Supplement Contamination Of All Types Is An Under-Researched Danger:
In-terms of product safety it seems if something is sold at a store, then it’s safe.
You might also get the idea that because governmental organizations like the FDA test all kinds of things for safety,
That they also test Supplements, too.
Well, as some researchers from California are finding out, there is a lot more risk in them than you might think.
Including all kinds of stuff that’s not even supposed to be there…
We’ve Seen This Rodeo Before:
This type of oversight has already happened accidentally, but not deliberately, with vitamins.
And you’d think that since the FDA tests all drugs for safety, they would test everything that is similar.
But with supplements, that’s wrong. They are just not tested before they go out onto the market.
Because of that, we have another chapter in the the ongoing story of potentially-unsafe consumer products.
And Yes, researchers discovered some pretty disturbing and harmful adulterations made to a lot of supplements.
Read on to learn what they found…
A Study On The FDA’s Public Resources:
So in a study of the FDA’s own internal database on risky-supplements,
Researchers from the CDFA found there were almost 800 flagged as tainted and dangerous.
All of them contained a minimum of some type of undisclosed prescription drug in them.
If you thought ground-up houseplants in your Echinacea was bad, you haven’t seen anything yet.
As for the Types of products, 46% percent of them were for Male Sexual-Enhancement, ie: herbal viagra.
41% were Weight-Loss supplements, and 12% of them were for Muscle-Building, with the remaining 1% being “other”.
What Was Found In The Contaminated Supplements This Time?:
Strangely-enough, the non-herbal stuff in these supplements were prescription-drugs that create the effect the supplements were represented to create themselves.
The Male-Enhancement products had viagra-like drugs in them.
The Weight-Loss products had the banned appetite-suppressant Sibutramine that damages the circulatory-system, and the laxative Phenolphthalein in them.
The Muscle-Building products contained added anabolic steroids.
What Did The FDA Do About It?:
And here we get to one of the biggest problems with the FDA according to Dr. Pieter Cohen and many of his peers.
Not only does the FDA fail to test herbal-supplements by brand & product at least for Purity like USP,
But they issued recalls for Less Than Half of the supplement-products they found to have undisclosed prescription drugs in them.
Since 1994, their hands have been a little-bit tied as to their powers to pre-sale test supplements in the US.
And in 2011, their purview & powers were expanded a bit more.
But since there were prescription drugs found in these supplements, the FDA was within their rights to issue recalls on the other ~400.
That Is Only The Beginning Of The Problem:
As of at-least 2016, more than 50% of the US population takes some kind of supplement on a daily-basis.
Also, even when the FDA does do what it can, and issues a recall,
Sometimes producers cheat.
Products may be recalled, then relabeled and put back out for sale just a few months later.
In another case, a supplement may be recalled for having bad ingredients, then get reissued for 2 years without them,
Only to have the newer formulation 3 years later add those bad ingredients back in.
In-fact, it’s usually the Exception and not the rule when the FDA takes strong action, as in the case of the Ephedra ban some years ago.
The problems caused by it were not because of added-drugs or impurities, but from issues of dosage and genetic defects.
In The Supplement-Game YOU Are The Lab Rat:
-Which is a perfect place to introduce the next idea.
Without pre-sale testing, You become the lab-rat.
In the case of Ephedra, the dangerous and sometimes lethal-results were the result of Overdosing & Stacking,
-Ie: Combining with other chemically-active substances to compliment or magnify the effects of one supplement.
In that case, it was the addition of large amounts of caffeine, and average amounts of Aspirin.
Ephedra’s lab-rats then found-out the hard-way if they had unknown congenital heart-defects, or weaknesses in their liver.
The FDA Only Recalls Or Bans After People Get Hurt:
These are exactly the type of risks that trial-tests would have discovered if it were treated like a Drug.
It’s the consumers who bring the prescritption-drug mentality into the supplement-world that makes these substances so dangerous.
Because the FDA recalls or even Bans only happen after several people are hospitalized from it in an epidemic,
Or even die as a result.
That is the real risk of post-disaster reaction instead of the healthy-precaution of the drug-testing-model.
If They Can Recall Salads, Why Not Supplements?:
Regardless of the risks, the current laws define supplements as food-items.
But why we can get a recall on salads from one grocery-store chain for having salmonella but not supplements for being dangerous remains a mystery.
And let’s face-it, many people take supplements because they expect druglike, or near-druglike effects from them.
Many experimenters at this Biochemistry-Casino have found out, along with their doctors,
That supplements can absolutely have both
1) Drug-Like Effects when taken in sufficient-doses,
and
2) Very serious Interactions+Side-Effects when combined with prescription drug intake
Supplements Should Be Treated Like Drugs:
Another problem that occurs in similar fashion to the Ephedra fiasco,
Is that because supplements are relatively easy to get, people don’t treat them with the respect & fear they deserve.
You have to go through at least some amount of trouble to get a prescription med.
And the context for that dispensation is a serious one.
The clear dosage amount & schedule is printed right on the label of every single one.
With supplements it all seems a bit more relaxed,
And as with Ephedra, people can easily fall-prey to
1) Overdosing, because they think more-is-better/faster
2) Stacking, because combinations seem like they would also work more/faster
3) Ignoring potential Interactions & Side-Effects through the assumption-of-safety.
Or Maybe Even Hazardous Materials:
Right now, there are only 2 real alternatives to what clear-thinkers like Dr. Cohen feel the FDA should be doing for supplements.
USP, and Labdoor.com
USP sets standards & provides certifications to companies that submit their products for testing.
And Labdoor is for consumers to look up potential purchases & get some kind of basic purity information on how a supplement ranks.
But the odd footnote to that is Botanicals like herbs.
One of the things we found out in the protein-powder-testing post is that egg or whey protein was much healthier than plant-based protein powders.
Why? -Because protein powders are Concentrates.
Supplements Are Concentrates, Especially Herbs:
So they concentrate the protein from the plant down into a powder that has greater nutrient-density.
-But they also concentrate all the Pesticides, and Environmental-Contaminants like heavy-metals and PCBs into the powder, too.
Well guess what a lot of plant/herb based Supplements are?
-Concentrates.
So testing for purity there is even more important.
I mean, if a Soy or Hemp-based protein-powder can have slightly-alarming levels of Cadmium, Mercury, Lead, and Arsenic in it,
Then couldn’t your plant-based supplement-concentrate have that, too?
So The Other 99%. What Can You Do? 32+ Thoughts:
If in this example, the FDA found approximately 1% of the 85,000 supplements out there were adulterated or contaminated, but only recalled less than half of them,
Then what can you do?
Here are some thoughts to consider if you are looking at supplements in the future, but before the FDA gets pre-sale testing power:
1) Don’t take supplements if you can help it
2) Talk with a doctor and take prescription medication when you need something to have drug-like effects
3) Try every other possible way to create the effect you’re looking-for without supplements.
4) If you must, consult with your doctor about every single one you’re going to take, and
4a) Have them monitor your health & results as you go
4b) Note: Most MDs are uneducated about supplements in school, so they may have to learn a bit along the way with you
4c) They can then use their analytical experience to inform the course of action you’re interested in.
5) You might also consider consulting a professional herbalist who will have much more experience than an MD
5a) -But find a good one, not just any old crazy hippie who throws up a shingle for it.
6) As with any drug, take the Minimum-dose you possibly can to achieve the desired-results and no more.
7) Use only Single-Ingredient supplements, because it’s at-least marginally more difficult to hide other adulterants in there.
8) Do Not Combine supplements with prescription-drugs or “Stack” them together with several others.
9) If you do try to “Stack”, you are putting yourself at-risk, because nearly-all the research done on this is not the result of work by Real scientists, it’s the trial-and-error experimentation of “Bro Scientists”
10) Only buy supplements from manufacturers with the most solid reputations.
10a) These are not always the most-expensive, as in the case of GNC still having problems with tainted products.
11) Only buy supplements from large, well-known vendors with good-reputations and user-reviews, like The Vitamin Shoppe
12) Don’t buy supplements from single-producer websites on some shady corner of the internet, where they only sell 1 allegedly magic combo-pill.
12a) Don’t ever buy supplements from a website of a company based in another country.
12b) Don’t ever buy supplements via international mail-order.
13) Don’t buy supplements with outrageous claims. If it’s too good to be true, it probably is.
13a) -Especially supplements that claim drug-like effects. As shown by the study we cite here, at least a few of the supplements that claim drug-like effects, ACTUALLY HAVE PRESCRIPTION -DRUGS- IN THEM!
14) Estimate the effect that prescription meds have on you if you can, and use that as a baseline to guide you to the proper dosage.
15) Start with a low-dosage
16) Do not exceed the dosage listed on the bottle. There may be little science behind it, but unless you have a better & more-reputable source of drug-effect information, the manufacturer’s dosage may be the safe upper-limit.
17) If you insist on taking supplements, check out their Prescription-Drug Interactions, Side-Effects, and Risks over at a place like WebMD’s Drug Interaction Checker
18) Unless you have solid-evidence that suggests the manufacturer’s dosage is too conservative, beware of the subconscious need to get results quicker by “More-Is-Better” thinking.
19) If you can, try to find Actual Clinical Studies that may back up the purpose you wish to use the supplement for.
19a) There may not be as much out there as prescription meds, because herbs, aminos, minerals, & vitamins can’t be patented by big drug companies, but you may find some.
20) Don’t ignore your body!
20a)If you feel weird in a bad way, not just an unfamiliar one, it might be best to just stop taking the supplement, get an appointment with your doctor so you can describe your symptoms, and get some lab-tests to make-sure you’re not in danger.
23) Be VERY careful with Botanicals like Herbs, or anything that comes from plants.
24) Mixed plant-based supplements as combined by the producer may be even worse; they are also an easier place to hide the adulterants.
25) Just because something originates in nature, doesn’t make it safer than a prescription-drug.
26) Health-nuts tend to overdo things like supplements, so beware of your own biases.
27) Sadly at least a few people who gung-ho the Wellness area may suffer some unfair consequences because they overdo the supplements. It’s happened more than once.
27a) A 2015 Study estimated there are at-least 23,000 yearly visits to hospitals that are a direct-result of supplement use.
27b) 2,000 of those end up having to stay in the hospital for some time as a result
27c) Even recently, a man in the UK had to get a liver transplant as a result of damage caused by of all things, Green Tea Extract. -Which is pretty serious, because the liver is AMAZINGLY resilient.
28) Until the laws change and the FDA starts policing the space, supplements may remain potentially-dangerous to your health for the foreseeable future.
29) The only consolation to that is if what you’re going to take has been independently tested and certified by an organization like USP. -But still, there may not be any bet-your-life guarantees.
30) Other than USP, the closest thing we have to what the FDA should be doing is a company called Labdoor.com.
30a) They do at least some testing on the Purity of supplements, but not the long-term risks.
31) According to researchers like the authors of this study, the contamination problem is growing as more & more supplements become available.
31a) One doctor estimates that in 2009 there were about 150 brands that contained prescription-meds,
31b) That number today is closer to 1,000 brands that do it.
31c) This is further-evidenced by the fact that 57 percent of all serious warnings ever issued on supplements have occurred only since 2012.
32) Pills of any kind are probably inferior to food for getting vitamins & minerals you need.
32a) A study a few years ago showed that contrary to Dr. Neal Barnard’s advice about it, men who got Vitamin-E in pill form had a 19% increased rate of prostate-cancer.
32b) When you get vitamins & minerals from food, they are in a slow-release, buffered form that the body is perfectly used-to and is very difficult or almost impossible to overdose-on.
Hopefully, some of those ideas can help keep you to be safe out there.
-But the more likely truth is that supplement contamination of all types is here to stay until the FDA’s powers are expanded.
Photo Credits: “Bull keep out”, by Eran Menashri
Links:
• Source Study: JAMA Network Open – Prohibited Stimulants in Dietary Supplements After Enforcement Action by the US Food and Drug Administration
• More Coverage: Dr. Pieter Cohen’s Editorial – The FDA and Adulterated Supplements—Dereliction of Duty
• Further Resources: The FDA’s Medical Recall Page | The FDA Food & Supplement Recall Page
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