{"id":158385,"date":"2020-02-20T08:23:53","date_gmt":"2020-02-20T13:23:53","guid":{"rendered":"https:\/\/today.uconn.edu\/?p=158385"},"modified":"2020-02-18T10:09:24","modified_gmt":"2020-02-18T15:09:24","slug":"op-ed-dietary-supplements-can-carry-hidden-risks","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2020\/02\/op-ed-dietary-supplements-can-carry-hidden-risks\/","title":{"rendered":"Op-ed: Dietary Supplements Can Carry Hidden Risks"},"content":{"rendered":"

More than two-thirds of Americans take dietary supplements. The vast majority of consumers \u2013 84% \u2013 <\/span>are confident<\/a> the products are safe and effective.<\/span><\/span><\/p>\n

They should not be so trusting.<\/span><\/span><\/p>\n

I\u2019m<\/a> a professor of pharmacy practice at the University of Connecticut. As described in <\/span>my new article<\/a> in the Annals of Pharmacotherapy, consumers take real risks if they use diet supplements not independently verified by reputable outside labs. <\/span><\/span><\/p>\n

What are the risks?<\/span><\/span><\/b><\/p>\n

Heavy metals, which are known to cause <\/span>cancer, dementia and brittle bones<\/a>, contaminate many diet supplements. <\/span>One study of 121 products<\/a> revealed 5% of them surpassed the safe daily consumption limit for arsenic. Two percent had excess lead, cadmium and aluminum; and 1% had too much mercury. <\/span>In June 2019<\/a>, the Food and Drug Administration seized 300,000 dietary supplement bottles because their pills contained excessive lead levels.<\/span><\/span><\/p>\n

Bacterial and fungal contamination in dietary supplements <\/span>is not uncommon<\/a>. <\/span>In one assessment<\/a>, researchers found bacteria in all 138 products they investigated. Toxic fungi were also in many of the supplements, and counts for numerous products exceeded the acceptable limits set by the <\/span>United States Pharmacopeia<\/a>. Fungal contamination of diet supplements <\/span>has been linked<\/a> to serious liver, intestinal and appendix damage. <\/span><\/span><\/p>\n

From 2017-18, <\/span>dozens were hospitalized<\/a> with salmonella poisoning after ingesting kratom, a highly addictive natural opioid. Thirty-seven of the kratom products studied were contaminated. <\/span><\/span><\/p>\n

Some dietary supplements contain drugs, yet the manufacturers <\/span>don\u2019t disclose that information<\/a> to consumers. Frequently, the concealed drugs are experimental and, in some cases, removed from the market because they\u2019re dangerous. Hundreds of weight-loss, sexual-dysfunction and muscle-building products are adulterated with inferior or harmful substances.<\/span><\/span><\/p>\n

Sometimes, the herb you think you\u2019re buying contains little to no active ingredient. Occasionally, another herb is substituted. <\/span><\/span><\/p>\n

The consequences for consumers are considerable. When manufacturers replaced the herb <\/span>Stephania tetrandra with the herb Aristolochia fangchi<\/a> in 2000, more than 100 patients developed severe kidney damage; 18 more got kidney or bladder cancer. Although the herb is now banned by the U.S., <\/span>a 2014 investigation<\/a> found Aristolochia fangchi in 20% of the Chinese herbal products sold on the internet. <\/span><\/span><\/p>\n

In an assessment<\/a> of CBD products, only 12.5% of vaporization liquids, 25% of tinctures and 45% of oils contained the promised amount of CBD. In most cases they held far less. A few CBD products had enough THC to put the user in legal jeopardy of marijuana possession.<\/span><\/span><\/p>\n

Embarrassed by a New York Attorney General\u2019s Office <\/span>investigation<\/a> suggesting widespread and fraudulent under-dosing of active ingredients in dietary supplements, <\/span>CVS pharmacies analyzed<\/a> 1,400 products that it previously sold in its stores. <\/span>Seven percent,<\/a> or about 100 products, failed, resulting in updates to the supplement facts panel or removal of the product from shelves. <\/span><\/span><\/p>\n

What should consumers do?<\/span><\/span><\/b><\/p>\n

The <\/span>Dietary Supplement Health and Education Act<\/a> of 1994 allows manufacturers to sell dietary supplements without providing proof of their quality to the FDA. Instead, it\u2019s up to the FDA to prove a product is unsafe and take it off the market. That\u2019s an incredibly tall order, and woefully inadequate. But it\u2019s unlikely to change.<\/span><\/span><\/p>\n

In the meantime, I recommend that consumers should not purchase supplements without verification from one of three highly regarded independent laboratories: the aforementioned United States Pharmacopeia, NSF International and ConsumerLabs.com. The United States Pharmacopeia is an organization that <\/span>sets reference and quality standards<\/a> for prescription medication and food in the U.S.; the NSF International is an independent group that assesses safety and risk for food, water and consumer products; and ConsumerLabs.com is a company started to verify product quality for consumers that are paying members. These laboratories conduct an <\/span>initial analysis<\/a> and then perform periodic unannounced assessments of the products; those with the appropriate amount of active ingredient, and without contamination or adulteration, can put the United States Pharmacopeia, NSF and <\/span>ConsumerLabs.com seals<\/a> on their bottles. CVS announced that all products sold at its stores going forward will need to provide the company proof of quality. Other major retailers should follow suit.<\/span><\/span><\/p>\n

Some manufacturers conduct quality testing and post certificates of analysis on their websites. But the autonomy of the laboratory, and its standards, <\/span>are often not known<\/a>. Sometimes, labs may select an inappropriate testing method, intentionally or unintentionally. Sometimes they perform the test incorrectly, or simply make up results.<\/span><\/span><\/p>\n

Because the FDA can\u2019t fully protect you from quality issues in dietary supplements \u2013 at least not right now \u2013 you must protect yourself. Even if a celebrity or \u201chealth guru\u201d recommends a product, that doesn\u2019t mean it\u2019s high-quality. Before you put any supplement into your body, demand proof.<\/span><\/span><\/p>\n

 <\/p>\n

Originally published in The Conversation<\/a><\/em><\/p>\n

\u00a0<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Popular dietary supplements may contain everything from experimental drugs to heavy metals, with consumers left in the dark, a UConn expert says.<\/p>\n","protected":false},"author":68,"featured_media":158392,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[2231,1864,2225],"tags":[],"magazine-issues":[],"coauthors":[1902],"class_list":["post-158385","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-well-being","category-pharm","category-uconn-storrs"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-11 06:34:45","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/158385","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/68"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=158385"}],"version-history":[{"count":1,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/158385\/revisions"}],"predecessor-version":[{"id":158386,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/158385\/revisions\/158386"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media\/158392"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=158385"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=158385"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=158385"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=158385"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=158385"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}