...control procedures necessary to make the purest, highest quality, and most effective nutritional supplements and natural medicines. While realize that "efficacy" is not a direct result of a high quality product, I can say with certainty that clinical outcome can be influenced by a poor quality product.

My goal in this article is to sound the alarm and draw attention to the many quality assurance holes in the supply chain and manufacturing arena for dietary supplements and natural products. This is not a situation of "crying wolf," but rather a serious discussion about significant quality assurance problems with these products that can, and probably do, adversely affect our friends, families, and patients. The overall intent of providing this information is to give a detailed presentation of solutions to these quality assurance issues, so that we can collectively increase the integrity of the supply chain. While the solutions I present won't necessarily be easy or inexpensive to institute, they are possible, feasible, and must be considered.

We clinicians don't really know if we have purchased and prescribed a high quality natural product, and we should. I believe this to be critically important for two reasons: clinical effectiveness and contamination. If a product is sub-potent, super-potent, or not authentic, it can definitely influence the desired short- or long-term clinical outcome. In addition, a contaminated product may, over time, cause possible harm to the patient that will probably go unrecognized, and most likely won't be linked back to the contaminated product. In my experience, this industry as a whole does not provide consistent quality. I have seen far too many examples of subpotency, lack of authenticity, contamination, and a general lack of quality assurance all across the supply chain that feeds...

NOTE: All illustrations and photos have been removed from this article.



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