Natural, organic, chemical free, and homeopathic are all buzzwords people tend to associate with safety and efficacy. In many cases this is far from the truth. Many people look for this terminology on packaging and product descriptions when purchasing dietary supplements and vitamins. This class of natural products intended to aid health can be broadly called nutraceuticals or ultraceuticals. People buy these products for countless reasons, often due to a lack of trust in pharmaceutical products, low cost, privacy, or a desire to avoid medication side effects. Nutraceuticals are not regulated by the Food and Drug Administration or any other agency to ensure their claims or ingredients are as advertised. What is really in them? What do they really do?
Since the 1990s, researchers and organizations have failed in standardizing regulation for nutraceuticals. The market for these products has grown exponentially in recent years. Amazon, eBay, and other online international retail stores have become a major platform for manufacturers to sell nutraceuticals directly to consumers. These online retail outlets empower consumers to choose from an enormous selection of products from all over the world. Usually, more choice is a good thing for a consumer, but the absence of regulation may attract manufacturers who cut corners to profit from this lucrative market.
Pesticides, heavy metals, harmful bacteria, unreported active pharmaceutical ingredients, and fraudulent adulterated pharmaceuticals could be and have been found lurking in these products…
While many of these products may contain and do what they say, no one is checking. Pesticides, heavy metals, harmful bacteria, unreported active pharmaceutical ingredients, and fraudulent adulterated pharmaceuticals could be and have been found lurking in these products, as reported by our research group previously for male enhancement and weight loss nutraceuticals. Transparency in labelling is vital to consumer health as natural herbs and food may impact how medications work or cause allergic reactions. Moreover, manufacturing standards vary greatly between countries, as most of these products are imported. Although the United States has clearly defined standards for what is acceptable in drugs and food, these regulations don’t exist for nutraceuticals.
Many nutraceuticals offer a seemingly simple fix to people’s insecurities that can be discreetly ordered online: weight loss, memory, energy, and erectile dysfunction. Though rarely discussed, erectile dysfunction is a common problem with many clinical and psychological causes. The pharmaceuticals available to treat erectile dysfunction alter blood pressure, so many health conditions prevent its safe use. Consequently, men look to nutraceuticals for a safe alternative. What they don’t know is that many contain pharmaceutical ingredients, some at dangerous doses, as shown in Figure 1. This may give some weight to the claims of efficacy, but it puts the health and safety of men using them at risk of serious side effects and even death, which is a major public health concern.
Manufacturers and online retail outlets have a responsibility to advertise honestly and ensure the safety and efficacy of their product. Companies that profit from selling these products should be held accountable for illegal therapeutic label claim and any adverse effects that may result.
The lack of legislation to protect the people who use nutraceuticals borders on negligence. As the market for nutraceuticals rapidly expands, it is imperative to implement a set of standards to protect health. Consumers should shop at their own risk and use a healthy dose of skepticism when purchasing these of products.
Flowchart (courtesy of the authors) showing steps to help determine quality of a supplement. Figure 1: (courtesy of the authors) Average amount of Sildenafil citrate (mg) in individual batches of Viagra®, Tiger King, Plant Viagra, Hercules, Natural Viagra and Herbal Viagra analyzed via High Performance Liquid Chromatography (HPLC). Sildenafil citrate is a phosphodiesterase inhibitor type 5 used clinically for erectile dysfunction and can lead to severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision.
Feature image: real444/iStock.