Q. I have read that you can’t trust the label on some supplements. I guess the FDA doesn’t bother to check them.

If it says USP on the container, can we assume the product is what it says it is?

A. We were appalled to read the research published in JAMA Internal Medicine (online Feb. 11, 2013) showing wide variations in compounded and OTC vitamin D pills. The scientists found that potency ranged from 9 percent to 146 percent of the dose listed on the label.

You are right that the FDA does not have the resources to check the quality of most supplements. You mention USP, the United States Pharmacopeia. This nongovernmental scientific organization has set quality standards for medicines for nearly 200 years.

We spoke with a representative who told us that the USP-Verified seal is backed by careful quality monitoring, including off-the-shelf vitamin testing. You can learn more about USP verification and see what the symbol looks like at the organization’s site.

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  1. JBG
    Reply

    I’ve discovered why I could not find the article about OTC vitamin D in “JAMA Internal Medicine (online Feb. 11, 2013)” — it’s because the article is in the April 8 issue. The first part of the article is available here:
    http://archinte.jamanetwork.com/article.aspx?articleid=1570096
    The remainder is behind a paywall. Readers can make their own assessment of the part of the article that is openly accessible.
    Notable is that the authors complain that, “…the Food and Drug Administration (FDA) does not regulate vitamin D supplements, so potency may not be well evaluated”, as though FDA oversight were a guarantee of anything. Also notable is that their data show that the manufacturer whose products were USP certified (a voluntary service) were quite dependable.

  2. JBG
    Reply

    There is a lot of push-back from conventional medicine on the subject of vitamin D, and one wonders whether the OTC vitamin D pills that were the subject of the JAMA Internal Medicine article might have been selected to introduce some additional Fear, Uncertainty, and Doubt into the discussion. I was not able to access the mentioned article (providing a link for things like this would be nice), so I don’t know exactly what it said. But I do note that Consumer Reports, which generally sticks to the conventional medicine line, nevertheless finds the OTC vitamin D situation quite reassuring:
    “Our latest tests yield some good news for the many people who take a daily vitamin D pill, or one that combines calcium and vitamin D: All of the 32 products met or exceeded their claimed levels of the vitamin, disintegrated or dissolved properly where applicable, and were well below the safe upper limit set by the Institute of Medicine.”
    http://www.consumerreports.org/cro/magazine/2013/05/most-vitamin-d-pills-measure-up-our-tests-find/index.htm?EXTKEY=NH34N00H

  3. PRK
    Reply

    I am a female 76 yrs old, & I have been taking vitamins & minerals from a reputable health food store since I was in my 20’s. No out sourcing then!
    Since most of our generic medicines are now out sourced & are made in other countries, I just recently found out that a lot of our vitamin supplements are also outsourced.
    I am losing faith in a lot of my generic medicines & I can’t afford all brand names!
    And now I am losing faith in some of the vitamins & minerals I take since I now take some medicines for high blood pressure & AFIB. I don’t know what drugs interact negatively with what vitamins.
    This keeps me confused & reluctant in taking any generics, either medicines or vitamin supplements!
    I am so disgusted with our Congress allowing things like this to happen.
    It’s time to make all medicines & supplements inside the USA with regulations!
    The FDA does not monitor them frequently enough outside of the USA!

  4. r.z.
    Reply

    Can you benefit from the iron and calcium in a multivitamin since they impede the absorption of one another?
    Thanks.
    PEOPLE’S PHARMACY RESPONSE: The interference is incomplete, but if you are deficient in either mineral you’d do better taking it separately.

  5. PLM
    Reply

    You should have mentioned Consumer Lab (as I think you have in the past). It is an excellent source of test and application data.

  6. ICR
    Reply

    Not sure what is causing numbness on my shoulder and my neck.
    It goes into the jaw and itches. Could this be a side effect of a medication I’m taking? Dr. checked and said head is OK and can’t come up with an answer. What medication can cause numbness?

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