PrintAn article in the October 8, 2009, issue of the New England Journal of Medicine, has reminded me of an issue that has bothered me for at least a couple of decades. While horse owners seem more than happy to give their horses any number of supplements, the fact is that, no matter what the supplements promise, horse owners can’t really know if the supplements do any good.
Why? One reason is that there is not a requirement that any of the supplements actually do what they say they’re going to do. Read that again; the claims made by supplements don’t have to be supported by any evidence. If you buy a watch, you have a reasonable assurance that it’s going to keep time, because that’s what watches do. But with supplements, just about any claim can be made, and there’s no requirement to prove it. In addition, even if a product were to do what it was claimed to do, horse owners still wouldn’t necessarily be assured that it would be effective, because there’s no way to assure that the product that they’re giving has in it what the labels says it contains.
This is a real problem in the human field. The article, titled "American Roulette -- Contaminated Dietary Supplements," by Pieter A. Cohen, notes that the combination of no regulatory oversight of the dietary supplement industry, combined with a lack of resources by any agency that is supposed to oversee the manufacture of such products, has led to human supplement takers playing an involuntary game of therapeutic Russian Roulette.
Manufacturers can put just about anything – or nothing – into their supplement products, and there’s really not much that consumers can do; there’s no practical way for an individual consumer to know what he or she is really getting in the product. In addition, products are continuously being put into the human market with claims that can’t be supported, even if the product contains what it says is on the label (which it often doesn’t). Finally, even though manufacturers of supplement products are required by law (since 2007) to report serious supplement-related adverse events to the United States Food and Drug Administration (FDA), the majority of them – estimated at 50,000 events per year – go unreported.
People certainly don’t seem to understand the extent of the problem. They seem to want to take the claims made for supplements at face value, that is, they seem think that if a product says it can do something, it can, and it does, and that someone is making sure of it.
Wrong.
As a result, in 2002, a Harris poll found that consumers believed that dietary supplements were approved by a government agency prior to being sold. That’s not true – supplements can be put onto the market without any approval at all, as long as they don’t make specific disease-preventing claims (for example, a supplement can claim to “support” joint health, as long as it doesn’t claim to help cure arthritis).
The faulty beliefs about supplement regulation aren’t limited to consumers; a recent survey of internal medicine residents found that one-third believed (wrongly) that dietary supplements required FDA approval, and the majority didn’t know that it was mandatory to report adverse events to the FDA.
