The Food and Drug Administration often recalls dietary supplements that contain banned substances. A new study, published in JAMA, the Journal of the American Medical Association found that dozens of supplements that had been pulled from shelves after they were found to contain anabolic steroids, or other prescription drugs. Approximately two-thirds were back on store shelves a year later with the same ingredients.

Marketed for weight loss, exercise and sexual enhancement, most of the supplements were sold at convenience stores, in health food shops and over the Internet.

Several of the weight-loss products were found to contain Sibutramine, an amphetamine-like drug that was removed from the market in the U.S., Asia and Europe after a clinical trial showed it increased the risk of heart attacks and strokes.

In the last few years, research has found that herbal supplements including echinacea, Ginkgo biloba and St. John’s wort are often mislabeled or diluted with cheap fillers like powdered rice. Last year, a study by a network of liver specialists found that the number of liver-related injuries linked to bodybuilding and weight-loss supplements was on the rise.

Jennifer Dooren, a spokeswoman for the FDA, said that supplement companies “are legally responsible for marketing a safe product that is not adulterated.” But because companies do not need approval to sell their products, she said the agency cannot identify tainted supplements before they reach consumers.

Dr. Pieter A. Cohen, an assistant professor at Harvard Medical School, and his colleagues purchased several dietary supplements, on average about one year after they had been recalled. Dr. Cohen limited his study only to those products that returned to shelves or websites with identical packaging.

The study found that two-thirds of the 27 supplements analyzed had at least one unlisted anabolic steroid, prescription drug or banned substance. In some cases, the products contained new additional drugs as well.

“This is the problem with supplements: They can be introduced without any vetting at all by the FDA,”
he said.

Dr. Cohen has published several studies identifying illicit or dangerous ingredients in dietary supplements. He said that consumers should be particularly wary of products containing a mixture of herbs or ingredients – what he called “herbal cocktails.”

“If you want to buy herbal supplements, buy individual ingredients,” he said. “Buy echinacea or black cohosh separately. But don’t buy a mixture and don’t buy a supplement that’s sold to cause weight loss or improve your workouts. These are exactly the types of supplements that these drugs have appeared in.” 10/21/14

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