Friday, 20 Oct 2017

You are here

The Unregulated $37 Billion Supplement Industry

In 1994 there were 600 supplement companies, producing 4,000 OTC supplement products for a total revenue of about $4 billion. Today we have close to 6,000 companies, producting nearly 75,000 supplement products, bringing in $37 billion annually.  And all of this is regulated by 26 people and a budget of $5 million at the FDA.

It was the 1994 Dietary Supplement Health and Education Act (DSHEA) that expanded the definition of “supplement” to include herbs and other nutritional supplements to be taken therapeutically. . Second, it allowed supplement makers to make “structure-function” health claims for their products without FDA oversight. This means supplement claims may include benefits to the immune system, cancer, pain, vigor etc. without providing proof of such efficacy.

The Business Insider has written an expose on the supplement/nutraceutical industry, citing that this growing industry is largely unregulated, replete with products that have unpublished or unstudied advserse events and overstated claims of benefit that are more based on opinion than science or randomized controlled trials.

Articles such as these polarize many of us into supplement belivers (be prepared for the steep slant against natural products) or ant-supplement anarchists (who will be fueled to decry the nutraceutical movement)

They point out that the highly popular, St. John's wort has little if any effect, but has been showed by an NIH study to have numerous drug interactions with prescription pharmaceuticals. Moreover, there have been 275,000 reports to US poison-control centers (in the last 20 years) for supplements; a third of them were about herbal remedies like St. John's wort.

The FDA defines supplements as products "intended to add further nutritional value to (supplement) the diet." They are not regulated as drugs by the FDA; who only is involved when a supplement is shown to be unsafe or cause significant harm.

Nearly half of US adults take at least one supplement every day.  These agents are widely promoted in ads, on the internet, in social media, magazines and TV. They're sold in corner health stores, pharmacies, and big grocery conglomerates.

Many supplements make therapeutic claims but fail to provide instructions on use or dosing.

A NEJM article showeed that from 2004 to 2013, there were 23,005 emergency-room visits a year were linked to supplements and that adverse reactions to supplements grew from 3.5 to 9.3 cases per 100,000 (166% increase).

The author believes this is a "con" on America's public and fails to meet standards upon which they sell their remedies.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Rheumatologists are Slow to Change DMARDs

The paradigm of rheumatoid arthritis (RA) therapy mandates early diagnosis and aggressive treatment.  Yet a recent cohort study has shown that RA patients with moderate to high disease activity (MHDAS) were met with infrequent DMARD adjustments; with median time to DMARD adjustment being 5 months and median time to low disease activity (LDAS) was roughly 10 months. 

Novel Gel Drug Delivery Developed for Rheumatoid Arthritis

Scientists at the Institute for Basic Science have invented a hydrogel capable of delivering drug at sites of inflammation in disorders such as rheumatoid arthritis. Published in Advanced Materials, this jelly-like material could be used to absorb extra fluids in swelling joints and release drugs wherever nitric oxide is produced in abundance.

2016 EULAR Guidelines on RA Management

The management of rheumatoid arthritis (RA) has evolved significantly with time.  Nevertheless, there are still some uncertainties - such as when, what and which biologic or novel therapy should be used.

New EULAR Guidelines for Ultrasound Use

In the current issue of ARD, the European League Against Rheumatism (EULAR) has revised and updated its 2001 guideline for musculoskeletal (MS) ultrasound (US) in rheumatology; this time incorporating new advances, technological developments and use indications in rheumatology. EULAR has provided this as an educational tool and standard reference for MSUS practice and research in rheumatology.

Curbside Consults - July 2017

Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines. Here are four new cases.