Primary Care Corner with Geoffrey Modest MD: OTC supplements — not what they say they are…

By: Dr. Geoffrey Modest 

The New York Times had a rather remarkable article on Feb 3rd noting that in a NY attorney general’s investigation, approx 80% of herbal supplements from 4 retailers “contained none of the herbs listed on their labels”, but included “cheap fillers like rice and house plants, or substances that could be hazardous to people with food allergies”. Specifically, they analyzed products from GNC, Target, Walmart, and Walgreens (see here). This raises several issues.

–there is a total lack of oversight/regulation for these “dietary supplements”: ie, no FDA or other agency assuring the quantity or quality. I have previously sent out an article on vitamin D supplementation of milk (see N Engl J Med 1992; 326: 1178), finding that only 29% of 42 samples of 13 brands of milk had the amount of vitamin D advertised on their label (within 20%), 62% had < 80% of what was advertised, and 3 of 14 samples of skim milk had NO vitamin D!! So, people relying on any of the “dietary supplements” are at risk of getting none of what they want.

–there is clearly a potential health risk if one has an allergy to an added (but not listed) ingredient to the supplements

–and, unfortunately, I do find that even in the relatively poor urban community where I work, many patients are buying these overpriced supplements (which it turns out are often fraudulently labeled).

 

Will append the list from the article below (O’Connor, 2015):

gncFrom GNC, Herbal Plus brand- 

Gingko Biloba:

  • No gingko biloba found
  • Did detect allium (garlic), rice, spruce and asparagus

St. John’s Wort

  • No St. John’s Wort found
  • Did detect allium (garlic), rice and dracaena (a tropical houseplant)

Ginseng

  • No ginseng found
  • Did detect rice, dracaena, pine, wheat/grass and citrus

Garlic

  • Contained garlic

Echinacea

  • No echinacea found
  • Did detect rice in some samples

Saw Palmetto

  • One sample contained the clear presence of palmetto
  • Other samples contained a variety of ingredients, including asparagus, rice and primrose

From Target, Up & Up brand-

Gingko Biloba

  • No gingko biloba found
  • Found garlic, rice and mung/French bean

St. John’s Wort

  • No St. John’s Wort found
  • Found garlic, rice and dracaena (houseplant)

Garlic

  • Contained garlic
  • One test identified no DNA

Echinacea

  • Most but not all tests detected Echinacea
  • One test identified rice

Saw Palmetto

  • Most tests detected saw palmetto
  • Some tests found no plant DNA

Valerian Root

  • No valerian root found
  • Found allium, bean, asparagus, pea family, rice, wild carrot and saw palmetto

From Walgreens, Finest Nutrition brand-

Gingko Biloba

  • No gingko biloba found
  • Did detect rice

St. John’s Wort

  • No St. John’s Wort found
  • Detected garlic, rice and dracaena

Ginseng

  • No ginseng found
  • Detected garlic and rice

Garlic

  • No garlic found
  • Detected palm, dracaena, wheat and rice

Echinacea

  • No echinacea found
  • Identified garlic, rice and daisy

Saw Palmetto

  • Contained saw palmetto

From Walmart, Spring Valley brand-

Gingko Biloba

  • No gingko biloba found
  • Found rice, dracaena, mustard, wheat and radish

St. John’s Wort

  • No St. John’s Wort found
  • Detected garlic, rice and cassava

Ginseng

  • No ginseng found
  • Found rice, dracaena, pine, wheat/grass and citrus

Garlic

  • One sample showed small amounts of garlic
  • Found rice, pine, palm, dracaena and wheat

Echinacea

  • No echinacea or plant material found

Saw Palmetto

  • Some samples contained small amounts of saw palmetto
  • Also found garlic and rice​
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