Tag Archives: consumerlab

30% of SAMe supplements fail to pass testing

Dietary supplements containing SAMe (S-adenosyl-methionine) can be effective in treating osteoarthritis as well as depression and mood disorders, but only 7 out of ten SAM-e supplements recently selected for testing by ConsumerLab.com met all quality criteria. Furthermore, the cost of SAMe varied almost 6-fold … with the most expensive product failing! Continue reading

ConsumerLab.com puts multivitamins to the test

Long-time readers know of my fondness for and (unpaid) endorsement of ConsumerLab.com, one of the two best companies that test natural medications (herbs, vitamins, and supplements) for safety and quality. Now ConsumerLab has test results of 60 multivitamins and have shown that you can’t always judge a supplement by its label—or by its price. Continue reading

Problems discovered with vitamin D supplements

Many consumers do not realize that natural medications (herbs, vitamins, and supplements) are essentially unregulated in the U.S. Without the wonderful work of several independent quality testing labs, professionals and consumers would be up the proverbial creek without a paddle. To illustrate this is a recent report showing that among 28 vitamin D supplements recently selected for independent testing by ConsumerLab.com, problems were found with 8 products (29% of those reviewed). Continue reading

CoQ10 test results show high quality, but wide differences in dosages, formulations, and cost

CoQ10 is among the most popular supplements in the U.S. and is used for cardiovascular disease and a range of other conditions. However, it is easy, however, for a consumer to be confused about CoQ10 due to mixed clinical findings, absorption issues, two chemical forms (CoQ10 and its activated from, ubiquinol), and a variety of suggested dosing across products. Continue reading

Isoflavones reduce postmenopausal insomnia, hot flashes

In a past blog, Natural Medications (Herbs, Vitamins, and Supplements) for Menopausal Symptoms, I discussed the data supporting a trial of isoflavones in women with menopausal symptoms. However, there was not a lot of data. Now, Medscape is reporting, “Isoflavones may reduce insomnia symptoms” in postmenopausal women, according to a small study in the journal Menopause. Continue reading

DHEA Supplements, Touted For Anti-Aging And Strength, Reviewed By Consumerlab.Com

Recent tests of DHEA supplements by ConsumerLab.com showed that most products contained their claimed amounts of the controversial ingredient, but one provided only 14.7% of its listed amount.

Dehydroepiandrosterone (DHEA), a steroid hormone now banned from use by certain athletic organizations and not permitted to be sold in Canada without a prescription, has been touted for its potential to “reverse the aging process” and “increase strength.” You can read my blog, “DHEA for Anti-Aging or other purposes … what’s the truth?” to learn more about DHEA. This is taken from my book, Alternative Medicine: The claims, the options, the evidence, how to choose wisely.

Alternative Medicine - 2009

ConsumerLab.com’s new Product Review of DHEA Supplements reviews these claims as well as the quality of products on the market. Sales of DHEA were $55 million in 2009, up 10% from the prior year according to figures from Nutrition Business Journal.

“Levels of DHEA decrease with age, which is why it has been promoted as a ‘fountain of youth,’ said Tod Cooperman, MD, President of ConsumerLab.com.”Several studies have shown that it does not improve strength or general well-being in seniors. But DHEA may improve skin condition, sexual function and libido, and osteoporosis in older individuals.”

Dr. Cooperman warned, however, that, “DHEA has potential side effects and should be used with caution.”

In addition to testing the quality of DHEA supplements, ConsumerLab.com compared the cost to obtain an equal amount (25 mg) of DHEA from the products that passed testing. The cost ranged from 4 cents to as much as 46 cents.

Had the product that failed testing contained its listed amount of DHEA, it would have been the most economical product (3 cents per 25 mg of DHEA). However, based on the amount of DHEA actually found, the cost was 23 cents. “If the price of a supplement seems too good to be true, be wary of it,” Dr. Cooperman added.

The new DHEA report is now available here. The report provides results for twelve products, of which ConsumerLab.com selected ten. Two products were tested at the request of their manufacturers/distributors through CL’s Voluntary Certification Program and are included for having passed testing.

Also listed is one product similar to another that passed testing but sold under a different brand name.

Products included in the report are:

  • Amerifit DHEA,
  • AST Sports DHEA,
  • Enzymatic Therapy Youthful You DHEA,
  • KAL DHEA,
  • Natrol DHEA,
  • Nature’s Bounty DHEA,
  • Physiologics DHEA,
  • PhysioMuscle dhea mass,
  • Schiff DHEA Plus,
  • TriMedica DHEA,
  • Ultimate Nutrition DHEA,
  • Vitamin Shoppe Specialties DHEA, and
  • Vitamin World Youth Guard DHEA.

ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products. ConsumerLab.com is affiliated with PharmacyChecker.com, an evaluator of online pharmacies, and MedicareDrugPlans.com, which reviews and rates Medicare Part D plans. Subscription to ConsumerLab.com is available online.

Lower-Priced Resveratrol Supplements Pass Quality Tests While Some Higher-Priced Brands Flunk

Nature’s Code ResveratrexConsumerLab.com has reported that tests of supplements containing resveratrol — a compound promoted as “life-extending” — revealed that two products provided only 43.4% and 86.7%, respectively, of their listed amounts of resveratrol. These two products were among the most expensive supplements of the ten products selected for testing by ConsumerLab.com.

Surprisingly, ALL of the lower-priced products fared well in the tests.

Results for all ten products are now published in ConsumerLab.com’s Review of Resveratrol Supplements. An additional nine products that passed the same testing through ConsumerLab.com’s Voluntary Certification Program are included in the report as well as one product similar to one that passed testing but sold under a different brand name.

Resveratrol products have proliferated following reports in 2006 of life-extending and athletic endurance-enhancing effects of resveratrol in animals. Sales of resveratrol supplements were estimated at $31 million in the U.S. in 2009 by Nutrition Business Journal.

Laboratory research has also shown antioxidant, anti-inflammatory, anticancer, and other effects. Human studies of resveratrol’s effectiveness have NOT been reported, but many are underway.

At least one researcher in the field, Dr. David Sinclair at Harvard Medical School, is noted as taking resveratrol personally at a dose of approximately 350 mg per day.

In addition to quality issues, ConsumerLab.com found the daily suggested dosage among resveratrol products to range from 50 to 1,020 mg of resveratrol. The cost to obtain 100 mg of resveratrol from products ranged from $0.15 to as much as $2.76 — more than a 17-fold difference.

Based on a daily dose of 400 mg of resveratrol, the daily cost would range from $0.60 to $11.04.

None of the products were contaminated with lead or cadmium, which can occur in plant-based supplements, and all tablets were able to properly break apart in solution.

“There is still much to learn about resveratrol,” said ConsumerLab.com’s president, Tod Cooperman, M.D.  “At least those who choose to use it can now find out which products contain what they claim, which do not, and how to save money buying resveratrol.”

Brands covered in the new report are:

  • Bioforte (Biotivia),
  • Country Life,
  • Finest Natural (Walgreen),
  • Life Extension,
  • Life Smart,
  • Nutralife,
  • Perfect ResGrape,
  • Protocol for Life Balance,
  • pureandhealthy Res98,
  • Puritan’s Pride,
  • ReserveAge Organics,
  • Resveratrex (Nature’s Code),
  • Resveratrol Max,
  • Resveratrox (Garden Greens),
  • Resvinatrol,
  • Solaray,
  • Solgar,
  • Swanson,
  • Transmax (Biotivia), and
  • Vitamin World.

The two products that failed testing were:

  • Nature’s Code Resveratrex
  • Resvinatrol Complete

The report also provides information regarding dosage and possible side-effects, and comparisons of active and inactive ingredients in the resveratrol products.

ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. Their reviews of popular types of vitamins, supplements, and generic drugs are available here. Subscription to ConsumerLab.com is available online.

The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.

Probiotics have health benefits in some children

The AP reports, “For years, companies have been making claims that their probiotic pills, yogurts, milks and juices help digestive health and the immune system. Some experts are still not so sure, however.

In recent blogs about probiotics and kids, I’ve told you, “Friendly Bacteria (Probiotics) Help Calm Colicky Babies and May Help Constipated Babies” and “Probiotics may ease kids’ belly aches (especially IBS).” And now, a “leading medical group says there’s some evidence that probiotics, or ‘good’ bacteria, may have limited benefits for certain illnesses in children.”

A new American Academy of Pediatrics (AAP) review published in the journal Pediatrics suggests that giving probiotics early to children with diarrhea from a viral infection, but who are otherwise healthy, can shorten the duration of illness.

The Time “Healthland” blog reported, “The review also found that probiotics can help prevent diarrhea in children who are taking antibiotics.”

But the AAP “stopped short of recommending that probiotics be added to children’s formula (although infant foods and formula that already contain probiotics, such as Bifidobacterium lactis, which has been available in formula since 2007, aren’t considered harmful to healthy children), and warned that the live microorganisms should not be given to seriously ill children with weakened immune systems or who use intravenous catheters.”

Investigators also pointed out that its “been proposed that in individuals with genetic susceptibility to [inflammatory bowel disease], chronic inflammation occurs in response to commensal digestive microflora because of various inherited defects of innate inflammatory-response pathways,” MedPage Today reported.

“However, although experience with probiotics thus far may be promising in chronic ulcerative colitis, further research with larger numbers of patients is needed.

As for Crohn’s disease in children, there has been no evidence of efficacy and probiotics are not recommended, the report said.”

But, if you want to try probiotics in the U.S., buyer beware. ConsumerLab.com says in its report about quality testing probiotics:

ConsumerLab.com selected thirteen probiotic products sold in the U.S. and/or Canada. Some products only listed the amount of organisms that were viable when the product was manufactured and not through the expiration date. This labeling practice is not typically employed with other types of supplements and can mislead consumers when a diminished amount is actually in the product at time of use. One of the products selected by ConsumerLab.com (Kashi Vive) did not list any amount of organisms.

Among the products selected by ConsumerLab.com, only two (Advocare Probiotic Restore and Udo’s Choice Adult Formula) were found to accurately list the number of cells that were viable at the time they were tested.  Other products were found to contain as little as 7% to 58% of the amount listed on their labels.

The ConsumerLab report lists several brands of probiotics that passed quality testing

Probiotics may ease kids’ belly aches (especially IBS)

In a past blog about probiotics, I told you, “Friendly Bacteria (Probiotics) Help Calm Colicky Babies and May Help Constipated Babies.” Now, an Italian study is suggesting that a daily dose of “friendly bacteria” (probiotics) could provide relief for kids suffering from the cruel pain of a CHRONIC tummy ache. Here are the details from a report in Reuters Health:

Yet little evidence exists to date for helpful medications or dietary changes, Dr. Ruggiero Francavilla of the University of Bari, in Italy, told Reuters Health in an e-mail.

Given recent research hinting at the therapeutic value of probiotics for adults with stomach problems, particularly a condition known as irritable bowel syndrome that can cause pain and abnormal bowel movements, Francavilla and his team wanted to see if good bacteria might benefit kids too.

The team studied 141 Italian children between the ages of 5 and 14 suffering from chronic belly pain, mostly resulting from irritable bowel syndrome. They randomly assigned each child to daily doses of either a common strain of probiotic, Lactobacillus rhamnosus strain GG, or a placebo that looked and tasted similar, for eight weeks.

At the end of the treatment period, L. rhamnosus GG appeared to reduce the frequency and intensity of the kids’ stomach pain, report the researchers in the journal Pediatrics.

While both groups averaged about four stomach aches per week prior to the study, frequencies reduced to about one per week for kids taking the probiotics and two per week for those on the placebo. Based on a 10-point scale, with 10 being worst, the average level of pain reported before treatment was 4.3 in both groups.

These scores dropped to 2.3 and 3.4, respectively, for kids in the treatment and placebo groups. Further, the researchers found that the effects of the probiotic lasted at least another eight weeks beyond completion of the study treatment.

Although they note that the probiotic’s pain-relieving benefits could still wane and require repeated use to maintain the effect. L. rhamnosus GG is widely available at drug stores and sold online, generally costing less than a dollar per daily dose.

Lactobacillus rhamnosus strain GG is one of the best-studied probiotic bacteria in clinical trials for treating and preventing several intestinal disorders and is widely available in different countries,” said Francavilla.

He added that his team conducted the study with kids recruited through their pediatricians in a wide range of communities in southern Italy, so the results could be applicable to the general population.

No other strain of probiotic is currently a valid alternative for this particular condition, Francavilla noted. “Probiotics are not all the same and should not be used deliberately for all the possible indications; we are entering the era of targeted probiotic use,” he said.

To fully achieve the specific stomach ache-reducing benefit of Lactobacillus rhamnosus GG, Francavilla advises taking the probiotic long-term or for at least eight weeks.

But, if you want to try probiotics in the U.S., buyer beware. ConsumerLab.com says in its report about quality testing probiotics:

ConsumerLab.com selected thirteen probiotic products sold in the U.S. and/or Canada. Some products only listed the amount of organisms that were viable when the product was manufactured and not through the expiration date. This labeling practice is not typically employed with other types of supplements and can mislead consumers when a diminished amount is actually in the product at time of use. One of the products selected by ConsumerLab.com (Kashi Vive) did not list any amount of organisms.

Among the products selected by ConsumerLab.com, only two (Advocare Probiotic Restore and Udo’s Choice Adult Formula) were found to accurately list the number of cells that were viable at the time they were tested.  Other products were found to contain as little as 7% to 58% of the amount listed on their labels.

The ConsumerLab report lists several brands of probiotics that passed quality testing and also contain Lactobacillus rhamnosus GG.

Less Than 25% of Valerian Herbal Sleep Supplements Pass Tests For Quality

Long-time readers of this blog know of my admiration for ConsumerLab.com, a leading provider of consumer information and independent evaluations of natural medications (herbs, vitamins and supplements). In fact, I use their findings almost daily in my practice to recommend natural medications to my patients.

In its most recent evaluation of a natural medication, valerian, ConsumerLab found that MOST of the valerian herbal supplements tested contained less of the herb than expected and/or were contaminated with lead.

Valerian is a popular herbal sleep aid used by approximately 6% of the U.S. population. Valerian accounted for $68 million in sales in the U.S. in 2009, up 10% from the prior year, according to Nutrition Business Journal.

Among nine leading and best-selling products selected by ConsumerLab.com for review, only TWO passed testing.

Of the seven that failed, one contained no detectable key valerian compounds and four others had only 26.7% to 82.5% of amounts expected from ingredient listings.

One of these products was found to be contaminated with lead, as were two other products. These results were confirmed in independent laboratories. Lead is a heavy metal that can impair mental functioning and may affect blood pressure. The amounts of lead found in the products (which ranged up to 3.5 mcg of lead per daily serving) are not likely to cause toxicity alone, but it is best to avoid unnecessary lead exposure.

Lead contamination was found to be an issue in products consisting primarily of valerian root powder as opposed to valerian root extract. The extraction process removes heavy metals.

“Valerian may help some people with sleep problems, although the evidence is mixed,” said Tod Cooperman, M.D., President of ConsumerLab.com. “Unfortunately, it appears that many people may not be giving valerian a fair try because the brand they buy lacks the expected ingredient. And some brands unnecessarily increase one’s exposure to lead.”

ConsumerLab.com found similar problems in earlier reviews of valerian supplements in 2001, 2004, and 2006. Dr. Cooperman added, “If you use valerian, it would seem prudent to choose a product that passed ConsumerLab.com’s testing.”

The complete report is available here. The report includes results for ten products. ConsumerLab.com selected nine. One other product was tested at the request of its manufacturer through CL’s Voluntary Certification Program and is included for having passed testing.

Brands included are:

  • A. Vogel (Bioforce),
  • Bluebonnet,
  • CVS,
  • Douglas Laboratories,
  • Genestra (Seroyal),
  • Mason,
  • Nature’s Answer,
  • Shaklee,
  • Solaray, and
  • Solgar.

Another of my favorite Internet-based sites for information on natural medications, the Natural Medicines Comprehensive Database, rates valerian as POSSIBLY EFFECTIVE for insomnia. The Database says:

Most research shows that taking valerian orally reduces the time to sleep onset (sleep latency), and improves subjective sleep quality. The greatest benefit is usually seen in patients using 400-900 mg valerian extract up to 2 hours before bedtime.

Valerian does not relieve insomnia as fast as benzodiazepines. Continuous nightly use for several days to four weeks might be needed for significant effect.

Some research suggests that valerian is not as effective as temazepam (Restoril) or diphenhydramine (Benadryl) for causing sedation in elderly people.

Valerian is often used in combination with other sedative herbs. Taking a combination product containing valerian extract 187 mg plus hops extract 41.9 mg per tablet, two tablets at bedtime, seems to modestly improve subjective sleep measures including subjective sleep latency compared to placebo after 28 days of treatment; however it was not significantly better than placebo after only 14 days of treatment (15018). A combination of valerian with lemon balm might also improve the quality and quantity of sleep in healthy people.

Valerian also seems to improve the sleep quality of insomniacs who have recently withdrawn from benzodiazepines. After tapering the benzodiazepine over two weeks, 300 mg valerian extract in three divided daily doses might subjectively improve sleep quality.

There is also preliminary clinical research that suggests valerian also might help improve sleep in intellectually impaired children.

Not all evidence is positive. Some evidence suggests that valerian does not significantly improve insomnia compared to placebo.

Valerian does not relieve insomnia as fast as benzodiazepines (6480). Continuous nightly use for several days to four weeks might be needed for significant effect (6249,10209).
Some research suggests that valerian is not as effective as temazepam (Restoril) or diphenhydramine (Benadryl) for causing sedation in elderly people (10424).
Valerian is often used in combination with other sedative herbs. Taking a combination product containing valerian extract 187 mg plus hops extract 41.9 mg per tablet, two tablets at bedtime, seems to modestly improve subjective sleep measures including subjective sleep latency compared to placebo after 28 days of treatment; however it was not significantly better than placebo after only 14 days of treatment (15018). A combination of valerian with lemon balm might also improve the quality and quantity of sleep in healthy people (10423).
Valerian also seems to improve the sleep quality of insomniacs who have recently withdrawn from benzodiazepines. After tapering the benzodiazepine over two weeks, 300 mg valerian extract in three divided daily doses might subjectively improve sleep quality (8006).
There is also preliminary clinical research that suggests valerian also might help improve sleep in intellectually impaired children (10207).
Not all evidence is positive. Some evidence suggests that valerian does not significantly improve insomnia compared to placebo (15046).

The Natural Medicines Database also rates valerian as POSSIBLY SAFE “when used orally and appropriately, short-term. Clinical studies have reported safe use of valerian for medicinal purposes in over 12,000 patients in trials lasting up to 28 day.” However, “the safety of long-term use is unknown.”

So, for my patients with occasional insomnia, I simply print off the ConsumerLab.com list of valerian products that have passed quality testing and say, “Buy the least expensive one and don’t use it more than a month at a time.”

The three products on the current “approved” list include:

  • Bluebonnet Herbals Valerian Extract (1 vegetable capsule, 1 per day)
  • Shaklee® Gentle Sleep Complex (3 tablets, 3 per day)
  • Solgar® Standardized Valerian Root Extract (1 vegetable capsule, up to 3 per day)

ConsumerLab.com Finds Quality Problems with Nearly 30% of Fish Oil Supplements Reviewed; “Fishy” Claims Identified

Fish, krill, and algal oil supplements now account for approximately $1 billion in sales in the U.S. To help consumers choose among products, ConsumerLab.com selected 24 of the best-selling oil supplements and tested them for EPA and DHA, contamination, freshness, and, if applicable, proper release by enteric coatings. Amazingly, nearly 30% of the fish oil supplements that they selected for testing failed to meet minimum quality standards.

As discussed in the news release below, ConsumerLab found PCBs in all fish oil supplements (including krill and algal oil supplements) but typically at extremely low levels (addressing questions raised by the California lawsuit in March that I discussed here).

ConsumerLab also we found that price is not an indicator of quality with fish oil and that a person need not pay more than about 6 cents a day to get a good product (as I discuss in another blog, here); they also point out that the term “pharmaceutical grade” on products is meaningless; and they note out that actual amount of omega-3’s will range from less than 20% to over 80% of the “fish oil” shown on the front label, so you need to read the Supplement Facts carefully.

Here are more details from the ConsumerLab press release:

Softgels and Liquids for Adults, Children and Pets Tested, Including Krill Oil and Algal Oil Supplements

White Plains, New York – Tests of fish, algal and krill oil supplements revealed quality problems with 7 out of 24 products selected by independent testing organization ConsumerLab.com.

Three products contained less of the omega-3 fatty acids EPA and/or DHA than claimed, spoilage was detected in one of these products as well as in two others (including a children’s supplement), an enteric-coated product released its ingredients too early, and a supplement for pets exceeded the contamination limit for PCBs.

Seventeen other products passed testing as did 15 products similarly tested through ConsumerLab.com’s voluntary certification program. ConsumerLab.com’s report is now available online to its members.

ConsumerLab.com reported these additional, notable findings:

  • Labels on some products included terms such as “pharmaceutical grade” and “tested in FDA approved laboratories,” which are meaningless as there is no  basis for either claim.
  • A krill oil supplement that failed for both spoilage and low omega-3 levels claimed to be quality assured under GMPs (good manufacturing practices).
  • Another “krill oil” supplement contained more fish oil than krill oil.
  • Most products met ConsumerLab.com’s strict contamination limit for dioxin-like PCBs of 3 picograms per gram (3 parts per trillion). However, one product (a pet supplement) slightly exceeded this limit with 3.14 picograms per gram. However, this exposure is still very small compared to that from fish meat — a small serving (3 ounces) of fatty fish such as salmon may easily provide 170 picograms of dl-PCBs as well as a significant amount of mercury. Trace amounts of dl-PCBs were found in all supplements, despite claims on some of being free of contaminants. There was no detectable mercury in any of the supplements.
  • The cost to obtain 100 mg of EPA and/or DHA from fish oil ranged from about 1 cent to 15 cents among fish oil supplements, and was about 30 cents from krill or algae oils. A fairly standard daily dose of 500 mg of EPA + DHA from a quality-approved product could be had for as little as 6 cents.  Higher prices were not associated with higher quality.
  • Concentrations of EPA and DHA ranged from less than 20% to over 80% of the marine oil content listed on front labels — which is why consumers should specifically look for the amounts of EPA and DHA which typically appear on side labels.

“Supplements providing EPA and/or DHA are a great alternative to fish as a source of beneficial omega-3 fatty acids, as they typically have far fewer contaminants, cost less, and are more convenient to obtain. But products vary in quality, strength, odor-reduction, and price, so you need to choose carefully,” said Tod Cooperman, M.D., ConsumerLab.com’s president.

Consumption of EPA and DHA appears to reduce the risk of coronary heart disease and may be helpful in the treatment of rheumatoid arthritis, other inflammatory diseases, and psychiatric illness. EPA and DHA may also reduce the risk of certain cancers and macular degeneration. Fish oil supplements are given to pets to help maintain their coats and skin.

U.S. sales of fish oil supplements in 2009 were $976 million, up 20% from the prior year, according to Nutrition Business Journal. A recent survey by ConsumerLab.com showed that fish oil had become the most commonly used supplement among people who regularly use supplements, exceeding, for the first time, the use of multivitamins. Seventy four percent of respondents reported using a fish oil supplement.

The new report includes test results, quality ratings, comparisons and reviews of products from the following brands: Advocare, CardioStat (Amerifit), Carlson, CVS, Dr. Sears, Finest Natural (Walgreen), Garden of Life, Kirkland (Costco), Life Extension, Liquid Solutions, Master Omega, Natrol, Natural Factors, Nature Made, New Chapter, Nordic Naturals, NOW, NSI (Vitacost), Olympian Labs, OmegaBrite, Origin (Target), PregnancyPlus, Puritan’s Pride, Quest Longevity (Canadian), Res-Q, Solgar, Source Naturals, Spring Valley (Walmart), Swanson, Trader Joe’s, The Simpsons, Vital Nutrients, VitalOils (VitalRemedyMD), Vitamin Shoppe, Vitamin World, Weil, Wellements, and 1-800-PetMeds. The report also includes information about dosing, side-effects, cautions, reduced-odor products, and proper storage of fish oil.

In addition to the products reviewed, two krill oil ingredients by Enzymotec USA have been tested and approved for quality through ConsumerLab.com’s Raw Materials Testing Program.

ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.

U.S. Dietary Supplements Often Contaminated: Consumer Reports

Many popular dietary supplements contain ingredients that may cause cancer, heart problems, liver or kidney damage, but U.S. stores sell them anyway and Americans spend millions on them, according to a report from the trusted Consumer Reports.

Here are the details from Reuters Health:

The consumer magazine published a report highlighting the U.S. Food and Drug Administration’s lack of power to regulate such supplements, and said the agency rarely uses what little power it does have.

The report from the influential group urged Congress to speed up small moves toward giving the agency more clout, especially in regulating supplements.

Despite the “natural” labels carried by many of the supplements, many are contaminated.

Yet Americans flock to take them, according to the magazine, citing the Nutrition Business Journal as saying the market was worth $26.7 billion in 2009.

“Of the more than 54,000 dietary supplement products in the Natural Medicines Comprehensive Database, only about a third have some level of safety and effectiveness that is supported by scientific evidence,” the report reads.

In addition, the FDA has not inspected any supplement factories in China, even though the agency set up field offices there starting in 2008, Consumer Reports said.

The organization pointed to 12 supplement ingredients in particular that it said could be dangerous: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe.

Potential dangers include liver and kidney damage, heart rhythm disorders and unhealthy blood pressure levels, it said.

The group is critical of the 1994 Dietary Supplement Health and Education Act or DSHEA, which it describes as industry friendly and which prevents the FDA from regulating supplements in the same way as it regulates prescription medications.

The Federal Trade Commission regulates the marketing of herbal supplements, whose makers are not allowed to claim they treat medical conditions.

The FDA has banned only one supplement ingredient — ephedrine alkaloids — although it has persuaded many companies to pull their products off the market.

“Supplements are marketed with very seductive and sometimes overblown sales pitches for increasing your performance in the bedroom, slimming down, or boosting your athletic prowess,” said Nancy Metcalf, senior program editor for the magazine.

“And consumers are easily lulled into believing that supplements can do no harm because they’re ‘natural’,” Metcalf said in a statement.

“However, some natural ingredients can be hazardous, and on top of that the FDA has repeatedly found hazardous ingredients, including synthetic prescription drugs, in supplements.”

In May, the Government Accountability Office found that sellers of ginseng, Echinacea and other herbal and dietary supplements often tell consumers the pills can cure cancer or replace prescription medications.

Experts at the Institute of Medicine said earlier this year the FDA needs to use the same strict standards to regulate supplements as it uses for drugs, and the GAO said the FDA should ask Congress for more power to regulate supplements.

So, what are we as consumers to do to protect our selves and our families? I recommend ConsumerLab, a subscription-based website that buys the most common natural medicines (herbs, vitamins, and supplements) and the tests them to be sure:

  • They contain in the bottle what the label says from lot to lot,
  • They are labeled as they should be be,
  • They contain no contaminates, and
  • They would be expected to be properly absorbed.

I tell my patients, just print off the list of ConsumerLab approved products, and buy the least expensive one.

My Recommendations for Glucosamine, Chondroitin, and SAMe for Osteoarthritis

Several readers have requested that I post the advice that I both use in practice and teach other healthcare professionals when it comes to a topic on which I frequently teach, Natural Medications for Osteoarthritis: An evidence-based evaluation.

This year I’ve given this talk in several hospitals and to state and national gatherings of physicians and PAs. Let’s start with the take home recommendations:

The Bottom Line

Take Home Point #1

All patients with osteoarthritis should take part in an active exercise regimen and reduce weight (if overweight or obese). I also recommend they begin a diet high in fruits, vegetables, and low in unsaturated fats. Antioxidants in pill form probably won’t help. Instead, I advise patients to boost consumption of vegetables and fruits that provide lots of vitamin C, vitamin E, and beta-carotene as high dietary intake of foods that contain these antioxidants might slow progression of osteoarthritis and have other benefits.

Take Home Point #2

I recommend starting with a a dose of glucosamine sulfate, 1500 mg once daily; however if this dose is not tolerated, I suggest switching to 500 mg three times daily with food. I do NOT recommend glucosamine hydrochloride (glucosamine HCL) or N-acetyl glucosamine (NAG). The evidence generally supports using glucosamine SULFATE for pain and possibly slowing disease progression. But, keep in mind that glucosamine has primarily been studied for osteoarthritis of the knee.

It might not be as effective in other joints.

Take Home Point #3

You need to give the glucosamine 4-8 weeks to see if it will help or not. If not effective, or only partially effective, then change to DONA Glucosamine Sulfate or Xicil Glucosamine Sulphate (both by Rotta Pharmaceuticals). According to the Natural Medicine Comprehensive Database, “This product has been studied in clinical research. Based on this research, this product’s Effectiveness Rating is: LIKELY EFFECTIVE for osteoarthritis. You can find DONA here. (BTW, I have no financial or other ties to sites like this that I recommend to you.)

Take Home Point #4

Chondroitin sulfate appears to be effective for osteoarthritis when combined with conventional treatments (either glucosamine sulfate or glcosamine HCL – using ConsumerLab.com approved combination products such as Cosamine-DS, Spring Valley, Member’s Mark, or Elations Healthier Joints); however, there is more and better evidence for glucosamine SULFATE – and a significant cost differential. I recommend these combinations only for patients who have not responded to 8 weeks of the DONA glucosamine sulfate.

Take Home Point #5

Combination products of glucosamine plus chondroitin or glucosamine plus MSM or glucosamine plus chondroitin plus MSM are probably effective, but there is no reliable evidence that the combination is better than treatment with just glucosamine SULFATE alone.

Take Home Point #6

Based on research to date, SAMe sounds like a great alternative. But two things keep SAMe from moving into primetime: (1) poor product quality and (2) high cost.

Take Home Point #7

Other products look promising … cat’s claw, devil’s claw, stinging nettle. However, since these products work through the same antiinflam-matory mechanisms as current NSAIDs, they may not prove to offer any advantage. It’s way too soon to recommend them.

Products such as avocado-soybean unsaponifiables and cetylated fatty acids also look interesting and appear to hold some promise for improving symptoms. But, I think it’s still a bit premature to recommend them. I’ll be watching closely for more solid evidence.

Now, here are some of the details that I share with healthcare professionals. Thanks to the Natural Medicines Comprehensive Database and ConsumerLab.com for their websites which provide great information for me to share.

Abstract

This presentation will discuss an evidence-based evaluation supporting or refuting the use of a variety of natural medications (herbs, vitamins, and supplements) for joint symptoms, joint health, and bone health. In addition, we’ll review clinically useful and evidence-based sources of information for natural medications, as well as how to find and recommend quality substances.

Learning Objectives

After this discussion, attendees should be able to:

  1. Describe the natural medications used for osteoarthritis symptoms,
  2. Describe an evidence-based, trustworthy source of information for natural medications,
  3. Describe a independent quality testing lab of natural medications that can be used to recommend safe products, and
  4. Describe the evidence supporting or refuting the use of several natural medications for arthritis.

Osteoarthritis

Osteoarthritis can be very frustrating for patients because it can significantly interfere with an active lifestyle. Treatment choices are limited in range of options and in effectiveness. Ideally, non-drug therapies should be implemented first, when disease severity is mild.

These therapies can include:

  • exercise and weight loss,
  • dietary changes, and
  • physical therapy, braces, wraps/rubs, and other orthopedic devices.

Drug therapy should be considered for patients with moderate to severe symptoms or multi-joint disease.

Commonly Used Medicines for Osteoarthritis

Conventional Medicines

  • Acetaminophen (Tylenol)
  • Non-steroidal Anti-inflammatory Drugs (NSAIDs) — prescription and OTC (such as ibuprofen [Advil] or naproxen [Aleve])
  • Prescription COX-2 Inhibitors such as celecoxib (Celebrex)

Despite treatment with these agents, most patients often only achieve partial pain relief. And these approaches do nothing to slow down the disease process.

Some patients also worry about potential side effects related to taking these drugs, particularly after all the press generated by the COX-2 inhibitors and cardiovascular disease risk.

As a result, many patients turn to natural medicines with the hope of finding something that might:

  • relieve their pain,
  • be safe, and
  • help slow down the disease process.
  • In short … improve their condition.

As such, osteoarthritis is the most common condition for which patients turn to alternative medicines.

Commonly Used Natural Medicines for Osteoarthritis

  • Capsicum
  • Capsicum species
  • Cat’s claw
  • Uncaria guianensis
  • Devil’s claw
  • Harpagophytum procumbens
  • Ginger
  • Zingiber officinale
  • Indian frankincense
  • Boswellia serrata

Commonly Used Structure Modifying Agents for Osteoarthritis

  • Chondroitin sulfate
  • Glucosamine hydrochloride
  • Glucosamine sulfate
  • N-acetyl glucosamine

Commonly Used Natural Medicines containing Antioxidants for Osteoarthritis

  • Beta-carotene (supplements/foods)
  • Superoxide dismutase (SOD)
  • Vitamin C (supplements or foods)
  • Vitamin E (supplements or foods)

Commonly Used Miscellaneous Natural Medicines for Osteoarthritis

  • Avocado (Persea americana)
  • Cetylated fatty acids
  • Methylsulfonylmethane (MSM)
  • S-adenosylmethionine (SAMe)
  • Soybean oil (Glycine max)

Balancing Safety and Effectiveness — My Recommendations for Various Products

Recommend Against — Possibly Ineffective, even though likely safe

  • Vitamin E

Recommend Against — Insufficient Evidence of Safety or Effectiveness

  • N-acetyl glucosamine
  • Phellodendron

Don’t Recommend — Likely or possibly safe, but in-sufficient evidence of effectiveness

  • Ginger
  • Indian frankincense
  • Limbrel
  • MSM
  • Stinging nettle
  • Turmeric
  • Willow bark

Don’t Recommend — Possibly Safe and Possibly Effective

  • Avocado (with soybean oil)
  • Cetylated fatty acids
  • Beta-carotene containing foods
  • Cat’s claw
  • Devil’s claw
  • Glucosamine hydrochloride
  • SOD (injectable)

Caution — Likely Safe and Possibly Effective

  • Chondroitin sulfate
  • Vitamin C  containing foods

Recommend — Effective and likely safe

  • Capsicum (topical)
  • Glucosamine sulfate
  • SAMe

Now, for more details on these products.

Capsicum (topical)

Capsicum peppers contain the constituent “capsaicin.” It’s this compound that makes the peppers fiery hot. Capsaicin is approved by FDA and Health Canada as an OTC drug. Capsaicin is the active ingredient in Zostrix and other OTC products used topically for pain. Topical capsaicin is effective for temporary symptom relief of pain related to osteoarthritis

Repeated use of capsaicin works as a counterirritant, depleting and inhibiting the reaccumulation of substance P (associated with the process of pain transmission in OA) in sensory nerves.

Practice Pearl: I tell patients to allow at least 3 days of multiple daily capsaicin applications to achieve significant pain relief.

Glucosamine sulfate

An optimal treatment for osteoarthritis would be one that modifies the joint structure and returns the joint to its normal, healthy state. So far, medicine has not been able to produce such a therapy. Some researchers think glucosamine might be a candidate.

There’s a lot of hype generated about supplements. In the case of glucosamine, some of it is deserved. But the research has been conflicting and confusing. Over 20 clinical studies lasting up to 3 years and enrolling over 2500 patients have been conducted, evaluating glucosamine for OA. The vast majority of these studies evaluated glucosamine SULFATE for osteoarthritis of the KNEE.

Overall, when the findings of these studies are pooled, glucosamine appears to reduce pain scores by 28% to 41%, and to improve functionality scores by 21% to 46%.

Also, for pain relief, GS 1500 mg qd appears to be comparable to

  • … ibuprofen 1200 mg daily.
  • … piroxicam (Feldene) 20 mg daily …
  • … acetaminophen 1000 mg three times daily.

The effects of GS appear to last longer than these analgesics, but the analgesics work much faster. NSAIDs relieve symptoms within 2 weeks. GS takes 4-8 weeks.

Researchers have speculated for years that GS could potentially modify joint structure and possibly reverse or slow disease progression.

  • In 2001, a study published in Lancet showed that GS might have this effect. Researchers measured joint space narrowing in patients taking glucosamine sulfate. After 3 years of treatment, these patients did not have further joint space narrowing, suggesting that GS might have slowed or stopped disease progression.
  • In 2002, a similar 3-year study published in the  Archives of Internal Medicine showed that patients taking GS did not have increased narrowing of the joint space, again suggesting that GS slows disease progression.
  • A meta-analysis of study results suggests that patients taking glucosamine sulfate 1500 mg/day have 54% reduced risk of osteoarthritis disease progression.
  • A retrospective analysis of patients who took glucosamine sulfate for 1-3 years also showed that glucosamine sulfate is associated with a 57% decreased risk of total knee replacement.

Although most of the research has been positive, especially related to glucosamine sulfate, some research findings have been negative. The reason for the discrepancies is not completely known; however, some experts suspect that different methodologies for assessing improvement, different product formulations, and perhaps different patients have contributed.

The vast majority of glucosamine sulfate research with positive outcomes has been done using a specific brand of glucosamine sulfate called Dona (Rotta Pharmaceuticals, Italy), which costs about $1 per day.

In fact, according to one analysis, when findings from studies using the Dona formulation are pooled, GS appears to be effective; however, when findings using other formulations are pooled, GS appears to be ineffective.

Practice Pearls:

  • Glucosamine does not have a significant effect on insulin sensitivity and does not seem to increase A1C in type 2 diabetes.
  • Glucosamine is derived from the exoskeletons of shrimp, lobster, and crabs, so there is concern that glucosamine products might cause allergic reactions in people who are sensitive to shellfish.
  • There are no documented reports of allergic reaction to glucosamine in shellfish allergic patients.
  • There is also some evidence that patients with shellfish allergy can safely take glucosamine products.

Chondroitin Sulfate

Like glucosamine, chondroitin appears to serve as a substrate for the formation of the joint matrix structure. Chondroitin sulfate alone seems to be effective for improving symptoms of OA when used in conjunction with analgesics.

Trials evaluating a specific blend of glucosamine hydrochloride plus chondroitin sulfate (CosaminDS, Nutramax) have also been positive.

Preliminary evidence also suggests that chondroitin might slow joint space narrowing. However, a 2006 study in the New England Journal of Medicine (GAIT) found that glucosamine HCL or chondroitin or the combination of both was ineffective for relieving symptoms of osteoarthritis.

In a subgroup of patients with more severe osteoarthritis, the combination provided modest relief, while the single agents did not. Some have interpreted this study to suggest that the COMBINATION of glucosamine hydrochloride plus chondroitin could be used for more severe osteoarthritis.

SAMe

You’ve probably been asked about SAMe (s-adenosylmethionine). It’s most often considered a natural medication for depression. But it is also commonly used for joint pain and osteoarthritis.

SAMe is significantly more effective than placebo, and as effective as NSAIDs, including the COX-2 inhibitor celecoxib (Celebrex), for improving symptoms of OA.

Based on research to date, SAMe sounds like a great alternative. But two things keep SAMe from moving into primetime:

  • poor product quality and
  • high cost.

Tests on SAMe products show that many contain little or none of the active ingredient. Furthermore, patients taking the typical dose (200 mg tid) would have to pay up to $120 per month.

For patients who try SAMe, the butanedisulfonate salt has the highest bioavailability (5%) and is more stable than the tosylate salt which only has 1% bioavailability and there are concerns about stability.

Practice Pearl: SAMe has serotonergic effects. Advise caution in patients with bipolar disorder … it can cause them to convert from depression to manic state. Also, combining SAMe with other serotonergic agents such as antidepressants might lead to symptoms of serotonin syndrome.

How do you find clinically useful, evidence-based, and trustworthy information on natural medications? How do you find safe natural medications to recommend? Especially since natural medications are NOT regulated in the United States

So, how do you find product:

  • that actually contains what the label claims?
  • that is bioavailable?
  • that is NOT contaminated?

ConsumerLab.com Findings:

  • Although prior testing has shown the vast majority of glucosamine products to meet label claims, glucosamine from shellfish such as shrimp and crabs may potentially be contaminated with lead. Among the 21 glucosamine supplements ConsumerLab.com selected and tested, only 16 (64%) met quality standards and FDA labeling requirements. In other words, 36% FAILED testing.
  • Chondroitin is an ingredient with which ConsumerLab.com has found problems in the past — with products not always providing the amount claimed of this expensive ingredient.
  • Among the 19 products claiming to contain MSM, glucosamine, and/or chondroitin, 5 (26%) FAILED testing.
  • Failed for providing less ingredient than labeled, lead contamination, failure to properly break apart, or other mislabeling.
  • All eight of the SAMe supplements that CL selected for testing passed the evaluation. This is considerably better than results in 2003, in which one product was found with only 30% of its listed amount, and in 2000, when nearly half of the products were short on SAMe.

Conclusion

  • There are limited options for patients with osteoarthritis.
  • Many experts, including myself, now consider glucosamine SULFATE a first-line treatment. Others remain skeptical.
  • Nonetheless, the evidence generally supports using glucosamine SULFATE for pain and possibly slowing disease progression.
  • Don’t recommend glucosamine HYDROCHLORIDE or NAG.
  • Keep in mind that glucosamine has primarily been studied for osteoarthritis of the knee. It might not be as effective in other joints.
  • SAMe and perhaps chondroitin also seem to be effective. However, due to product quality control problems and high costs, they may not be as practical an option for most patients.
  • Other products look promising … cat’s claw, devil’s claw, stinging nettle. However, since these products work through the same antiinflam-matory mechanisms as current NSAIDs, they may not prove to offer any advantage. It’s way too soon to recommend them.
  • Products such as avocado-soybean unsaponifiables and cetylated fatty acids also look interesting and appear to hold some promise for improving symptoms. But, it’s still a bit premature to recommend these. I’ll be watching closely for more solid evidence.
  • Antioxidants in pill form probably won’t help. Instead, I advise patients to boost consumption of vegetables and fruits that provide lots of vitamin C, vitamin E, and beta-carotene. High dietary intake of foods that contain these antioxidants might slow progression of osteoarthritis and have other benefits.

Bibliography

GAO study reveals contaminants in herbal supplements

Today I’m in Orlando, Florida, where I’ll be speaking to the Florida Academy of Family Physicians on this exact issue. And, I find that most of my patients and most physicians are simply unaware of the danger. The New York Times is reporting, “Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found.”

Although the “levels of heavy metals – including mercury, cadmium and arsenic – did not exceed thresholds considered dangerous,” almost half of them “contained pesticide residues that appeared to exceed legal limits.”

Notably, “Dr. Joshua M. Sharfstein, principal deputy commissioner of the Food and Drug Administration, said in an interview that he was not concerned about the safety of the supplements tested by the GAO investigators.”

Still, Sharfstein added that “the FDA had increased enforcement actions against supplements spiked with prescription drugs.”

One ginkgo biloba product had labeling claiming it could treat Alzheimer’s disease (no effective treatment yet exists), while a product containing ginseng asserted that it can prevent both diabetes and cancer, the report said.

At least nine misleading health claims were noted in the report. These claims included assurances that the products could cure diseases, such as diabetes, Alzheimer’s disease and cancer, investigators said. In one instance, a salesperson claimed that a garlic supplement could replace blood pressure drugs, the Times reported.

Products that purport to treat or relieve disease must go through strict reviews because they are considered drugs by the U.S. Food and Drug Administration.

HealthFinder reported, “The report findings were to be presented to the Senate … before discussion begins on a major food safety bill that will likely place more controls on food manufacturers.

“How tough the bill will be on supplement makers has been the subject of much lobbying, but the Times noted that some Congressional staff members doubt manufacturers will find it too burdensome.

“‘The oversight of supplements has improved in recent years,’ said Sen. Herb Kohl (D-Wisconsin), who will preside over Wednesday’s hearing. However, the FDA needs the authority and tools to ensure that dietary supplements are as safe and effective as is widely perceived by the Americans who take them, he told the Times.’

One witness scheduled to testify is a friend of mine. Dr. Tod Cooperman, president of ConsumerLab.com, said supplements with too little of the indicated ingredients and those contaminated with heavy metals are the major problems.

In testing more than 2,000 dietary supplements from some 300 manufacturers, his lab has found that one in four has quality problems, the Times said.

According to the newspaper’s account, the proposed food safety bill could require that supplement manufacturers register annually with the FDA and permit the agency to recall potentially dangerous supplements.

It’s estimated that half of adult Americans take vitamin supplements regularly, and about a quarter take herbal supplements at least occasionally. Annual sales are about $25 billion a year, the Times said.

So, what can you do to be sure that any natural medication (herb, vitamin, or supplement) you take is safe. I recommend you consider reviewing those you take at ConsumerLab. For less than the price of a bottle of vitamins, you can find brands of natural medications that have been independently testing for safety.

I highly recommend the site.

Tests of Protein Powders and Drinks Show Some Lead Contamination

New tests by one of my favorite natural medicine web sites, ConsumerLab.com, found most protein powders, shakes and drinks to meet their nutrient claims, but two products were contaminated with lead (6 to 18 mcg per day) and a third product contained four extra grams of sugar. The report provides test results for twenty products including those used for body building, meal replacement, sports recovery/endurance, and dieting.

“What sets these products apart from other types of supplements and energy foods is protein — typically about 10 to 30 grams per serving,” said Tod Cooperman, MD, President of ConsumerLab.com. Adults need about 60 grams of protein per day and more if physically active.

“Fortunately, none of the products were found to contain melamine, a cheap and toxic substitute for protein, but lead contamination and undeclared sugars were an issue with some products.”

The new report provides results and comparisons for twenty products — seventeen selected by ConsumerLab.com and three that passed ConsumerLab.com’s Voluntary Certification Program.

Products include those made with whey protein (concentrates, isolates, and hydrolysates), soy protein, and rice protein.

Reviewed are products from ABB (Mass Recovery), Allmax, BioPlex Nutrition, Body Fortress, BSN Syntha-6, Cytomax, EAS, Endurox, Genisoy, Gold Standard, Jay Robb, Metagenics, Nature’s Plus (Spiru-Tein), NutriBiotic, Power Bar, Reliv, Slim-Fast (Optima), Solgar, TwinLab, and Universal Nutrition.

The report also provides information regarding nutritional requirements and the relative pros and cons of the various types of protein used in these supplements.

ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.

Newly released test show most Milk Thistle supplements are substandard

White Plains, New York — December 2, 2009 — A recent review by ConsumerLab.com of ten milk thistle supplements showed that only one met ConsumerLab.com’s quality standards.  Two products failed to properly list the part of the milk thistle plant used — a FDA requirement.  Among the remaining supplements, only one contained the expected amount of silymarin compounds, which are believed to be the active constituents of milk thistle. Studies suggest silymarin may be helpful in type 2 diabetes and, possibly, certain liver conditions.  While most products claimed that their milk thistle extracts were standardized to 80% silymarin, ConsumerLab.com found actual amounts to range from 47% to 67%.  Sales of milk thistle in the U.S. have climbed for several years, reaching $95 million in 2008 according to the latest figures from Nutrition Business Journal.
ConsumerLab.com’s Vice President for Research, Dr. William Obermeyer, a former scientist with the U.S. Food and Drug Administration (FDA), suggested supplement makers may be relying on non-specific tests, such as UV spectrophotometric analysis, that can falsely inflate a product’s silymarin content by counting other compounds that are not silymarin. In contrast, ConsumerLab.com used a highly specific HPLC method to test the products.  Some ingredient suppliers offer both a higher priced and a lower priced milk thistle extract. The higher cost product is certified with the HPLC test, while the lower cost product is certified with the non-specific UV test.  The FDA does not set standards for the quality or testing of herbal supplements, so manufacturers may choose either form of milk thistle.  Consumers normally have no way of knowing which form they purchase.
The Product Review of Milk Thistle Supplements can be found at www.consumerlab.com/results/milkthistle.asp and includes results, reviews, and comparisons of ten supplements selected by ConsumerLab.com.  The Review provides information on how to choose and use these supplements. Brands included in report are 1Fast400, Enzymatic Therapy, Finest Natural, Jarrow Formulas, Natural Factors, Nature’s Plus, Nutrilite, Pharmex, Smart Basics (Vitacost.com), and Whole Foods.
ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. Reviews of other popular types of supplements are available from www.consumerlab.com.  Subscription to ConsumerLab.com is available online. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.

A recent review by ConsumerLab.com of ten popular milk thistle supplements showed that only ONE met ConsumerLab.com’s minimum quality standards.

Two products failed to properly list the part of the milk thistle plant used — a FDA requirement. Among the remaining supplements, only one contained the expected amount of silymarin compounds, which are believed to be the active constituents of milk thistle.

Studies suggest silymarin may be helpful in type 2 diabetes and, possibly, certain liver conditions.

While most products claimed that their milk thistle extracts were standardized to 80% silymarin, ConsumerLab.com found actual amounts to range from 47% to 67%.

Sales of milk thistle in the U.S. have climbed for several years, reaching $95 million in 2008 according to the latest figures from Nutrition Business Journal.

ConsumerLab.com’s Vice President for Research, Dr. William Obermeyer, a former scientist with the U.S. Food and Drug Administration (FDA), suggested supplement makers may be relying on non-specific tests, such as UV spectrophotometric analysis, that can falsely inflate a product’s silymarin content by counting other compounds that are not silymarin.

In contrast, ConsumerLab.com used a highly specific HPLC method to test the products.

Some ingredient suppliers offer both a higher priced and a lower priced milk thistle extract. The higher cost product is certified with the HPLC test, while the lower cost product is certified with the non-specific UV test.

The FDA does not set standards for the quality or testing of herbal supplements, so manufacturers may choose either form of milk thistle. Consumers normally have no way of knowing which form they purchase.

An abstract of the Product Review of Milk Thistle Supplements can be found here, however, the full review, including the full results, reviews, and comparisons of ten supplements selected by ConsumerLab.com is only available by subscription.

The Review provides information on how to choose and use these supplements. Brands included in report are 1Fast400, Enzymatic Therapy, Finest Natural, Jarrow Formulas, Natural Factors, Nature’s Plus, Nutrilite, Pharmex, Smart Basics (Vitacost.com), and Whole Foods.

ConsumerLab.com is one of my favorite web sites for evidence-based information on natural medications (herbs, vitamins, and supplements) and a leading provider of consumer information and independent evaluations of products that affect health and nutrition.

Reviews of other popular types of supplements are available from www.consumerlab.com. Subscription to ConsumerLab.com is available online here. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.

You may also enjoy these blogs:

You can also read more in my book Alternative Medicine: The Christian Handbook. You can see the book’s Table of Contents and Chapter One by clicking on these links.

Trustworthy consumer websites for NATURAL MEDICATION info (herbs, vitamins, and supplements)

How can you make informed choices about natural medications (herbs, vitamins, and supplements)? For one thing, don’t get your information from ads or labels! There is almost no regulation in the U.S. on these products. So, where can you turn?

More Information: Continue reading

The Top 10 Natural Products of the Year

As you’ve read in my recent health headline postings, alternative medicines are used by 38 percent of American adults and nearly 12 percent of children, according to a large national survey done in 2007 that was released last week by the National Center for Complementary and Alternative Medicine (NCCAM). Natural products were the most popular alternative treatment used by the nearly 24,000 adults and more than 9,400 children interviewed for the survey. But, what were the top natural products used in 2007?

More Information: Continue reading

Study Links Herbal Medicines to Lead Poisoning. How can you find safe herbs?

Fox News is commenting on a study published in the August 27 issue of JAMA in which medical researchers say that one-fifth of Ayurvedic herbal medicines sold on the Internet contain dangerously high levels of lead, arsenic and mercury. How’s a consumer to protect themselves?

My Take? Continue reading

Red yeast rice, fish oil fight high cholesterol

Reuters Health is reporting new research showing that a regimen of supplements and lifestyle coaching is just as effective as a statin medication for reducing levels of low-density lipoprotein (LDL) or “lethal” cholesterol. Not only that, the combination was shown to be more effective in helping people lose weight.

My Take? Continue reading

Dr. Walt’s Take on the Health Headlines – June 6, 2008

Here are my takes on some of today’s health headlines, including one that is, in my opinion, being blown way out of perspective:

Mercury teeth fillings may harm some: FDA

Silver-colored metal dental fillings contain mercury that may cause health problems in pregnant women, children and fetuses, the Food and Drug Administration said on Wednesday after settling a related lawsuit. Continue reading