What to make of natural supplements

Yet another dog-free post!

I read this a few days ago and vowed to republish it in this place. Because I had assumed that supplements were safe to take. This copy of a recent article in The Conversation suggests otherwise.

Read it and then let me know your thoughts.

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Natural supplements can be dangerously contaminated, or not even have the specified ingredients

February 14, 2020 5.23pm EST. Updated February 17, 2020 5.43pm EST
By Professor Michael White, Professor and Head of the Department of Pharmacy Practice, University of Connecticut

Some supplement products contain substances that are harmful. Getty Images / David Malan

More than two-thirds of Americans take dietary supplements. The vast majority of consumers – 84% – are confident the products are safe and effective.

They should not be so trusting.

I’m a professor of pharmacy practice at the University of Connecticut. As described in my new article in the Annals of Pharmacotherapy, consumers take real risks if they use diet supplements not independently verified by reputable outside labs.

What are the risks?

Heavy metals, which are known to cause cancer, dementia and brittle bones, contaminate many diet supplements. One study of 121 products revealed 5% of them surpassed the safe daily consumption limit for arsenic. Two percent had excess lead, cadmium and aluminum; and 1% had too much mercury. In June 2019, the Food and Drug Administration seized 300,000 dietary supplement bottles because their pills contained excessive lead levels.

Bacterial and fungal contamination in dietary supplements is not uncommon. In one assessment, researchers found bacteria in all 138 products they investigated. Toxic fungi were also in many of the supplements, and counts for numerous products exceeded the acceptable limits set by the United States Pharmacopeia. Fungal contamination of diet supplements has been linked to serious liver, intestinal and appendix damage.

From 2017-18, dozens were hospitalized with salmonella poisoning after ingesting kratom, a highly addictive natural opioid. Thirty-seven of the kratom products studied were contaminated.

There are ways consumers can verify the quality and safety of supplements. Getty Images / Tanya Constantine

Some dietary supplements contain drugs, yet the manufacturers don’t disclose that information to consumers. Frequently, the concealed drugs are experimental and, in some cases, removed from the market because they’re dangerous. Hundreds of weight-loss, sexual-dysfunction and muscle-building products are adulterated with inferior or harmful substances.

Sometimes, the herb you think you’re buying contains little to no active ingredient. Occasionally, another herb is substituted.

The consequences for consumers are considerable. When manufacturers replaced the herb Stephania tetrandra with the herb Aristolochia fangchi in 2000, more than 100 patients developed severe kidney damage; 18 more got kidney or bladder cancer. Although the herb is now banned by the U.S., a 2014 investigation found Aristolochia fangchi in 20% of the Chinese herbal products sold on the internet.

In an assessment of CBD products, only 12.5% of vaporization liquids, 25% of tinctures and 45% of oils contained the promised amount of CBD. In most cases they held far less. A few CBD products had enough THC to put the user in legal jeopardy of marijuana possession.

Embarrassed by a New York Attorney General’s Office investigation suggesting widespread and fraudulent under-dosing of active ingredients in dietary supplements, CVS pharmacies analyzed 1,400 products that it previously sold in its stores. Seven percent, or about 100 products, failed, resulting in updates to the supplement facts panel or removal of the product from shelves.

It can be difficult for the FDA to adequately oversee supplements. Associated Press / Andrew Harnik

What should consumers do?

The Dietary Supplement Health and Education Act of 1994 allows manufacturers to sell dietary supplements without providing proof of their quality to the FDA. Instead, it’s up to the FDA to prove a product is unsafe and take it off the market. That’s an incredibly tall order, and woefully inadequate. But it’s unlikely to change.

In the meantime, I recommend that consumers should not purchase supplements without verification from one of three highly regarded independent laboratories: the aforementioned United States Pharmacopeia, NSF International and ConsumerLabs.com. The United States Pharmacopeia is an organization that sets reference and quality standards for prescription medication and food in the U.S.; the NSF International is an independent group that assesses safety and risk for food, water and consumer products; and ConsumerLabs.com is a company started to verify product quality for consumers that are paying members. These laboratories conduct an initial analysis and then perform periodic unannounced assessments of the products; those with the appropriate amount of active ingredient, and without contamination or adulteration, can put the United States Pharmacopeia, NSF and ConsumerLabs.com seals on their bottles. CVS announced that all products sold at its stores going forward will need to provide the company proof of quality. Other major retailers should follow suit.

Some manufacturers conduct quality testing and post certificates of analysis on their websites. But the autonomy of the laboratory, and its standards, are often not known. Sometimes, labs may select an inappropriate testing method, intentionally or unintentionally. Sometimes they perform the test incorrectly, or simply make up results.

Because the FDA can’t fully protect you from quality issues in dietary supplements – at least not right now – you must protect yourself. Even if a celebrity or “health guru” recommends a product, that doesn’t mean it’s high-quality. Before you put any supplement into your body, demand proof.

[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]

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I was about to close it there and then I saw another report, in the same vein, come up on the Harvard Health Blog.  Now I can’t republish it in full but essentially it is a reprint of the above. But here’s a taster:

Harmful effects of supplements can send you to the emergency department

Susan Farrell, MD

Contributing Editor

For many people, a healthy lifestyle means more than eating a good diet and getting enough exercise — vitamins, supplements, and complementary nutritional products are also part of the plan. But though there is much publicity about their potential benefits, there is less awareness of their possible harmful effects.

In fact, using these products can land you in the emergency department.

A study published today in The New England Journal of Medicine found that adverse effects of supplements were responsible for an average of about 23,000 emergency department (ED) visits per year. That’s a lot for something that is supposed to be good for you.

Now we too take a fair handful of supplements.

I’ve stopped all of them while I do more research.

I shall be happy to share our findings.

4 thoughts on “What to make of natural supplements

  1. It wouldn’t surprise me in the slightest to discover that there’s more to this than the possibility of ‘fake news’. I remember reading a report some time ago about bottled water in which several brands were tested, and many were found to contain harmful substances, bacteria and the like; the conclusion was that tap water was better! (Why am I not surprised that folk will pay for water that they can get for free, and wrapped up in a toxic plastic bottle to boot? I think they must think that it must be better because they’re paying for it… /sigh.)

    Like

  2. Paul, I only ever buy supplements after checking ConsumerLabs.com , who analyse different brands for quality and any contaminants. They are a respected organisation and receive funding only from subscribers. It’s not that expensive to join and well worth it.
    And I would never buy so called health supplements sold under a Chinese or Indian label.
    Consumer Labs also have lots of research articles and results of studies and trials.

    Liked by 1 person

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