Contaminants lurk in many ‘natural’ products

"The committee is concerned about the quality of dietary supplements in the United States. Product reliability is low," says its report, which urged amending the 1994 law to tighten consumer protections.

Trade associations say the FDA's new rules do that.

"We are FDA-regulated products," though not in the same way as prescription or over-the-counter drugs, said Steven Mister, president of the Council for Responsible Nutrition.

Although many people take supplements with no apparent ill effects, there have been many quality problems that a consumer might never realize because they don't always produce symptoms.

ConsumerLab.com found lead in at least one brand each of zinc, black cohosh and ginkgo products tested in recent years. Lead can accumulate and cause many health problems, and the testing company wants a national limit of 0.5 micrograms per day — a level that in California requires a warning on the label.

A fungal toxin was found in four red yeast rice products in March 2008. And in 2007, federal officials warned about a liquid herbal supplement sold for colic and teething pain after finding cryptosporidium, a waterborne parasite that causes severe diarrhea.

Ayurvedics — popular herbals used in traditional medicines from India — often contain hazardous metals, studies in medical journals report. In 2004, researchers tested 70 ayurvedic remedies in the Boston area and found that one in five had potentially harmful levels of lead, mercury or arsenic. Tests in Houston, Chicago, San Francisco and New York City turned up similar results.

Metals naturally accumulate in certain herbs and come from the soil they are grown in. Many supplement ingredients come from Europe, India and China.

Potency problems
In ConsumerLab.com testing last November, four out of seven supplements contained less ginkgo than claimed on their labels, and one failed to break apart properly to release its ingredients. Seven out of nine failed in tests in 2003, as did six out of 13 in 2005.

Supplement safety The federal Food and Drug Administration does not analyze the content of dietary supplements, which do not need proof of safety or effectiveness before they go on sale. Here are tips from the government on their use: — Don't self-diagnose a health condition or substitute a supplement for medicine. — Ask your doctor before taking a supplement, especially if you are pregnant, taking other medicines or are having surgery soon. — Request proof from the manufacturer or distributor to back up any claims. — Ask the seller or manufacturer for information on tests showing safety or effectiveness of ingredients, and whether consumers have complained of adverse events. — Look for "seals of approval" from independent groups that have standards to help ensure the product was properly made, contains what the label says, and is free of contaminants. These groups include Consumerlab.com, NSF and the U.S. Pharmacopeia.

"It is now believed that ginkgo is among the most adulterated herbs," the company reports.

Tests by California scientists of two dozen ginseng supplements, reported in a nutrition journal in 2001, found that many differed from their labels. The concentrations of some ginseng compounds varied by up to 200-fold from product to product.

In ConsumerLab.com tests, six out of nine chondroitin supplements failed testing in April 2007. One had only 8 percent of what it claimed to contain, and one "maximum strength" product had none.

Vitamins and minerals had problems, too. A "high potency" iron supplement contained less than half the amount claimed. Of 23 top-selling vitamin C pills, one provided less than half the amount promised; the suggested dosages of some others were beyond recommended safe levels.

Last year, nearly 200 people were sickened by supplements containing up to 200 times the amount of selenium stated on the label.

Hidden prescription drugs
The FDA has repeatedly warned about herbal pills found to contain versions of Viagra and similar drugs to help men get an erection. These can pose a heart hazard, especially when taken with certain medications.

In December, the FDA expanded warnings about dozens of brands of weight loss pills that contained prescription drugs not disclosed on labels.

Drug interactions
Ginkgo, vitamin K, garlic, ginseng and other herbals can cause bleeding or clotting problems if taken with certain medications or before surgery. St. John's wort, promoted for depression, affects metabolism of more than half of all prescription drugs and can undermine birth control pills. Other supplements that can interfere with medicines include glucosamine, saw palmetto, soy and valerian.

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Other risks
Even "safe" supplements can be harmful. Beta-carotene takers still had increased rates of lung cancer six years after one study was stopped. These supplements "appear to increase rates of the disease, particularly among smokers," the National Cancer Institute warns.

In another study, men taking vitamin E were slightly more likely to get prostate cancer, and those taking selenium were a little more likely to develop diabetes. The results could have been due to chance, but federal officials stopped the study last October.

Other studies suggest that high doses of vitamin C may help shield cancer cells from treatments designed to kill the cancer.

"Antioxidants are not the magic bullets that the supplement industry would like consumers to believe," said David Schardt, a nutrition expert with the consumer advocacy group, the Center for Science in the Public Interest. "They're not even necessarily benign."

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