Are Supplements Safe?

Created 01-28-2009

How much do you know about supplement safety? A 2002 study of primary care physicians found that 42% were not aware of any drug-herb interactions that had appeared in the medical literature, nor treated a patient that had one. A more recent study (2007) of internal medicine residents revealed that one-third did not know that supplements do not need to be approved by the FDA, or that safety and efficacy data are not required before supplements are put on the market.

This ignorance is not limited to physicians in training. A survey of consumers has shown that 68% of consumers believed that supplements were regulated by the government, 59% believed dietary supplements were FDA- approved, and 55% believed that manufacturers could not make claims of product efficacy without scientific evidence.

Here are the facts: dietary supplements are currently regulated according to the Dietary Supplement Health and Education Act of 1994, which permits the initial marketing of a product without proof of safety, efficacy, bioavailability or standardization. The manufacturer is held responsible for ensuring a product's safety. The FDA is responsible for taking action against any product that is found to be unsafe after it is on the market, and for monitoring information on labeling and package inserts. The Federal Trade Commission is responsible for any false advertising claims. More detailed information can be found here. (http://www.cfsan.fda.gov/~dms/supplmnt.html)

Studies of surgical patients have shown that nearly a third take at least one herbal product on a regular basis, but many don't disclose this to the surgeon or to the anesthesiologist prior to surgery. Without the bottle in hand, one in five patients were unable to identify what they were taking when asked. A study of pregnant women in Australia revealed that 36% took an herbal product while pregnant.

You can be a responsible consumer of dietary and herbal supplements by reading labels carefully. Look for certifications such as "USP Dietary Supplement Verified", or certification by ConsumerLab.com, NSF International, or Good Housekeeping. The certifications vary, but it's a start, and they at least indicate evidence of laboratory testing. USP stands for U.S. Pharmacopeia, and the standards include testing for uniformity, cleanliness, and freedom from environmental
contaminants such as lead, mercury, or drugs. It is safer to buy single-herb products that clearly show how much of the herb each dose contains than to buy a mixture of several herbs with unknown amounts of each herb. And be very wary of buying any herbs that have not been manufactured in the US, the EU, or Canada, as supplements from other countries have been found to contain contaminants.

Resources for learning more:
http://www.herbmed.org/
http://www.healthfinder.gov/
http://www.nlm.nih.gov/medlineplus/druginformation.html
http://www.naturalstandard.com/