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Why can't labels on nutritional supplements be trusted?

Alan Gaby
Nutrition & Dietetics
You can if you are dealing with a reputable company, typically companies that have been in business for a long time.
Neal Spruce
Neal Spruce on behalf of dotFIT
Fitness
You can if you take the time to do the extensive research on the formulation and the manufacturing process, including the facility -- AND you find a product that matches the findings of scientific studies. However, most people don’t have the time or expertise.

Unfortunately, dietary supplements are not regulated as tightly as drugs. This often leaves them an easy target for criticism but in reality, they do have strict rules to follow:

1. They cannot make unsubstantiated claims, meaning human clinical trials must support the health or fitness claims if they go beyond simply making a statement about the structure and function of the ingredients. This regulation is policed by the Federal Trade Commission (FTC), which is often very slow in acting.

Solution -- Have the supplement company supply the follow info: Current clinical research supporting the use of the active ingredients. Active ingredients shown to be in the proper doses and forms that demonstrated the positive outcomes described in the clinical data.

 2. The ingredients and amounts must match the levels shown on the label. This is self-regulated by the manufacturer but many manufactures or supplement companies use 3rd party testing to assure their customers that what’s on the label is in the bottle. The good news here is that as of this year all manufacturers must follow Good Manufacturing Practices (GMPs), which requires them to test raw materials and finished products. However this doesn’t mean it’s always done, which is why 3rd party testing has become more common.

Solution -- if the company does not use 3rd party testing, ask for their Certificate of Analysis (COA) for the lot number of the product in question. Either way they should be able to supply the records. The COA validates the ingredients in the finished product.

Once the organization passes the above scrutiny, you have found a company you can trust.
Dr. Michael Roizen, MD
Internal Medicine
Since nutritional supplements aren't regulated by Food and Drug Administration (FDA) the way that prescription drugs and over-the-counter drugs are, their sellers are free to do just about anything they want.

Manufacturers can sell supplements in any quantity or combination they want, and quality control…let's just say it's eclectic. Different brands of the same supplement might contain wildly different ingredients. They'll frequently contain contaminants not listed on the label.

For example, if you buy two bottles of an herb such as saw palmetto from two manufacturers, and they may each contain a different substance -- and each may bear no resemblance to saw palmetto. Yes, the law allows this!

The Dietary Supplement Health and Education Act (DSHEA) allows herbal remedies to be sold in the United States as food products, and the second paragraph states (and I paraphrase): "What is on the (bottle) label may or may not be in the bottle. And what is in the bottle may or may not be listed on the label."

Can you imagine if aspirin manufacturers were given the same leeway? We could have brands that contain no aspirin whatsoever and others that pack 10 times as much as the label declared. Manufacturers would also be free to market aspirin under the name that Native Americans knew it by, cinchona bark, which would add dozens of interesting possibilities for confusion or deception.

If you're wondering why more alternative medicines aren't more dangerous given how unregulated they are, well, that's a good question. The answer: Most include too few active ingredients in their pills, so you're often taking nothing more than a placebo.
YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

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YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

Everyone needs to become a smart patient. In fact, in the worst cases, your life may even depend on it. Number one bestselling authors and doctors Michael Roizen and Mehmet Oz have written this...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.