Are Weight-Loss Supplements Safe?

Are Weight-Loss Supplements Safe?
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Only 2 out of 12 supplement companies were found to have products that were even accurately labeled.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

According to a national survey, a third of adults who’ve made serious attempts at weight loss have tried using dietary supplements, for which Americans spend literally billions of dollars every year. Most mistakenly thought that over-the-counter appetite suppressants, herbal products, and weight-loss supplements had to be approved for safety by some governmental agency, like the FDA, before being sold to the public—or at least include some kind of warning on the label about potential side effects. Nearly half even thought they had to demonstrate some sort of effectiveness. None of that is true.

The Food and Drug Administration estimates that dietary supplements in general cause 50,000 adverse events annually––most commonly liver and kidney damage. Of course, prescription drugs don’t just adversely effect, but kill more than 100,000 Americans every year. But, at least you notionally have the opportunity to parse out the risks versus benefits, thanks to testing and monitoring requirements typically involving thousands of individuals.

When the manufacturer of the ephedrine-containing supplement Metabolife 356 had it tested—on 35 people—only minor side effects were found, such as dry mouth, insomnia, and headaches. However, once unleashed on the populace, nearly 15,000 adverse effects were reported before it was pulled from the market, including heart attacks, strokes, seizures, and deaths.

Given the lack of government oversight, there’s no guarantee that what’s on the label is even in the bottle. FDA inspectors have found that 70 percent of supplement manufacturers violated so-called Good Manufacturing Practices, which are considered the minimum quality standards. This includes things like basic sanitation and ingredient identification. Not 7 percent in violation; 70 percent.

DNA testing of herbal supplements across North America found that most could not be authenticated. In 68 percent of the supplements tested, the main labeled ingredient was missing completely, and substituted for something else. For example: a “St. John’s wort” supplement containing nothing but senna, a laxative that can cause anal blistering. Only 2 out of 12 supplement companies had products that were accurately labeled.

This problem isn’t limited to just fly-by-night phonies in some dark corner of the internet. The New York State Attorney General commissioned DNA testing of 78 bottles of commercial herbal supplements sold by Walgreens, Walmart, Target, and GNC. “Four out of five [bottles] did not contain any of the herbs on their labels.” Instead, capsules were often little more than cheap fillers like powdered rice “and houseplants.”

Please consider volunteering to help out on the site.

Image credit: Jsmileycreek via creativecommons. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

According to a national survey, a third of adults who’ve made serious attempts at weight loss have tried using dietary supplements, for which Americans spend literally billions of dollars every year. Most mistakenly thought that over-the-counter appetite suppressants, herbal products, and weight-loss supplements had to be approved for safety by some governmental agency, like the FDA, before being sold to the public—or at least include some kind of warning on the label about potential side effects. Nearly half even thought they had to demonstrate some sort of effectiveness. None of that is true.

The Food and Drug Administration estimates that dietary supplements in general cause 50,000 adverse events annually––most commonly liver and kidney damage. Of course, prescription drugs don’t just adversely effect, but kill more than 100,000 Americans every year. But, at least you notionally have the opportunity to parse out the risks versus benefits, thanks to testing and monitoring requirements typically involving thousands of individuals.

When the manufacturer of the ephedrine-containing supplement Metabolife 356 had it tested—on 35 people—only minor side effects were found, such as dry mouth, insomnia, and headaches. However, once unleashed on the populace, nearly 15,000 adverse effects were reported before it was pulled from the market, including heart attacks, strokes, seizures, and deaths.

Given the lack of government oversight, there’s no guarantee that what’s on the label is even in the bottle. FDA inspectors have found that 70 percent of supplement manufacturers violated so-called Good Manufacturing Practices, which are considered the minimum quality standards. This includes things like basic sanitation and ingredient identification. Not 7 percent in violation; 70 percent.

DNA testing of herbal supplements across North America found that most could not be authenticated. In 68 percent of the supplements tested, the main labeled ingredient was missing completely, and substituted for something else. For example: a “St. John’s wort” supplement containing nothing but senna, a laxative that can cause anal blistering. Only 2 out of 12 supplement companies had products that were accurately labeled.

This problem isn’t limited to just fly-by-night phonies in some dark corner of the internet. The New York State Attorney General commissioned DNA testing of 78 bottles of commercial herbal supplements sold by Walgreens, Walmart, Target, and GNC. “Four out of five [bottles] did not contain any of the herbs on their labels.” Instead, capsules were often little more than cheap fillers like powdered rice “and houseplants.”

Please consider volunteering to help out on the site.

Image credit: Jsmileycreek via creativecommons. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

Next up is Are Weight-Loss Supplements Effective?

I similarly covered weight-loss medications in Are Weight-Loss Pills Safe? and Are Weight-Loss Pills Effective?

So what’s the best way to lose weight? Find out in my new book: How Not to Diet.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

40 responses to “Are Weight-Loss Supplements Safe?

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  1. In How Not to Diet you give all clear to soy, almond, coconut milk added to tea and coffee. Is homemade cashew cream (blended cashews and water)okay too?

    1. Cashew are very healthy Amelia, you should be able to find your answer by searching “cashew” on this site.

      Feedback on the book: I’m currently at the 3 hour mark in the audio, and still on chapter 6. It’s a great book, but these chapters are way too large, making it difficult to navigate. If you ever do a revised version of “How Not to Diet”, maybe consider smaller chapters so a reader can easily jump to, or skip areas of interest.

  2. I don’t take any herbal supplements, but for those of you who do, wouldn’t it be nice to know the names of the 2 companies out of the 12 tested, who produce authentic supplements?

    I went to the references to try to find out the 2 companies and the paper (the last one in the list) is not behind a paywall, so I downloaded the pdf versions and started reading. But to my dismay, the company names are not mentioned! They are only identified by letters of the alphabet. So if I ever buy any supplement, I’m going to make sure I buy from company “C” or “G”. I’m definitely not going to buy from “E” because their sample has nothing but contaminants in their supplement.

    Now if anyone can find out the names of these twelve companies, we might have some real “information” here! I certainly couldn’t find the names in the published paper, but I might have missed it.

    So if this is all the information we have, the bottom line of the video must be “If you buy supplemental herbs, you’re playing Russian Roulette (a 1 out of 6 chance) with getting the correct ingredients. So it’s best to get your herbs directly from the plants themselves :-)

      1. Now, if the public can get Walmart, Walgreens, Vitamin Shoppe and GNC to demand that the products they sell be third party tested, that really could change the situation.

      2. Deb,

        From the article you linked:

        “Cohen stresses that testing is only helpful if it continues on a given product to ensure that its listed ingredients remain accurate over time. He adds, “If this is a one-time process it’s going to help for maybe a few months, maybe this year, and then we’ll slip back into exactly what was happening before.”

        A disclaimer at the bottom of the CVS supplement testing program’s webpage reads, “Tests performed on a single lot of the vitamin or supplement. Third-party testing for subsequent lots is not required. As a result, we cannot confirm that all lots would pass these tests.””

        Though CVS claims that they will or plan to do follow-up testing, no schedule or further comment is available.

        1. Dr J, Canada has regulation of vitamin and supplement industry in place, but I rarely buy anything anyway. Sometimes B12, vit D, lysine, iron,blueberry tea, spices but rarely anything else. Many herbs, spices, and supplements can increase bleeding risk for those taking prescription meds. From year to year, lot to lot, substances can vary. I ask for an INR test if I have concerns about blood clotting time.

    1. “I don’t take any herbal supplements, but for those of you who do, wouldn’t it be nice to know the names of the 2 companies out of the 12 tested, who produce authentic supplements?”

      Yes, extremely so. I take on occasion valerian root from Solaray and I have been taking ashwaghanda by Organic India for a very long time. I chose these companies because they seem trustworthy and I learned about their testing and such. Organic India is particularly trustworthy, to my mind, because they are the manufacturers of the herbs they sell and there’s so much transparency. I believe the company Gaia has excellent transparency as well. Regardless, it is very concerning to see just how many of these herbal supplements were completely inauthentic, and to such a degree that they used powdered rice and houseplants! So I’m actually quite annoyed that the names of the companies were not disclosed in this video.

      So, in short…

      It wouldn’t just be nice to know, it’s essential that this kind of information is disclosed when it is available and I have no idea why it wasn’t provided in the video.

      I also think that the title of this video did not do the video justice. I have no interest in diet pills and I only watched the video because I saw that first line of Darwin’s comment and seeing that herbal companies were tested struck my interest for obvious reasons. This information is not only incredibly useful, but extremely important and more people could be reached and more light could be shed on this epidemic (because that’s what it actually is) if the video was entitled something more like “Are Herbal Supplements Safe/Authentic?” Now THAT would get a lot of views and get this information out there better and this information really needs to get out there.

    2. I actually just read the rest of your comment and thus “But to my dismay, the company names are not mentioned!” So that explains why this information isn’t in the video… How awful that they didn’t disclose the company names! Not sure what they were worried about but you’d think they’d be worried about the consumers above all else because they did this study in the first place.

      Sometimes herbal supplements are a great alternative to harmful pharmaceuticals, so if we would simply and rightfully be protected by the law on this…

  3. Would it be possible to add a feature to directly travel back and forward in the blogs without returning to the list of all of the blogs? Like how the videos on the site have the ‘Previous Video’ and ‘Next Video’ links at the bottom of every “Doctor’s Now” section?

  4. @Amelia Rose

    Yes, it’s perfectly fine making your own cashew cream or milk at home. It’s even better because increased freshness and less additives. Try doing hempseeds + water for hempmilk! Very creamy oats.

    @everybody
    Any idea how much water is needed per one tablespoon vinegar? I just did half a tall glass for one tablespoon raspberry vinegar. I don’t want to burn my insides?

  5. I’m not sure if this is a good idea though? Pouring almost pure acid trough your troath at every meal… especially 2 freakin tablespoons? It doesn’t seem like a good idea healthwise for your insides, acid reflux isn’t very good either.

    And that little vulnerable valve in humans that switches between liquid/solid foods is easily damaged according to Dr. Klaper. I can’t imagen him doing something like this…

    If it takes one tall glass or more for every tablespoon that’s 3 extra tall glasses of water every day. Do this long enough and your organs start retaining water from overhydratation… I’m not very convinced yet… Does a teaspoon per meal work too?

  6. I don’t know how we got to milk and vinegar from this video, but I don’t take any herbal supplements so am not too worried about which two companies were doing it right.

    As to milk, I’ve been making my own oat milk for years and it works fine, even if it needs shaking after sitting in the fridge for a day. As to vinegar, I frequently put a very unscientific dollop of vinegar in a 16 ounce glass and fill with filtered water. It creates a very nice, refreshing drink with no adverse side effect. I tend to use my fig vinegar for a mellow flavor, apple cider vinegar for an in-your-face flavor.

    1. Barbie,

      I take B-12 and D3 and sometimes zinc and magnesium and Omega 3, but I have also taken things like garlic and turmeric and CoQ10 and melatonin and milk thistle and lutein and berberine in the past. Plus, I have taken Serrapeptase and Nattokinase and other digestive enzymes when I had cancer symptoms. Plus, I have taken probiotics after antibiotics.

      I don’t take most of them now that I eat fruits and vegetables, but the concept that these companies have gotten away with it for so long is unconscionable. The concept of people making billions of dollars on products that don’t have any of the items in them at all is outrageous.

      Honestly, the people I know who have had cancer and diabetes would be two groups that often take supplements.

      The concept of there not being any turmeric in the turmeric capsules or any berberine or lutein or milk thistle or melatonin.

  7. Because the Food and Drug Administration doesn’t verify that supplements contain what they say they do or whether they’re contaminated with heavy metals, bacteria, or pesticides before they are sold, some third-party groups have taken on the role.

    These groups include ConsumerLab.com, NSF International, and U.S. Pharmacopeia (USP). USP is a nonprofit organization that sets what are the most widely accepted standards for supplements. (It also sets mandatory standards for pharmaceuticals.) The not-for-profit NSF offers two types of certification: NSF Contents Certified and NSF Certified for Sport. ConsumerLab.com, a for-profit company, regularly tests and certifies supplements. A more recent addition is UL, a for-profit company known for testing electronics.

  8. Googling DNA testing shows lots of inconsistencies, using questionable techniques, ever smaller samples, etc. Even the NY tests have negative scrutiny for pure science methodology, extracts and processing may change DNA, etc. Plus the unavailability of the actual tests even with names removed is odd.
    However, another plug for nutrition to come from whole foods, so thank you again.

    1. @ veggievet:
      MMMMM, anal blisters!

      @ others asking about quality:
      I would suggest you buy organic supplements as much as possible, this way you can be sure the company is audited at least yearly, which includes the facility, and all the books regarding ingredients, processing, storage, equipment, sanitation, etc.

  9. Leslie Kasanoff,

    After looking at your blog that you linked, I think that I would rather eat whole plant foods than rely on supplements for the most part.

    Though I do take vitamin B12 and D3, which are supplements. I prefer sunshine for D3, but it’s not possible during the winter months here in the northeastern US.

  10. Greger doesn’t advocate the use of supplements for weight loss. He advocates eating an appropriate diet. Also, I think there are questions about the (long-term) safety of supplement use even if production quality control is meticulous.

  11. Can’t we do something about the supplement industry? I mean from my understanding in the video the majority of supplements are scams and this stuff is being sold in the untried states. They should be regulated and at least contain the ingredients that are listed on the label! There has to be something we can do.

    1. “There has to be something we can do.”
      – – – –

      Avoid them. Eat modest portions of REAL food instead.

      (Except for a gummy multivitamin eaten with a spoonful of raw organic pumpkin seeds so as not to taste so sweet. :-)

      1. When your an athlete you need supplements to compensate for what you put your body through. Instead of avoiding something that should be beneficial, it should be regulated just like any other product sold is regulated.
        I couldn’t sell 24k gold when it only contains 10k.. You can sue someone for fraud. Why doesn’t that happen in the supplement industry?

        1. Yusef, There is a documentary movie out called “Game Changers” that addresses the concern that many athletes have about eating a whole plant food diet. One of the producers is Arnold Schwarzenegger. I found it interesting and have been recommending it to all my athletic friends. It’s available through several different streaming sources.

          https://gamechangersmovie.com/

          1. Yes I’ve seen it before but it’s not related to the concerns we have about the supplement industry. Thank you for the tip though. 

  12. Why is it that Consumer Lab, an independent third party tester of supplements doesn’t seem to come up with such dire numbers as far as supplements that don’t contain what they are purported to? Is it because they don’t tend to test the mentioned brands? I really don’t think so. As a matter of fact, I recall GNC brand being chosen as the Consumer Lab top pick among supplements of at least one category. It does seem that Consumer Lab is not able to approve a few products in every category they test, but I’ve maybe only seen in one case among dozens it being the vast majority of them. Something tells me that Dr. Greger is off on another cherry picking mission.

  13. In Dr. Gregor’s first book Eat not to Die he talks about erythritol as a good choice of a calorie free sugar replacement. I haven’t seen that he recommends that in his new book on diet. Has he changed his opinion on erythritol.? What sugar replacement does he recommend now. Why has he changed his opinion on erythritol?

      1. I saw that before. But you don’t recommend specific companies.

        The video was about how many supplement companies don’t give you what they promised.

        A lot of supplements don’t contain the listed ingredients. That’s why I was asking for the supplement recommendations

      2. The recommendations provided do not cover which brands of supplements are the safest/best…
        Unless you’re only referring to one brand name called Optimum Nutrition but I don’t think that’s the case in that article.

  14. Like others – wondering, how does one know which companies and products can be trusted to contain what they claim to have? Is there some independent reviewer that has analyzed any of these products and published their findings in a way that can be publicly viewed? Many have commented here that the author of the article doesn’t mention who are the 12 companies tested.

    Consumers want to know – so is there someone who has reviewed and published their findings?

  15. So I take a nutritional supplement that has a Nutritional label and is NSF certified…so are we talking apples and oranges With regards to those with a supplement label vs those without a supplement label?

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