A few months ago GOOP rolled out their line of physician approved supplements. The very best supplements curated by experts direct to you for only $90 for one month’s supply or if you sign up for a monthly delivery only $75 a month.

The health claims that GOOP makes about these supplements were recently labelled deceptive by the advocacy group Truth In Advertising. For example, Truth in Advertising took issue with the claims that the “Balls in the Air” supplement can target autoimmune diseases. Look, I don’t even know what targeting an autoimmune disease means and I am a doctor. Possibly that’s a legal term for getting around an actual health claim or maybe it reflects the precision of this untested product? Who know?

Three of the doctors with GOOP branded supplements, Junger, Gottfried and Myers, all practice in the United States and so it is worth looking at their endorsed supplements with a view to any statements from American professional medical societies regarding these kinds of ventures as well as any financial ties.

What do Professional Societies Say?

The American Congress of OB/GYN (ACOG) has perhaps the strongest policy statement of any medical speciality on the matter, which I find justified as women are often the target of “hormone cures” that don’t exist and weight loss scams. For example, GOOP specifically markets the non existent adrenal fatigue to women and of course the supplements to treat it under the guise of feminism. The ACOG August 2017 Committee Opinion on Commercial Enterprises in Medical Practice says self-referral, a physician recommending a product or service in which they have a direct financial stake, is something to be discouraged.

ACOG also states the following:

Obstetrician–gynecologists should not sell or promote agents or devices as being therapeutic without an adequate evidence base for medical benefit.

Obstetrician–gynecologists should not use their professional influence or clinical environment to sell or promote nonmedical products or services or to enroll participants into multilevel marketing schemes.

The sale of prescription or nonprescription medication or devices directly to patients from obstetrician–gynecologists’ offices is discouraged when reasonably convenient, alternative vendors exist.

This statement is particularly relevant as Dr. Sara Gottfried, who designed the GOOP “High School Genes” supplement, is an OB/GYN and is listed on the ACOG website as a fellow. Dr. Gottfried also has a wide range of personally formulated supplements and shakes on her website and claims her products have worked “gloriously well on the 10,000+ people” she’s seen in the past 10 years although it is hard to see how that would count as medical evidence or unbiased.

The American Medical Association (AMA) also has pretty clear views on the matter. They state the following:

Physicians who choose to sell health-related products from their offices should not sell any health-related products whose claims of benefit lack scientific validity. When judging the efficacy of a product, physicians should rely on peer-reviewed literature and other unbiased scientific sources that review evidence in a sound, systematic, and reliable fashion.

There is no evidence GOOP supplements are scientifically valid and in fact they could potentially harm.

None of GOOP’s specific supplements have been tested in a sound, peer-reviewed fashion although some of the components have been addressed in studies.

There is large body of medical literature indicating supplements do nothing and may even be harmful. Multivitamins and supplements are not going to help you reverse aging, hack your genes (what ever the fuck that means, like really?), or help you safely lose weight. In fact you may be more likely to die if you take anti oxidant supplements.

There are studies suggesting vitamin A supplements may increase the risk of some cancers and this is relevant to the GOOP products as they contain a fair bit of Vitamin A. According to the National Institutes of Health Office of Dietary Supplements in addition to a potential cancer risk excess vitamin A from supplements can lead to liver damage and “increased intracranial pressure (pseudotumor cerebri), dizziness, nausea, headaches, skin irritation, pain in joints and bones, coma, and even death.” It’s not as if GOOP and their physicians are unaware of this as they actually have a vitamin A disclaimer.

For the record the recommended dietary allowance (RDA) of Vitamin is A is 700 mcg a day of retinol activity equivalents (RAE) for women who are not pregnant or breastfeeding. One sweet potato gets you about 1,400 mcg but where’s the profit in that?

“High School Genes” and “Why am I so Effing Tired” (a.k.a. Ode to Paltrow) each have 5,000 IU of Vitamin A and “Balls in the Air” has 10,000 IU. In each product the vitamin A is supposed to be equally divided between beta-carotene and retinyl acetate or retinol. According to the NIH Office of Dietary Supplements there is an association between > 1,500 mcg daily of preformed vitamin A (i.e. retinol or retinyl acetate) and reduced bone mineral density, and increased fracture risk. If I did my math and chemistry correctly (1 IU of retinol is 0.3 mcg retinol activity equivalents or RAE) the 5,000 IU of retinyl acetate in “Balls in the Air” is 1,500 mcg of preformed vitamin A. Yikes.

It’s not just the retinol that has health concerns according to the NIH the beta-carotene in supplements may increase the risk of lung cancer and heart disease.

Really, eat a sweet potato or have some pumpkin pie. Tastier, safer, and cheaper. That’s not alternative medicine it’s just medicine.

Dr. Junger’s “Effing” product has an even a more frightening disclaimer:

Glycyrrhizic acid is a licorice derivative and studies showing ingestion of over a 100 mg a day can raise blood pressure. “Effing” claims to have 300 mg of licorice root with 75 mg of glycyrrhizic acid. I guess it’s up to you whether you trust the GOOP chemists or not. I’m not sure how Junger decided 600 mg a day was safe. Maybe this is why Paltrow is so unwell? Could Junger have her jacked up on licorice?

The supplements branded by the three American based doctors also contain green tea leaf extract which in high doses is associated with liver injury. It is hard to know how much is actually in the product as this is a propriety blend, however, the concern is so great that liver specialists specifically advice against all supplements with green tea extract even in blends. It ain’t worth the risk.

GOOP, Doctors, and Big Supplements

Every concierge doctor with a wellness shop and a side venture in shakes wants you to be scared of “western” medicine because we evidence based doctors are apparently all in the pockets of Big Pharma. It’s drugs drugs, drugs! Okay some obviously are but most are not and you can and should look up those conflicts of interest. However, there is also Big Functional Medicine and there is no ProPublica website where you see how much money doctors are making from selling supplements or lending their professional influence to GOOP. Did the doctors who designed these supplements for GOOP get a lump sum? Do they get a percentage? Is this all just for the privilege of being featured on GOOP?

There no peer review evidence to suggest any of the GOOP physician branded supplements do anything and they could have risks. These supplements also don’t appear to fit ACOG and AMA guidelines as appropriate for promotion by physicians.

Dietary supplements are only indicated when there is a true nutritional deficiency and invented conditions like sluggish thyroid, adrenal fatigue, and postnatal depletion simply don’t count. In fact, they are offensive marketing terms in my opinion.

I’m always amazed how functional medicine doctors claim to promote healthy living and natural lifestyles and yet that living appears to be rarely achievable with, you know, food.

Me, I’m going to make pumpkin muffins tomorrow.