FDA data review on extent of spiked supplements

[Harry Hooper]

JAMA online has an article by researchers in California. Key findings:

In this quality improvement study, analysis of the US Food and Drug Administration warnings from 2007 through 2016 showed that unapproved pharmaceutical ingredients were identified in 776 dietary supplements, and these products were commonly marketed for sexual enhancement, weight loss, or muscle building. The most common adulterants were sildenafil for sexual enhancement supplements, sibutramine for weight loss supplements, and synthetic steroids or steroid-like ingredients for muscle building supplements, with 157 products (20.2%) containing more than 1 unapproved ingredient.

Link

 

[mt8thsw9th]

The most common adulterants were sildenafil for sexual enhancement supplements

Whoever's buying these supplements since Viagra isn't readily available to them will be really, really pissed off to find out their yohimbe is actually Viagra.

 

[EricFeczko]

Whoever's buying these supplements since Viagra isn't readily available to them will be really, really pissed off to find out their yohimbe is actually Viagra.

On the plus side, it could explain the person's stroke. Maybe. Or maybe not. From the article:

One study found that dietary supplement use was associated with 23 000 emergency department visits and 2000 hospitalizations in the United States each year.8 Serious adverse events reported with the use of dietary supplements include stroke, acute liver injury, kidney failure, pulmonary embolisms, and death.9 Identifying adverse events through postmarket surveillance efforts poses some challenges, mainly owing to difficulties in asserting causality and underreporting. A US Government Accountability Office report found that, of adverse event reports received by the FDA, most do not initiate consumer protection actions like inspections or warning letters.6 Additionally, many consumers and physicians may not attribute symptoms to use of a dietary supplement or know to report to the FDA or the associated dietary supplement firm.6,10 In fact, poison control centers received over 1000 more reports of adverse events associated with dietary supplement use than the FDA did over a 3-year period.6

Not to pick on @jkempa, but he's the most honest person I know with a radically different perspective on the FDA from most of us. As much as I typically disagree with him regarding the FDA; I'd love to hear his important take on the article, which is open access.

 

[mt8thsw9th]

On the plus side, it could explain the person's stroke. Maybe. Or maybe not. From the article:

Probably not the type of stroke they were looking for, at least.

Though certainly not victim-blaming (I hope), but people at risks for strokes or cardiovascular events should be steering clear of ED drugs, anyhow. I get it that a lot of people are desperate, though, and turning to supplements since they can't afford OTC medicines (or if they have coverage, are too ashamed to bring it up with their doctor). And a system where we squeeze every bit of profit at the occasional expense of human lives, this type of thing will happen until there are serious regulations/consequences of spiking unregulated supplements with cheaper and stronger drugs.

 

[Murderer's Crow]

The implication here, of course, is the question of whether or not spiked supplements can trigger positive steroid tests for MLBers. Isn't it pretty widely known than vitamin supplements are embarrassingly unregulated?

 

[shaggydog2000]

The implication here, of course, is the question of whether or not spiked supplements can trigger positive steroid tests for MLBers. Isn't it pretty widely known than vitamin supplements are embarrassingly unregulated?

They were reclassified as food and not drugs back in the 90's. The regulation has been almost nil ever since. They have to really screw up and kill people regularly (like with ephedra) before any action is taken.

 

[Manramsclan]

They were reclassified as food and not drugs back in the 90's. The regulation has been almost nil ever since. They have to really screw up and kill people regularly (like with ephedra) before any action is taken.

It should be noted that ephedra was used in those products at dosages 20 to 30 times higher than what is recommended (6-15g).