The Assisted Living Federation of America estimates that there will be 28 million Americans 80 or older by 2040. The elderly increasingly retain their independence deep into old age. As a consequence, a greater number of Americans with complicated conditions will manage their own care in the future.
The National Health and Nutrition Examination Survey 2003-2006 found that 71% (±1%) of Americans over the age of 70 routinely take dietary supplements. Lack of regulation limits FDA control over the dietary supplement industry to post-marketing surveillance. The low barrier of entry for dietary supplements allows low-quality products to enter the market and endangers the health of elderly populations.
Dietary supplement manufacturers are restricted from making curative claims. However, consumers can generally gather the intended use of marketed products just by looking at the name. The FDA issued a voluntary recall notice for one such product, Super Arthgold™, earlier this year.
The product was clearly intended to be used by patients suffering from osteoarthritis, and I’m sure that the product was effective, because it contained chlorzoxazone, diclofenac, and indomethacin. The Beers Criteria for medication use in the elderly recommends against any use of chlorzoxazone or indomethacin and the chronic use of diclofenac in the population most affected by osteoarthritis.
The marketer didn’t intentionally include those three ingredients in their product, but the lack of oversight over the industry discourages the quality control measures necessary to prevent adulteration and recall supplements in a timely manner. 14 dietary supplements have been removed from the market in 2014 for containing an undeclared active ingredient.
Dietary supplements have their place in safe and effective medical therapy, but when do we start seriously pushing for dietary supplements that are guaranteed to be safe?