ANALYSIS OF DIETARY SUPPLEMENTS REVEALED WHICH PRODUCTS? HOW FREQUENTLY ARE THEY USED IN THE MILITARY COMMUNITY?
(Next research presentation from American College of Medical Toxicology Meeting)
Dietary supplement use is ubiquitous with a higher prevalence of use reported in first responders and military communities.
Prevalence of use in the US and Military Communities:
• US- 50%
• Military- 60-75% (Knapik 2016)
• US Coast Guard- 70% (Austin 2015)
• Firefighters- 50-75% (Ramirez 2018, Kaipust 2014)
Operation Supplement Safety is a Dept of Defense (DOD) dietary supplement resource for the military community, leaders, healthcare providers, and DOD civilians. On their website, you can access the ask the expert tab and email a confidential question.
This group of military investigators identified the 41 products most frequently referenced in the ask the expert tab.
Product analyses (LC/QToFMS) were then performed on these 41 products to verify whether selected products were accurately labeled (according to the Supplement Facts listed ingredients) and to identify any risky ingredients contained in the products.
Of the 41 products:
• 12 (29%) were pre-workout products
• 14 (34%) were weight loss products
• 4 (9.8%) were male enhancement/testosterone boosters
• 11 (26.8%) were bodybuilding supplements
• 11 (27%) were accurately labeled
• 26 (63%) misbranded
• Missing ingredients
• 10-(24%) adulterated
• 6 (15%) misbranded and adulterated
• 23 (56%) contained risky ingredients
• 5 products contained anabolic steroids not identified on the label
*Comment: We know that dietary supplements are not tested under FDA guidelines. And although there have been many reports of adulterated and misbranded products, what is most concerning in this analysis is “risky products” were found in over half of the products analyzed. The authors did not include their definition of “risky products”, other than the anabolic steroids. (We’ll have to wait for the publication). But this should remind us to always ask our patients if they are taking any supplements and to educate them on the potential dangers. Although the dose in the supplement may be small, the majority of people who take supplements use them daily or at least repeatedly.
Question prepared by Donna Seger, MD
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DONNA SEGER, MD
Department of Medicine, VUMC
Tennessee Poison Center
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