Contamination of supplements and complementary medicines – caveat emptor

Supplements and other complementary medicine products are very widely used indeed, but are they what they are represented to be? Regulatory bodies such as the TGA and the US FDA have for many years warned consumers about products containing undeclared, unapproved pharmaceutical ingredients. Data were recently extracted from the FDA’s Center for Drug Evaluation and Research, Tainted Products Marketed as Dietary Supplements_CDER database from 2007 – 2016, and reported by researchers in the United States. 776 adulterated dietary supplements were identified by the FDA and 146 different dietary supplement companies were implicated. The products were marketed for sexual enhancement (353 [45.5%]), weight loss (317 [40.9%]), or muscle building (92 [11.9%]), with 157 adulterated products (20.2%) containing more than one unapproved ingredient. Sildenafil, sibutramine and synthetic steroids were the commonly encountered pharmaceutical products identified. The issue is not unique to the USA – the Australian TGA also issues health warnings about adulterated products, with a recent example being Liangzern Dietary Supplements, which were found to contain sildenafil. A TGA slide deck addressing illegal imported products can be viewed here