Are Your Supplements Safe?

Are dietary supplements part of your regular routine? Youíre not alone; about 53% of Americans take supplements, mostly in the form of multivitamins, according to the Centers for Disease Control and Prevention. But unlike conventional medications, dietary supplements are unregulated and often untested for quality. How do you know if the pills, powders, and potions you take are safe?

What if the supplements you take every morning to boost your immune system or protect your heart donít actually contain the ingredients listed on the label? How would you know?

Unfortunately, you canít know for sure, because the sale of dietary supplements is unregulated. Government agencies that oversee prescription and over-the-counter medications for safety and effectiveness are not responsible for supplements. The U.S. Food and Drug Administration (FDA) has established Good Manufacturing Practices, which require supplement manufacturers to verify that the supplements they produce are pure, safe, and correctly identified, but the FDA doesnít review manufacturersí claims. So for the most part, your faith in a supplementís authenticity must come down to trust.

Unfortunately, this lack of authority does, at times, lead to the sale of ineffective and sometimes tainted products. In February 2015, for instance, investigators from the New York State attorney generalís office revealed that four popular national retailers were selling fraudulent herbal supplements. Walgreens, Target, Walmart, and GNC were all accused of selling store-brand supplements that contained none of the ingredients listed on the labels of four out of five supplements.

At best, the actual ingredients in an adulterated or mislabeled supplement may be worthless and distasteful; at worst they may be contaminants or allergens that can make you sick. In recent years, tainted supplements infected more than 70 people in 16 states with hepatitis; another supplement contaminated with yeast proved fatal for an infant. In the New York State investigation, DNA testing revealed that GNC supplements labeled gingko biloba, St. Johnís wort, ginseng, echinacea, and saw palmetto contained little to no trace of the actual product and instead were made with dried and powdered rice, garlic, wheat, vegetables, and/or common houseplants. There were similar findings for Target brand gingko biloba, St. Johnís wort and valerian Root; Walgreens brand gingko biloba, St. Johnís wort, ginseng, and echinacea; and Walmart brand gingko biloba, St. Johnís wort, ginseng, garlic, Echinacea, and saw palmetto supplements.

The New York Attorney Generalís office has since come to an agreement with GNC to make broad and sweeping reforms in the way they oversee the production and quality control of dietary supplements sold in all their stores, nationwide. As this office embarks on a broader investigation of the herbal supplement industry, the hope is that their arrangement with GNC will serve as a national model for all supplement manufacturers and agencies overseeing their safety and effectiveness.

Meanwhile, there are a few things you can do to help ensure your supplements are safe and reliable:

  1. Look for a seal of approval from U.S. Pharmacopeia (USP), ConsumerLab or NSF International. These not-for-profits (USP and NSF International) and independent companies (ConsumerLab) review supplements. Keep in mind, however, that although these seals provide assurance that the product has been tested for quality and contains the ingredients listed on the label, they do not guarantee safety or effectiveness.
  2. Remember that "natural" does not necessarily mean "safe," or "good for you."
  3. Be wary of dietary supplements produced outside of the United States, where there may be even less regulation and oversight. In particular, tainted supplements have been reported from China, India, and Mexico.

"Beyond the obvious safety concerns regarding some brands, supplements sold on third-party websites have a high risk of being counterfeit," adds Tania Tyles Dempsey, MD, ABIHM, founder of Armonk Integrative Medicine in New York. "The only way to be sure you are getting the real thing is to buy direct from a legitimate manufacturer or from a trusted health practitioner."

Tania Tyles Dempsey, MD, ABIHM, reviewed this article.

Sources

Dempsey, Tania Tyles, MD, ABIHM. Email to author, May 16, 2015.

Centers for Disease Control and Prevention. "Dietary Supplement Use Among U.S. Adults Has Increased Since NHANES III (1988Ė1994)." NCHS Data Brief 61, 2011. Page last updated April 13, 2011.

OíConnor, Anahad. "New York Attorney General Targets Supplements at Major Retailers." New York Times. February 3, 2015.

"Questions and Answers on Dietary Supplements." U.S. Food and Drug Administration. Page last updated April 28, 2015.

"A.G. Schneiderman Announces Agreement With GNC to Implement Landmark Reforms for Herbal Supplements." New York State Office of the Attorney General. March 30, 2015.

"Dietary Supplements: What You Need to Know." National Institutes of Health Office of Dietary Supplements. Reviewed June 17, 2011.