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Death By Supplement: Insufficient Oversight Leaves Patients Dying In Their Pursuit Of Health

Japan Deaths Linked To Red Mold Supplements 

According to recent reports, supplements produced by Osaka-based Kobayashi Pharmaceutical Co. have contributed to the deaths of at least five people and the hospitalization of more than 100 others. Current records indicate that 114 patients are being treated in hospitals after consuming products containing benikoji, a red species of mold. The affected products include Benikoji Cholese Help, marketed as a lower cholesterol supplement.

Kobayashi Pharmaceutical has been selling benikoji products for years, with a reported one million packages sold over the past three fiscal years alone. However, a serious issue emerged earlier this year with the supplements produced in 2023. The company revealed that it had produced 18.5 tons of benikoji last year, raising concerns about the scale of the potential health risk.

Japan’s health ministry has warned that the death toll could continue to rise. The ease with which these supplements could be purchased at drug stores without a doctor’s prescription has compounded the problem. Moreover, some may have been bought or exported before they were recalled, including by tourists who may not be aware of the health risks associated with these products.

Sources cited in the news have pointed to recent deregulation initiatives in Japan as a potential contributing factor to this tragedy. These initiatives, aimed at spurring economic growth, simplified and expedited the approval process for health products. However, this streamlining may have come at the cost of proper safety checks and oversight.

A Global Wake-Up Call: Supplement Safety 

This incident in Japan is not an isolated case; instead, it highlights a broader global concern regarding the lack of proper regulation and oversight in the supplement industry. The tragedy serves as a wake-up call, emphasizing the urgent need for stricter laws, improved safety testing, and increased public awareness about the potential risks of unregulated supplements.

The Scope of the Problem

Statistics reveal that supplement safety issues may be more widespread than publicized events indicate. According to the American Association of Poison Control Centers, emergency room visits related to adverse supplement reactions averaged over 23,000 per year from 2004 to 2013. Another study found that hospitalizations due to supplement-related liver injuries increased seven-fold from 2000 to 2013. While more research is needed, these numbers suggest that thousands of people may be harmed annually by supplements in the US alone.

Cause of Death: Supplement Toxicity

Tragically, supplement toxicity has claimed lives in various parts of the world. In Ohio, a 37-year-old man recently died after consuming a supplement containing tianeptine, an atypical tricyclic antidepressant turned street drug with opioid agonist effects. The Food and Drug Administration (FDA) had previously warned about the dangers of this compound and worked to eliminate widely available supplement products that contained it, such as Neptune’s Fix, the supplement involved in this tragedy.

In another case, an 89-year-old man in the UK was rushed to a hospital with hypercalcemia and died ten days later due to vitamin D toxicity. This incident underscores the fact that even seemingly harmless supplements can have deadly consequences when not adequately supervised by medical professionals.

Dangers Lurking In Weight Loss and Muscle-Building Supplements

The problem of supplement safety is particularly prevalent in the weight loss and muscle-building supplement market, which includes products sold through Facebook groups, Amazon storefronts, vague online health stores, and other unverified suppliers. Records of patients between the ages of 17 and 45 dying after consuming diet pills can be easily accessed, revealing a wide range of potentially lethal ingredients and their sources.

Some individuals purchased “Avitia Cobrax” on Facebook, while others bought supplements containing dinitrophenol (DNP) online or green tea extract directly from supplement stores.

The biological reactions and toxic events caused by these supplements vary, but the consequences are equally devastating. Some patients suffered heart attacks after overdosing on caffeine or dimethylamine (DMAA), while others experienced severe liver damage or liver failure.

Unfortunately, the dangers associated with weight loss and muscle-building supplements are just the tip of the iceberg when it comes to the risks posed by the unregulated world of dietary supplements. The lack of proper oversight and control extends beyond these specific categories, leaving consumers vulnerable to various potential health hazards.

The Unregulated World of Dietary Supplements

Dietary supplements, which encompass a wide variety of products like vitamins, minerals, herbs, botanicals, and other ingredients, are easily accessible to consumers. While their availability over-the-counter and through expansive online marketplaces increases access, it has likewise contributed to minimal oversight and quality standards being applied.

The supplement industry has long operated in a regulatory gray area, leaving consumers vulnerable to the potential dangers of unverified products. Unlike prescription or over-the-counter medications, supplements face regulation only after a problem has been reported. This means that instead of the Food and Drug Administration testing substances in advance for safety, supplements are assumed to be safe until shown otherwise.

Consumers often purchase supplements from Amazon, Facebook, online nutrition stores, and other unverified sources, putting them at risk of consuming products that may not contain the ingredients listed on the label or may even include harmful substances. Many dietary supplements aren’t what they claim to be or contain potentially dangerous ingredients. This is because they are not required to undergo any testing to ensure safety before going to market.

Unlike conventional drugs, supplements are not subject to the same rigorous pre-market review and approval process mandated by regulatory bodies like the FDA. Manufacturers are not required to provide extensive evidence of safety and efficacy before selling their products. They need only show that supplements are reasonably expected to be safe based on their ingredients and suggested use.

Unregulated Industry With No Supplement Safety Standards

This lack of regulation has created a market flooded with products of questionable quality and safety. Consumers are left to navigate this complex landscape without the necessary tools and information to make informed decisions about their health and well-being.

The Dietary Supplement Health and Education Act (DSHEA) of 1994, which governs the regulation of dietary supplements, places the responsibility of ensuring product safety on the manufacturers themselves. However, this self-regulatory approach has proven insufficient in protecting consumers from potentially harmful substances and misleading claims.

As a result, the supplement industry operates in a largely unregulated environment, allowing for the proliferation of products with questionable safety profiles and unproven efficacy claims. This regulatory gap not only leaves consumers vulnerable to potential health hazards but also poses significant challenges for healthcare providers. Many providers find themselves ill-equipped to navigate and guide their patients through the minefield of a complex and often confusing market of dietary supplements left unchecked.

Lack of Specialized Training and Education in Healthcare 

One of the most significant barriers to ensuring the safe and effective use of dietary supplements is the lack of adequate knowledge and training among healthcare providers. Despite patients’ widespread use of supplements, many providers receive little to no formal education on the subject during their medical training.

Medical schools and residency programs often place limited emphasis on nutrition and supplement education, leaving providers with a knowledge deficit in understanding the potential benefits, risks, and interactions of various dietary supplements. This lack of training makes it difficult for providers to offer informed advice and guidance to their patients and can adversely affect patient safety and well-being.

The Importance of Quality Control

When advising patients about supplements, practitioners must be aware of the increased risks associated with products that don’t come from trusted sources. Supplements purchased online from unknown third-party sellers, or unregulated specialty shops could pose a greater danger. Without confirmed quality control procedures in place, there is a higher likelihood of issues with these products.

Product labels might not accurately reflect the actual content and harmful substances could be intentionally added. Supplements may also degrade over time due to prolonged storage. Companies must demonstrate that every batch undergoes thorough testing to verify the composition, ensure the correct dosage, confirm proper dissolution, and identify potential contaminants or degradation. This guarantees consistent quality rather than relying solely on reputation or anecdotal evidence.

The Vital Role of Integrative Practitioners

Certified professionals trained in integrative and nutritional medicine can be crucial in addressing the knowledge gap surrounding dietary supplements. Physicians, nurses, and other healthcare practitioners with expertise in functional medicine are uniquely positioned to advise patients on the safety, efficacy, and appropriate use of nutritional supplements. These practitioners can help patients navigate the complex supplement landscape by recommending trusted brands and resources for high-quality products.

Patients As Partners In Promoting Supplement Safety

Patients also have a responsibility to promote dietary supplement safety. They must be aware of the potential risks associated with these products and consult with their healthcare provider before starting any new nutritional supplement regimen. Furthermore, patients should be cautious of supplements sold through unverified sources and avoid purchasing these products altogether. By working closely with their integrative practitioners and using trusted resources for high-quality supplements, patients can take an active role in ensuring their safety and well-being.

While regulations and oversight are essential, education remains the long-term solution to minimizing inadvertent harm from nutritional supplements and maximizing their benefits. It is crucial for healthcare professionals, patients, and supplement manufacturers to work together to ensure the safe and responsible use of dietary supplements, ultimately promoting better health outcomes for all.

Bridging The Education Gap: Innovative Training For Healthcare Professionals

Designed by expert supplement strategists and nutraceutical consultants, A4M’s newest program — Supplement Certification Course: From Evidence To Practice — equips providers with the knowledge and skills to prescribe nutritional supplements for optimal outcomes.

By providing practitioners with the clinical acumen and scientific foundation required to incorporate supplements into integrative treatment protocols safely, this first-of-its-kind course aims to bridge the education gap and promote responsible use of nutritional therapies.

Take Action: Learn More About A4M’s Supplement Certification Course

To learn more about A4M’s Supplement Certification Course and how providers can contribute to advancing dietary supplement safety, click here.

As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement. These statements have not been evaluated by the Food and Drug Administration. 

Content may be edited for style and length.

References/Sources/Materials provided by:

https://blog.a4m.com/death-by-supplement-insufficient-oversight-supplement-safety-leaves-patients-dying-in-their-pursuit-of-health/

https://blog.a4m.com/the-nutritional-supplement-market-a-dynamic-sector-promising-long-term-growth/

https://time.com/6962091/japanese-health-supplement-recall-deaths-auhorities-raid-factory/

https://apnews.com/article/supplement-recall-deaths-japan-health-benikoji-1ce6a27d6495e500e991e36581b2dbde

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196363/

https://www.cdc.gov/mmwr/volumes/73/wr/mm7304a5.htm

https://fortune.com/well/article/vitamin-d-toxicity/

https://www.hsph.harvard.edu/wp-content/uploads/sites/1267/2021/02/STRIPED_news_summaries-diet-pills.pdf

https://ods.od.nih.gov/About/DSHEA_Wording.aspx

https://go.a4m.com/4d8HqPV

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