"We're urging clinicians to remain alert to the possibility that patients may be inadvertently exposed to experimental stimulants when consuming weight loss and sports supplements," said Dr. Pieter Cohen, Associate Professor of Medicine at Harvard Medical School, Internist at Cambridge Health Alliance and a co-author of the study, in a press release from NSF. "We're talking about active pharmaceutical stimulants that have not been approved by the U.S. FDA for oral use as either prescription medications or dietary supplements. These ingredients have no place in dietary supplements."
John Travis, Senior Researcher at NSF International and co-author of the study, added: "These hidden stimulant cocktails have never been tested in humans and their safety is unknown. You never want to find unlabeled ingredients in supplements, but it is especially concerning to find these strange brews of experimental stimulants in products that are readily available inthe United States."
The Council for Responsible Nutrition took issue with aspects of the analysis. “This report continues to tell an unfortunate but unsurprising truth about the internet: If researchers, like Dr. Pieter Cohen, specifically look online for products labeled to contain an illegal ingredient, they are not only likely to find them but other illegal ingredients as well," said Steve Mister, CRN President & CEO. “The small collection of products identified in the March 23 report certainly does not represent the mainstream sports nutrition and weight management categories. The products identified in the analysis are not legal dietary supplements but illegal products that masquerade as supplements, hoping to evade detection."
Mister stressed the difference: "Legitimate dietary supplements in the sports nutrition and weight management categories—the ones most consumers would encounter in local stores or on mainstream shopping platforms—are safe, beneficial, and help consumers meet their fitness and weight goals. As with other dietary supplements, these products are meant to complement smart lifestyle choices, such as eating a healthy diet, exercising regularly, and getting enough sleep."
As Mister pointed out, reputable natural products serve as gatekeepers to help safeguard customers: “This report serves as a reminder for consumers that it matters where one purchases dietary supplements. The illegal products identified in the report come from unscrupulous online sellers, unlikely to be found on store shelves of reputable retailers or mainstream online platforms. CRN reminds consumers to seek products from nationally recognized brands or store brands from trusted retailers. Avoid products that promise extreme results, research companies and supporting science, and always talk to a healthcare practitioner for advice on responsible supplement use."
A key point to the analysis that CRN agrees with: stronger, more proactive enforcement action is needed to protect the public from adulterated products in the market. "When illicit products are brought to the agency’s attention, FDA must act more quickly and decisively, both to establish a deterrent and to protect consumers," Mister said. "FDA lacks a system to efficiently track products that come to market, so CRN continues to advocate for a mandatory product listing as a solution. This would allow FDA to identify new products and act more quickly to remove illegal products from the market."
Related: CRN Launches New Supplement OWL Website Vitamin C, Zinc Don’t Help COVID-19? CRN Dismisses “Weak” JAMA Study Building Trust: Third-Party Lab Testing and CertificationsCRN offers tools that can help in the meantime. "Regulators and consumers should visit CRN’sSupplement OWL(Online Wellness Library) to easily access important product and manufacturer information. This self-regulatory initiative serves as a model for mandatory product listing and showcases brands that choose to be accountable for their labels and ingredients. Consumers can also visitCRN’s websitefor tips and resources about purchasing dietary supplements.”
For its part, NSF noted that the research points to the need for independent testing and certification of dietary supplements. To earn NSF certification, products are tested for product formulation, label claims and harmful levels of specific contaminants and potentially harmful ingredients, according to the NSF release, which further explains that NSF certified dietary supplements must be produced in a manufacturing facility that is inspected twice a year to comply with the U.S. FDA's Good Manufacturing Practice (GMP) requirements. earn NSF certification, products are tested for product formulation, label claims and harmful levels of specific contaminants and potentially harmful ingredients. Products certified under NSF's Certified for Sport program must meet additional requirements and are screened for 280 athletic banned substances.