I've stated many times that we shouldn't take supplements to boost our immune system, because where there is any evidence that they might work, it's by boosting lymphocyte production - the last thing we need!
Sadly, there's a more fundamental reason - often you can't trust the ingredients are what you've paid for.
Analysis of Select Dietary Supplement Products Marketed to Support or Boost the Immune System
This case series study analyzed 30 dietary supplement products purchased from Amazon.com with claims related to immune health. Seventeen of 30 products had inaccurate labels; 13 were misbranded, and 9 had additional components detected but not claimed on the label.
Meaning
Quality control measures seem insufficient for most select dietary supplement products. The public has a right to know that they are buying what is stated on the label.
Product Descriptions
The 30 immune health dietary supplement products tested and analyzed had claims related to immune support, immune defense, and bolstering or boosting the immune system. Examples of such claims included “all seasons immune support,” “immune strengthening ingredients,” “a powerhouse immune system booster,” and “bolster up your body’s immune support.” Fifteen products additionally had scientific sounding claims by using terms such as “research based” or “research supported,” “clinically studied,” scientifically proven,” “supported by…gold-standard clinical studies,” and “backed by science.”
:
Of these 30 featured products on the Amazon website, only 13 (43.3%) received a score of 4 or more when applying the OPSS Scorecard, and 10 of the 13 (76.9%) had accurate labels confirmed through product analysis.
Discussion
Claims made on the labels of most dietary supplement products seem to stretch what would be considered as allowable claims, which can by statute and/or FDA regulations be made for dietary supplements.26,27 Some other claims sounded scientific but did not have any peer-reviewed publication cited. Therefore, it is unknown how or whether these claims were substantiated.
Neil
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can you please tell us anything about the following - grapeseed to strengthen blood vessel walls against 'bleeds', aged garlic, lutein and bilberry, olive leaf extract, for person on acalabrutinib
That would require a fair bit of research time. I presume that you are aware of a product or products making those claims? If so, sharing details of those would help me. If there was some good evidence behind these, this would be a complementary therapy to reduce the risk of bleeding which can happen with BTKi drugs like acalabrutinib, provided there were no potentially dangerous interractions with acalabrutinib or other drugs being taken.
I experienced bruising and petechiae while on acalabrutinib and my platelets dropped to a low of 29, but I never had any serious bleeding events.
Discussion of this paper on Twitter turned up similar concerns in Australia.
Combined Liquid Chromatography-mass Spectrometry and Next-generation DNA Sequencing Detection of Adulterants and Contaminants in Analgesic and Anti-inflammatory Herbal Medicines
Results: Twenty-six of 49 (53%) herbal medicines were adulterated or contaminated with undeclared ingredients. LC-MS revealed the presence of pharmaceutical adulterants including atropine and ephedrine. DNA sequencing uncovered concerning levels of herbal substitution, adulteration and contamination, including the use of fillers (alfalfa, wheat and soy), as well as pharmacologically relevant species (Centella asiatica, Panax ginseng, Bupleurum and Passiflora). Pig/boar and bird DNA was found in some preparations, inferring substandard manufacturing practices. Of the 26 contaminated samples, 19 (73%) were manufactured in Australia, and 7 (27%) were imported from other countries (6 from China, 1 from New Zealand). In 23 of 49 (47%) herbal medicine samples, no biological ingredients were detected at all. These were predominantly pain and anti-inflammatory preparations such as glucosamine and eicosapentaenoic and docosahexaenoic acids found in krill and fish oils, so DNA would not be expected to survive the manufacturing process.
Conclusion: The high level of contamination and substitution of herbal medicine preparations sourced from Australian dispensaries supports the need for more stringent pharmacovigilance measures in Australia and abroad.
Toxicological screening and DNA sequencing detects contamination and adulteration in regulated herbal medicines and supplements for diet, weight loss and cardiovascular health
Use of herbal medicines and supplements by consumers to prevent or treat disease, particularly chronic conditions continues to grow, leading to increased awareness of the minimal regulation standards in many countries. Fraudulent, adulterated and contaminated herbal and traditional medicines and dietary supplements are a risk to consumer health, with adverse effects and events including overdose, drug-herb interactions and hospitalisation. The scope of the risk has been difficult to determine, prompting calls for new approaches, such as the combination of DNA metabarcoding and mass spectrometry used in this study. Here we show that nearly 50% of products tested had contamination issues, in terms of DNA, chemical composition or both. Two samples were clear cases of pharmaceutical adulteration, including a combination of paracetamol and chlorpheniramine in one product and trace amounts of buclizine, a drug no longer in use in Australia, in another. Other issues include the undeclared presence of stimulants such as caffeine, synephrine or ephedrine. DNA data highlighted potential allergy concerns (nuts, wheat), presence of potential toxins (Neem oil) and animal ingredients (reindeer, frog, shrew), and possible substitution of bird cartilage in place of shark. Only 21% of the tested products were able to have at least one ingredient corroborated by DNA sequencing. This study demonstrates that, despite current monitoring approaches, contaminated and adulterated products are still reaching the consumer. We suggest that a better solution is stronger pre-market evaluation, using techniques such as that outlined in this study.
In Australia supplement manufacturers and suppliers must register their product with the Therapeutic Goods Administration, through which their receive an Aust L number, which must appear on the product packaging. It's illegal to sell such products in Australia unless they are registered.
This just goes to show that without independent inspection of production by random, unannounced audits, you can't be sure of what you are buying.
"This just goes to show that without independent inspection of production by random, unannounced audits, you can't be sure of what you are buying."
I fully support it. This is the very truth.
But as we sometimes say in our country - "hopefully, maybe not". Unfortunately, I can't exactly translate the expression.
The problem is that at least 80% of production and trade is held by...doctors.
In our country, it is a common practice for "mutts" to launder their money through such supplements. Because the profit is from 200 to 500%!!!
The main producers of the substances are in China and India. Almost everyone buys in bulk and cuts for a 200-500% profit.
I have many such clients. And they do not shy away from making investments in equipment.
In our country, by law, the importer and/or the manufacturer bear sole responsibility for the composition of the nutritional supplements they sell. This is done through a declaration.
And who and when checks them? Nobody! Never.
I also use supplements, which I buy from "certified" manufacturers in the UK mainly. With the clear awareness that I am buying hope. It is not clear about the rest...
Gideon Meyerowitz-Katz, the epidemiologist responsible with colleagues for the withdrawal of several research papers for using faked data, brings this all together in his article:-
Supplements: Do You Really Know What You’re Taking?
Why you should be very careful when buying herbal and dietary supplements
Before I get into the implications of all these dodgy practices, I would like to point out something very important: most supplements are a waste of time anyway. Yes, there are people with deficiencies who need extra vitamins, and there are a handful of dietary and herbal supplements with evidence for efficacy that doesn’t come directly from terrible studies funded by the manufacturer, but in general you probably don’t need to take a supplement unless a doctor tells you to do it.
That being said, if you feel like you have to buy supplements the main take-home here is that quite a lot of them are not what they seem. You can probably reduce your risk as a consumer by buying your pills from a high-quality and trustworthy producer, but even then it’s hard to know if you are getting exactly what it says on the label.
Part of this is to do with the regulation of supplements broadly. While medicines usually have to go through extremely exacting regulatory processes to prove, among other things, that they contain exactly what they say they do, supplements are often regulated much less tightly leaving consumers at a disadvantage. Even in countries with very tight medicines regulations, like Australia and the US, a large number of problematic pills sneak through under the guise of herbal remedies and immune health boosters.
Unfortunately, these scientific studies don’t identify which supplements they’ve reviewed, so it’s hard for me to tell you exactly which brands to avoid, but the key here is to be careful with what you buy. Supplements are often not very beneficial anyway, but if you don’t want to be the person ending up with liver damage because the ‘natural’ bodybuilding supplement you took actually contained anabolic steroids without saying so on the label, you should be very careful about which supplements you pick off the supermarket shelves.
Hi Neal, I drink Turmeric tea which includes green tea, ginger, lemon liquorice and cardamom. I also use Turmeric (ground form) and put it on my food sometimes with pepper and also use a lot of garlic and ginger in my cooking. I understood these type of spices are good for you, I understand obviously these are not a cure but should benefit the blood or are these just more sales tactics? thanksWill
There's a difference between using spices in food and drinks for enjoyment and taking concentrated extracts to hopefully assist with a health condition. Mostly, the amounts used as spices are unlikely to interfere with medications you may be taking, but note that you can't be certain of this. For example, eating grapefruit or marmalade jam made with grapefruit or Seville oranges when on ibrutinib and other BTKi drugs can worsen the side effects from the drug. With that proviso, spices are supposed to be good for our health.
I hear that Amazon.com has a big problem with counterfeit products. I typically will not buy anything to be ingested on Amazon unless I am certain about the vendor or item. I’d be curious to see a study done on supplements from their original manufacturer and not from Amazon.
Both of the Australian studies above healthunlocked.com/cllsuppo...yet-another-disconcerting-investigation-into-b-dietary-supplement-products-b?responses=148382675 were on supplements made in Australia and not from Amazon.
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Cll Drugs and the Immune System
Vaccines – at what point do they become a disbenefit?
Good article on navigating complementary cancer treatments
Cancer drug found to contain life-threatening bacteria
