I became interested in the safety of dietary supplements early in my practice. While in El Paso I took care of a retired couple, Mr. and Mrs. C, who were both engineers that had worked at White Sands Missile Range.

I became interested in the safety of dietary supplements early in my practice. While in El Paso I took care of a retired couple, Mr. and Mrs. C, who were both engineers that had worked at White Sands Missile Range. They were both very smart and the wife was a native of Germany, where they would return twice a year. She would always bring home a large suitcase full of dietary supplements. After learning this I asked her why she didn’t just purchase them locally, and her response was unforgettable. In her surest German accent, she said, “If you buy supplements in Germany you know what’s in them. If you get them here, God knows!” I asked her what she meant, and she informed me that the German government regulates the supplement industry, but in this country there is very little regulation. I looked into what she said, and she was right.

My conversation with Mrs. C took place in the early 1990s, about the time of the last great change in the way the government views the supplement industry. The standard for a drug is that it must be shown to be both safe and effective before it is released for sale to the public, and many people believe that supplements should be held to a similar standard (as is the case in Germany). However, there has been a political battle between these people and others who believed that the government should merely remove from the market any supplements found to be tainted. In 1994 the Dietary Supplement Health and Education Act (DSHEA) was passed, which is much more in keeping with the second position and largely deregulated supplements, as long as they don’t claim to function as drugs. Actually it effectively allows manufacturers to make almost any claim they want, as long as it is followed by words such as, "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease;"

Several years ago a survey was made of supplements being sold for enhancing athletic performance. The researchers purchased products off of the shelf and tested them to see what they contained. They found that half did not contain one or more of the ingredients listed on the label, and a quarter contained something potentially dangerous that was not on the label. Three years ago the state of New York tested herbal products, that were said to contain specific plant derived substances and 79% of these products contained zero DNA from the plant they were supposedly derived from. One national brand faired particularly badly, with only 4% of their products containing such DNA. An article from Forbes at the time noted, “While overall 21% of the product tests confirmed [unique DNA sequences] from the plant species listed on the labels, 35% of the product tests identified [unique DNA sequences] from plant species not listed on the labels, representing contaminants and fillers. A large number of the tests did not reveal any DNA from a botanical substance of any kind…. In many cases, unlisted contaminants were the only plant material found in the product samples.” https://ag.ny.gov/press-release/ag-schneiderman-asks-major-retailers-halt-sales-certain-herbal-supplements-dna-tests

The regulation of dietary supplements is essentially equivalent to that on frozen pizza, or fresh lettuce. If someone reports a hazard it is investigated, reported and then tracked, but there is no proactive testing or enforcement regarding formulation. Having said that, I do believe that supplements can be beneficial. Just as I buy frozen pizza and fresh lettuce, I apply the same criteria to supplements. The most important thing is to stick with outlets and brands you know and trust. For greatest safety I advise the use of brands that do not use ingredients from China and whose finished products are tested by independent laboratories. These brands include, but are not limited to, Thorne, Xymogen and Pure.

This column is a service of The Health and Wellness Coalition of Runnels County which now meets every second Thursday at 7 pm. The next meeting will be May 10 at 7 p.m. in Winters at the North Runnels Clinic conference room, and will be devoted to Emergency Planning and Preparation for Healthcare Services and Facilities.