Evidence, not quality, is key issue for supplements

However, while I see the potential for change with the new regulations, I'm concerned that they don't do enough. I was hopeful when the Dietary Supplement Health and Education Act was passed in 1994, but its impact on the supplement industry was minimal. History seems to be repeating itself with the latest regulations concerning good manufacturing practices.

For starters, small companies will not be held accountable under the new regulations until 2010. Based on studies I've participated in and my observations, it's the small, fly-by-night companies that are most notorious for putting suspicious products on the market. The large manufacturers have a lot to lose if their supplements are revealed as impure or dangerous, and they generally do the best job of making safe supplements. Quality control is rarely a concern with them.

Ideally, this most recent FDA action would produce a list of companies that have fulfilled the new manufacturing requirements via independent assessment. A simple Internet-based list would tell both physicians and patients which companies are spending the time and money to meet quality standards. This would be particularly valuable for urologists, whose patients hear about supplements like lycopene, saw palmetto, and male or female enhancement supplements so frequently.

While we're waiting for the new standards to take effect over the next 3 to 4 years, a good standard you can set for yourself is to only recommend supplements that have undergone independent testing, have been shown to have good quality control, contain what they say they do, and can refer consumers to quality human research explaining the rationale for their unique concoction. Quality control measures from FDA are important, but in the end, if a product is worthless, expensive, and even dangerous, then quality is a moot point.