1. In this study, the majority of commercial dietary supplements targeting the immune system had inaccurate labels.
2. A significant proportion of commercial dietary supplements contained listed ingredients that were not detectable and detected ingredients not listed on the label.
Level of evidence assessment: 4 (Below average)
During the COVID-19 pandemic, supplements that boost or modulate the immune system have grown in popularity. Unlike drugs, supplements are not approved by the United States Food and Drug Administration (FDA) for their safety and effectiveness. However, the FDA has issued specific regulations regarding product manufacturing and labeling. The extent to which dietary supplements currently on the market comply with these regulations has not been well studied.
This case series study examined whether dietary supplements advertised as supporting or enhancing the immune system were correctly labeled. The top 30 supplements sold through Amazon in May 2021 were purchased and their ingredients were analyzed by liquid chromatography-mass spectrometry. The ingredients were then compared to the product labeling to determine accuracy. In addition, claims made on the product label were assessed using the Operational Supplement’s Safety Dashboard question set.
Of the 30 products evaluated, only 13 had accurate labels. Of the 17 with inaccurate labels, 13 had ingredients listed on the label that were not detected in the mass spectrometry analysis and 9 had detected ingredients not claimed on the label. However, this study was limited by the number of products tested, the potential bias due to mass spectrometry being less sensitive for polysaccharides, lipids, enzymes and proteins, and the binary rather than quantitative nature of the analyzes performed. Nevertheless, these results highlighted a concerning trend since many of the products tested had inaccurate labels and claims that were inconsistent with FDA requirements for dietary supplements. Therefore, further work is needed to improve quality control measures for dietary supplements.
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