Many Americans turn to dietary supplements, with nearly three-quarters of adults consuming them and over half using them regularly. However, experts caution that certain categories of these products pose significant risks due to potential undisclosed ingredients and unproven efficacy.
Supplements marketed for sexual performance, weight loss, and athletic enhancement have been identified as the riskiest, forming what some experts call the "unholy trinity" of the supplement industry. These categories often promise rapid or dramatic results, creating incentives for some manufacturers to bypass regulations.
Unlike prescription drugs, the U.S. Food and Drug Administration (FDA) does not review dietary supplements for safety or effectiveness before they are sold. Manufacturers are responsible for ensuring compliance with federal regulations. Third-party organizations, such as NSF International, offer an additional layer of oversight by testing products to verify their contents, manufacturing conditions, and absence of harmful substances.
A primary concern highlighted by these organizations is that the ingredients listed on a supplement's label may not accurately reflect what is actually in the product. Historically, FDA enforcement actions have frequently targeted products in the sexual enhancement, weight loss, and sports performance categories for containing undeclared pharmaceutical ingredients. This practice leaves consumers unaware of potentially dangerous substances in the supplements they are taking.
Recent FDA warnings illustrate these risks. In May, the FDA advised consumers against using X10 Natural Enhancement Supplement, found to contain sildenafil and tadalafil, prescription drug ingredients not listed on its label. In 2023, a study of 57 sports performance supplements revealed that 89% had inaccurate labels, with some missing claimed ingredients and others containing illegal drugs. Earlier this month, the FDA added three botanical weight-loss products to its list of those contaminated with toxic yellow oleander, a plant known to cause heart damage.
Beyond hidden ingredients, these supplements are also criticized for making unsubstantiated claims. Products marketed for erectile dysfunction, for example, are legally regulated as drugs and require FDA approval, but some supplements make such claims. Similarly, weight-loss supplements are prohibited from promising to cure conditions like diabetes or metabolic syndrome, yet these claims persist on product labels.
Experts emphasize that dietary supplements are intended to augment the diet, not to produce drug-like effects. While the FDA can intervene once a product is on the market by requesting recalls or taking action against false claims, manufacturers bear the initial responsibility for compliance.
To mitigate risks, consumers are advised to look for independent third-party certifications on supplement packaging. Seals from organizations like NSF International or Informed Sport indicate that a product has been tested against rigorous quality and safety standards. Such verification is particularly valuable for products in high-risk categories, helping consumers differentiate between rigorously evaluated items and those with unsupported claims.