There is a surprising lack of regulation in the supplement industry. Any supplement can be sold without the FDA reviewing what's in the product, and the government only becomes involved if a complaint is filed. That means unless your supplement invests in a third-party certification (like NSF Certified for Sport®), there is no guarantee that the label is accurate or the product is free of dangerous substances or illegal ingredients.
No matter the reason you might be taking supplements—maybe you need more protein, you’re a vegetarian needing more iron, or your doctor has told you to bump up your Vitamin D—the supplement shelves can feel like a foreign subway system. You’re overwhelmed, looking every which way, and just hoping that you’ve made the right choice.
With more than 90,000 supplements on the market (and more than half of Americans taking vitamins), you have lots of choices when it comes to vitamins, minerals, and herbals—and the forms they come in (capsules, tablets, powders, drinks, bars).
It’s not always possible to get all the nutrients you need through food alone, and that’s where supplements come in.
There’s also a lot of confusion surrounding not only what to buy—but how much oversight they receive. We may assume that because supplements are something we put into our bodies that they’re regulated the way food and medicine are, but that’s not the case.
Is Your Supplement Safe?
The U.S. Food and Drug Administration (FDA) doesn’t inspect or approve the safety or effectiveness of supplements before they hit the shelves, according to the National Institutes of Health.
You'll be hard-pressed to find any nutritionist suggest that supplements are well-regulated by the U.S. government. Trust us. We reached out to 5 different nutritionists, and none were willing to go on record and make that statement.
It goes back to the Dietary Supplement Health and Education Act of 1994, which classifies supplements as food, not drugs. The act said that supplements with established ingredients (those sold in the United States before 1994) could be marketed without any evidence that they’re effective or safe.
The Federal Trade Commission (FTC) requires all information about a dietary supplement product to be truthful and not misleading. A closer look at a supplement label will reveal the phrasing you’re so used to: “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”
All of which means this: It’s the supplement creator’s responsibility to evaluate the safety and proper labeling of their products, and it’s the consumers’ responsibility to research the supplement.
The Risk Is Real
In general, it's a good idea to treat supplements like medicine, even those that are technically food-grade products (like protein powders). According to a study in the New England Journal of Medicine, more than 23,000 people are sent to the emergency room each year due to adverse effects from supplements (with the most frequent adverse reactions involving cardiovascular issues from weight-loss or energy products).
What's worse? Even when the FDA becomes involved, there's no guarantee a supplement will make changes to improve the product.
According to an article published in Scientific American,
"More than 750 supplement brands have been found to be tainted with drugs—sometimes containing two or more hidden drug ingredients, a new study finds.
What’s more, although the Food and Drug Administration (FDA) identified these tainted supplements, less than half of these products were recalled.
That means that these products—which are essentially “unapproved drugs”—remain on the market, where they have the potential to cause serious health problems, the researchers, from the California Department of Public Health, wrote in the study, published in the journal JAMA Network Open."
Even your over-the-counter allergy medicine can have an interaction with your supplements, says Ann Montgomery, Director of Pharmacy at West Suburban Medical Center in Oak Park, IL. And some interactions can reduce a drug’s effectiveness, according to the Office of Dietary Supplements. For example, St. John’s wort can speed the breakdown of many drugs, including antidepressants and birth control pills.
If you have kidney or liver problems, consider this a red flag when taking supplements, Montgomery says. Supplements can exacerbate a kidney or liver issue because these organs are the processing the supplements, she says.
How to Find Safe Supplements
If you're going to buy a supplement, it's highly recommended that you look for a seal of approval from a third party. There are several independent organizations — NSF International (NSF) and U.S. Pharmacopeia (USP), for example—that offer quality testing of supplements and then pop on their seals of approval on labels if they pass.
But, not all of these seals are equal. For instance, USP is oftentimes a single test to guarantee label accuracy. But, it doesn't look for impurities in products or banned substances. It also doesn't require a brand to test every batch to guarantee that no dangerous products are ever sold.
The gold standard for safety and purity for professional athletes and Olympians is NSF Certified for Sport.® This is a specific certification created by NSF and recognized by the NFL, MLB, NHL, and the World Anti-Doping Agency for their standards. In fact, in some sports, non-NSF Certified for Sport® products are not even allowed in locker rooms. It's why many products that are promoted by athletes can't be safely used by the spokespeople.
This seal of approval ensures that every batch that is manufactured is tested to ensure:
- Labels are accurate
- No dangerous levels of toxins or metals
- No banned substances (they review more than 272 illegal ingredients)
The idea is simple: you deserve the same health standards as Olympians and professional athletes, even if your livelihood doesn't depend on being drug tested.
According to the National Institutes of Health Office of Dietary Supplements—looking for a seal of approval is highly recommended in the minimally regulated supplement market.
If you choose to take a product that doesn't have the strictest level of certification, you might want to find out where the product comes from.
“You must be careful when supplements are imported from other countries as they can contain contaminants,” says Montgomery. You can also check for any warnings from the FDA website on the supplement.