How to Evaluate Dietary Supplements for Safety and Effectiveness

In order to stay in remission, I work with an integrative oncologist who, among other things, recommends a large and expensive quantity of supplements.  There is a great deal of evidence for the anticancer effects of the supplements I’m taking, but the research cannot be considered definitive. For that reason, most mainstream oncologists would probably not recommend their use. However, what mainstream oncologists do recommend is to wait until the cancer is visible on scans and then return to their horror show of chemotherapy, etc., which I am not willing to do. So long as the supplements are not likely to harm me, I will do what I can to alter my terrain in hopes of preventing a metastasis.

However, there are some issues about the safety and effectiveness of supplements. The Food and Drug Administration (FDA) regulates prescription drugs, but it does not evaluate or review dietary supplements for safety and effectiveness. Manufacturers are not required to submit safety information about products before they are marketed. In addition, China and India produce nearly 80 percent of the pharmaceutical ingredients and nearly 40 percent of the finished prescription drugs consumed in the U.S, and the FDA is just now starting to build a presence overseas. To stop the sale of dangerous products, the FDA must rely mostly on evidence from different sources, such as adverse event reports and product sampling. Since the FDA lacks the resources to monitor and regulate thousands of individual products, the public is mostly unprotected against supplements and herbs that are unsafe.

One way you can protect yourself is to ask your doctor which brands to take. Another way is to look for third party verification. This means that an independent body determines that a product complies with a standard, and it usually includes a follow-up system to ensure on-going compliance. The third party will issue a certificate of compliance to the manufacturer and/ or it may authorize use of a certification mark on the product. Following is a list of the major third parties that have marks you can look for on products. You should be aware that there are other third parties with certification marks, and not all of them are reputable.

NSF International

NSF International certifies dietary supplements as well as many other products. In order to earn the seal, products must meet standards regarding quality and identity of ingredients, contamination, pesticide residues, and potential pathogens. The NSF seal also indicates  compliance with FDA current Good Manufacturing Practices (GMP) guidelines. The NSF website has a search tool you can use to look up certified supplements.

Consumer Labs

Consumer Labs (CL) is a for-profit company that tests various supplements and nutritional products to see whether or not they match the descriptions on their labels.  It publishes online reports which include the test results along with extensive information about appropriate usage, dosage, and potential side effects of these products. CL randomly buys products from stores, from catalogues, over the Internet or through multilevel marketing companies and tests for identity of ingredients, strength, contamination and ability to disintegrate. If a product passes the tests, the manufacturer can pay a licensing fee and then display the CL seal on its label for one year and in advertising. CL also has a Voluntary Certification program under which manufacturers who want to have their products tested may pay to do so. Consumers can look for the CL seal when they shop and, for an annual subscription fee ($39 as of this writing), they can access reports on the CL website.

USP Dietary Supplement Verification program

The USP Verified mark is issued by a private nonprofit organization that sets quality standards for medicines, food ingredients, and dietary supplements. Manufacturers can voluntarily submit their products for testing, and the USP will verify that each product contains the ingredients listed on the label in the declared potency and amounts; that it does not contain harmful levels of dangerous heavy metals, microbes, pesticides, or other contaminants; that it will break down and release into the body within a specified amount of time; and that it has been made according to FDA current Good Manufacturing Practices (GMP) using sanitary and well-controlled procedures. The USP website lists the dietary supplements that have been verified, as well as the stores where you can buy them.

Natural Products Association

The Natural Products Association (NPA) represents members involved in the retail, manufacturing, wholesale, and distribution of natural products, and it has a strong lobbying presence in Washington. NPA offers a third party GMP certification program specifically for the manufacturing of dietary supplements and dietary ingredients. It is designed to verify that member suppliers’ manufacturing practices for dietary supplements conform to Good Manufacturing Practices (GMPs) and to provide reasonable assurance that products match what is on their labels in terms of identity, purity, strength and composition. NPA member suppliers that qualify will receive GMP certification and may use the NPA GMP certification seal. A list of GMP certified companies is on the website.

UL Consumer Products

UL Consumer Products, a division of global safety science leader UL, has recently launched a Verification Program for dietary supplements. Clients that participate in the Verification Program and qualify based on a set of guidelines branded as UL ClearView® may use UL’s new Verified Mark on their products, packaging, and promotional items.

In addition, UL and NPA will partner to certify that dietary supplement makers are following GMP guidelines. NPA and UL have developed a cobranded, dietary supplement-specific logo for use in product labeling. The use of both the NPA and UL marks for this co-branded partnership will be available for companies that are certified under the NPA GMP standard and audited by UL.

In addition to companies that verify that what is in the bottle matches what is on the label, there are also very specific verifications, like gluten free, vegetarian, or non-GMO.