Consumer Reports identifies the “12 Most Dangerous Supplements” along with the “11 Supplements to Consider” in its September 2010 issue which hit newsstands last week.
Using an independent research group, Consumer Reports compiled the report using the Natural Medicines Comprehensive database, reviewing over 1,100 ingredients.
The “dirty dozen” were selected based on whether they were linked to serious adverse events including cardiovascular, liver and kidney problems. Other criteria included evidence of efficacy and degree of availability.
Consumer Reports’ twelve supplements to avoid include aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, grater celandine, kava, lobelia and yohimbe.
Given that the cumulative sales of these 12 ingredients are ~0.2% of the annual supplement market, the annual compilation by Consumer Reports was considered sensationalism by experts in the supplement industry.
Indeed, the FDA has previously informed consumers about many of these ingredients so these warnings are not necessarily new. A number of these ingredients are found just a few product categories – weight loss, sexual enhancement and body building. In some instances, these type of supplements have contained steroids and prescription drugs.
Several of the other herbs are labeled to inform consumers of safety issues material to their use. For example, the American Herbal Products Association (AHPA) maintains a labeling policy for kava that provides information that is consistent with FDA’s 2002 Consumer Advisory on this herb. And chaparral, lobelia and yohimbe are all classified by AHPA’s Botanical Safety Handbook in categories that identify specific cautions.
“Consumer Reports is attempting to draw broad conclusions about the regulation of dietary supplements based on anecdotes related to products that do not represent the mainstream,” noted Michael McGuffin, AHPA president. “This tone is unfortunate and misses an opportunity to express support for the efforts of responsible industry players to improve enforcement of the good laws already in place.”
In the same issue, Consumer Reports reviewed the eleven supplements to consider. This list was based on the overall evidence that supports their use for a specific benefit(s) and includes:
- Calcium for osteoporosis
- Cranberry for urinary-tract infections
- Fish oil for reducing triglycerides
- Glucosamine sulfate for osteoarthritis
- Lactase for reducing GI symptoms
- Lactobacillus to prevent diarrhea
- Psyllium for reducing constipation & lowering cholesterol
- Pygeum to reduce symptoms of an enlarged prostate
- SAMe for reducing depression
- John’s Wort to improve symptoms of depression
- Vitamin D to prevent osteoporosis
In reading the Consumer Reports issue, you might think that dietary supplements are not regulated. However, dietary supplements are regulated by the FDA but they are regulated differently than medications. This is partly due to their excellent safety track record.
For example, in the two years since the FDA instituted adverse event reporting – the same type that is required for drugs – fewer than 2,000 reports have been filed with the agency. These numbers pale in comparison to medications.
To further strengthen the quality of nutritional supplements in the marketplace, the FDA tightened industry regulations in late 2007. Known as Current Good Manufacturing Practices (cGMPs), all dietary supplement manufacturers must establish and meet specifications for the identity, strength, composition, quality and purity of their products. This requirement ensures that consumers buy supplements that are not adulterated, contain the dietary ingredients declared on the product’s label and contain the amount or strength listed on the label.
Every industry includes marginal players that try to get away with providing poor quality products. To protect yourself, when purchasing a nutritional supplement, keep in mind the following:
- Be careful of products in the weight loss, sexual enhancement and body building categories as this is where many of the problems have been found.
- Heed FDA warnings – if the agency issues a warning, don’t purchase supplements that use the ingredient.
- Avoid supplements that make claims to cure, prevent or treat disease. Be particularly careful of supplements that guarantee a miracle such as curing cancer.
- Avoid supplements that do not readily offer a supplement facts panel. If you need to call a toll free number to obtain this information, be prepared for a hard sell.
- Purchase from companies like VitaMedica that use high-quality manufacturing processes and standards; USP ingredients and exclude ingredients in formulations that have been deemed unsafe.
In sum, if a product sounds too good to be true, then it probably is.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.