Remember last February when the New York State Attorney General’s office went on the offensive regarding the safety and unintended side effects of supplements?

He was not just lobbing a warning at you the consumer. He called out four of the nation’s biggest retailers and accused them of outright fraud, deception, and contributing to public health safety concerns regarding some of their top selling herbal supplements.

This stemmed from the results of independent testing requested by the Attorney General’s office of these top-selling supplements. Their investigation brought forward concern for potential unintended side effects so great that they demanded a voluntary removal and recall of the supplements in question.

So what did they find? The results of the testing were pretty incredible.

  • 4 out of 5 of the products did not contain any of the herbal ingredients listed on the labels.
  • Many contained “cheap fillers including powdered rice, asparagus, and houseplants”.
  • In some cases “they contained substances that could be dangerous to those with allergies”.
  • A popular brand of ginseng with claims to increase physical endurance and vitality “contained only powdered rice and garlic”.
  • At another retailer, a gingko biloba “memory enhancer” supplement also labeled as wheat- and gluten-free contained “radishes, houseplants and wheat”.  You read that correctly – a wheat-free product contained wheat!
  • 50% of the products at another retailer tested negative for the herbs and other ingredients on the label but did contain “powdered rice, beans, peas and wild carrots”.
  • The products tested commonly used fillers “containing powdered legumes” (the class of plants including peanuts and soybeans – a common allergen)

With all the government regulations we have courtesy of the Food and Drug Administration (FDA), how is it possible that these potentially harmful products are allowed to be mass-marketed to you?

The short answer – they are regulated by a different set of rules than food or pharmaceutical medications.

Direct from the FDA website:

“The FDA regulates dietary supplements under a different set of regulations than those covering “conventional” foods and drug products. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA)”

Basically, supplements are not a food or a drug, so a separate law was created for regulation of supplements. The DSHEA (in place and relatively unchanged for the past 20+ years) has allowed supplement manufacturers to operate more or less under an honor code.

The law mandates labeling of supplement products to indicate what is contained in the product. They are not however mandated to prove that the ingredient is actually in the supplement, that it has been tested for safety, clinical effect, or that it lacks potential harmful ingredients.

As long as the products are “not adulterated or misbranded”, it is essentially the word of the company that the products produced are tested for safety, possible contaminants, and any clinical effectiveness (or what nerds like me refer to as bioavailability).

Do you see any potential problems with a for-profit company doing their own safety or quality testing, and voluntarily offering up whatever results they feel like sharing with the FDA?

To be transparent on this issue, and the investigation above, there were letters from prominent scientists who challenged the methods of testing used by the Attorney General’s team of investigators.3   (If you are interested it is called DNA barcoding, a method that can identify the genetic fingerprint of any plant organism. There is a possibility of destroying part of the genetic fingerprint depending on how the supplement was manufactured.)

Nonetheless, and testing methods aside, this was not the first (or last) major challenge of the supplement industry – an industry that has become a multi-billion dollar yearly money maker in the United States alone.  The problems continue to mount as to how supplements should be tested, regulated, and more importantly how you the consumer can really understand if the products are

As I mentioned previously, the goal of my practice and the education I provide is not to lambast mega-retailers, supplement companies or the FDA.

My goal is to help you become a more informed consumer of healthcare, specifically with what we are discussing today – what you put in your body in pursuit of better health.

[If interested, you can easily dig a little deeper on the internet to find out that the sponsor of the DSHEA law of 1994 has been the staunchest opponent to any revisions (most recently in 2012) that would mandate stricter FDA regulations on manufacturers of supplements. Would it surprise you that he has received hundreds of thousands of dollars of campaign contributions over the years from supplement companies?]

Ahem, moving away from conspiracy theories, if you really want to look behind the curtain, you will see that the supplement industry has become quite a circus. It is filled with a few major ringleaders, smoke and mirror filled illusions, and if you’re (un) lucky, maybe even supplements that will turn you into the bearded lady!

It is estimated that last year alone 150 million people in the U.S. were taking supplements to the tune of $35 billion.

This is big, big business. Supplement companies, and larger retailers, spend millions of dollars each year marketing miracle supplements, potions, powders and pills promising a “cure in a bottle”. They market to the consumer’s desperation to make them believe they are getting a deal, when they may actually be robbing you blind and potentially making you sick.

And many of these companies don’t care.  Even if they are eventually caught, they have already made their millions, if not billions. The fines they may be assessed if caught are merely a drop in the billion-dollar bucket. If the product is pulled from the market, some companies just re-formulate, or change the label, and market it under a different name.

If I dropped you in the middle of the desert without a compass, could you navigate your way home?

That is more or less what you the consumer faces when you stand in the supplement isle at your local grocery or health store, or search online.

  • Do you really know what is in the product?
  • Do you know how it was tested?
  • Is the product delivered directly from the company to you?
  • Do they tell you how much to take specifically for your individual health goals?
  • Do they discuss a reasonable time to take the supplement to have effect?
  • Do they inform you of potential side effects? (Yes, even high-quality supplements can have side effects, or interactions if you are taking other medications)
  • Do you trust the reviews on the website? Did the company create those?

I can keep going with the list of questions, but you get the point. Figuring this out on your own can be a pretty daunting task.

I know, because I spend hundreds of hours and thousands of dollars on continuing education per year, to stay as current as I can in attempt to sort out this mess for my patients. It is really tough!

I have developed a simple strategy to evaluate any supplement, and more importantly, to implement a strategic plan for use as a component of a comprehensive treatment plan.
Stay tuned for Part II of the great sizzling supplement debate, and save yourself from the supplement scams.

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