That bottle of ginseng in your medicine cabinet may not contain what you think it does. In fact, it may not even contain ginseng at all…

Thanks to an investigation by the New York Attorney General, revealed in late March, several big chain retailers were found to have stocks of herbal supplements that had suspicious ingredients.

In the crosshairs were GNC, Target, Walgreens and Walmart stores throughout the state – all of whom the Attorney General allege had aisles of name brand bottles that contained unlisted ingredients that might pose health dangers.

In GNC’s case, the bottled ginseng that was tested didn’t contain any ginseng. Instead, it was filled with powdered rice, wheat, pine and houseplant extracts. This is despite the federal law put into place in 1994 that requires supplement bottles to list ingredients and their amounts.

“Many herbal products contain contaminants and fillers, and are not as effective as they claim to be,” explains Dr. Natalie Digate Muth, national advisor on vitamins and supplements, and medical expert at ACE Healthcare Solutions Director in San Diego.

According to a Gallup poll, half of Americans are taking vitamins, and the Center for Disease Control has found that about 40 percent are taking dietary supplements.

Turning a Blind Eye

Even prior to the latest investigation, researchers from the University of Guelph in Canada tested 44 popular herbal supplements made by 12 companies. Researchers found that nearly two-thirds of the products contained unlisted ingredients, and one-third contained contaminants or fillers.

The Food and Drug Administration says that almost three-quarters of supplement manufacturers turn a blind eye to adulteration. Surprisingly, the law says that these manufacturers are not obligated to prove whether their products are safe or effective. It is only when the FDA discovers a danger with a supplement that it is pulled from the shelves.

Despite their comprising a $33billion a year industry, “these supplements are not tightly controlled by the FDA and there is no guarantee that you’re getting what you think you’re getting,” explains Dr. Muth.

That’s not to say, however, that all these products should be placed under a shroud of suspicion.

“Supplements can help cover nutrients that are not included regularly in the diet to help prevent deficiencies that may develop,” says Joey Gochnour, a registered dietician and nutritionist in Austin, Texas. “The most recommended supplements include a multivitamin, vitamin D, and fish oil.”

He concedes, though, that great care must be taken, due to the associated problems of quality control.

Paul Thomas, registered dietician and scientific consultant with the National Institutes of Health Office of Dietary Supplements, notes that “most people don’t get enough calcium, and supplements might help.” That comes with the caveat that calcium may interact negatively and interfere with the efficacy of some medications.  Furthermore, he adds, caution must be taken with niacin and vitamin B3, which in high doses can harm the liver.

Supplements, says Massachusetts-based Dr. Barry Sears, “canprovide critical nutrients the body cannot make and thus may be useful in treatment of chronic disease.” Dr. Sears is a leading authority on anti-inflammatory nutrition and also author of the recently published, The Mediterranean Zone.

“The two dietarysupplements that have had the most robust scientific support include omega-3 fatty and polyphenols, but usually at high concentrations,” he reports.

“You’ve Got to be Careful”

While the idea of adding more nutrition to one’s body sounds like a good idea in theory, all of the experts interviewed for this article have the same takeaway: ingesting supplements randomly, or without your doctor’s knowledge, may cause problems.

Suggestions from experts range from seeking medical approval, being mindful of the side effects, and being aware of safety issues.

Also, they warn, beware of any product that promises it will “cure” anything.

At a minimum, check for third-party authentication. The industry has its own reliable set of certifications, such as NSF International, US Pharmacopeia, or Consumer Lab seal – all identifying reputable products. Usually, anything made outside the US tends not to be tested for safety, or regulated, and could contain toxic ingredients.

“You’ve got to be careful, because some supplements can cause a response, some cause no response, and some can cause an adverse response,” notes Gail Cresci, registered dietician and assistant professor of surgery and director of surgical nutrition at the Medical College of Georgia.

People who should avoid certain supplements include: pregnant or nursing women, because some supplements can be dangerous for the baby; patients taking medications that can interact negatively with other chemicals; people going in for surgery, since some supplements can cause bleeding; and those with cancer, as some supplements can actually trigger cancer cell growth.

Georgie Fear, registered dietician and author of Lean Habits For Lifelong Weight Lossand sports dietician for Rutgers University Athletics in New Jersey, concurs.

“It is not uncommon for independent labs to test and discover that supplements do not contain what is claimed on the label, or are contaminated with potentially dangerous pharmaceuticals.”

She explains, however, that well-made supplements can help meet the nutritional needs of people with a limited diet. For example, people with milk allergies or lactose intolerance often don’t take in enough calcium from whole foods.

“Women who don’t consume lots of red meat, those who are highly active athletes and individuals on gluten-free diets are at increased risk for iron deficiency anemia, a condition which can be prevented and cured with inexpensive supplements,” she adds.

Supplementing, Not Substituting

But none of that means one can forego on eating the right
foods regularly.

“Supplements and vitamins may lure a person into a false sense of security, leading people to think it is okay to not eat vegetables or balanced meals,” she cautions. “Consuming a well-balanced diet is the only evidenced way to decrease risk of chronic diseases, including obesity, heart disease, and cancer.”

One physician advocates eating right, in addition to taking vitamins, to boost health. Dr. Robert L. True from Colleyville, Texas, a former pharmacist, notes that much of today’s food has been found to have less nutritional value than in decades past.

“The problem nowadays is that people may not be getting all of the vitamins and minerals from the foods they eat that they once did,” he says. “Maybe it’s the soil, or pesticides, but the evaluations are showing up they’re not as nutritious.”

Bottled vitamins, therefore, are the perfect complement for a healthy lifestyle, he contends.

“I like the higher dose ones, becauseyou don’t know if you’re getting an adequate amount in the foods you eat.”

And there’s little to worry about in terms of side effects or overdose, he asserts, except in very specific instances where supplement use is markedly excessive. For example, taking too much Vitamin E can cause blood thinning, but Dr. True says this is “extremely rare.”

Registered dietician Gail Cresci, while being a proponent of vitamins, warns that high doses of vitamins A, D, E and K could build up in the body and develop toxins.

In the end, even seemingly innocuous vitamins sold at reputable pharmacies and stores should come with a warning: do your research, consult your doctor, and proceed to supplement your diet with caution. You never know when you might be ingesting more (or less) than you think.