More attention than ever is paid to fast and furious fat-burning herbal and dietary supplements that turn on the body’s metabolic inferno and voila—you lose 50 pounds and look like a model. We all have seen them on late-night television infomercials or Internet scams that seduce desperate Americans who are born and raised in the failed culture of magic-bullet medicine.

A big problem is that dietary supplements, even in their pure forms, are not without potential harm. I treated a patient who ingested sustained-release niacin and days later required a liver transplant, which allowed this individual to narrowly escape death.


Another related issue is the growing number of herbal supplements suspected of causing liver injury—sometimes fatal.

There are growing concerns about the supplement industry and the potential Russian roulette of picking up bottles of vitamins in your local store and “trusting” the authenticity and purity of the product.

The N.Y. State Attorney General has recently investigated the authenticity of dietary supplements sold at the national retailers Target, GNC, Walmart, and Walgreens. The investigation was prompted as a follow-up to a report showing fraudulent practice by several herbal supplement companies.

Of course, this is not the first time supplements have been found to contain questionable ingredients.

So the real question is this: Who is minding the store?

The FDA? The problem is that under the Dietary and Supplement Health and Education Act (DSHEA) passed in 1994, the FDA does not have jurisdiction over the approval process for dietary supplements, as legislators didn’t want government interference in the right to natural medicine products.

However, the “honor system” of self-monitoring by industry doesn’t seem to be working, and the FDA is unable to ensure the public safety for such a gorilla of an industry.

Finally, a word about weight loss supplements.

This multibillion industry ($2 billion in annual sales) creates products consumed by 15 percent of Americans who are constantly striving to lose weight but have rarely been shown to be effective for weight loss and are lethal in some cases.

Remember what happened with Metabolife 356—an ephedra-containing supplement—the top-selling dietary supplement in 2000 with $70 million in sales, but was responsible for 64 percent of all herb-related adverse events in the U.S.

The Federal Trade Commission (FTC) announced that advertisements touting green coffee bean supplements for weight loss would be banned.

I have published a systematic review of the research on many of the common nutraceutical weight loss products currently on the market, and, to put in bluntly, very few have credible scientific evidence to support them.

As expected, the dietary supplement industry is fighting back against these allegations.

Hopefully the Attorney General’s indictment will be a sobering call to action for more vigorous policing of the dietary supplement industry and we will be able to impose effective deterrents for those who defraud consumers.

Mullin, a national authority on nutrition and integrative medicine, is an associate professor of Medicine and director of Integrative GI Nutrition Services at The Johns Hopkins School of Medicine.* His views do not necessarily reflect those of The Johns Hopkins Medical Institutes.