YONKERS, NY – With the help of an expert group of independent physicians and dietary supplement researchers, Consumer Reports identified 15 supplement ingredients currently on the market that are potentially harmful, with risks including organ damage, cancer and cardiac arrest. Moreover, Consumer Reports’ experts said that none of the 15 supplement ingredients provide sufficient health benefits to justify the risk.

With supplements on the rise – from about 4,000 products in 1994 to more than 90,000 on the market today – the report suggests consumers must be vigilant about what they are purchasing. Consumer Reports found all 15 ingredients on its list available online or in major retail stores where supplements are sold.

The severity of these threats to supplement users often depends on such factors as pre-existing medical conditions as well as the quantity of the ingredient taken and the length of time a person has been exposed to the substance. Many of these ingredients also have the potential to interact with prescriptions and over-the-counter medications, such as cholesterol-lowering statins and blood-thinning drugs including aspirin and warfarin.

Consumer Reports also found that almost anyone can blend and package a supplement–even a product that contains potentially harmful ingredients. And supplement products don’t need to be approved by the Food and Drug Administration before they’re sold. What’s more, the facilities in which they are made are not overseen as well as those of pharmaceutical companies.

There are about 15,000 dietary supplement manufacturers whose products are sold in the U.S. A Freedom of Information Act request filed by Consumer Reports in May 2016 found that since 2010, the FDA has inspected fewer than 400 of those companies per fiscal year.

“The dietary supplement marketplace lacks the oversight it needs to keep consumers safe,” said Ellen Kunes, Consumer Reports Health Content Team Leader. “Supplement manufacturers should register their products to enable them to be identified and tracked for safety recalls and to show they are safe before being sold in retail stores, doctors’ offices and hospitals.”

Almost half of American adults think, incorrectly, that supplement makers must test their products for efficacy, and more than half, again incorrectly, believe that manufacturers must demonstrate products are safe before selling them, according to a 2015 nationally representative Consumer Reports survey.

According to CR’s story, The Council for Responsible Nutrition, the leading trade group for the supplement industry, says that its products are well-regulated and that a vast majority pose no risk. “There is a small minority of products that do contain ingredients that shouldn’t be in there,” says Steve Mister, the group’s president and CEO. “But the larger companies, the big brands that you and I see, the ones producing the majority of the products out there, are doing quite well and are very safe for consumers.”

Consumer Reports’ in-depth analysis found that dietary supplements—vitamins, minerals, herbs, botanicals, and a growing list of other “natural” substances—have migrated from the vitamin aisle into mainstream medical establishments. Hospitals are increasingly including supplements in their formularies (lists of approved medication), they’re also opening their own specialty supplement shops on-site and online.  Some doctors are doing the same.  

The distinction between dietary supplements and prescription drugs is most pronounced in the local drugstore. Unlike behind-the-counter prescription drugs, supplements lack needed safeguards. Consumers can pluck them off a drugstore shelf without having to consult a medical professional. And if consumers have specific questions, they might be out of luck.

To find out the advice that customers may be getting from store employees, Consumer Reports sent 43 secret shoppers—real consumers we provided with critical information and deployed across the country to serve as our eyes and ears—to Costco, CVS, GNC, Walgreens, Whole Foods, and the Vitamin Shoppe. They went to 60 stores in 17 states, where they asked employees (mostly sales staff but also some pharmacists) about products containing several of the ingredients in CR’s list of “15 Ingredients to Always Avoid.” Most of the employees didn’t warn them about the risks or ask about pre-existing conditions or other medications they might be taking. Many gave information that was either misleading or flat-out wrong.

For example, yohimbe, a plant extract touted to help with weight loss and enhance sexual performance, has been linked to serious side effects. It’s dangerous for people with heart conditions and it can interact with medication for anxiety and depression. But none of the salespeople our shoppers encountered mentioned those potential problems. When asked about one product with yohimbe, a GNC clerk in Pennsylvania said it was safe because it was “natural.”

Staying Healthy and Safe: What Consumers Can Do

“We are concerned that many supplements are either unsafe or unproven. Rather than looking to supplements, consumers should consider other lifestyle changes such as being more active, and eating a balanced diet rich in fruits and vegetables,” said Kunes.

Consumers should get physically active, eat healthy, and if testing reveals that supplements are needed, always discuss the use of dietary supplements with a physician or medical provider prior to taking them. Before seeking a supplement as a way to achieve better health, Consumer Reports recommends these natural health fixes:

• Reduce Joint Pain: Skip fish oil, glucosamine and chondroitin; instead try gentle, low-impact exercise such as swimming and walking.

• Build Stronger Bones: Skip calcium pills and vitamin D; instead try calcium-rich foods such as milk and yogurt, as well as weight-bearing aerobic activities, such as walking and dancing.

• Improve Memory: Skip vitamin B12 and ginkgo biloba; instead aim for a weekly goal of 150 minutes of moderate exercise and consider the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet which includes lots of veggies, nuts, whole grains, olive oil, some beans, fish, and poultry, plus a daily glass of wine.

• Prevent and Cure Colds: Skip echinacea and vitamin C; instead utilize soap and water. Wash your hands regularly.

• Relieve Depression: Skip the omega-3 fatty acids and St. John’s Wort; instead try talk therapy, such as cognitive behavioral therapy, and getting 20 to 30 minutes of daily exercise.

• Lower Cholesterol: Skip red yeast rice; instead try fiber from whole grains, fruit and vegetables and beans while limiting red meats and full-fat dairy.

More information, including details on the 15 potentially harmful supplement ingredients on the market today, can be found in “Supplements: A Complete Guide to Safety,” featured at www.ConsumerReports.org and in the September 2016 issue of Consumer Reports magazine starting July 27th. The report also includes what labels mean (and don’t) and why focusing on the right food and exercise are a better bet for consumers.

For more on supplements and living a safe, healthy lifestyle, visit ConsumerReports.org.