Herbal Supplements: What Are You Actually Taking?

The next time you reach for a bottle of herbal supplements, can you really be sure you’re getting what the label says?

Herbal supplements are derived from natural sources like plants, fungi or other organic materials, and herbal or dietary supplements are meant to be just that—supplements to one’s health. For example, garlic doesn’t cure high cholesterol, but evidence suggests garlic has a few cardiovascular benefits, making it just one of many sought-after supplements for its perceived benefits.

However, something being “natural” doesn’t always make it safe. “Herbs can be very powerful drugs. It’s not like eating a salad. You can’t just look at them like they’re benign,” says Bryan Coehrs, PharmD, RPh, ProMedica Pharmacy.

Unlike medicines, which must face strict FDA guidelines, vitamins, minerals and supplements bypass a large portion of government regulation. Supplements are allowed to enter the market as long as they don’t claim to treat or cure a disease or disorder, and federal law doesn’t require that a product be proven safe before it is publicly marketed. What’s more, the responsibility to insure product safety falls on the manufacturer, who must comply with all other product safety regulations. Only after a product enters the market does the FDA monitor and investigate potentially harmful or misbranded products through adverse event reporting from supplement manufacturers, medical professionals and the public.

“The onus is on the government to disprove the supplement,” says Coehrs. “I could start a company in my garage where I put grass clippings in capsules and just start selling on Amazon tomorrow. It really worries me that people put stuff in their bodies not knowing what they’re really getting.”

USPEven though the FDA doesn’t test supplements, The US Pharmacopeial Convention (USP) is an independent organization that helps determine whether supplements meet certain safety and quality standards. USP tests to insure supplements contain the ingredients listed, as well as the supplement’s potency and how it’s processed by the body. The organization also tests for harmful levels of heavy metals, pesticides, microbes, and other contaminants; and determines if a product was made according to current FDA Good Manufacturing Practices. If a product meets each of these standards, it is awarded the USP Verified mark.

“They’re in no way a regulatory body,” says Coehrs, “but when they put their stamp on something they’re determining it’s a pure product. You know you’re getting what the manufacturer says because USP has tested it. Whether or not there’s something in there that’s going to work is another story.”

Now, back to our good friend garlic. Despite widely held beliefs about garlic’s benefits, a conflicting study funded by the National Center for Complementary and Integrative Health, an institute of the National Institutes of Health, found no long-term effect on cholesterol levels. Inconsistent studies and testing methods, coupled with the potential for a product’s inconsistent quality, makes determining whether or not a supplement is effective a tricky task.

“I definitely believe there are controlled studies that prove there is clinical benefit for some supplements. The problem is because there’s very little standardization and government regulation, I can never guarantee you’re getting what they say you’re getting in the product. We don’t advocate for supplements, but we don’t deny they have medical benefits,” says Coehrs, adding that for every supplement, there is a prescription medication proven to treat an ailment and treat it more effectively.

Coehrs stresses the importance of telling your doctor and your pharmacist about any supplements you may be taking. Some supplements such as St. John’s Wart, which some believe aids mental wellbeing, have been known to cause adverse reactions when taken with other medications.

“Pharmacists are experts on how supplements are metabolized and can determine if it will cause other drugs to become toxic. The herb might not itself be harmful, but it could cause the other drugs to harm you,” says Coehrs. “Treat a supplement as if it’s any real drug and make sure you’re asking the right questions before you put it in your body.”

Do you have a question about supplements? Leave your question in the comments below.

**Editor’s Note: A previous version stated vitamins and minerals met the same FDA guidelines as medications.