Last time, I discussed the evidence Truehope presented for using its EMPowerplus in depression. You can check out that review here. (I also discussed the Truehope EMPowerplus formulations, their disclaimer, and the Food and Drug Administration (FDA) rules around supplements.) Today, I am going to delve into the claims Truehope makes about using EMPowerplus micronutrient formula in bipolar disorder and why the claims made by this company are so dangerous.

Claims Truehope Makes About EMPowerplus’s Effects When Used in Those with Bipolar Disorder

The following screenshot is what Truehope has on its website with regard to the EMPowerplus Truebhope Program and bipolar disorder.

As you can see, EMPowerplus and the Truhope program for bipolar disorder is supposed to:

From the Truehope Website June 25, 2023 (click image to enlarge)
  • Eliminate symptoms of mania, manic behaviors, racing thoughts and speech, and explosive rage
  • Stabilize moods

The research list that is supposed to support this EMPowerpkus and the Truhope program for use in bipolar disorder is:

  1. An Individualized Approach to Treatment-resistant Bipolar Disorder: A Case Series
  2. Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders
  3. Successful Treatment of Bipolar Disorder II and ADHD with a micronutrient formula: A Case Study
  4. Feasibility of a nutritional supplement as a treatment for pediatric bipolar spectrum disorders
  5. Database anaylsis [sic] of children and adolescents with Bipolar Disorder consuming a micronutrient formula
  6. Database analysis of adults with bipolar disorder consuming a micronutrient formula
  7. Multinutrient Supplement as Treatment: Literature Review and Case Report of a 12-year-old Boy with Bipolar Disorder
  8. Effective mood stabilization in bipolar disorder with a chelated mineral supplement

(Note they don’t bother actually linking to the study, but rather, just a copy of the abstract they have on their site, just like with depression.) The above are numbered for ease.

Evidence for the Claims Truehope Makes for the Use of EMPowerplus in Bipolar Disorder

(After the breakdown, there is an overall conclusion if this is too long.)

  1. All of six people are included in this case series. Of course, there was no control of any sort and no blinding (see previous article for more on case series and study design). These cases were selected retroactively. In other words, they chose patients who fit the criteria they wanted and tested nothing. You can consider this a write-up of six selected cases that showed the outcome they wanted. The results are the following: “Using individualized, integrative psychiatric treatment methods, the majority of medications were eliminated. Long-term remission was attained in all cases, defined as clinical stability with no discernable symptoms of bipolar disorder for at least one year.” In other words, in these six cases, people were able to get most of some of their psychiatric medications. Not only can nothing from six people be generalized due to the paltry size, but the authors also admit that not all the medications were removed. So, no matter what was done (even if a micronutrient was applied, be it EMPowerplus or something else), we know not all psychiatric medications could be removed. And, of course, this research does not support any of the claims Truehope makes about EMPowerplus. (See here for the abstract and other information on this case series.)
  2. Here, all of 10 children with pediatric bipolar spectrum disorders took EMPowerplus, and only seven of them completed the eight-week study. The safety and tolerability of the EMPowerplus micronutrient formula was tested. No efficacy for anything was tested. Thus, this research does not support any of the supposed benefits of the EMPowerplus Truhope program. The only thing this article indicates is that seven children tolerated and were safe while taking a micronutrient formula. (Well, I should hope so. Taking a vitamin really shouldn’t hurt a child.) (See here for the full article.)
  3. This is yet another case study — so this may have worked in one person. In this case, one 21-year-old bipolar II, attention-deficit/hyperactivity disorder (ADHD), social anxiety, and panic disorder took a “nutritional supplement” for eight weeks. It was an open-label trial, so she knew she was taking a treatment. And this resulted in improvements in mood, anxiety, and hyperactivity/impulsivity. She then went off it for eight weeks and saw those gains disappear. She then went back on the supplement, and after one year, she was in remission. What can we learn from this? Well, first off, she knew she was trying something, so we can’t rule out the placebo effect — which we know can be very, very strong. We also can’t rule out that she might have been in remission after a year, no matter what, because there was no comparison group. In other words, all we can say is that a nutritional supplement may have worked for one particular person. (See here for the abstract. The article is available for a fee.)
  4. This is a feasibility study. It aims to suggest that further study is warranted. In this case, seven subjects, aged 6-12, with childhood bipolar spectrum disorders, completed a 6.5-month open-label trial of EMPowerplus. Depression and mania scores dropped from the first visit to the last. The conclusion (which is likely warranted) is: “Future randomized, placebo-controlled trials of EMP+ are warranted and feasible.” In other words, even the authors do not say that the supplement did anything — they simply say further testing makes sense, which it does. (See here for the abstract. The article is available for a fee.)
  5. This might be the most biased analysis I’ve ever seen. While, yes, there appears to be a correlation between the improvement of 120 children with bipolar disorder taking a micronutrient formula — this data came from Truehope! That’s right, the maker of the EMPowerplus gave the analysts the data. This is beyond biased in about 100 ways. The data could not be accurate. The data could be cherry-picked. They may only have that data because those who felt they saw a benefit were the only ones reporting to the company. And, of course, there is no placebo group, so even if everything was accurate, it means almost nothing. This analysis is not even worth the pixels it’s shown with (although, admittedly, even the authors say that efficacy can’t be established by their data). (See here for the complete analysis.)
  6. I think this is a biased analysis take two. This data was also given by Truehope to the analysts. I don’t know how any self-respecting doctor could attach their name to this stuff. See point #5 for the obvious problems with this analysis. For the record, the authors make no claims that EMPowerplus works; they just say that further research is warranted. (See here for the complete analysis.)
  7. This is another case study — so a write-up of a single case. In this case, a single 10-year-old with multiple diagnoses appears to have been helped by EMPowerplus. (See here for the abstract.)
  8. According to this 2001 paper, 11 adults experienced “symptom reduction,” with additional participants dropping out. Again, you could be looking at any number of factors that showed this result — for example, perhaps most of the people who the micronutrient supplement didn’t help dropped out of the study and thus skewed the numbers dramatically as there were only 11 people left. (See here for the abstract. The article is available for a fee.)

What the Listed ‘Evidence’ for EMPowerplus by Truehope Actually Says About the Product

This is the TL;DR section.

In short, not a single listed piece of research supports their product claims of mood stabilization and elimination of mania, manic behaviors, racing thoughts and speech, and explosive rage. Not a single one. The only thing this research does is that if you squint, it suggests that real studies are warranted.

Other Tidbits About EMPowerplus by TrueHope

There are two additional tidbits about EMPowerplus by Truhope that are worth noting:

  • The paper from 22 years ago states, “A randomized, placebo-controlled trial in adults with bipolar I disorder is currently underway, as well as open trials in children.” You’ll note that this trial is nowhere to be found on their website. Is that because it didn’t realize positive results? (A search of PubMed finds no such published trial as of July 20, 2023.)
  • There is an excellent paper that takes a scientific approach to analyzing all the literature on EMPowerplus. Don’t believe what I have to say? Read this paper. It concludes, “In light of the contradictions and flaws in the research associated with the most studied multivitamin in the world (allegedly), Truehope should stop making causal claims, which can lead to the deception of desperate consumers searching for relief. To avoid engaging in pseudoscience, it would befit the company to accurately modify its claims or acquire more conclusive evidence regarding EMPowerplus’ efficacy.” (Find the full paper here.)

If You’re Thinking of Buying EMPowerplus by Truehope for Bipolar Disorder

I’m not going to tell you what to do, or what not to do for that matter, but please understand this: by taking EMPowerplus, you are trying something with no proof that it works. You are taking what is, basically, a very expensive multivitamin. And you are buying it from a company making unproven statements on their website to get your money. They are a company. They are not there to help you. They are there to make money. From you.

From FAQ section of Trehope Website, July 20, 2023 (click image to enlarge )

Also, know that Truehope may try to get you to buy other products they offer, claiming their products won’t work until you do, meaning the cost of EMPowerplus won’t be your only one.

Know that they try to get you to check in with the company over and over. I can’t say this is to sell you other products, but what I can say is that the people on the phone are not doctors — and more specifically, they are not your doctor. Your doctor is the person you should be going to for treatment concerns.

Also, please know that Truehope claims you need to get off of your actual medication for EMPowerplus to work. (See screenshot from their website to the right.) This is the most ridiculous thing I’ve ever heard. If their product actually worked, it would work with your medication, and then you could taper off the medication after that. They have some unproven statements that say otherwise but don’t buy it. No real medication works that way.

Getting off of medication can seriously hurt you and the people around you. Consider this carefully. If you do choose to make any medication changes, do it under the supervision of your doctor and not anyone from Truehope. Again, their goal is money. They have no responsibility for your health.

I am not saying there is no benefit to their product or any other vitamin — nothing here shows that these things do or do not do anything — what I’m saying is that nothing here shows that they do anything useful for those with bipolar disorder.

More About the Evidence Claims of EMPowerplus by Truehope

There is actually yet more to say. I want to talk about why Truehope’s claims about EMPowerplus are so dangerous and how these claims of evidence fit in with the Food and Drug Administration regulations. But all that will have to wait for another day.

Until then, caveat emptor; buyer beware.

More About TrueHope and EMPowerplus