As reported last week by the Boston Globe’s Stat News, 14 Olympic sports federations — including USA Gymnastics and USA Track & Field — have signed sponsorship deals with dietary supplement manufacturers.
In addition, hundreds of individual athletes have personally endorsed various vitamin and other supplements, including protein shakes and energy drinks.
Yet, as Stat News reporter Rebecca Robbins notes, there is “little scientific backing” that these products “provide a nutritional or energy boost [or] ward off common problems like muscle cramps.”
The supplements’ ineffectiveness is, however, only part of the problem. Supplements can also be dangerous. Indeed, many brands of dietary supplements have been found in the past to contain potentially harmful ingredients, such as amphetamine or methylsynephrine (ingredients that have also been banned by the World Anti-Doping Agency).
“Sports executives involved in these endorsement deals said they partnered only with supplement makers that they or another sports federations have rigorously vetted and that they trust to produce safe and effective products,” writes Robbins.
Yet, as Dr. Pieter Cohen, a Harvard Medical School assistant professor who has studied supplements extensively, told Robbins, even supplements that are unlikely to contain banned or dangerous ingredients are part of “a massive market of products that simply don’t work, but can be dressed up and advertised to pretend that they do, so that consumers will buy them.”
“I suspect that this type of Olympiad sponsorship of supplements will lead many young people to try new sports supplements,” he added. “If they don’t want to buy these expensive ones that are being advertised by the athletes, they might end up purchasing one sitting next to it in the store that’s spike with drugs.”
Doctors and hospitals, too
It’s not just champion athletes, however, who are pushing supplements with unproven benefits and potential harms onto an unsuspecting public. In another article published last week, Consumer Reports describes in some detail an unsettling development in the medical world:
Dietary supplements — vitamins, minerals, herbs, botanicals, and a growing list of other “natural” substances — have migrated from the vitamin aisle into the mainstream medical establishment. Hospitals are not only including supplements in their formularies (their lists of approved medication), they’re also opening their own specialty supplement shops on-site and online. Some doctors are doing the same. According to a Gallup survey of 200 physicians, 94 percent now recommend vitamins or minerals to some of their patients; 45 percent have recommended herbal supplements as well. And 7 percent are not only recommending supplements but actually selling them in their offices.
No wonder, then, that so many consumers are in the dark about the risks associated with dietary supplements. In a 2015 Consumer Reports survey, almost half of American adults said “yes” when asked if supplements are tested for efficacy and/or safety before being sold.
Neither of those assumptions is correct, as Consumer Reports’ investigative health reporter Jeneen Interlandi makes clear:
Dietary supplements are subject to far less stringent regulations than over-the-counter and prescription medication. The FDA classifies them differently from drugs. So the companies that make and sell them aren’t required to prove that they’re safe for their intended use before selling them, or that they work as advertised, or even that their packages contain what the labels say they do.
And because of those lax policies, supplements that make their way into retail stores, doctors’ offices, and hospitals can pose a number of potential problems. They can be ineffective, contaminated with microbes or heavy metals, dangerously mislabeled, or intentionally spiked with illegal or prescription drugs. They can also cause harmful side effects by themselves and interact with prescription medication in ways that make those drugs less effective.
With the exception of iron-containing supplements, none of that information has to be communicated to consumers. Nor do consumers necessarily realize the need to ask about problems.
But even if you ask, you’re unlikely to get an informed answer. Consumer Reports found that out when it sent a team of 43 “secret shoppers” into 60 stores in 17 states — stores that included such well-known retailers as Costco, GNC and Whole Foods.
The shoppers asked the stores’ pharmacists and sales staff detailed questions about specific supplements on their shelves — ones that contained ingredients experts say should be always avoided because they can cause organ damage, cardiac arrest and other serious medical problems.
“We were alarmed by their lack of awareness about the risks associated with those supplements,” writes Interlandi. “… Most of the employees didn’t warn [the shoppers] about the risks or ask about pre-existing conditions or other medications they might be taking. Many gave information that was either misleading or flat-out wrong.”
When questioned about green tea extract (GTE), an herbal supplement marketed for weight loss, two out of three salespeople said it was safe to take. None warned that the herb has been found to alter the effectiveness of a long list of drugs, including certain antidepressants and anticlotting drugs. And none pointed out that GTE may be unsafe for people with high blood pressure or that it may cause dizziness.
Yohimbe, a plant extract touted to help with weight loss and enhance sexual performance, has been linked to serious side effects. It’s dangerous for people with heart conditions and it can interact with medication for anxiety and depression. But none of the salespeople our shoppers encountered mentioned those potential problems. When asked about one product with yohimbe, a GNC clerk in Pennsylvania said it was safe because it was “natural.”
Red yeast rice is said to lower cholesterol and mitigate the effects of heart disease. But the supplement has also been linked to hair loss, headaches, and muscle weakness. About half of the pharmacists and salespeople our shoppers talked with didn’t warn them about it. Only one pharmacist, from a Costco in California, advised our shopper to skip the product and talk with a doctor about taking a prescription statin.
More than 1,000 supplements have been found to contain prescription or experimental drugs, the Consumer Reports article points out. And each year, an estimated 23,000 Americans end up in a hospital emergency room after taking a supplement.
Some die. Between 2008 and 2011, the U.S. Food and Drug Administration received 6,307 reports of dietary-supplement-related health problems, including 92 deaths, hundreds of life-threatening conditions, and more than 1,000 serious injuries or illnesses, reports Interlandi.
As she also notes, those numbers are small relative to the number of supplements that are sold, “but there’s no reliable way to tell whether any given supplement is safe,” she adds.
One day, perhaps, Congress may finally get out from under the lobbying sway of the $40-billion-a-year supplement industry and pass legislation that requires all such products to prove their effectiveness and safety before they go on the market.
In the meantime, caveat emptor.