Written Jul 29th, 2014 by Franco Varriano
[Guest Post] Protecting Your Patients from Counterfeit Supplements by Dr. Warren Brown, ND
Dr. Warren Brown is back again with another informative article on supplements - this time on counterfeit supplements. Be sure to check out his previous article on 3 things you need to know about supplement product quality. He is a naturopathic physician and former member of the Bastyr Center for Natural Health’s Formulary Review Committee.
Not too long ago, the process of counterfeiting was limited mostly to currency, government documents, works of art, and designer apparel. The allure to counterfeiters is simple: maximize profits by stealing the brand equity or authenticity of one product and apply that value to a cheaper, counterfeit product. Unfortunately, counterfeit goods are highly profitable and usually very difficult to identify. Furthermore, there is a relatively new and dangerous trend: the counterfeiting of foods, medications, and supplements.
In January of last year, ABC news reported on the rising prevalence of fake ingredients in foods such as fruit juice, spices, and olive oil. The report indicated that some of these products contained the advertised ingredients but were diluted with cheaper ingredients in such a way that they could be obscured. For example, it was determined that some brands of pomegranate juice had been diluted with pear juice - a cheaper alternative - in order to maximize profits and fool unsuspecting consumers. Some brands of olive oil and spices were also affected. These products had been diluted and substituted with cheaper ingredients.
According to the United States Pharmacopeial Convention (USP), it is estimated that 7% of the U.S. food supply contains fraudulent ingredients. The problem has become so widespread that the USP has developed the Food Fraud Database in an effort to address this issue (1). Numerous government agencies, including the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA) and World Health Organization (WHO), have acknowledged the problem of counterfeit medications.
The Partnership for Safe Medicines reports that the most commonly counterfeited medications are: cardiovascular drugs, antibiotics, cancer drugs, drugs to treat erectile dysfunction, weight loss drugs, pain killers, psychiatric medications, and various medications used to treat conditions like HIV, diabetes, and Alzheimers. Counterfeit medications are not only ineffective for patients, but may even be harmful since they are often contrived using industry byproducts (2).
Counterfeit dietary supplements generally follow one or both of the following patterns:
- A product may contain ineffective, inert, unknown, or harmful ingredients. In November of last year, Natural News, a consumer advocacy group and natural product company, reported that some third-party sellers on Amazon.com were selling counterfeit dietary supplements to unsuspecting consumers. In the report, Natural News claimed that their own brand of Turmeric and Clean Chlorella were being counterfeited and sold by a third party seller on Amazon.com. Unfortunately, it was not clear whether any counterfeit product was recovered or examined. Part of the problem is that third party sellers on Amazon.com and similar websites are very difficult to identify, which allows them to operate at a level of accountability only equivalent to the criteria used to establish their seller rating (3).
- A product may be contaminated with pharmaceuticals. According to the FDA, certain lot numbers of the popular male sexual health supplement ExtenZe were found to contain sildenafil and/or tadalafil, FDA-approved medications for the treatment of erectile dysfunction. A recall for the contaminated lots was issued and the makers of ExtenZe claim to have corrected the issue (4). Similar issues with male hormone products have been documented. In 2008, the Journal of Mass Spectrometry reported “15% of non-hormonal dietary supplements were contaminated with anabolic-androgenic steroids.” (5)
Because it is often very difficult to distinguish between counterfeit and genuine products, the best way of dealing with the issue is to lower your risk of being exposed. There are two things you should keep in mind in order to protect yourself and your patients from purchasing counterfeit dietary supplements:
- Be Wary of Deep Discounts – The bottom line here is that high quality and low price are not typically compatible in the marketplace. Professional product lines are rarely found at clearance prices unless they are either expired or counterfeit.
- Use Trusted Sources – Whenever possible, buy your products either directly from the manufacturer or from an authorized distributor such as Emerson Ecologics or Natural Partners. To make sure your distributor is authorized by the manufacturer, you may want to call the manufacturer. If you do not carry physical inventory in your clinic, but would like to offer your patients the convenience of online shopping and the security of buying from an authorized distributor, consider setting up a virtual dispensary through Fullscript.
For more information on counterfeit medications, as well as the latest updates, please visit the FDA’s website
Dr. Warren Brown is a naturopathic physician and former member of the Bastyr Center for Natural Health’s Formulary Review Committee. His practice in Suwanee, Georgia focuses on sports medicine and men’s health.