Two-thirds of commercially available FDA-recalled supplements contain anabolic steroids, weight-loss stimulants, or erectile-dysfunction drugs.

The FDA recently has recalled nearly 300 dietary supplements because of contamination or purposeful adulteration with potentially dangerous drugs (primarily stimulants and anabolic steroids). Many of these branded supplements now are available commercially — but are they still tainted?

Investigators selected 27 supplements subjected to class I recall (reasonable possibility of serious adverse events or death) and available for sale ≥6 months later (mean, 34 months) with the same names, manufacturers, and distributors. Pharmaceutical adulterants were identified in two thirds of all samples, including 11 of 13 supplements for sports enhancement (2 of which had been recalled twice), 6 of 9 for weight loss, and 1 of 5 for sexual enhancement. The most common adulterants were anabolic steroids or steroid-like analogues (12 samples), sibutramine (9 samples), and sildenafil or related compounds (5 samples).


Clinicians can use these findings to advise patients that many dietary supplements (even those with recalls purportedly addressed by the manufacturer) might contain potentially dangerous adulterants or contaminants. In overseeing recalls, particularly those involving possible fraudulence, the FDA can issue warning letters, carry out seizures and injunctions, and seek criminal prosecution. However, these results indicate that such enforcement measures are not 100% effective.

Thomas L. Schwenk, MD reviewing Cohen PA et al. JAMA 2014 Oct 22/29.


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