US consumer group names dirty dozen dietary supplements

[Guest guest]

BMJ 2004;328:975 (24 April), doi:10.1136/bmj.328.7446.975-c

News

US consumer group names " dirty dozen " dietary supplements

Janice Hopkins Tanne

New York

Americans can easily buy 12 dangerous dietary supplements over the counter

or from the internet, the latest (May) issue of Consumer Reports magazine

says. At least five of these supplements are banned in Asia, Europe, or

Canada.

Consumer Reports (accessible at www.consumerreports.org) is published by the

non-profit Consumers Union, which tests products and services and aims to

protect the public through information and advocacy.

The revelation came in the same week that a federal judge finally upheld the

US Food and Drug Administration's ban on ephedra, the stimulant that has

been linked to more than 100 deaths, including that of a major league

baseball player.

Aristolochic acid is categorised as a carcinogen by the World Health

Organization. Its inclusion in a Chinese herbal product for weight loss

caused an outbreak of kidney failure and cancers of the kidney, ureter, and

bladder in patients in Belgium ( New England Journal of Medicine 2000;342:

1686-92[Abstract/Free Full Text]). Consumer Report investigators were able

to purchase products labelled as containing aristolochia.

The " very likely hazardous " supplements on the list include comfrey,

androstenedione, chaparral, germander, and kava. Supplements in the " likely

hazardous " category include bitter orange, organ/glandular extracts,

lobelia, pennyroyal oil, skullcap, and yohimbe. Products containing

androstenedione, kava, and yohimbe supplements produced sales of $76m (£42m;

63m) in 2002 in the United States.

Senator Joe Biden (left) shows " Andro, " a precursor used by athletes instead

of banned steroid hormones

Credit: SUSAN WALSH/AP

In March the administration wrote to manufacturers of androstenedione,

saying that it considered the supplement unsafe and asking distributors to

stop marketing it. " Andro, " as it is known, is a precursor to sex hormones.

Athletes use it instead of banned steroid hormones.

Last December the UK Medicines Control Agency linked kava to liver toxicity

and said, " There is no evidence to support a safe dose of kava. "

Supplements are not subject to the same regulations and safety checks as

prescription drugs. Instead, to impose a ban the administration has to prove

that a supplement is unsafe under the terms of the 1994 Dietary Supplement

Health and Education Act.

Although supplement manufacturers can't claim that a product prevents or

treats a disease or disorder, they can say their product affects structure

or function or supports healthy function. Labels of supplementary medicines

are supposed to list ingredients and their quantity, but labelling varies

widely, and some ingredients have confusing and different names.

A national poll showed that customers mistakenly thought that supplements

had been approved by a government agency, that products were required to

carry warning labels about possible side effects, and that supplement makers

could not make safety claims without scientific support.

[Guest guest]

BMJ 2004;328:975 (24 April), doi:10.1136/bmj.328.7446.975-c

News

US consumer group names " dirty dozen " dietary supplements

Janice Hopkins Tanne

New York

Americans can easily buy 12 dangerous dietary supplements over the counter

or from the internet, the latest (May) issue of Consumer Reports magazine

says. At least five of these supplements are banned in Asia, Europe, or

Canada.

Consumer Reports (accessible at www.consumerreports.org) is published by the

non-profit Consumers Union, which tests products and services and aims to

protect the public through information and advocacy.

The revelation came in the same week that a federal judge finally upheld the

US Food and Drug Administration's ban on ephedra, the stimulant that has

been linked to more than 100 deaths, including that of a major league

baseball player.

Aristolochic acid is categorised as a carcinogen by the World Health

Organization. Its inclusion in a Chinese herbal product for weight loss

caused an outbreak of kidney failure and cancers of the kidney, ureter, and

bladder in patients in Belgium ( New England Journal of Medicine 2000;342:

1686-92[Abstract/Free Full Text]). Consumer Report investigators were able

to purchase products labelled as containing aristolochia.

The " very likely hazardous " supplements on the list include comfrey,

androstenedione, chaparral, germander, and kava. Supplements in the " likely

hazardous " category include bitter orange, organ/glandular extracts,

lobelia, pennyroyal oil, skullcap, and yohimbe. Products containing

androstenedione, kava, and yohimbe supplements produced sales of $76m (£42m;

63m) in 2002 in the United States.

Senator Joe Biden (left) shows " Andro, " a precursor used by athletes instead

of banned steroid hormones

Credit: SUSAN WALSH/AP

In March the administration wrote to manufacturers of androstenedione,

saying that it considered the supplement unsafe and asking distributors to

stop marketing it. " Andro, " as it is known, is a precursor to sex hormones.

Athletes use it instead of banned steroid hormones.

Last December the UK Medicines Control Agency linked kava to liver toxicity

and said, " There is no evidence to support a safe dose of kava. "

Supplements are not subject to the same regulations and safety checks as

prescription drugs. Instead, to impose a ban the administration has to prove

that a supplement is unsafe under the terms of the 1994 Dietary Supplement

Health and Education Act.

Although supplement manufacturers can't claim that a product prevents or

treats a disease or disorder, they can say their product affects structure

or function or supports healthy function. Labels of supplementary medicines

are supposed to list ingredients and their quantity, but labelling varies

widely, and some ingredients have confusing and different names.

A national poll showed that customers mistakenly thought that supplements

had been approved by a government agency, that products were required to

carry warning labels about possible side effects, and that supplement makers

could not make safety claims without scientific support.

[Guest guest]

BMJ 2004;328:975 (24 April), doi:10.1136/bmj.328.7446.975-c

News

US consumer group names " dirty dozen " dietary supplements

Janice Hopkins Tanne

New York

Americans can easily buy 12 dangerous dietary supplements over the counter

or from the internet, the latest (May) issue of Consumer Reports magazine

says. At least five of these supplements are banned in Asia, Europe, or

Canada.

Consumer Reports (accessible at www.consumerreports.org) is published by the

non-profit Consumers Union, which tests products and services and aims to

protect the public through information and advocacy.

The revelation came in the same week that a federal judge finally upheld the

US Food and Drug Administration's ban on ephedra, the stimulant that has

been linked to more than 100 deaths, including that of a major league

baseball player.

Aristolochic acid is categorised as a carcinogen by the World Health

Organization. Its inclusion in a Chinese herbal product for weight loss

caused an outbreak of kidney failure and cancers of the kidney, ureter, and

bladder in patients in Belgium ( New England Journal of Medicine 2000;342:

1686-92[Abstract/Free Full Text]). Consumer Report investigators were able

to purchase products labelled as containing aristolochia.

The " very likely hazardous " supplements on the list include comfrey,

androstenedione, chaparral, germander, and kava. Supplements in the " likely

hazardous " category include bitter orange, organ/glandular extracts,

lobelia, pennyroyal oil, skullcap, and yohimbe. Products containing

androstenedione, kava, and yohimbe supplements produced sales of $76m (£42m;

63m) in 2002 in the United States.

Senator Joe Biden (left) shows " Andro, " a precursor used by athletes instead

of banned steroid hormones

Credit: SUSAN WALSH/AP

In March the administration wrote to manufacturers of androstenedione,

saying that it considered the supplement unsafe and asking distributors to

stop marketing it. " Andro, " as it is known, is a precursor to sex hormones.

Athletes use it instead of banned steroid hormones.

Last December the UK Medicines Control Agency linked kava to liver toxicity

and said, " There is no evidence to support a safe dose of kava. "

Supplements are not subject to the same regulations and safety checks as

prescription drugs. Instead, to impose a ban the administration has to prove

that a supplement is unsafe under the terms of the 1994 Dietary Supplement

Health and Education Act.

Although supplement manufacturers can't claim that a product prevents or

treats a disease or disorder, they can say their product affects structure

or function or supports healthy function. Labels of supplementary medicines

are supposed to list ingredients and their quantity, but labelling varies

widely, and some ingredients have confusing and different names.

A national poll showed that customers mistakenly thought that supplements

had been approved by a government agency, that products were required to

carry warning labels about possible side effects, and that supplement makers

could not make safety claims without scientific support.

[Guest guest]

BMJ 2004;328:975 (24 April), doi:10.1136/bmj.328.7446.975-c

News

US consumer group names " dirty dozen " dietary supplements

Janice Hopkins Tanne

New York

Americans can easily buy 12 dangerous dietary supplements over the counter

or from the internet, the latest (May) issue of Consumer Reports magazine

says. At least five of these supplements are banned in Asia, Europe, or

Canada.

Consumer Reports (accessible at www.consumerreports.org) is published by the

non-profit Consumers Union, which tests products and services and aims to

protect the public through information and advocacy.

The revelation came in the same week that a federal judge finally upheld the

US Food and Drug Administration's ban on ephedra, the stimulant that has

been linked to more than 100 deaths, including that of a major league

baseball player.

Aristolochic acid is categorised as a carcinogen by the World Health

Organization. Its inclusion in a Chinese herbal product for weight loss

caused an outbreak of kidney failure and cancers of the kidney, ureter, and

bladder in patients in Belgium ( New England Journal of Medicine 2000;342:

1686-92[Abstract/Free Full Text]). Consumer Report investigators were able

to purchase products labelled as containing aristolochia.

The " very likely hazardous " supplements on the list include comfrey,

androstenedione, chaparral, germander, and kava. Supplements in the " likely

hazardous " category include bitter orange, organ/glandular extracts,

lobelia, pennyroyal oil, skullcap, and yohimbe. Products containing

androstenedione, kava, and yohimbe supplements produced sales of $76m (£42m;

63m) in 2002 in the United States.

Senator Joe Biden (left) shows " Andro, " a precursor used by athletes instead

of banned steroid hormones

Credit: SUSAN WALSH/AP

In March the administration wrote to manufacturers of androstenedione,

saying that it considered the supplement unsafe and asking distributors to

stop marketing it. " Andro, " as it is known, is a precursor to sex hormones.

Athletes use it instead of banned steroid hormones.

Last December the UK Medicines Control Agency linked kava to liver toxicity

and said, " There is no evidence to support a safe dose of kava. "

Supplements are not subject to the same regulations and safety checks as

prescription drugs. Instead, to impose a ban the administration has to prove

that a supplement is unsafe under the terms of the 1994 Dietary Supplement

Health and Education Act.

Although supplement manufacturers can't claim that a product prevents or

treats a disease or disorder, they can say their product affects structure

or function or supports healthy function. Labels of supplementary medicines

are supposed to list ingredients and their quantity, but labelling varies

widely, and some ingredients have confusing and different names.

A national poll showed that customers mistakenly thought that supplements

had been approved by a government agency, that products were required to

carry warning labels about possible side effects, and that supplement makers

could not make safety claims without scientific support.