We often hear about the evils of Big Pharma, and there’s plenty to be concerned about there. But some who promote “alternatives” — the manufacturers, distributors and sellers of supplements, aka Big Herba —take advantage of regulatory loopholes, public distrust of the medical realm, and consumer confusion to push pills and potions that may do absolutely nothing for your health, or worse. Big Herba is big business, and when profit is the motive, let the buyer beware.
Increasingly, Big Pharma and Big Herba are indistinguishable. The very same mega-companies with gigantic chemical labs that make drugs are cooking up vitamin and herbal supplements labeled with sunny terms like “natural” and “wholesome.” Pfizer, Unilever, Novartis, GlaxoSmithKline and other big pharmaceutical firms make or sell supplements. Procter & Gamble Co. and Arm & Hammer are also in on the action. Wall Street is getting in on the game, too: the Carlyle Group, a private-equity titan, owns NBTY (formerly Nature's Bounty), whose brands include Nature's Bounty, Sundown Naturals, Puritan's Pride, and Vitamin World. When they make supplements, companies don’t have to play by the same rules as when they make drugs. True, there are still some small firms that concentrate on just a few products, and many of them want to sell products that are properly labeled and beneficial. But the smaller guys represent just a small fraction of total sales in what has become a $23-billion-a-year business.
Last week, the New York attorney general's office told GNC, Target, Walgreens and Walmart to pull several store-brand supplements when most of them were found to contain things other than what their labels advertised, including allergens like wheat that are potentially dangerous to some consumers. At all the stores investigated, the St. John’s Wort contained absolutely no St. John’s Wort. Likewise, the Gingko Biloba had no Gingko Biloba. Instead, many of the products contained nothing but cheap fillers, including a common houseplant called dracaena.
In 2012, the Office of the Inspector General of the U.S. Department of Health and Human Services released a report showing that 20 percent of supplements sold for weight loss and immune system support they bought made illegal claims about their effectiveness in treating and cure ailments. “Sampled supplements,” says the report, “were inconsistent with FDA guidance on competent and reliable scientific evidence.”
In 2013, the New York Times published an article describing numerous problems with common products. Research conducted in Canada on popular supplements like echinacea and St. John’s Wort sold by 12 different companies found that many consumers were getting completely swindled. According to the report:
“Americans spend an estimated $5 billion a year on unproven herbal supplements that promise everything from fighting off colds to curbing hot flashes and boosting memory. But now there is a new reason for supplement buyers to beware: DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds.
The same year, Harvard researchers found that between 2004 and 2012, there were 237 “Class I recalls” of dietary supplements. That means for each product, there was a “reasonable probability that the use of or exposure to a product will cause serious adverse health consequences or death.” Dietary supplements —which include vitamins, minerals, botanicals, and herbal remedies — accounted for half of such recalls during those years.
Consumer Reports reveals that of 54,000 supplements listed in the Natural Medicines Comprehensive Database, only a third have any scientifically supported level of safety and efficacy. Twelve percent are linked to safety concerns or quality issues. The report calls attention to health risks including cardiovascular, liver and kidney problems; contamination with nasty things like heavy metals due to poor quality control and inspection; and raw ingredients sourced in China, where factories are riddled by lax standards.
So many people worry about having to spend money at the doctor. So much money to be made. In 1994, the Dietary Supplement Health and Education Act (DSHEA) was passed which allowed dietary supplements to operate with little regulation. The supplement industry, as a result, does not have to do thorough trials for safety and efficacy. And they don’t necessarily have to alert consumers about harmful side-effects. Even when a supplement is clearly shown to be harmful, it’s difficult for the FDA to step in and ban it. Just take the case of ephedra, which people used to take for weight loss and to boost energy. Despite mounting evidence of dangerous effects, in some cases fatal, manufacturers challenged a 2004 FDA ban and got it overturned. It took the U.S. Court of Appeals to restore the ban in 2006.