Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

FDA Urged to Step Up Regulation of Supplements: Adverse events are largely underreported.
Family Practice News ^ | 15 March 2009 | MICHELE G. SULLIVAN

Posted on 04/05/2009 7:26:39 AM PDT by neverdem

The days when the dietary supplements industry is allowed to regulate itself may be numbered following release of a federal report addressing growing concerns about dietary supplement industry.

The report, issued this month by the Government Accountability Office, calls on the Food and Drug Administration to expand adverse event reporting and increase its efforts to educate the public about the safety, efficacy, and labeling of these products. The GAO investigation into supplement safety was made at the request of Congress.

According to the 77-page report, the FDA should be tracking all levels of adverse events related to the use of dietary supplements and herbs, not just severe events. And, the report noted, despite the 2007 requirement for improved manufacturing practices, the FDA still lacks even the most basic ability to track the quality of dietary supplements (www.gao.gov/new.items/d09250.pdf).

Companies that manufacture the products are not required to identify themselves as such, or to provide the FDA with information about the products, including the product name and ingredients, the report said. And if a product is found to be dangerous, the agency is hamstrung—it can only ask for a voluntary recall as it did in December, when Star Caps, a popular weight-loss supplement, was found to contain prescription-strength levels of the diuretic bumetanide.

The FDA lost its authority to regulate the ingredients of dietary supplements prior to marketing with the enactment of the Dietary Supplement Health and Education Act of 1994 (DSHEA) (www.cfsan.fda.gov/∼dms/dietsupp.html). Prior to passage of the DSHEA, which went a long way toward deregulating the dietary supplement industry, the ingredients of dietary supplements were regulated under the 1958 Food Additive Amendments to the Federal Food, Drug, and Cosmetic Act.

Dietary supplements fall within the definition of complementary and alternative medicine (CAM). An earlier federal report issued by the Centers for Disease Control and Prevention found that use of CAM is widespread. For example, when patients with arthritis become frustrated by lack of pain relief, they often turn to dietary supplements.

The issue of quality control has bothered Dr. Roy Altman for years. Supplements and herbal preparations designed to promote joint health and relieve pain are some of the most popular products on the market, grabbing almost as big a market share as weight-loss products, he said in an interview. “We are looking at probably $40-$60 billion spent on over-the-counter arthritis supplements each year,” he said, but noted that “this is only a fraction of what is spent on prescribed arthritis medications.”

Some of these products probably do have a beneficial effect in patients with rheumatic disorders, said Dr. Altman, professor of rheumatology at the University of California, Los Angeles. The problem is identifying which products actually contain what the label promises, and nothing else. “We, and a group of colleagues from Canada, once tested 10 different glucosamine products sold in the U.S. Four of them didn't even have glucosamine in them, and of the remaining six, four had much less than was stated on the product label.”

Similar quality control problems led Congress to request the investigation about 18 months ago, said Lisa Shames, the GAO's director of Food Safety and Agriculture Issues. “There has been a lot of congressional interest into how FDA was implementing the requirements [for oversight of dietary supplements and herbal products], especially the requirement for reporting adverse events,” she said in an interview.

One of the paper's key findings is that adverse events are probably significantly underreported, she said. In December 2007, the FDA began requiring manufacturers of dietary supplements and herbal preparations to report all serious adverse events related to the use of their products. “Since then, FDA has had a threefold increase in the number of events reported, but the big question is whether this is all the events that are happening,” Ms. Shames said. From January through October 2008, the FDA received 948 reports of adverse events, compared with 298 over the same time frame in 2007. “FDA recently estimated that the true number of adverse events could be well over 50,000 each year. We recommended that the FDA require reporting of all adverse events, regardless of their severity.”

The report also called on the FDA to require more information from manufacturers about the ingredients in their products.

Also, under current law, manufacturers are the ones to decide whether an ingredient is “generally recognized as safe,” and thus exempt from the laws that govern pharmaceutical products, she said. The report asks that the FDA take part in this responsibility, by clarifying the evidence needed to document an ingredient's safety and the methodology necessary to establish that safety.

The agency should also increase its efforts to educate the public about the safety of supplements, the report concluded. “People think all these products are safe and approved by the FDA, and of course, this isn't the case,” Ms. Shames said.

The report didn't even touch on manufacturing issues, which are controlled by a set of laws that until recently left manufacturing oversight to the companies, with little government regulation. In 2007, the FDA finalized its Good Manufacturing Practice regulations, which will require quality control measures for all domestic manufacturers and foreign manufacturers that distribute in the United States. But the law is being phased in by company size, with the smallest companies having until June 2010 to come into full compliance.

Dr. Altman noted that country of manufacture is not a good guideline. “You might think you are better off buying something that was made in the U.S., but in reality a lot of those are manufactured in China and then repackaged in the U.S.”

Dr. David Riley, founder of the Integrative Medicine Institute in Santa Fe, N.M., pointed to a study in which researchers obtained 190 Ayurvedic medicines from China and India through Internet sources and determined their components by x-ray fluorescence spectroscopy. They found that 20% contained some level of toxic metal (lead, mercury, or arsenic). U.S.-manufactured products were just as likely to be contaminated as were those made in India (22% vs. 19%). Among companies manufacturing the metal-containing products, 75% claimed that they adhered to the FDA's Good Manufacturing Practices (JAMA 2008;300:915-23).


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: arsenic; codex; codexalimentarius; fda; health; lead; medicine; mercury; supplements
Navigation: use the links below to view more comments.
first previous 1-2021-34 last
To: neverdem
Dr. David Riley, founder of the Integrative Medicine Institute in Santa Fe, N.M., pointed to a study in which researchers obtained 190 Ayurvedic medicines from China and India through Internet sources and determined their components by x-ray fluorescence spectroscopy. They found that 20% contained some level of toxic metal (lead, mercury, or arsenic). U.S.-manufactured products were just as likely to be contaminated as were those made in India (22% vs. 19%). Among companies manufacturing the metal-containing products, 75% claimed that they adhered to the FDA's Good Manufacturing Practices (JAMA 2008;300:915-23).

This is an argument against offshoring/outsourcing, not against supplements.

Oh, I forgot. Free trade benefits everyone.

Screw Congress, screw the FDA.

It was *supposed* to have been your job to prevent this kind of sh*t in the first place.

Vermin.

21 posted on 04/05/2009 9:38:10 AM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: grey_whiskers
U.S.-manufactured products were just as likely to be contaminated as were those made in India (22% vs. 19%).

How is this an argument against outsourcing again ?

22 posted on 04/05/2009 9:56:44 AM PDT by MetaThought
[ Post Reply | Private Reply | To 21 | View Replies]

To: neverdem
growing concerns

Like they've not been wanting to regulate vitamins for decades.

Do concerns ever shrink?

23 posted on 04/05/2009 10:35:09 AM PDT by 1010RD (First Do No Harm)
[ Post Reply | Private Reply | To 1 | View Replies]

To: PhiKapMom

Not if we fight em. Why are we just giving up? Obama is not our destiny.

“Nothing is written!” - T.E. Lawrence (Lawrence of Arabia)


24 posted on 04/05/2009 10:37:06 AM PDT by 1010RD (First Do No Harm)
[ Post Reply | Private Reply | To 7 | View Replies]

To: 6SJ7
The FDA is a joke. Almost everyday there's another story of someone being harmed by prescription drugs.

The last one I heard this week was somone who had 3 brain surgeries with stents in the brain and come to find out her problem was the drugs she was taking.

Unfortunately, this is not an extreme case. What in the heck is wrong with doctors, pharmacists, pharmaceutical companies and he FDA?

I will never take a drug unless it is an extreme emergency. I have seen the damage and I have seen the benefits of nutritional supplements.

25 posted on 04/05/2009 10:49:52 AM PDT by Conservativegreatgrandma (When the righteous rule, the people rejoice; when the wicked rule the people mourn. Proverbs 29;2)
[ Post Reply | Private Reply | To 4 | View Replies]

To: neverdem
if a product is found to be dangerous, the agency is hamstrung—it can only ask for a voluntary recall

This reporter hasn't got a clue what she is talking about. How did tryptophan disappear from the shelves if FDA didnt have the power to ban it?

The agency can remove any harmful product from the market. In fact it can remove safe products from the market by claiming them to be harmful with the flimsiest of evidence.

These bureacRATS have all the power they need. Heaven help us if they get more.

26 posted on 04/05/2009 11:22:38 AM PDT by freespirited (Is this a nation of laws or a nation of Democrats? -- Charles Krauthammer)
[ Post Reply | Private Reply | To 1 | View Replies]

To: PhiKapMom
Look who was in charge when this happened — Clinton and the Democrats in Congress. How much money did they take in from the dietary supplement people to get the law repealed?

Probably quite a bit... from the pharmaceutical industry. The Clinton regime was the one that tried to pass the Codex Alimentarius into law and give the FDA complete power over all foods and supplements. The only reason they failed and the DSHEA was passed was because of the furious grass roots reaction of the public. The hue and cry raised forced congresstards into passing the DSHEA in order to protect the public from the avaricious clutches of the FDA/BigPharma (but I repeat myself).

Might be a little wise to do some basic research before posting a knee jerk reaction without knowing the facts. I hate the Clinton admin as much as anyone, but the DSHEA wasn't one of their doing- quite the contrary.

Read a few more of the responses on this thread and get enlightened. Especially the link to the Codex info. The FDA has all the draconian power it needs, it doesn't need to be given any more.

27 posted on 04/05/2009 11:44:37 AM PDT by hadit2here ("Most men would rather die than think. Many do." - Bertrand Russell)
[ Post Reply | Private Reply | To 2 | View Replies]

To: MetaThought
It's easier to yank the chain of domestic manufacturers; and easy enough for foreign manufacturers to feign ignorance, language difficulties, etc. etc.

Cheers!

28 posted on 04/05/2009 12:38:52 PM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
[ Post Reply | Private Reply | To 22 | View Replies]

To: neverdem

The goal of the deadly globalists is to decrease the health benefits available that are uncontrolled.


29 posted on 04/05/2009 4:42:58 PM PDT by Quix (POL Ldrs quotes fm1900 2 presnt: http://www.freerepublic.com/focus/religion/2130557/posts?page=81#81)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Veto!; Quix
"Bring America to her knees by making Americans financially and physically weak."

Yep. The objective is to put us completely at the mercy of government healthcare authorities with no deviation at any time, making us vulnerable to whatever they dish out.

The only possible silver lining to this is that the lefties love their supplements also, perhaps even more that we do, and will not roll over for this either. Perhaps some will awaken from their hypnosis.

30 posted on 04/05/2009 9:17:05 PM PDT by oprahstheantichrist (The MSM is a demonic stronghold, PLEASE pray accordingly. 2 Cor. 10:3-5)
[ Post Reply | Private Reply | To 19 | View Replies]

To: oprahstheantichrist

They are happy to kill their own, too.

The elite expect to be well buffered against illness and calamities engineered for the rest of humanity.

And to have a select group of slaves/surfs to help them enjoy the ‘national park-like’ planet once they get it re-landscaped with most signs of man erased.

Of course, they aren’t planning on GOD’S TRASHING their plans.


31 posted on 04/05/2009 9:26:05 PM PDT by Quix (POL Ldrs quotes fm1900 2 presnt: http://www.freerepublic.com/focus/religion/2130557/posts?page=81#81)
[ Post Reply | Private Reply | To 30 | View Replies]

To: mysterio
Yep. I said the same thing over on this thread.
32 posted on 04/06/2009 5:36:19 AM PDT by Dead Corpse (1000110010101010100001001001111)
[ Post Reply | Private Reply | To 13 | View Replies]

To: oprahstheantichrist
lefties love their supplements also

There is that. I "was into" vitamins and protein powder and and and far ahead of the curve. Friends thought I was the agent of leftwing weirdness. One even sent me a letter stating she would not allow vitamins in her house, as "General Mills knows what is good for us." Yep. And she died of lung cancer at a much too early age.

Nevertheless, I'm very worried about Codex Alimentarius creeping up on us incrementally.

33 posted on 04/06/2009 6:51:48 AM PDT by Veto! (Opinions freely dispensed as advice)
[ Post Reply | Private Reply | To 30 | View Replies]

To: neverdem

herbal supplement banning and the EU ping

http://gaia-health.com/articles301/000301-big-pharma-scores-big-win-medicinal-herbs-disappear-eu.shtml


34 posted on 09/25/2010 8:43:44 AM PDT by Joya
[ Post Reply | Private Reply | To 1 | View Replies]


Navigation: use the links below to view more comments.
first previous 1-2021-34 last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson