Dietary Supplements: The Good, The Bad & The Ugly
By John Michael Ricci, March 28th, 2014

In 2009, Americans spent $27 billion on dietary supplements. Of this $27 billion, U.S. dietary supplement sales by product category showed 34% were spent on vitamins, 19% on herbs and botanicals, 11% for sports nutrition, 10% on meal replacements, 8% on minerals, and 18% on specialty or other supplements.1 More than 30% of the adult population take supplements, some to lose weight, some to stay healthy, and some to gain an edge in sports. Of course, some of these adults are doing this for any combination of these reasons.

While many of these supplements are perfectly safe, consumers must be aware that some – although manufactured and sold legally, have not been evaluated by the Food and Drug Administration, an agency of the United States Department of Health and Human Services which is responsible for protecting and promoting public health through the regulation and supervision of food safety, dietary supplements, prescription medication, bottled water, and over-the-counter pharmaceutical drugs.
The Dietary Supplement Health and Education Act of 1942 mandates that the FDA regulate dietary supplements as foods, not drugs. When contemplated by Congress, special interest groups and lobbyists convinced enough members of Congress to classify dietary supplements as foods in order to evade the regulation and oversight that the Act would provide. Although calling zinc, copper, potassium, or vitamin E for that matter, a food is absurd, the multi-billion dollar industry got what they wanted and the American consumer suffers for it. Because dietary supplements are not subject to safety and efficacy testing, there are no approval requirements. As a result, the FDA can only take action against dietary supplement manufacturers after they are proven unsafe. An example of this was posted by the FDA in June of 2010, when a company supplied a product called “Magic Power Coffee”, an instant coffee being sold online as a dietary supplement for sexual enhancement. After conducting lab experiments, the FDA determined that this coffee contained a chemical similar to the active ingredient in Viagra, used to treat erectile dysfunction, which can cause dangerously low blood pressure. The report told consumers to “stop using this product immediately.”3 This product would never have made it to the market if the 1994 Act had classified dietary supplements as drugs.

Without the regulatory authority the FDA needs, it lacks the ability to inspect manufacturing plants, which has resulted in numerous reports of supplements contaminated with heavy metal, pesticides, and other dangerous substances. China is a major supplier of raw supplement ingredients and has been caught many times exporting contaminated products. The FDA will eventually be given the authority to regulate this industry properly, as more dietary supplements are shown to be unsafe, ineffective or both. Until then, consumers must be cautious when purchasing these products.

In 2010, Consumer Reports joined the Natural Medicines Comprehensive Database (an independent research group) and published an article in their September, 2010 issue entitled “Dangerous Supplements – What You Don’t Know About These 12 Ingredients Could Hurt You”4 which identified a dozen ingredients linked to “serious adverse events” following clinical research. The Natural Medicines Comprehensive Database now has more than 54,000 dietary supplement products listed and reports that only one-third of them are safe and effective.
Consumers can take steps to make sure the supplements they take are both safe and effective. Suggestions that can prevent unnecessary illness include:

1) Consult your physician: Patients should inform their doctors of any dietary supplements they are taking. Many supplements are perfectly safe, but may interact with prescription medications. Women who are pregnant or nursing should always let their pediatrician know exactly what they are taking.

2) Check for a “USP Verified” mark: U.S. Pharmacopeia is a trusted, non-profit organization that verifies quality, purity, and potency of both raw ingredients and finished products. It indicates that the dietary supplement manufacturer has voluntarily asked to have their products tested. USP maintains a list of verified products on its website at http://www.uspverified.org.

3) Avoid products that claim “mega doses”: It is possible to overdose on vitamins and minerals, even if they are beneficial in recommended daily amounts. More is not always better, and this is especially true for infants and children. The FDA has warned that overdosing infants with vitamin D can cause nausea, vomiting, loss of appetite, constipation, abdominal pain, confusion, fatigue and kidney damage – even though proper amounts of vitamin D play a key role in developing strong bones. The human body can only absorb a certain amount of supplements over a given time period, and excesses can damage your liver, kidneys, and other organs.

4) Do your own research: Check online to see if a particular product has been banned or if warnings have been published. Some reliable sources include: The National Institutes of Health’s Office of Dietary Supplement at http://www.ods.od.nih.gov and the FDA at http://www.fda.gov.

5) Find out where the dietary supplement is made: Why buy supplements from China? Buy American made dietary supplements or purchase from companies you trust, for example those that voluntarily apply for and receive “USP Verified.”
Until the 1994 Act is repealed and the FDA is given the authority to adequately monitor manufacturers of dietary supplements, taking them should be done with caution. Taking the right amount of vitamins and minerals is fundamental to proper nutrition. It is always better to get nutrients through healthy foods, but assuring adequate amounts through dietary supplements, including multi-vitamins and minerals is optimal. Take measures to make sure anything you put in your body is safe and effective.

Sources:

1 Nutrition Business Journal at http://www.nutritionbusinessjournal.com/supplements/market-research/supplement-business-report-nutrition-journal/
2 The Dietary Supplemental Health and Education Act of 1994 at http://www.ods.od.nih.gov/About/DSHEA_Wording.aspx
3 FDA at http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm216399.htm
4 Consumer Reports. Dangerous Supplements – What You Don’t Know About These 12 Ingredients Could Hurt You, September 2010, p. 16

Tags: dietary, FDA, health, NIH, nutrients, nutrition, supplements, USP, vitamins