Americans are using dietary supplements.

Speaker 40 They should be asking consumers about their supplement usage and then advising them if they need to go off of one of those products while they're on the drug.

Speaker 41 Do you think that doctors should be responsible for knowing each of the products that are on the market and the burden should shift to them for warning their patients if there are potential drug interactions?

Speaker 3 And where does the science come from on that? So the doctors are educated? Who does that?

Speaker 40 There are national databases that are available that doctors can consult that will tell them if there are potential interactions between supplements and certain classes of drugs.

Speaker 40 They're proprietary, but doctors can certainly get into them.

Speaker 41 What does that mean they're proprietary?

Speaker 40 It means some private company has developed them.

Speaker 40 Not a supplement company, but some private information company or publishing house has developed the database. And so you pay an annual subscription fee to have access to it.

Speaker 40 And you can go in and look at these databases to see if there are potential interactions.

Speaker 41 Those are private companies that develop them, so you can pay an annual subscription fee. I'm wondering, in your experience, if that seems to be an effective method for getting doctors' information.

Speaker 3 I think that,

Speaker 3 again,

Speaker 3 this may not

Speaker 3 give you a lot of confidence,

Speaker 3 but when it comes to these dietary supplements, the average doc is clueless.

Speaker 3 They may know one or two, certainly if you're an OBGYN folic acid, because the science is there,

Speaker 3 they're going to be very knowledgeable about that. But the last thing you want to do is rely on your doc for dietary supplement advice.

Speaker 3 I mean, unless that doc is prescribing them and they're knowledgeable, and that's what their practices are.

Speaker 3 But

Speaker 3 those are few and far between.

Speaker 3 You know, I've been dean of medical schools, I've trained medical students. I mean, there just is not that scientific basis that has been

Speaker 3 really developed over the last 50 years.

Speaker 3 It's,

Speaker 3 again,

Speaker 3 they are low priorities.

Speaker 41 I read your code of ethics and some of the voluntary policing or guidelines that you asked people to follow.

Speaker 41 How do you know that members of the CRN are actually complying with the code of ethics that the FDA or even the council has proposed?

Speaker 40 So, we do self-police our guidelines.

Speaker 40 We occasionally will take one of our guidelines and then go out and look at all of the companies in our space and look to see, you know, are our members actually abiding by them.

Speaker 40 So, for instance, we have a voluntary guideline around protein to be sure that companies are accurately labeling their protein powders with the right amount.

Speaker 40 And so, a couple years ago, we went out and did a sort of an undercover operation, you know, purchased a lot of our company's products and sent them out for analysis.

Speaker 40 We were very pleased to, at the end of that, to be able to report back to the membership that they were 100% compliant.

Speaker 40 So we do those kinds of things on a regular basis to be sure that there is some teeth to our voluntary programs.

Speaker 41 What I'm wondering is if we want your scientists telling us whether something has a low enough level of toxicity or if it's effective.

Speaker 40 You know, I'm going to take personal affront at that, Dan. The fact that someone works for an industry trade association, they do not check their integrity at the door.

Speaker 40 And you're suggesting that because somebody works for an industry association that they somehow has an agenda that would get in the way of their scientific integrity?

Speaker 40 No, our scientists look at the

Speaker 40 adverse event reports, they look at what's going on in the industry, and they are able to make, I think, very strong independent judgments based on what they see.

Speaker 3 I mean, ask the average consumer what they think about the industry policing themselves. I mean, pick pick any industry you want.

Speaker 3 Are there some advantages? Sure. Does it really give you a lot of confidence? Probably not.
So if the industry really cared about consumer confidence, it would not have lobbied for Descheyer.

Speaker 3 But that's what the industry bought through the enactment of legislation.

Speaker 3 And as long as consumers understand when they pick up a dietary supplement, that does not have the FDA in premature, then the consumer at least knows that they're on their own and can bring their own judgment to that.

Speaker 41 Do you think we should think of self-policing as not enough when it comes to things that we ingest that could affect our health?

Speaker 40 Well, self-policing is certainly not going to solve a problem in and of itself because we don't have the kinds of sticks at the end of the day that an enforcement agency would.

Speaker 40 And that's one of the reasons that in addition to all of the self-regulatory work that we do, we strongly support increasing resources to FDA.

Speaker 40 And in fact, the industry working with some other groups helped FDA get an additional $3 million this year in the budget, specifically for dietary supplement programs.

Speaker 40 $3 million may not sound like a lot, but prior to this, the Office of Dietary Supplement Programs was operating on only about $7 million.

Speaker 40 So going from $7 million to $10 million is a substantial increase for the agency. And that's really what needs to happen is there needs to be more enforcement.

Speaker 40 Self-policing is not going to solve the problem on its own.

Speaker 3 Yeah,

Speaker 3 I think

Speaker 3 they would like very much for there to be a strong FDA and the FDA to give their products cover.

Speaker 3 The problem at the end of the day is while they may say they want a strong FDA, they don't want a strong FDA when it comes to the regulation of dietary supplements.

Speaker 40 Would I like to have other independent scientists also looking at this other than just the industry? Of course, I would. And there are.
There are groups like U.S.

Speaker 40 Pharmacopeia, an NSF, and Informed Choice that look at products as a third-party certifier.

Speaker 40 But that's a very different thing to say that someone who works for my industry is incapable of analyzing that first event and making sure that you're not sure.

Speaker 3 I didn't say they were incapable.

Speaker 41 I was saying that asking the public to trust the information that comes from an industry trade and lobby group is asking a lot. That's all I'm saying.

Speaker 3 U.S. Pharmacopeia, the USP, is a standard-setting organization.

Speaker 3 There's no doubt that for the last hundred years, the USP has worked very closely with FDA and has enacted some of the highest standards in the world. But USP doesn't review labels or review claims.

Speaker 3 It sets standards. And in the case of dietary supplements,

Speaker 3 they can or cannot be followed.

Speaker 3 I've always believed

Speaker 3 that one of the great things about the Federal Food, Drug, and Cosmetic Act in the last hundred years of regulation is that it protects against economic fraud.

Speaker 3 Go back 100 years ago, and we lived in a marketplace of snake oil. You put a claim on a bottle and you can sell it for as long as you can maintain credibility in the eyes of the consumer.

Speaker 3 But that's economic fraud. And it's one of the great things about consumer protection and the Federal Food, Drug, and Cosmetic Act.
And those things are linked.

Speaker 3 No doubt, preventing harm is the first priority. Safety is the first priority.
But I was the commissioner who sees thousands of gallons of orange juice that were labeled fresh when it wasn't fresh.

Speaker 3 And I did that because I thought consumers had a right to be able to trust the labeler.

Speaker 3 If you're going to sell a product and put it on the shelves and make a claim and say it's fresh, it should be fresh.

Speaker 38 Just imagine if the FDA could use this same power in the vitamin aisle at CBS or Whole Foods. Like, no, you cannot say that your product cures colds or fixes your digestion problems.

Speaker 38 That would be wild. But that's not the way it is.
It's the Wild West.

Speaker 3 You know, the industry will look to what its competitors are doing. And if they're cheating and if they're getting away with things, they'll likely do the same.

Speaker 3 But if you insist on certain standards, then everybody will rise to meet those standards. No doubt, they're making sure that what's on the label is what's in the product.

Speaker 3 It may cost more in the short run, but just think of the millions and millions of dollars that we spend on products that don't work. Where is that money going?

Speaker 3 Understand, I took on the tobacco industry. Tobacco in some ways was easy compared to the dietary supplement industry.

Speaker 3 Tobacco, I think, in front of the American public does not have a lot of credibility.

Speaker 3 I think most people recognize that for 50, 75 years, that industry lied to the American public. So people see the industry for what it is.

Speaker 3 The political clout, I mean, the lobbying effort on the part of the dietary supplement industry, the ginning up of the consumer to say FDA was going to take away your vitamins.

Speaker 3 They were very effective. We got beat by the dietary supplement industry.
They won. I think the public health lost,

Speaker 3 but so be it.

Speaker 42 Going online without ExpressVPN is like not having a case for your phone.

Speaker 42 Most of the time, you'll probably be fine, but all it takes is one drop, and you'll wish you spent those extra few dollars on a case. ExpressVPN is super secure.

Speaker 42 I use it on programs that I make that could maybe, you know, get hacked into. And it's really easy to use.
Fire up the app, click one button, and you're protected. And it's at its lowest price ever.

Speaker 42 Plans start at just $3.49 a month. That's $3.49 a month.
12 cents a day. As listeners of the dream, you know we look into politicians quite a bit and scammy things within the government.

Speaker 42 So I end up using a VPN quite a bit to do research, to contact people. It just keeps me feeling more secure with my reporting.

Speaker 42 Select plans include include Identity Defender, a new suite of tools to get your data removed from data brokers, alert you when your data appears on the dark web, and even insure you against data theft for up to $1 million.

Speaker 42 Secure your online data today by visiting expressvpn.com slash the dream. That's expressvpn.com slash the dream to find out how you can get up to four extra months.
Expressvpn.com slash the dream.

Speaker 38 It's that time of year again. The holidays are coming fast.
And if your kids are anything like mine, that wish list is getting pretty long.

Speaker 38 Let's be honest, some of the things on that list make us stop and think, like a smartphone. Do they actually need all that stuff to stare at? Well, no, they don't.
Just get them a gab.

Speaker 38 I got one for my kid. It has tracking, which I only look at every once in a while because I don't like to spy on her.
It has a phone number, very helpful.

Speaker 38 And it has a list of people you can text that I approve. Plus, I can spy on the the text, which I don't do.

Speaker 3 Haven't had to yet.

Speaker 38 But if something weird comes in on one of those texts, I do get a notification. And then I look and it's just some dumb YouTube makeup video that the Gab phone doesn't let you watch.

Speaker 38 So win, win, win, win, win, win.

Speaker 3 I love it.

Speaker 38 Gab offers phones and watches made just for kids. No internet, no social media, and just the right features for their age.

Speaker 38 Kids want phones to feel independent and connected, and as parents, we want to know they're safe. With Gab, you can have both and protect them from the scary stuff.

Speaker 38 With Gab's Tech and Steps approach, kids get the right tech at the right time.

Speaker 38 From watches with GPS tracking for the youngest explorers to the perfect first phone with no internet or social media to the teen phones with parent-approved apps.

Speaker 38 So get ready for a Christmas morning they'll never forget, the one where they get their first phone. And really, it's a gift for you too, because these kids-safe phones will give you peace of mind.

Speaker 38 Visit gab.com slash the dream and use code the dream for a special holiday offer. That's gabb.com/slash the dream.
Gab, tech-in-steps. Independence for them, peace of mind for you.

Speaker 1 Why choose a sleep number smart bed?

Speaker 2 Can I make my site softer?

Speaker 3 Can I make my site firmer? Can we sleep cooler?

Speaker 1 Sleep number does that, cools up to eight times faster, and lets you choose your ideal comfort on either side. Your sleep number setting.

Speaker 1 Enjoy a personalized comfort for better sleep night after night. It's the final days of our Black Friday sale.
Recharge this season with a bundle of cozy, soothing comfort.

Speaker 1 Now only $17.99 for our C2 mattress and base plus free premium delivery. Prices higher in Alaska and Hawaii.
Check it out at a sleepbumber store or sleepbumber.com today.

Speaker 6 Rediscover skin that looks as vibrant as you feel.

Speaker 7 Medicate is a British clinical skincare brand trusted by dermatologists for visible, age-defying results without compromise.

Speaker 9 And right now is the best time of the year to try it.

Speaker 11 Medicate's 30% off during their Black Friday sale.

Speaker 13 If you've been curious about retinol, start with Medicaid's Crystal Retinol Night Serum.

Speaker 19 It's award-winning, ultra-gentle, and proven to work 11 times faster than traditional retinol, smoothing wrinkles, brightening dark spots, and firming skin without irritation.

Speaker 22 Or try the fan-favorite liquid peptide serum, clinically proven to smooth fine lines in just seven days.

Speaker 28 And if you want that lifted, deeply hydrated feel, Medicate's newest innovation, Advanced Pro Collagen Plus Peptide Cream, delivers visibly rejuvenated skin while reducing wrinkles.

Speaker 31 This is the moment to elevate your routine.

Speaker 12 Medicaid's 30% off Black Friday sale is happening now through Tuesday, December 2nd.

Speaker 35 Visit medicate.us.

Speaker 37 That's M-E-D-I-K-8.us and save 30% on age-defying skincare.

Speaker 38 Grandma Ruth called me the other day to wish me a happy birthday and to tell me she loves me and that God loves me.

Speaker 38 For all you wondering if we're still talking after I spoke negatively about her essential oils, yes.

Speaker 38 And I asked her what she thought of all this, of the idea of the government regulating her supplements. She told me she's frightened of that idea.

Speaker 38 And then she threatened that she'd have to start buying her essential oils and trace minerals and colloidal silver on the black market.

Speaker 38 Her beliefs about how these products benefit her, though so much evidence points to the contrary, wouldn't be shaken. So we started talking about my cousin's prom dress.

Speaker 38 We've been talking all season about the safety of unregulated wellness products that, though most of them just work their way through your system, have been known to hurt and even kill people.

Speaker 38 Like that liver-destroying OxyElite Pro stuff that GNC was selling in Hawaii.

Speaker 38 But on top of the potential physical harm this stuff could do, who knows because no one's really in charge, there's the financial harm the wellness industry inflicts upon us.

Speaker 38 The millions of dollars millions of people spend on tens of thousands of products and services that might not or simply don't work.

Speaker 38 Millions of dollars that would be better spent on things we at least know have some efficacy, that we don't have to believe in for them to help us.

Speaker 38 A complicated thing about wellness is that it means something different to each of us.

Speaker 38 I hated almost every wellness treatment I got during this journey because I spent so much precious, precious time and precious money and drove all over town to sit down somewhere other than my house where I can watch TV and hang out with my kid and eat fast food.

Speaker 38 I said almost every wellness treatment.

Speaker 38 After I was released from the hospital for the maybe measles, I went for one last wellness treatment on my tour of hellness.

Speaker 38 It was called a tuning fork session, which I kept referring to as getting forked. I had no idea what to expect.

Speaker 38 I imagine something like a sound bath, which I've also never been to, but I think is like sitting in a room while people play giant wine glasses sort of or something like that, but with tuning forks.

Speaker 38 Instead, what I got was one of the most moving, immersive, immersive, relaxing experiences of my entire life.

Speaker 38 I laid down on a massage table, just like you would to get a massage. I closed my eyes.

Speaker 38 The practitioner had a hard disc strapped to her leg that she'd tap tuning forks on and then either place them on my body in different places or walk around my head with them.

Speaker 38 I think a sound bath bowl thing was maybe used at some point, but I was so blissed out, I never once opened my eyes.

Speaker 38 After we were done and I sat up in a daze, like feeling super stoned, she said, This is gonna sound weird, but are you sure this is your first time doing this?

Speaker 38 Yes.

Speaker 38 Okay, because you gave over to the experience faster than any first-time client I've had. Usually, people are uncomfortable or ask questions, but you were just out.

Speaker 38 So I hope you don't mind, but I did a little work on your inner child.

Speaker 38 All right, I just left the tuning fork

Speaker 38 session and I am not calling it forking anymore.

Speaker 38 Okay, that inner child thing kind of made me side-eye her because I was blissed out, but I was still Jane. But was I still Jane?

Speaker 38 Was I still me, the skeptic, the cynic, sitting there feeling better than I had in a really long time?

Speaker 38 I don't even feel like making any jokes right now.

Speaker 3 It was

Speaker 3 so

Speaker 3 like, um

Speaker 3 I don't know I'm feeling emotional

Speaker 3 I feel bad that I

Speaker 3 am doing this for a podcast kind of it made me feel really guilty

Speaker 3 But I didn't ask her if I could record because I didn't want to offend her. She was just really nice

Speaker 38 I would go so far as to say I didn't feel like me in that moment, but I felt well.

Speaker 3 Oh man, I don't know. All right.

Speaker 3 Gonna call Dan.

Speaker 38 I'm kind of glad he's not here right now.

Speaker 3 I don't know. I'd be really embarrassed.
But

Speaker 3 all right.

Speaker 38 I'm gonna do this again. I'm gonna come back next week.
It was so nice.

Speaker 38 The Dream is a production of Little Everywhere and Stitcher, written and reported by me and Dan Gallucci. Editing by Peter Clowney and Tracy Samuelson.
Producing by Lyra Smith and Stephanie Kariuki.

Speaker 38 The Dream is executive produced by me, Dan Gallucci, Peter Clowney, and Chris Bannon. Our mixing engineers are Casey Holford and Brendan Burns.
Special thanks to Catherine Price.

Speaker 38 Rate, review, and subscribe wherever you listen. Thank you.

Speaker 5 Rediscover skin that looks as vibrant as you feel.

Speaker 8 Medicate is a British clinical skincare brand trusted by dermatologists for visible age-defying results without compromise.

Speaker 9 And right now is the best time of the year to try it.

Speaker 11 Medicate's 30% off during their Black Friday sale.

Speaker 14 If you've been curious about retinal, start with Medicate's Crystal Retinol Night Serum.

Speaker 19 It's award-winning, ultra-gentle, and proven to work 11 times faster than traditional retinol, smoothing wrinkles, brightening dark spots, and firming skin without irritation.

Speaker 22 Or try the fan-favorite liquid peptide serum, clinically proven to smooth fine lines in just seven days.

Speaker 28 And if you want that lifted, deeply hydrated feel, Medicaid's newest innovation, Advanced Pro Collagen Plus Peptide Cream, delivers visibly rejuvenated skin while reducing wrinkles.

Speaker 32 This is the moment to elevate your routine.

Speaker 12 Medicate's 30% off Black Friday sale is happening now through Tuesday, December 2nd.

Speaker 25 Visit medicate.us, that's M-E-D-I-K-8.us and save 30% on age-defying skincare.

Speaker 2 Hey guys, it's Paige from Giggly Squad, and if you're anything like me, holiday shopping has officially started. And you know where I'm going? Ulta Beauty.

Speaker 2 They have the cutest gift sets right now, like the Sol de Janeiro, Shea Rosa, and Cheer Perfume Mist Trio. It smells so good.
I've been misting it everywhere, on me, on the street, on my pillow.

Speaker 2 It's a whole vibe. I'm obsessed with the Tarte Kindness Cafe Collector set.
It's packed with everyday makeup must-haves, and it's honestly too cute to wrap.

Speaker 2 And if you need a cozy little self-care moment, the Moroccan Oil Hand Care Essentials kit is luxe, hydrating, and smells delicious. Don't worry if you can't decide right now.

Speaker 2 An Ulta Beauty gift card is the perfect gift for everyone. So whether you're gifting your bestie or yourself, make the season yours and head to Ulta Beauty today.
Ulta Beauty gifting happens here.

Speaker 16 You know you've reached peak couple energy when your undies match.

Speaker 30 Me, undies, match me has you both covered, literally, in super soft ultra-modal undies, socks, PJs, and loungewear.

Speaker 44 Festive prints?

Speaker 46 Check.

Speaker 8 Cozy vibes?

Speaker 7 Double check.

Speaker 9 And right now, it's deal season.

Speaker 10 Get up to 50% off site-wide for Black Friday and Cyber Monday.

Speaker 44 Take your couple game to the next level with MeUndies Match Me. To get deals up to 50% off, go to meundies.com slash Acast.

Speaker 46 Enter promo code ACAST.

Speaker 26 That's meundies.com slash Acast.

Speaker 46 Code ACAST.

Speaker 38 Hey, dream listeners, it's finally here. The Dream Plus, where you can get every single episode of our show with no ads.
It's $5 a month. It's the only tier.
No commercials. Plus, bonus content.

Speaker 38 This helps keep us independent. And your contribution will help change the way every listener hears the dream.
We'll be able to take out the ads that we don't even know are getting put into this show.

Speaker 38 which is annoying to both you and us. We're also going to have an amazing discussion board.
The interface has it cataloged under AMA, Ask Me Anything. But I don't love rules.

Speaker 38 So what I did is started a bunch of threads like ask Dan and I questions, general chit chat, just to make friends and stuff.

Speaker 38 And every time I've been in charge of a discussion board, I've made a tab called Women Be Shopping, and it's there. And we're just going to talk about what we bought.
It'll be fun.

Speaker 38 That's the dream.s-U-P-E-R-C-A-S-T dot com. Supercast.
Please, please go subscribe. It's five bucks.
It's less than a latte if you live in Los Angeles. See you there.