How to Tell If Your Supplements Are Safe

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Supplements are not regulated as medicines. Their creators do not need to prove that they are safe or effective. Let’s talk about some of the pitfalls of using supplements and how you can improve your chances of getting a pill that works as it should.

Hard Guesses: Why You Can’t Trust the Label

You are not alone if you suspect vitamins and other supplements must go through some sort of in-store approval process (59% of adults agreed with a 2002 Harris survey ) that any claims on a label must be backed up by scientific evidence (55%), or that additives with hazardous effects must have a warning label (68%).

All of this is not true.

US companies cannotlegally sell supplements that are “intended for adults or are of the wrong brand,” but no testing or approvals are required. The FDA states on its website :

By law (DSHEA), the manufacturer is responsible for ensuring the safety of its food additives prior to their placing on the market. Unlike drugs, which must be validated for safety and efficacy before being placed on the market, there is no statute that allows the FDA to “approve” dietary supplements for safety or efficacy before they reach the consumer. According to the DSHEA, once a product is marketed, the FDA is responsible for demonstrating that a food additive is “unsafe” before it can take action to restrict the use of the product or remove it from the market.

In a survey of the supplement industry, 85% of Americans agreed that they are “confident” about the “safety, quality, and effectiveness” of supplements. Academic research has shown similar results, including the idea that peopleconsider supplements safe because they are available over the counter and because they are “natural.”

It’s not hard to find examples of supplements that did real harm: Hydroxycut was finally remembered , followed by liver damage over the years ; It turned out that the supplement called Total Body Formula contains extremely damaging overdoses of selenium , far more than the label suggests.

The FDA has the power to challenge supplement manufacturers who claim drugs and recall products (such as the ones above) that are clearly unsafe, but only have the budget to cover a handful of companies each year, and their safety reporting system is clearly inadequate .

Bottom line: just because the label says it will do something great for your body doesn’t mean it will; and just because it’s on the shelves and sold over the counter doesn’t mean it’s safe.

Supplements may not contain what they say they do

Just like the front of a label cannot be trusted, it can also be unwise to trust the back. Recent DNA analysis of several herbal supplements (sold at major retail stores such as Target and Walgreen’s) found some of them did not contain any of the alleged ingredients . New York’s attorney general has called for food to be removed from shelves based on these results, although experts recently identified potential problems with the used dough . Even if the results turn out to be incorrect, we still know that such a situation is possible given the lack of oversight.

While we can’t say with certainty if ingredients are missing from some supplements, we know others have too many. For athletes, this is a particularly serious problem: some sports supplementshave the additional effect of drugs that are not on the label, and which could disqualify athletes for doping rules if these drugs are found on a test. The US Anti-Doping Agency maintains a list of known dangerous additives , but before you can see this list, you must click an agreement that confirms that the list is not complete and that other dangerous additives may be available.

Even after supplements are withdrawn, they can remain on shelves with prohibited ingredients. The study, conducted by Dr. Cohen’s team found that 85% of revoked sports supplements bought in an average of three years after the withdrawal still contain banned substances, including anabolic steroids.

Maybe You Don’t Really Need Supplements

When I asked supplement safety expert Dr. Peter Cohen what he advises consumers, he began his answer with a harsh reality check:

First, do you really need a supplement? Most, if not all, herbal supplements will not improve your health, so you can save money.

By “botanical” he means herbal supplements such as St. John’s wort, echinacea, ginkgo and ginseng. (You can list hundreds of lesser-known plants that are sold in capsule or tea form.) Similar advice applies to other types of supplements, including vitamins and probiotics.

An analysis by Consumer Reports found that only a third of supplements have any evidence to support their safety or effectiveness.

When vitamins were first discovered, they were hailed as medical miracles because debilitating vitamin deficiencies can be cured almost immediately by adding the vitamin back to the patient’s diet. However, if you are not deficient, vitamins will not help you. When it comes to taking multivitamins to “insure” against possible diet gaps, experts are divided . Some people think this is a great idea; others are frank about how vitamins for healthy people are a waste of money .

Probiotics or supplements that contain beneficial bacteria sound better and better as we learn more about how the microbiome affects our health. Unfortunately, a handful of species that you can buy as a supplement haven’t made their way into our gut . There is little evidence that they contribute to a healthy microbiome, which, incidentally, may be beyond our current ability to define .

Herbal supplements include plants that are used, to a greater or lesser extent, as medicines to treat or prevent disease (even if the label does not explicitly state this by law). They can contain whole plant parts or extracts, and often the active ingredient is unknown, as is the dose of the active ingredient, since for many plants the dose will vary depending on which part of the plant was used and when it was used during the growing season. collected.

How to find the safest supplements

If you do take supplements, how can you give yourself a better chance of buying the ones that contain what you expect, no more and no less? I asked for consumer advice, nutritional researcher Kamal Patel of Examine.com (an independent information company about supplements; they don’t sell any supplements). Here’s what he wrote:

One unofficial trend is that consumers are buying more “pure” formulations of supplements. For example, instead of buying tropical fruit punch flavored BCAA powder, they’ll buy pure BCAA (which tastes terrible) without any additives or fillers. The few companies that provide such products seem to be more transparent about their manufacturing practices and quality initiatives.

At a recent conference, I spoke with a researcher whose family primarily uses supplements whose specific brand has been clinically tested. For example, lavender is an anxiety supplement. One particular brand has been tested called Silexan. There are several major manufacturers that have supplements that are often used for clinical trials.

Besides NSF, there are several other testing organizations and product databases. This has its pros and cons, as certification does not necessarily mean quality as some quality criteria may differ depending on the specific additive. And private organizations that do testing do not have to be transparent about how they test and how it changes over time.

People usually turn to Consumer Reports, but they don’t seem to be all that good financially. It is almost as important for organizations to verify the health claims of a supplement (as Consumer Reports does) to verify the accuracy of the health claims on the supplement label as it is to verify the actual supplement. Airborne OTC immune supplement lost a large sum in 2010 and had to fund a two-year grant to combat misleading ads in supplements. Some (or most?) Of the money went to Consumer Reports.

You can also find your favorite supplements in these organizations and databases that report supplement testing results:

Supplements may not always contain what the label says, but with these tips and databases, you can be more confident that you know what you are getting.

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