How the FDA handles this game of cat and mouse. Diet, weight loss, and sexual supplements are all contaminated with unapproved medications. This pattern is currently being repeated, the FDA has not warned consumers about additional stimulants discovered in weight loss and sports supplements. It is not uncommon for the FDA to release a public notification for a product, followed by a voluntary recall from the associated dietary supplement company or distributor, in the coming weeks or months, resulting in 2 warnings for the product in the database.
Cohen, who is an adjunct professor at Harvard Medical School, told Nutritional Outlook that the FDA's lack of action is “completely inexplicable,” adding that the agency is neglecting its responsibilities to enforce the Dietary Supplements Health and Education Act (DSHEA) and protecting public health. This retrospective observational prevalence study is an essential investigation and quantification of illegally added pharmaceuticals or prescription drugs, specifically fluoxetine, phenolphthalein, and sibutramine, in herbal weight-loss supplements sold in the UAE. Cheap supplements sold on the Internet are more likely to have problems with unlabeled ingredients or impurities than those sold in stores like Costco or Whole Foods, which have a process for examining supplement products, Israelsen says. The results of this research have shown that a supplement is more likely to contain undeclared prescription drugs or chemicals when there is no country of origin on the product compared to those in which the country of origin is indicated.
The Pharmacopoeia Convention (USP) has convened an Expert Panel (EP) to develop screening methods for synthetic pharmaceuticals as adulterants in products marketed as dietary supplements. These drugs can be included in the same dietary supplement in an effort to counteract the effects of others. While herbal weight-loss supplements offered for sale in the UAE have relatively low percentages of undeclared pharmaceuticals, many people take several different supplements daily and may encounter fairly high levels of combined exposure to toxic compounds. Erectile dysfunction, weight loss and athletic performance products continue to lead the way in adulteration.
Israelsen confirmed that China is the main supplier of many supplement ingredients, estimating that “70 to 75 percent of dietary ingredients come from China. The FDA does not have funding for police supplements and “there is no systematic monitoring of safety and efficacy,” says Peter Lurie, a former FDA official who is now executive director of the Center for Public Interest Sciences. Similarly, he says, it's better to look for supplements that list ingredients he can identify than those that use proprietary blends that don't disclose. The incidence of undeclared pharmaceutical chemicals in weight-loss supplements was defined as the proportion of products containing significant concentrations of sibutramine, phenolphthalein or fluoxetine.
The problem of contaminated supplements remains in sight, Cohen says, because the Dietary Supplements Health and Education Act of 1994, or DSHEA, was created with great input from the supplement industry and consumers who use its products. Of these, 16 out of 33 products (48.5%) were marketed for weight loss, 13 out of 33 (39.4%) for sexual enhancement and 4 out of 33 (12.1%) for “other indications”.