Are drugs lurking in your dietary supplements?


Former Executive Editor, Harvard Health

Another day, another safety alert from the FDA that a so-called dietary supplement or natural herbal remedy actually contains a drug. That’s the eighth such warning in the last three months (see FDA warnings). The latest one warns that products marketed as “natural testosterone boosters” or sex enhancers, including Arom-X, 4-AD, Decavol, and Reversitol, contain an aromatase inhibitor. This drug, which is used to treat some kinds of breast and ovarian cancer, blocks the body from making estrogen, a hormone needed by both men and women. According to the FDA, unapproved use of an aromatase inhibitor can lead to “decreased rate of bone maturation and growth, decreased sperm production, infertility, aggressive behavior, adrenal insufficiency, kidney failure, and liver dysfunction.” People with liver, kidney, adrenal, or prostate problems are at higher risk for getting into trouble with an aromatase inhibitor. The FDA says that “products containing aromatase inhibitors have a reasonable probability of resulting in permanent impairment of a body structure or function in at risk consumers.”

Earlier alerts warn that some “natural” supplements contain sildenafil or tadalafil (the active ingredients in Viagra and Cialis, prescription drugs used to treat erectile dysfunction) or compounds that are chemically similar to them. These substances interact with nitrates found in prescription drugs commonly taken by men with heart disease, and can dangerously lower blood pressure. Others warn of the presence of sibutramine (the active ingredient in Meridia, a prescription weight-loss drug) or compounds that mimic it.

These warnings highlight the sleazy underside of the dietary supplement industry. Some companies slip drugs into their “natural” remedies so they’ll work as advertised. Others allow them in through shoddy manufacturing processes.

How can this happen? Back in 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA). In a nutshell, it said that manufacturers could make and sell loosely defined “dietary supplements” with little or no testing beforehand, and that the products are assumed to be safe and effective unless the government proves otherwise. That’s in stark contrast to the testing and safety process that new and existing drugs must go through, overseen every step of the way by the FDA. Pharmaceutical companies must prove a drug is both safe and effective, and will be carefully and properly made, before it’s allowed onto the market.

I’m not an anti-supplement agitator. I take a multivitamin every day. I believe that many supplement makers and promoters are honest and are working to improve public health. I also think that some herbs or plant extracts are good for preventing or treating some diseases. But they almost certainly affect how the body works just as prescription drugs do, so they should be governed by the same set of rules and regulations.

In February 2004, the FDA banned sales of dietary supplements containing ephedra, also called Ma huang. But it took the FDA more than seven years to gather the evidence to support this move. During that time, it received 16,000 reports of injuries, 62,000 consumer complaints, and at least 155 deaths related to ephedra-containing products. It shouldn’t take that long, or umpteen safety alerts, to ensure that dietary supplements are safe.

Senators John McCain and Byron Dorgan have introduced a bill into the Senate that could bring a small bit of order to the Wild West of dietary supplements. In the mean time, your safest bet is to buy only dietary supplements that carry a seal from the U.S. Pharmacopeia’s Dietary Supplement Verification Program. It verifies the quality, purity, and potency of dietary supplements. (Click here to see a list of USP verified dietary supplements.) But the USP seal doesn’t vouch for the effectiveness of the product. In that regard, it’s still caveat emptor—let the buyer beware.

Date Supplement Marketed for Warning
Sept. 16, 2010 Arom-X, 4-AD, Decavol, Reversitol Boosting testosterone, muscle building, sexual enhancement Contains an aromatase inhibitor
Aug. 24, 2010 MasXtreme Natural herbal supplement to improve sexual desire and male sexual health. Contains a compound similar to tadalafil (active ingredient in Cialis, a prescription drug used for erectile dysfunction)
Aug. 18, 2010 Slim-30 Herb Supplement Weight loss Contains a compound similar to sibutramine (the active ingredient in Meridia, a prescription weight-loss drug)
Aug. 9, 2010 Prolatis’ Herbal sexual enhancement product for men Contains a compound similar to sildenafil (active ingredient in Cialis, a prescription drug used for erectile dysfunction)
July 28, 2010 ejaculoidXXTREME Natural sexual enhancement for men Contains a compound similar to sildenafil
July 22, 2010 Joyful Slim Herb Supplement Natural herbal weight loss Contains a compound similar to sibutramine
July 16, 2010 Vialipro Supplement for erectile dysfunction Contains a compound similar to sildenafil
June 25, 2010 Magic Power Coffee Natural aphrodisiac for men and women Contains a compound similar to sildenafil


  1. Fred Evans

    Let’s see. All supplements should be approved by the FDA since there are potential health risks from taking some of them. Would that mean that all supplements would need to be tested to demonstrate that they are effective and not harmful? If so, supplements would become as expensive as prescription drugs, and multi-vitamins would probably be banned as not efficacious and potentially harmful.

    We will never achieve a risk free world. Spare me from those risk averse bureaucrats who want to make it so.

  2. Ed Lange

    Who’s winning – Supplements or the FDA? Seems to me the good guys are always going to be that step behind. Scams in the computer industry are a good example of never catching up with bad guys!
    The Pensioner<

  3. Laith

    Best way is to get our ‘supplements’ directly from food.

    Vegetables can be concentrated into juice form etc.

    As for aphrodisiac’s there are many many food items that help to increase ones libido [URL removed by moderator]

    Seems like there is much controversy with this subject, however, many scientific studies have been made to test the hypotheses; so we need to keep an open mind.

  4. Shelley

    I am not surprised than many nutritional supplements contain “a compound similar to” a drug. In actuality most drugs contain a compound similar to a plant that is in your nutritional product. Why do people think it is the other way around?

    There are shoddy practices in every industry. For every supplement on that list I could list hundreds of drugs that have killed people, or have caused side effects that impact quality of life. That’s regulation for ya :-))


    I think spupplements are okay, bud u alway’s take care of what dose u take

  6. Robert

    Like Ron Lewis mentioned above six of the supplements mentioned above have to do with sexual health and no wonder because this subject is very close to our hurts. But when we talk about our sexual health the best thing that we can do is use only natural ways and foods. The first thing that we should do to have a better sex life is to eat the right foods, if we use food strategically we can loose wight,boost our sexual health and ignite our love life.
    [URL removed by moderator]

  7. thomas thomas

    great blog its good to know that you give a warning for your readers about the bad effect of supplements in the body.
    [URL removed by moderator]

  8. E. Guimont

    you don’t make a distinction from buying supplements from the retail market vs. multi-level marketing vs. professional lines of supplements. while what you are saying is horrifying to think; you need to consider the source from where your supplements come from.

  9. Pharmg245

    Very nice site!

  10. Pharmg147

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  11. tunukwa

    The government is aware of the misuse of some supplements. Like the use of drugs like heroin, the government benefits from their presense – hence the war in Afghanistan where popy production is up 80% under U.S. control – because the
    illegal activity allows the government to write legislation to reduce constitutional rights of the citizens under the guise of making the population safe. There are more deaths from pharmaceuticals than herbs now and in the future. The government prevents people from becoming herbalists so that physicians can, without training, fulfill that role and make money.I have seen this personaly with acupuncture.

    When products like ephedra where readily available at your local gas station, in my opinion it was to allow deaths to occur and then remove the product. This has happened
    with many other supplements.

    I have studied Chinese and western herbology and acupuncture, ephedra is for upper respiratory conditions like asthma, not weight loss. While the public may not know this the FDA certainly does.

    Alternative medicine is a multibillion dollar industry which the pharmacetucial companies intend to take over. Restricting the acredidation of herbolists and allowing the misuse age of herbs is just one of their tactics to achieve that goal.

    The pharmaceutical companies are deeply involved in the despensation of toxic “so called” medicines and try to appear as the good guys. Please read, Excitotoxins the Taste That Kills, by retired neurosurgeon, Dr. Richard Blaylock.

    We need trained herbolists to avoid
    the tragic events discribed above.

  12. Dr. Samuel Dyer

    Great article

  13. Jacob

    There are so many high grade supplement sites out there it is ridiculous. How do we combat them when you can easily click and buy supplements that you need a physician’s license just to buy from the wholesale distributor?
    There are neuroscience supplements and orthomolecular supplements that are super high grade sold at a bunch of other sites. When people are buying them, they don’t know proper dosage instructions. The fact that drugs are in some of these doesn’t surprise me.
    [URL removed by moderator]

  14. Dheen

    I agree about the FDA says that “products containing aromatase inhibitors have a reasonable probability of resulting in permanent impairment of a body structure or function in at risk consumers.”
    Thank for share.
    [URL removed by moderator]

  15. Brandon

    My family has had the worst luck with taking both over the counter supplements and prescription drugs. My mother was taking a dietary supplement for weight loss that was supposed to be “safe & all natural”, it contained something similar to ephedra and she ended up in the hospital due to heart palpitations and chest pains. She stopped taking the “all natural” stimulant as per suggestion of her doctor and the hot flashes, chest pains, and heart palpitations stopped occurring. That same year, my Grandmother was taken off of the drug Vioxx after the recall. As if that was not enough, my Grandmother was prescribed Darvocet for pain relief due to a botched hip replacement (a completely different story of bad luck) and just recently stopped taking it when she found out that the FDA had pulled it from the market due to the Darvocet side effects, namely heart trouble. Finally, after being on several medications that were recalled due to dangerous side effects, she has decided to take action and is in the process of suing the drug manufacturer of Darvocet, Xanodyne Pharmaceuticals as part of a class action lawsuit. My question is: why don’t we get this information before the drugs (or dietary supplements) hurt or kill thousands of people? Are we destined to be human guinea pigs for the drug companies? These are the kind of thins that should be tested during, hello – the testing phase! And we can’t place all the blame on the manufacturer either, the doctors push new medications on patients like its going out of style! Anyway…enough of my rant. Thanks for the great post, I’m forwarding this to the rest of my family.

    [URL removed by moderator]

  16. sarahwbaumbach

    I also heard about ephedra banned by the FDA. Just like the case of darvocet which the manufacturer now strongly face Darvocet Lawsuit. FDA banned this product when a young girl died after taking it.
    Anyway, I like the thought that you laid down those supplements so we can have referrals too and we will be aware of its side effects.

  17. John

    Thanks for your vigilance in listing supplements found to contain unwanted pharmaceuticals or other added compounds.

    Customers–read your labels! Also, look into some guarantee from your supplement supplier that they are using “third party lab testing” to verify purity of raw ingredients, and finished products.

    Also, find a company that produces herbal products that use standardized extracts to ensure potency.

    You get what you pay for when it comes to supplements–avoid cheap or “hyped” supplements unless you carefully read your labels first.

    Thanks again.

  18. king

    how natural are these natural suplements, of course they have been processed, i always think that thesem pills always have some kind of side effects no matter how natural they are.

    • Robert White

      Yes Sir, If we need anything restricted it would be the outrageous behavior of the pharmaceutical companies with their “take this for better joint function BUT you finger nails my fall off”
      More visibility for alternative medicine is what we need.,The newest that I think will soon be at the top of the list is the new multi vitamin with added stem cell nutrition. You may want to take a look if you haven’t heard of it yet.
      I LOVE IT Thank-You…Robert White

  19. CR Hays

    think that any medication, incluting herbal supplements, have their place.
    Great post, thanks

    [URL removed by moderator]

  20. Alpha Crew

    Interesting article, but any informed athelete would be aware of what they are putting in there body, its all on the label. the only synthetic compounds listed there, are the ones in products that are sold as “ProHormone/Designer Steroids”
    [URL removed by moderator]

  21. Gil

    I remember about a year ago that a company put a type II drug in a diet pill. the diet pills were a hit but I mean when you are taking stuff that helps you FOCUS and you NEVER get tired why wouldn’t you like it?

  22. Ron Lewis

    If you want a purely natural supplement, read the label and investigate any ingredient you don’t recognize to determine what it really is. Six of the supplements mentioned above have to do with sexual health (ED,lack of sexual desire, low testosterone,etc.)– conditions for which herbs have been safely and effectively used for centuries — without drugs or negative side effects.

    (Edited by a moderator)

  23. Jo Chris

    That is why it is best to follow a natural muscle building plan. Unfortunately, not everybody understands the consequences of taking manufactured supplements or are willing to overlook the harm that can come from them.

  24. Clint Blumer


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