Study warns: Millions of Americans may be taking toxic dietary supplements

In this new study, researchers from Baylor College of Medicine led by Dr. Maya Balakrishnan found that the most common reasons for using herbal products were to improve or maintain health, prevent health problems, or boost the immune system. They report that many people use these products to treat or prevent certain conditions, such as osteoarthritis, fatigue, or menopausal hot flashes. The team also found that most users decide to take these supplements on their own, without consulting their doctor.

The researchers used data from NHANES, a national cross-sectional survey of the U.S. population collected between January 2017 and March 2020, and included population estimates from the 2020 U.S. Census for their study.

In the cohort of 9,685 adults, the mean age was 47.5 years. Of these participants, 51.8% were women, 62.2% were white, 11.5% were black, and 16.3% were of Mexican or non-Mexican Hispanic descent.

The researchers estimated that at least 15.6 million adults in the United States have taken at least one of six potentially liver-toxic herbal products within the past 30 days.

According to the results, users of the six herbal and nutritional supplements studied by the researchers were significantly older. Adjusted odds ratios indicate higher use among those aged 40 to 59 (OR 2.36) and those over 60 (OR 3.96). They also had a higher level of education (OR 4.78) and were more likely to suffer from arthritis (OR 2.27) than non-users.

26.8% of turmeric users took it for joint health or arthritis. Green tea users reported having more energy (27.2%), while 70% of garcinia cambogia users were seeking weight loss. Black cohosh users used it primarily for hot flashes (84.2%), and 90% of those taking red yeast rice did so for heart health.

Regulations for food supplements

In the United States, herbal and dietary supplements (HDS) are regulated as foods, not as disease treatments. The FDA does not require ingredient reviews or safety studies unless the product contains a novel chemical. Current studies show significant discrepancies between product labeling and actual contents, and standardization of herbal products is difficult due to environmental and production variability.

The number of HDS products has increased dramatically from 4,000 in 1993 to around 80,000 in 2022, with many users relying on the benefits offered to them on the market rather than professional advice. The researchers warned that it is crucial for the public to be aware that most botanicals in supplements are much more concentrated than in their natural form.

Given the limited regulatory oversight of herbal products, Balakrishnan’s team recommends that doctors conduct a comprehensive medication and HDS history when evaluating patients with unexplained symptoms or liver problems. Given the increasing popularity of these products, they called on government agencies to tighten regulation of the production, marketing, testing and monitoring of these supplements.