What types of supplements are people using the most?
In 2014, dietary supplement sales by category were:
- 32% vitamins
- 18% specialty supplements
- 18% herbs and botanicals
- 13% sports nutrition
- 12% meal replacements
- 7% minerals
Why is there so much disagreement about the effectiveness and recommended uses of different supplements?
- There is shockingly little scientific evidence for most supplements available on the market. When studies are completed, they are done on megadoses of isolated micronutrients, which does not demonstrate how they actually work in the body.
- The industry has no impetus to fund clinical research, as it already generates $40 billion annually.
- Clinical effectiveness and safety does not need to be proven in order for a product to go to market.
- While drugs must undergo independent product validation; dietary supplements do not.
- There is a lack of formal education for health professionals regarding dietary supplements.
What is the Dietary Supplement Health and Education Act (DSHEA)?
DSHEA was passed in 1994. It defines supplements as a distinct category and subjects them to much less regulatory oversight than pharmaceuticals. DSHEA allows companies to make unproven claims about supplements, as long as they don’t mention a specific disease state. For instance, “promotes heart health” is OK, even if there’s minimal evidence that it’s true. “Prevents heart disease”, on the other hand, is not OK without proof. Although DSHEA requires manufacturers to report life-threatening adverse events, the FDA receives about 1,500 – 2,000 of these reports annually and it’s believed that the true number is around 50,000.
What are some examples of ingredients found in “natural”
- Sibutamine- the active ingredient in Meridia, which was banned in 2010 because it caused heart attacks and strokes
- Lorcaserin – causes life-threatening serotonin syndrome when combined with common antidepressants)
- Sildenafil – Viagra
- A chemical cousin of methamphetamine
- Environmental toxins including mercury and lead
- DMAA (“geranium extract”) – causes heart attack, psych disorders, and death
- Fluoxetine – active ingredient in Prozac
- Methylsynephrine – a stimulant that increases blood pressure and stimulates the heart, not approved in the U.S, was found to be present in 14 of 27 supplements. Side effects of the stimulant include vomiting, agitation, and cardiac arrest.
How likely is it that my herbal supplement contains what the label says that it does?
In a 2013 analysis of 44 herbal supplements made by 12 different companies, 1/3 contained no trace of the “main ingredient” and ½ contained contaminants or unlisted fillers like rice and grasses.
In 2015, the NY State Attorney general Eric Schneiderman commissioned DNA barcoding of 78 supplements bought at four major retailers. Only 21% of the supplements showed evidence of the herbs that they supposedly contained. Many contained potential allergens not disclosed on the label, including wheat, walnut, and houseplants.
Where can I go to find a supplement that contains what it says that it does?
There are some third-party certification/verification programs that are fee-based and voluntary.
- NSF International
- S. Pharmacopeial Convention
What are some basic tips for people who want to try supplements?
- Consult your doctor before starting any supplement.
- Avoid products that make exaggerated claims.
- Some experts recommend choosing supplements that contain no more than six ingredients; others recommend only one ingredient.
- Look for Quality Seals – CL, NSF International, USP, or UL.
- Gummies and chewables usually contain far less than the recommended levels of vitamins and minerals.