The Food and Drug Administration (FDA) oversees supplements, so any vitamins and herbs you buy for arthritis symptoms, whether at the store, online or even at your doctor’s office must be safe – right? Not necessarily. Although every over-the-counter (OTC) drug must have been proven safe and effective before it’s released, FDA regulations only require that supplements must not be “adulterated” or “misbranded,” and asking manufacturers and distributors to follow safety requirements of the FDA and the Dietary Supplement Health and Education Act (DSHEA) of 1994.
If the FDA uncovers violations, it issues a warning or may recall the product. “But the process can take months and even years. In the meantime, potentially harmful products continue to be sold,” says Pieter Cohen, MD, an internist at Cambridge Health Alliance, assistant professor of medicine at Harvard Medical School in Boston and a leading expert on supplement safety. (FDA.gov reveals just a handful of recalls in the past year, for issues including salmonella contamination and undeclared ingredients.)
In contrast, testing by third party organizations often reveals contamination and other issues. For example, a recent ConsumerLabs. com review of 18 popular supplements used to treat osteoarthritis symptoms – including different brands of glucosamine, chondroitin, methylsulfonylmethane (MSM) and boswellia –revealed that three were contaminated with small amounts of lead, did not dissolve properly or did not contain the ingredients they claimed to. But the overall quality of many supplements commonly used for arthritis, particularly glucosamine and chondroitin, has improved, says ConsumerLab.com president Tod Cooperman, MD. “Supplement companies seem to be responding to consumer pressure as well as tests like ours,” he notes. “Consumers and retailers are asking for quality-proven products that are safe and do what they say they do – and these products do exist,” says Lisa Thomas, general manager of Dietary Supplements & Sports Nutrition Programs at NSF International, a Chicago-based nonprofit organization focused on consumer safety.
What to Look for and What to Avoid
Avoid any product that makes health claims. “Because of DSHEA, a supplement is legally permitted to say a product ‘helps with joint health,’ even if there’s no proof that it does,” says Dr. Cohen. But you should avoid ones that specifically claim to treat the disease.
Choose single-ingredient products. “Multiple ingredient products, especially herbal blends, have the highest rates of contamination,” says Dr. Cooperman. Be wary of “proprietary blends,” advises Thomas. “It means that the supplement company doesn’t have to list the exact amount of each individual ingredient, so you don’t know exactly what you’re getting.”
Go for tried and true, not hot and new. “We see the most problems with new ingredients that are hyped or become popular very quickly,” says Dr. Cooperman. A hot new ingredient may be scarce or expensive. “As a result, companies may purchase poor quality ingredient, put in less ingredient than listed, and may not know how to properly formulate the product so that it is stable as well as able to properly release the ingredient,” he adds.
Look for the right stamps of approval. Dr. Cohen recommends opting for products that bear the United States Pharmacopeia (USP) and/or the NSF International seal; both organizations conduct stringent testing for safety and accuracy.