The supplement aisle at the drug store is the “friendly” section. It’s full of Earthy packaging, few if any warning labels (perhaps just one the warning label about not having warning labels, e.g. has not been verified or tested by the FDA), and enormous claims of health benefits. Just the herbal portion of that aisle alone makes up a $ 5 billion a year industry in the United States. That certainly isn’t the $ 70 billion of the over-the-counter drug industry—but still, it isn’t bad for an investment involving few if any regulatory hurdles or R&D expenditures. In fact, at least among publicly-traded supplement companies, you’ll find research budgets frequently below 1 percent of total expenditures.
In the United States, supplements are highly deregulated thanks largely to 1994’s Dietary Supplement Health and Education Act. Effectively, the law enshrines deregulation, mandating that manufacturers have to say what’s in something, and how much, but pretty much nothing else. A supplement maker doesn’t even have to tell the FDA that it’s producing and selling something, leaving the agency without a list of herbal supplements on the market. It’s a deal that, as an herb seller, you might not want to fuck up by, say, selling dried rice instead of St. John’s Wart.
A damning report out in October in the journal BMC Medicine found instances of dried rice and junk weeds being sold instead of St. John’s Wart in a study examining 44 popular herbal supplements made by 12 different manufacturers. That’s just the beginning. Of those 44, a full third actually contained zero trace of the advertised herb.
Among those cases were Gingko biloba supplements containing, instead, black walnut, a potentially dangerous substitution for consumers with nut allergies. Soybeans and wheat were other popular fillers, with the latter a potentially dangerous ingredient for those suffering from gluten allergies (which, based on my own extremely informal research, is every single herbal supplement consumer over the past three years). Meanwhile, bottles of Echinacea were found to contain the invasive weed Parthenium, known to cause rashes and respiratory problems and historically used to make rubber.
The research comes courtesy of a relatively new testing method based on DNA barcoding, or the sampling of a small region of DNA rather than examining the whole thing. It’s a handy and proven technique, but one with some skeptics. Stefan Gafner of the American Botanical Council, a group that advocates for the supplement industry, notes in The New York Times that the technique may not identify high-refined or purified herbs. “I think that what’s represented here is overblown,” he told the paper. “I don’t think it’s as bad as it looks according to this study.”
Unfortunately, “not as bad” versus “the worst ever” is a smaller distance than it seems. The fundamental problem is illustrated just fine by any substitution at all. You might consider it an admission about the product’s very efficacy that at some point in the manufacturing process a decision was made that it didn’t matter what actual substance was going into the capsules. The problem is that there’s virtually no risk for supplement manufacturers in making that decision—though there clearly is for the consumer. After all, the FDA might not even know it’s on store shelves at all.