Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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What’s Really In That Supplement You’re Taking?

“Talk to your doctor before starting any new supplement.” You hear it all the time, but do you always check with your primary care doctors at Cohen Medical Associates in Delray Beach, Florida before you take that pill? There are many reasons to do so, from ensuring that supplements won’t interfere with other prescription and non-prescription medications you may be taking, to ensuring that they are safe for you to take. (Did you know, for example, that the supplements beta-carotene and vitamin E have been shown to increase the risk of lung cancer in smokers?)


New study finds dangerous ingredients in supplements

Here’s another reason to check with us first: A study published online earlier this month in the Journal of the American Medical Association (JAMA) Network Open reviewed findings from the U.S. Food and Drug Administration (FDA) in which 776 dietary supplements from 146 companies contained prescription drugs, some of which can be very dangerous to consumers. Some of these supplement brands contained more than one prescription drug. Two of the supplements contained six unapproved drugs.

The researchers analyzed data from an FDA database spanning the period from 2007 to 2016. The products were primarily those marketed for weight loss, muscle growth, and sexual enhancement. The FDA found the most common contaminant to be sildenafil, the drug marketed as Viagra, as well as other erectile dysfunction drugs. The weight loss supplements contained either sibutramine or phenolphthalein, or both, while the muscle-enhancing products contained various types of steroids.

The problem stems from the fact that so many of these supplements are marketed as containing all-natural or safe ingredients, and consumers believe that because they’re sold over the counter, online, or in gyms that they contain nothing harmful.


Possible severe side effects from these ingredients

But there can be significant side effects from some of these ingredients. Sibutramine, an appetite suppressant, was withdrawn from the market due to the increased risk of rapid heartbeat, heart attack, and stroke in those who took it. Yet it is still found in many of these products. Sildenafil, the erectile dysfunction drug, can cause heart attacks. Taking it along with some drugs used to treat high cholesterol, diabetes, and high blood pressure can lower blood pressure to dangerous levels. Fluoxetine, also found in some of the weight-loss products, is better known as Prozac, and certainly not to be used without a doctor’s supervision.

The study said previous research had revealed an estimated 23,000 visits to emergency rooms and 2,000 hospitalizations every year in this country, due to such adverse effects as kidney failure, stroke, acute liver damage, pulmonary embolisms, and even death. The problem seems to be growing worse.

“Over the past decade, ever since I first began tracking the problem, I have only seen the number of supplements adulterated with drugs increase rapidly,” Dr. Pieter Cohen wrote in an editorial accompanying the study. Cohen is a general internist with the Cambridge Health Alliance, and an associate professor at Harvard Medical School in Boston. “Back in 2009, it appeared that there might be less than 150 brands of supplements that contain active drugs. Now it is clear that there are well over 1,000 brands of supplements that contain active drugs.”


Why can’t the FDA ban them?

Many consumers believe that if there was anything wrong with the supplements they take, the government would take them off the market. Historically, that has not been the case. First, by law, supplements are regulated as food rather than drugs, and therefore don’t have to go through FDA review before being marketed. Second, once a substance has been shown to cause harm, the FDA tends to issue “warning letters” and rely on voluntary versus mandatory recalls, even though in 2011 it received the power to issue mandatory recalls of dangerous supplements. It appears here that the FDA tends to defer to manufacturers’ wishes over the safety of the public. The study found that in over half the cases of adulterated products, those products are still on the market.


Steps you can take

If you want to avoid these contaminated supplements, don’t take any marketed for muscle building, erectile dysfunction, or weight loss, since up to 80 percent of these products were found to be adulterated. For other supplements, look for the quality or purity seals “NSF” or “USP Verified” to ensure the contents are as stated on the bottle. And, as always, talk to us if you think you need to take supplements of any kind. We can help you decide whether you need them or whether they can interfere with other health issues you have or medications you may be taking.

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