Curcumin as harm reduction NSAID misuse

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drusso

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Curcumin has similar efficacy to diclofenac but demonstrated better tolerance among patients with knee OA. Curcumin can be an alternative treatment option in the patients with knee OA who are intolerant to the side effects of non-steroidal anti-inflammatory drugs.

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At day 28, a weight-lowering effect (P<0.01) and anti-ulcer effect (P <0.01) of curcumin were observed.

So it protects the GI tract and reduces weight.

Smells fishy.
Why open label?
Would need to tear into the categorical data but I suspect their study is background noise.
 
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At day 28, a weight-lowering effect (P<0.01) and anti-ulcer effect (P <0.01) of curcumin were observed.

So it protects the GI tract and reduces weight.

Smells fishy.
Why open label?
Would need to tear into the categorical data but I suspect their study is background noise.


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Diabetes Metab Syndr. 2019 Jul 30;13(5):2819-2825. doi: 10.1016/j.dsx.2019.07.045. [Epub ahead of print]
The effect of curcumin supplementation on circulating adiponectin: A systematic review and meta-analysis of randomized controlled trials.
Clark CCT1, Ghaedi E2, Arab A3, Pourmasoumi M4, Hadi A5.
Author information
1Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK. Electronic address: [email protected].2Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address: [email protected].3Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: [email protected].4Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: [email protected].5Halal Research Center of IRI, FDA, Tehran, Iran. Electronic address: [email protected].
Abstract
OBJECTIVE:
Our objective was to perform a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effect of curcumin on serum adiponectin concentration.
METHODS:
We searched PubMed/Medline, Scopus, ISI Web of Science, Cochrane Library, and Google scholar databases up to April 2019. RCTs conducted among human adults studied the effects of curcumin on serum adiponectin concentrations as an outcome variable was included. The weighted mean differences (WMD) and standard deviations (SD) of change in serum adiponectin levels were calculated. The random effects model was used for deriving a summary of mean estimates with their corresponding SDs.
RESULTS:
Out of 313 records, 6 trials that enrolled 652 subjects were included. The pooled results showed that curcumin supplementation significantly increased adiponectin concentrations in comparison with placebo (WMD: 0.82 Hedges' g; 95% confidence interval (CI): 0.33 to 1.30, P˂0.001). Greater effects on adiponectin were observed in trials lasting ≤10 weeks (WMD: 1.05 Hedges' g; 95% CI: 0.64 to 1.45, P˂0.001).
CONCLUSION:
Curcumin significantly improves adiponectin concentrations. However, due to some limitations in this study, further studies are needed to reach a definitive conclusion about the effect of curcumin on the levels of adiponectin.
Copyright © 2019. Published by Elsevier Ltd.
KEYWORDS:
Adiponectin; Curcumin; Meta-analysis; Randomized controlled trials
 
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GIGO.
If it caused weight loss, we would see it still being used. Most have found it useless for everything. Also, nutriceuticals are like stem cells, no oversight, no idea what you are actually getting.
 
GIGO.
If it caused weight loss, we would see it still being used. Most have found it useless for everything. Also, nutriceuticals are like stem cells, no oversight, no idea what you are actually getting.

Your Semmelweis reflex is 4+ with sustained clonus...check bulbocavernosus next...

 
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I don't believe this for a minute. No one here should take this seriously.
 
Turmeric works in 40% of patients IMHO.
 
Nonsense. Use bee venom for real relief:

 
The problem with turmeric is the blood levels of curcumin achieved are extremely low, 0.17 mcg/ml (Comparative Oral Absorption of Curcumin in a Natural Turmeric Matrix with Two Other Curcumin Formulations: An Open-label Parallel-arm Study. - PubMed - NCBI) compared with ibuprofen (31mcg/ml) (Bioavailability of ibuprofen following oral administration of standard ibuprofen, sodium ibuprofen or ibuprofen acid incorporating poloxamer in healthy volunteers) or 2.5 mcg/ml for meloxicam (Absence of ethnic differences in the pharmacokinetics of moxifloxacin, simvastatin, and meloxicam among three East Asian populations and Caucasians) or 95mcg/ml for naproxen (Steady-state pharmacokinetics of enteric-coated naproxen tablets compared with standard naproxen tablets. - PubMed - NCBI). Unless curcumin is an analgesic that is 200 times the analgesic potency of ibuprofen (unlikely) or 15 times the potency of meloxicam or 500 times the analgesic potency of naproxen, turmeric capsules 500mg will not achieve substantial pain relief, but will also not cause the negative effects of NSAIDs.

Turmeric is the major available supplement in the US that contains curcumin, and is available in capsules of 500mg. There is a study showing equivalency between ibuprofen 1200mg/day PO and curcumin extracts (1500mg/day) for knee pain (Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study) , but given that turmeric contains only 2% curcumin, to obtain this amount of curcumin per day would require 150 tablets of turmeric per day (75,000mg). Therefore, given the placebo effect is 1/3, then at least 1/3 of the patients are likely to benefit from turmeric in the usual recommended dosage of 1000-2000mg per day.
 
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Decent looking study. No placebo. Also, significant weight reduction in the Curcumin group - could this be the main benefit, and the true take home message?

Algos, they did kind of address this issue by combining the Curcumin with oil of turmeric (paragraph 4 under background)
 
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True, but they concentrated the curcumin from the native 2% in turmeric to 85%- something that is not usually available in the US.
 
The problem with turmeric is the blood levels of curcumin achieved are extremely low, 0.17 mcg/ml (Comparative Oral Absorption of Curcumin in a Natural Turmeric Matrix with Two Other Curcumin Formulations: An Open-label Parallel-arm Study. - PubMed - NCBI) compared with ibuprofen (31mcg/ml) (Bioavailability of ibuprofen following oral administration of standard ibuprofen, sodium ibuprofen or ibuprofen acid incorporating poloxamer in healthy volunteers) or 2.5 mcg/ml for meloxicam (Absence of ethnic differences in the pharmacokinetics of moxifloxacin, simvastatin, and meloxicam among three East Asian populations and Caucasians) or 95mcg/ml for naproxen (Steady-state pharmacokinetics of enteric-coated naproxen tablets compared with standard naproxen tablets. - PubMed - NCBI). Unless curcumin is an analgesic that is 200 times the analgesic potency of ibuprofen (unlikely) or 15 times the potency of meloxicam or 500 times the analgesic potency of naproxen, turmeric capsules 500mg will not achieve substantial pain relief, but will also not cause the negative effects of NSAIDs.

Turmeric is the major available supplement in the US that contains curcumin, and is available in capsules of 500mg. There is a study showing equivalency between ibuprofen 1200mg/day PO and curcumin extracts (1500mg/day) for knee pain (Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study) , but given that turmeric contains only 2% curcumin, to obtain this amount of curcumin per day would require 150 tablets of turmeric per day (75,000mg). Therefore, given the placebo effect is 1/3, then at least 1/3 of the patients are likely to benefit from turmeric in the usual recommended dosage of 1000-2000mg per day.

Thank you for this.

There are supplements containing 95% curcuminoids, so achieving appropriate dosage is possible. Assuming you trust the standardization of supplements, which is sketchy.

 
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I agree....supplement manufacturers have no responsibility to patients, the FDA, or any other regulatory agency to have accurate analysis or labeling. In many cases supplement manufacturers simply fabricate labels based on what the Chinese source suppliers tell them is in the raw ingredients, without ever testing them.
 
The problem with turmeric is the blood levels of curcumin achieved are extremely low, 0.17 mcg/ml (Comparative Oral Absorption of Curcumin in a Natural Turmeric Matrix with Two Other Curcumin Formulations: An Open-label Parallel-arm Study. - PubMed - NCBI) compared with ibuprofen (31mcg/ml) (Bioavailability of ibuprofen following oral administration of standard ibuprofen, sodium ibuprofen or ibuprofen acid incorporating poloxamer in healthy volunteers) or 2.5 mcg/ml for meloxicam (Absence of ethnic differences in the pharmacokinetics of moxifloxacin, simvastatin, and meloxicam among three East Asian populations and Caucasians) or 95mcg/ml for naproxen (Steady-state pharmacokinetics of enteric-coated naproxen tablets compared with standard naproxen tablets. - PubMed - NCBI). Unless curcumin is an analgesic that is 200 times the analgesic potency of ibuprofen (unlikely) or 15 times the potency of meloxicam or 500 times the analgesic potency of naproxen, turmeric capsules 500mg will not achieve substantial pain relief, but will also not cause the negative effects of NSAIDs.

Turmeric is the major available supplement in the US that contains curcumin, and is available in capsules of 500mg. There is a study showing equivalency between ibuprofen 1200mg/day PO and curcumin extracts (1500mg/day) for knee pain (Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study) , but given that turmeric contains only 2% curcumin, to obtain this amount of curcumin per day would require 150 tablets of turmeric per day (75,000mg). Therefore, given the placebo effect is 1/3, then at least 1/3 of the patients are likely to benefit from turmeric in the usual recommended dosage of 1000-2000mg per day.
You can buy turmeric powder for about 6 dollars a pound on Amazon. No idea why anyone would buy the capsules unless they were ignorant.
 
Again, you have no idea what you are getting. ( see http://cms.herbalgram.org/BAP/BAB/T...45&signature=1187bb2615cb9ea13e35487cccb850fc)
Known adulterants: The fact that this spice is frequently sold in powdered form (which renders identification to species by macroscopic visual inspection impossible) makes it more susceptible to mixing with extraneous, lower-cost botanical ingredients, starches, chalk powder, cassava, and synthetic dyes.32,37-40 A report has raised the issue regarding what appears to be the trade of turmeric roots that were pre-extracted and mixed with non-extracted roots. The spent roots were lighter, less dense, and of a red color different from the roots that did not appear to be pre-extracted. (R. Upton email communication to S. Gafner, April 16, 2018). Whole rhizomes of turmeric have also been found to be adulterated with species from the same genus containing curcumin, e.g., C. zedoaria.27,32,38,40,41
The first report of adulteration of C. longa with C. zedoaria and C. aromatica was published in the 1970s.32 Curcuma zedoaria, a wild relative of turmeric, also sometimes known as white turmeric, is a plant easy to mix with turmeric powder due to its close resemblance and wide availability. The plant is indigenous to Bangladesh, Sri Lanka, and India, and is also widely cultivated in China, Japan, Brazil, Nepal, and Thailand.32,42 Adulteration has also been reported with C. zanthorrhiza.43

Due to the high demand in international trade, turmeric powder has been subject to economically-driven adulteration with potentially toxic chemical compounds. Metanil yellow (sodium 3-[4-anilinophenylazo] benzenesulfonate) is a synthetic, non-permitted food color and additive, which has been used as a turmeric adulterant, since it mimics the color appearance of curcumin.37,44 Other dyes which have been cited as adulterants in turmeric are lead chromate,27,39,43 acid orange 7 (sodium 4-[(2E)-2-(2-oxonaphthalen-1-ylidene) hydrazinyl]benzenesulfonate),45 and Sudan Red G.46 Turmeric is also diluted with yellow soapstone powder, a natural mineral.

Extracts standardized to curcuminoids are among the fastest-growing herbal ingredients presently in the United States (Tables 1 and 2). Prices for natural curcuminoids from C. longa are above $150/kg, about three times that of synthetic curcumin, which costs around $50/kg. This has given rise to unethical suppliers spiking natural turmeric extracts with synthetic curcumin (N. Kalyanam [Sabinsa] email communication, March 1, 2017).

3.2. Sources of information supporting confirmation of adulteration: Scientific papers from the 1970s and 1980s describe adulteration of turmeric with other Curcuma species, starches, and dyes, and provide methodologies for their detection, but no commercial samples were evaluated in these papers.32,46,47

In 2004, three market samples of turmeric powder brands in the Indian market were analyzed based on genetic profiling (Random Amplified Polymorphic DNA [RAPD] analysis) and compared to genuine powders of C. longa and C. zedoaria. The analysis revealed the presence of more C. zedoaria (wild species) powder than C. longa (the common culinary turmeric) powder, even though the curcumin levels of the samples met the quality standards.42

In 2011, six samples of turmeric powder procured from a local market at Calicut, Kerala, India were analyzed using two Sequence Characterized Amplified Region (SCAR) markers, a method to determine the identity of turmeric based on DNA markers. Both markers detected the presence of adulteration with C. zedoaria or C. malabarica in four market samples and in simulated mixtures, i.e., samples of turmeric powder and the adulterants made at different concentrations.48 In 2015, one out of 10 turmeric samples analyzed by DNA using single nucleotide polymorphisms (SNPs) that discriminate between C. longa and C. zedoaria was shown to be adulterated with C. zeodaria.49

The Bureau of Indian Standards suggests a minimum of 3% curcumin for powdered turmeric, whereas the mandatory Prevention of Food Adulteration (PFA) Act of 1954 does not specify any minimum curcumin limit.44 Despite the regulations in place in India, the quality of turmeric products on the Indian market is highly variable.

In 2008, a report showed turmeric adulteration and detected the presence of organic dyes, such as metanil yellow (1.5–4.6 mg/g), Sudan I (4.8–12.1 mg/g), and Sudan IV (0.9–2 mg/g) in loose turmeric and chili samples from city markets across India. The curcumin content in turmeric and mixed curry powder samples ranged from 6.5 to 36.4 mg/g and from 0.3 to 1.9 mg/g, respectively.37

In a 2013 report, four commercial samples of whole dried rhizome turmeric were collected randomly from four different areas of the spice market of Allahabad, India, and analyzed for possible adulteration using laser-induced breakdown spectroscopy (LIBS), an atomic absorption technique providing signatures of each element. The analysis demonstrated that one of the four samples had spectral signatures corresponding to lead (Pb) and chromium (Cr), suggesting they might contain lead chromate as an adulterant providing color to make them more attractive to consumers.27

In another study, food samples from the unorganized sector in West Bengal, India were tested. The unorganized sector is comprised of private enterprises owned by individuals or households that produce or sell goods and services, operate on a proprietary or partnership basis, and employ less than ten workers. Fifty-eight samples of a total of 253 collected (20.94%) contained metanil yellow, with 32.95% of the turmeric powder specimens and 31.32% of the laddoo(ball-shaped traditional Indian dessert made with flour, milk, sugar, and turmeric) samples containing metanil yellow. No significant contamination of metanil yellow was found in besan (a flour made from a variety of ground chickpea) samples.50

A recent review on ground turmeric as a source of lead exposure in the United States was conducted by researchers at the Department of Environmental Health, School of Public Health at Boston University. The review focused on the contamination of turmeric with lead (with high lead levels likely coming from the addition of lead chromate) in products imported from India and Bangladesh to the United States. According to the authors, spices, food, and dietary supplements in the United States may be extensively adulterated with lead to enhance its weight, color, or both.39 In 2011 and 2012, the authors purchased 32 samples of turmeric from mainstream grocery stores, specialty stores, and ethnic markets throughout the greater Boston area and found detectable levels of lead in all of the samples, with a median concentration of 0.11 μg/g (range: 0.03-99.50 μg/g), using inductively coupled plasma-mass spectrometry. The authors cite several FDA enforcement reports from 2011 to 2014 showing 13 lead contaminated turmeric brands recalled (voluntarily) in several US states. In 2016, seven brands of turmeric were recalled because of elevated lead levels, as well as five brands of curry powder, amounting to 337,000 pounds.39

Most recently, 38,000 pounds of turmeric that were distributed to Florida and New York by Spices USA, Inc. were recalled because of elevated lead levels.51 The FDA issued an import alert of lead poisoning on September 26, 2016, which allows ports to detain future shipments from specific importers, targeting turmeric from Pran (Bangladesh), Visakarega Trading (India), and Indo Vedic Nutrients (India).51

In 2014, Harvard University researchers reported lead concentrations of up to 483 μg/g in turmeric samples collected from 18 households in rural Bangladesh, a country where the permissible level of lead in turmeric is 2.5 μg/g.39,52 A newspaper article (Times of India, published May 10, 2010) reported a raid by the Indian Food and Drug Authority in 2010, with inspectors discovering over 100 bags of raw turmeric contaminated with lead chromate at a spice manufacturing plant.53

The issue of adulteration of natural curcumin with synthetic curcumin was first reported in 2011, when EuroPharma (Green Bay, WI), a US manufacturer of natural turmeric extract supplements, considered the possibility of commercially available curcumin supplements made with a lower-cost synthetic version and began working with University of Georgia on tests using radiocarbon dating techniques to analyze curcumin products on the market to determine the percentage that contained synthetic versus natural curcumin, or a combination of both.23,54

After the 2011 report by EuroPharma, other suppliers initiated strategies to identify products adulterated with synthetic ingredients23,54,55 and, in some instances, apparently prompted industry members to take legal action. On May 26, 2015, Sabinsa Corporation's parent company Sami Labs Limited (Bangalore, India), filed a criminal complaint with the chief magistrate, Bangalore and the Peenya police department, Bangalore, against Bayir Extracts Private Limited, Bangalore, India for knowingly supplying adulterated turmeric oleoresin with a forged Certificate of Analysis.56,57

The 14C testing of five commercial samples of curcumin sold by Bayir for export to the U.S. showed that four of the materials contained curcumin that was 32-45% synthetic, while the fifth sample was 100% natural.57 Using the same testing approach, materials from another supplier (Biotikon®, Gorxheimertal, Germany) were also found to contain significant amounts of synthetic curcumin.58

3.3. Accidental or intentional adulteration: Turmeric is likely one of the spices most frequently adulterated because of its widespread use and high cost. In some situations, the use of C. zedoaria could be a case of mistaken identity and qualified to be an accidental adulteration due to human error. But the uses of cassava, talc powder, starches, yellow dyes, minerals and synthetic curcumin are clearly intentional and constitute economically-motivated adulteration.

3.4. Frequency of occurrence: Adulteration of turmeric powder commonly occurs with synthetic dyes, zedoary root, starch, and cassava in food ingredients, and also with synthetic curcumin on turmeric curcumin used as an ingredient in dietary supplements. The use of dyes in unbranded turmeric powders sold in bulk is prevalent in different regions in India. The frequency of adulteration of C. longa with C. zedoaria is not known. Morgan et al.59 suggest that adulteration with C. zedoaria is rare, but a large market sample analysis has yet to be performed.

The presence of C. zedoaria was detected in all three samples of popular turmeric powder products tested.42 In another study, one out of 10 branded samples from an Indian market showed the presence of zedoary and starches although the label claimed nothing other than turmeric powder.49

Thin-layer chromatography (TLC) analysis of market samples (of turmeric, chili, and curry purchased in Lucknow, India) showed the presence of the food dyes metanil yellow (1.5–4.6 mg/g), Sudan I (4.8–12.1 mg/g), and Sudan IV (0.9–2.0 mg/g) in loose turmeric and chili samples; the occurrence of the Sudan dyes was limited to the chili samples.37

In a more detailed study by the same group, 712 commercial samples in India were tested using a two-dimensional high-performance thin-layer chromatography (HPTLC) method. None of the branded samples (N =100) showed the presence of artificial color, but 105 (17.2%) of the non-branded samples (N = 612) of turmeric powders were dyed with metanil yellow.44

Four samples of whole dried turmeric rhizome collected randomly from four different areas of the spice market of Allahabad (India) were analyzed directly by the LIBS technique for a complete profiling of elements present in the samples. Three samples were found to be authentic, while one sample had a bright yellow color. This latter sample was found to be adulterated with lead II chromate dye.27

Analysis of 253 food samples, consisting of three different types of food items —turmeric powder, laddoo, and besan — were tested for the presence of metanil yellow. Fifty-eight out of the 253 samples collected, i.e., 20.9%,were found to contain metanil yellow with 36.2% of the positive samples below the maximum permissible limit and 63.8% above the maximum permissible limit of 100 mg/kg, as specified in the Prevention of Food Adulteration Act of India.50,60 No metanil yellow was found in any food samples prepared from the food items (turmeric powder, laddoo, and besan) produced by the organized sector, i.e., those companies that are registered with the Indian government and follow its rules and regulations.50

The practice of adulteration with dyes in India is regional, and turmeric from poorer sectors in the Indian state of West Bengal has been found to contain metanil yellow more often than turmeric from the more affluent regions of the state.50

The occurrence of adulteration of C. longa with other Curcuma species as lower-cost substitutes in the marketplace has been mentioned in many publications since the 1970s,32,38,49 but reports of the analysis of samples of branded commercial turmeric products are limited. In one report, one of the 10 samples analyzed by DNA barcoding showed the presence of C. zedoaria DNA. The 10 samples were from popular brands of turmeric powder procured locally from Kozhikode (Kerala state, India). Each of the 10 samples was produced by a different company.49 Another report using RAPD markers to distinguish among Curcuma species found all three samples analyzed were adulterated with C. zedoaria.42 Finally, an investigation from 2014 into the quality of 39 commercial turmeric samples for food, dietary supplement and cosmetic use sold in supermarkets and retail stores in the United Kingdom (27), India (8), the Netherlands (2), Iceland (1), and Greenland (1) labeled to contain C. longa (34), C. amada (1), C. aromatica (2), C. zanthorrhiza (1), and C. kwangsiensis (1) by HPTLC showed that three products did not contain any bands, one turmeric product was adulterated with C. aromatica, and one product from India contained merely curcumin, with little to no demethoxy- and bisdemethoxycurcumin.41

As noted above, a more recent practice is the use of synthetic curcumin to adulterate turmeric extracts claiming a specific curcuminoid content. Since synthetic curcumin is of much lower cost, companies that produce all-natural ingredients have reported that fraudulent suppliers of turmeric extracts containing synthetic curcumin are able to offer materials at lower prices (N. Kalyanam [Sabinsa] email communication, April 2, 2017).

As stated in section 3.2 above, four out of five samples from one supplier were found to contain synthetic curcumin.57To date, no report with test results of a larger set of commercial samples is available to confirm the frequency of adulteration with synthetic curcumin, and its geographic distribution.
 
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Again, you have no idea what you are getting. ( see http://cms.herbalgram.org/BAP/BAB/T...45&signature=1187bb2615cb9ea13e35487cccb850fc)
Known adulterants: The fact that this spice is frequently sold in powdered form (which renders identification to species by macroscopic visual inspection impossible) makes it more susceptible to mixing with extraneous, lower-cost botanical ingredients, starches, chalk powder, cassava, and synthetic dyes.32,37-40 A report has raised the issue regarding what appears to be the trade of turmeric roots that were pre-extracted and mixed with non-extracted roots. The spent roots were lighter, less dense, and of a red color different from the roots that did not appear to be pre-extracted. (R. Upton email communication to S. Gafner, April 16, 2018). Whole rhizomes of turmeric have also been found to be adulterated with species from the same genus containing curcumin, e.g., C. zedoaria.27,32,38,40,41
The first report of adulteration of C. longa with C. zedoaria and C. aromatica was published in the 1970s.32 Curcuma zedoaria, a wild relative of turmeric, also sometimes known as white turmeric, is a plant easy to mix with turmeric powder due to its close resemblance and wide availability. The plant is indigenous to Bangladesh, Sri Lanka, and India, and is also widely cultivated in China, Japan, Brazil, Nepal, and Thailand.32,42 Adulteration has also been reported with C. zanthorrhiza.43

Due to the high demand in international trade, turmeric powder has been subject to economically-driven adulteration with potentially toxic chemical compounds. Metanil yellow (sodium 3-[4-anilinophenylazo] benzenesulfonate) is a synthetic, non-permitted food color and additive, which has been used as a turmeric adulterant, since it mimics the color appearance of curcumin.37,44 Other dyes which have been cited as adulterants in turmeric are lead chromate,27,39,43 acid orange 7 (sodium 4-[(2E)-2-(2-oxonaphthalen-1-ylidene) hydrazinyl]benzenesulfonate),45 and Sudan Red G.46 Turmeric is also diluted with yellow soapstone powder, a natural mineral.

Extracts standardized to curcuminoids are among the fastest-growing herbal ingredients presently in the United States (Tables 1 and 2). Prices for natural curcuminoids from C. longa are above $150/kg, about three times that of synthetic curcumin, which costs around $50/kg. This has given rise to unethical suppliers spiking natural turmeric extracts with synthetic curcumin (N. Kalyanam [Sabinsa] email communication, March 1, 2017).

3.2. Sources of information supporting confirmation of adulteration: Scientific papers from the 1970s and 1980s describe adulteration of turmeric with other Curcuma species, starches, and dyes, and provide methodologies for their detection, but no commercial samples were evaluated in these papers.32,46,47

In 2004, three market samples of turmeric powder brands in the Indian market were analyzed based on genetic profiling (Random Amplified Polymorphic DNA [RAPD] analysis) and compared to genuine powders of C. longa and C. zedoaria. The analysis revealed the presence of more C. zedoaria (wild species) powder than C. longa (the common culinary turmeric) powder, even though the curcumin levels of the samples met the quality standards.42

In 2011, six samples of turmeric powder procured from a local market at Calicut, Kerala, India were analyzed using two Sequence Characterized Amplified Region (SCAR) markers, a method to determine the identity of turmeric based on DNA markers. Both markers detected the presence of adulteration with C. zedoaria or C. malabarica in four market samples and in simulated mixtures, i.e., samples of turmeric powder and the adulterants made at different concentrations.48 In 2015, one out of 10 turmeric samples analyzed by DNA using single nucleotide polymorphisms (SNPs) that discriminate between C. longa and C. zedoaria was shown to be adulterated with C. zeodaria.49

The Bureau of Indian Standards suggests a minimum of 3% curcumin for powdered turmeric, whereas the mandatory Prevention of Food Adulteration (PFA) Act of 1954 does not specify any minimum curcumin limit.44 Despite the regulations in place in India, the quality of turmeric products on the Indian market is highly variable.

In 2008, a report showed turmeric adulteration and detected the presence of organic dyes, such as metanil yellow (1.5–4.6 mg/g), Sudan I (4.8–12.1 mg/g), and Sudan IV (0.9–2 mg/g) in loose turmeric and chili samples from city markets across India. The curcumin content in turmeric and mixed curry powder samples ranged from 6.5 to 36.4 mg/g and from 0.3 to 1.9 mg/g, respectively.37

In a 2013 report, four commercial samples of whole dried rhizome turmeric were collected randomly from four different areas of the spice market of Allahabad, India, and analyzed for possible adulteration using laser-induced breakdown spectroscopy (LIBS), an atomic absorption technique providing signatures of each element. The analysis demonstrated that one of the four samples had spectral signatures corresponding to lead (Pb) and chromium (Cr), suggesting they might contain lead chromate as an adulterant providing color to make them more attractive to consumers.27

In another study, food samples from the unorganized sector in West Bengal, India were tested. The unorganized sector is comprised of private enterprises owned by individuals or households that produce or sell goods and services, operate on a proprietary or partnership basis, and employ less than ten workers. Fifty-eight samples of a total of 253 collected (20.94%) contained metanil yellow, with 32.95% of the turmeric powder specimens and 31.32% of the laddoo(ball-shaped traditional Indian dessert made with flour, milk, sugar, and turmeric) samples containing metanil yellow. No significant contamination of metanil yellow was found in besan (a flour made from a variety of ground chickpea) samples.50

A recent review on ground turmeric as a source of lead exposure in the United States was conducted by researchers at the Department of Environmental Health, School of Public Health at Boston University. The review focused on the contamination of turmeric with lead (with high lead levels likely coming from the addition of lead chromate) in products imported from India and Bangladesh to the United States. According to the authors, spices, food, and dietary supplements in the United States may be extensively adulterated with lead to enhance its weight, color, or both.39 In 2011 and 2012, the authors purchased 32 samples of turmeric from mainstream grocery stores, specialty stores, and ethnic markets throughout the greater Boston area and found detectable levels of lead in all of the samples, with a median concentration of 0.11 μg/g (range: 0.03-99.50 μg/g), using inductively coupled plasma-mass spectrometry. The authors cite several FDA enforcement reports from 2011 to 2014 showing 13 lead contaminated turmeric brands recalled (voluntarily) in several US states. In 2016, seven brands of turmeric were recalled because of elevated lead levels, as well as five brands of curry powder, amounting to 337,000 pounds.39

Most recently, 38,000 pounds of turmeric that were distributed to Florida and New York by Spices USA, Inc. were recalled because of elevated lead levels.51 The FDA issued an import alert of lead poisoning on September 26, 2016, which allows ports to detain future shipments from specific importers, targeting turmeric from Pran (Bangladesh), Visakarega Trading (India), and Indo Vedic Nutrients (India).51

In 2014, Harvard University researchers reported lead concentrations of up to 483 μg/g in turmeric samples collected from 18 households in rural Bangladesh, a country where the permissible level of lead in turmeric is 2.5 μg/g.39,52 A newspaper article (Times of India, published May 10, 2010) reported a raid by the Indian Food and Drug Authority in 2010, with inspectors discovering over 100 bags of raw turmeric contaminated with lead chromate at a spice manufacturing plant.53

The issue of adulteration of natural curcumin with synthetic curcumin was first reported in 2011, when EuroPharma (Green Bay, WI), a US manufacturer of natural turmeric extract supplements, considered the possibility of commercially available curcumin supplements made with a lower-cost synthetic version and began working with University of Georgia on tests using radiocarbon dating techniques to analyze curcumin products on the market to determine the percentage that contained synthetic versus natural curcumin, or a combination of both.23,54

After the 2011 report by EuroPharma, other suppliers initiated strategies to identify products adulterated with synthetic ingredients23,54,55 and, in some instances, apparently prompted industry members to take legal action. On May 26, 2015, Sabinsa Corporation's parent company Sami Labs Limited (Bangalore, India), filed a criminal complaint with the chief magistrate, Bangalore and the Peenya police department, Bangalore, against Bayir Extracts Private Limited, Bangalore, India for knowingly supplying adulterated turmeric oleoresin with a forged Certificate of Analysis.56,57

The 14C testing of five commercial samples of curcumin sold by Bayir for export to the U.S. showed that four of the materials contained curcumin that was 32-45% synthetic, while the fifth sample was 100% natural.57 Using the same testing approach, materials from another supplier (Biotikon®, Gorxheimertal, Germany) were also found to contain significant amounts of synthetic curcumin.58

3.3. Accidental or intentional adulteration: Turmeric is likely one of the spices most frequently adulterated because of its widespread use and high cost. In some situations, the use of C. zedoaria could be a case of mistaken identity and qualified to be an accidental adulteration due to human error. But the uses of cassava, talc powder, starches, yellow dyes, minerals and synthetic curcumin are clearly intentional and constitute economically-motivated adulteration.

3.4. Frequency of occurrence: Adulteration of turmeric powder commonly occurs with synthetic dyes, zedoary root, starch, and cassava in food ingredients, and also with synthetic curcumin on turmeric curcumin used as an ingredient in dietary supplements. The use of dyes in unbranded turmeric powders sold in bulk is prevalent in different regions in India. The frequency of adulteration of C. longa with C. zedoaria is not known. Morgan et al.59 suggest that adulteration with C. zedoaria is rare, but a large market sample analysis has yet to be performed.

The presence of C. zedoaria was detected in all three samples of popular turmeric powder products tested.42 In another study, one out of 10 branded samples from an Indian market showed the presence of zedoary and starches although the label claimed nothing other than turmeric powder.49

Thin-layer chromatography (TLC) analysis of market samples (of turmeric, chili, and curry purchased in Lucknow, India) showed the presence of the food dyes metanil yellow (1.5–4.6 mg/g), Sudan I (4.8–12.1 mg/g), and Sudan IV (0.9–2.0 mg/g) in loose turmeric and chili samples; the occurrence of the Sudan dyes was limited to the chili samples.37

In a more detailed study by the same group, 712 commercial samples in India were tested using a two-dimensional high-performance thin-layer chromatography (HPTLC) method. None of the branded samples (N =100) showed the presence of artificial color, but 105 (17.2%) of the non-branded samples (N = 612) of turmeric powders were dyed with metanil yellow.44

Four samples of whole dried turmeric rhizome collected randomly from four different areas of the spice market of Allahabad (India) were analyzed directly by the LIBS technique for a complete profiling of elements present in the samples. Three samples were found to be authentic, while one sample had a bright yellow color. This latter sample was found to be adulterated with lead II chromate dye.27

Analysis of 253 food samples, consisting of three different types of food items —turmeric powder, laddoo, and besan — were tested for the presence of metanil yellow. Fifty-eight out of the 253 samples collected, i.e., 20.9%,were found to contain metanil yellow with 36.2% of the positive samples below the maximum permissible limit and 63.8% above the maximum permissible limit of 100 mg/kg, as specified in the Prevention of Food Adulteration Act of India.50,60 No metanil yellow was found in any food samples prepared from the food items (turmeric powder, laddoo, and besan) produced by the organized sector, i.e., those companies that are registered with the Indian government and follow its rules and regulations.50

The practice of adulteration with dyes in India is regional, and turmeric from poorer sectors in the Indian state of West Bengal has been found to contain metanil yellow more often than turmeric from the more affluent regions of the state.50

The occurrence of adulteration of C. longa with other Curcuma species as lower-cost substitutes in the marketplace has been mentioned in many publications since the 1970s,32,38,49 but reports of the analysis of samples of branded commercial turmeric products are limited. In one report, one of the 10 samples analyzed by DNA barcoding showed the presence of C. zedoaria DNA. The 10 samples were from popular brands of turmeric powder procured locally from Kozhikode (Kerala state, India). Each of the 10 samples was produced by a different company.49 Another report using RAPD markers to distinguish among Curcuma species found all three samples analyzed were adulterated with C. zedoaria.42 Finally, an investigation from 2014 into the quality of 39 commercial turmeric samples for food, dietary supplement and cosmetic use sold in supermarkets and retail stores in the United Kingdom (27), India (8), the Netherlands (2), Iceland (1), and Greenland (1) labeled to contain C. longa (34), C. amada (1), C. aromatica (2), C. zanthorrhiza (1), and C. kwangsiensis (1) by HPTLC showed that three products did not contain any bands, one turmeric product was adulterated with C. aromatica, and one product from India contained merely curcumin, with little to no demethoxy- and bisdemethoxycurcumin.41

As noted above, a more recent practice is the use of synthetic curcumin to adulterate turmeric extracts claiming a specific curcuminoid content. Since synthetic curcumin is of much lower cost, companies that produce all-natural ingredients have reported that fraudulent suppliers of turmeric extracts containing synthetic curcumin are able to offer materials at lower prices (N. Kalyanam [Sabinsa] email communication, April 2, 2017).

As stated in section 3.2 above, four out of five samples from one supplier were found to contain synthetic curcumin.57To date, no report with test results of a larger set of commercial samples is available to confirm the frequency of adulteration with synthetic curcumin, and its geographic distribution.
That is certainly interesting. Suggest this then, at $15.00 a pound. If you think this stuff is bad, then I suspect you grow your own food? Amazon product
 
Consumerlab.com is a great resource. An independent laboratory that tests supplements, vitamins, etc to confirm it contains what's on the label. Can do a free 7 day trial of the site.

I use it to check any vitamins or supplements before taking them. About 20% of the market is BS, but most are real. Just need third party verification.
 
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I agree....supplement manufacturers have no responsibility to patients, the FDA, or any other regulatory agency to have accurate analysis or labeling. In many cases supplement manufacturers simply fabricate labels based on what the Chinese source suppliers tell them is in the raw ingredients, without ever testing them.

Turmeric is sold to consumers, not "patients." Do you want the FDA to impose regulatory barriers that make it prohibitively expensive to sell turmeric/curcumin for medicinal use, like they do everything else they regulate? I buy Turmeric at Costco. I'm very happy with its very real, positive effect on joint pain, and very happy that I have the freedom to use it as an alternative to conventional NSAIDs without the permission of some flunkie in government or intellectually dependent doctor who doesn't recognize its value. The company I buy it from vets the product to ensure it contains what the manufacturer says it contains. But the government should cut me off from it, because any perceived benefit is just anecdoctal/n=1/a placebo effect, right? Supplement manufacturers should have to prove their products to the government, not the people who distribute and use those products, right? Because those all-knowing, priestly bureaucrats are the only people we can really trust to know what's best for us and have no conflicts of interest, right?
 
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I believe the entire supplement industry should be strictly regulated. For those that advocate supplements for health and advocate their use in patients are simply playing russian roulette since most supplements have not been analyzed for harmful impurities or veracity of content, and the suppliers of raw materials are ever changing.
 
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So what do you want? The FDA to take curcumin away from the people who like it and force them into the “safety” of FDA-approved NSAIDs?

The regulations you favor have been analyzed, and their impact on the individual health are terrible.
 
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The funny part about all this is that turmeric is a spice used to make curry among other things. So you can find turmeric right alongside the pepper and salt in the grocery stores. Who regulates spices? The FDA.
 
I want the FDA to "take away" the ability of the multibillion dollar supplement industry to fleece consumers with shoddy, if not dangerous products. The FDA's hands are largely tied by Congress, and they act only retroactively to remove supplements from the market after they have maimed or killed people. This is unacceptable. We don't need proof of efficacy- we need proof that what is being sold is what is on the label, and that the label discloses all ingredients.
 
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I want the FDA to "take away" the ability of the multibillion dollar supplement industry to fleece consumers with shoddy, if not dangerous products. The FDA's hands are largely tied by Congress, and they act only retroactively to remove supplements from the market after they have maimed or killed people. This is unacceptable. We don't need proof of efficacy- we need proof that what is being sold is what is on the label, and that the label discloses all ingredients.


Unacceptable to who? I find it perfectly acceptable. Supplements are NOT a credible health threat. People who have been harmed by supplements are the tiny minority of the overall market who make inexcusably stupid, irresponsible decisions. Far more people take supplants like turmeric, fish oil, and glucosamine/chondroitin that likely offer some benefit than take dangerous things like fat burners. Those opportunities only exist thanks to the relative absence of regulations. In the areas the FDA regulates, its net effect is a loss of quality and length of life for almost everyone due to the loss of treatment opportunities that could exist without the regulations. Ultimately all regulations are just about protecting trade groups from competition. The real beneficiaries of supplement regulation are the most corrupt drug companies, they very things you probably think the FDA protects you against.
 
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I take turmeric supplements but Im skeptical about them being all that effective.
 
I take turmeric supplements but Im skeptical about them being all that effective.
Then feel free to stop taking it and let others be free to continue doing so if their judgment differs.
 
I want the FDA to "take away" the ability of the multibillion dollar supplement industry to fleece consumers with shoddy, if not dangerous products. The FDA's hands are largely tied by Congress, and they act only retroactively to remove supplements from the market after they have maimed or killed people. This is unacceptable. We don't need proof of efficacy- we need proof that what is being sold is what is on the label, and that the label discloses all ingredients.
Exactly this. I don't care about whether or not supplement manufacturers have done studies proving that their product actually does any good.

I care that if my patients buy Brand X vitamin D pills that those pills actually contain what the bottle says they do.

I'm pretty sure that's neither government overreach nor overly burdensome.
 
I am not so naive to think that supplements cause little harm. The FDA has sanctioned over 100 companies in the past couple of years for misbranded supplements including those containing known carcinogens (not on the label), multiple NSAIDs (up to 6 in the same pill) in arthritis formulas, cialis and viagra in high quantities in "men's health" products, known allergens (not listed), and others. These have caused untold numbers of people to develop cancer, have GI bleeds, asthma and other allergic reactions, hypotension and myocardial infarctions, but the ER docs seeing these patients don't put 2 and 2 together because they also are unaware of the mass mislabeling in the supplement industry. There have been cases where China in particular, where 95% of all raw materials originate for our supplements then are remixed in the US, falsified analysis documents and the US manufacturers never took the time or effort to recheck the contents. When the FDA orders a recall on a supplement, the manufacturers frequently pull it off the shelf, then simply place a new label for a different product on the same bottle, then send it back to the retail store. It is like whack-a-mole, and the FDA lacks the Congressional authority to protect the public from misbranding. Of course there are many products that contain zero amount of the primary labeled ingredient as discovered by the NY State Atty General in an analysis. While this may not harm people (since most supplements have no benefit anyway), it is overt fraud to the public without any accountability by supplement manufacturers. A recall is the only weapon the FDA has at its disposal and only if the supplements are producing harm or are misbranded. Given there are over 100,000 supplements on the market with many new formulations every year, the FDA lacks the resources to test but a small fraction of the supplements. This should change.
 
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There have been cases where China in particular, where 95% of all raw materials originate for our supplements then are remixed in the US, falsified analysis documents and the US manufacturers never took the time or effort to recheck the contents.

I'm getting really mad China these days...
 
never been to China but im guessing they arent redistributing wealth for the global warming cause...errr i mean climate change. And since the Obamas just signed into escrow a $14+ milllion waterfront home, 29 beachfront acres in Martha's vineyard, maybe the sea level isnt rising as fast as we thought?

 
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I am not so naive to think that supplements cause little harm. The FDA has sanctioned over 100 companies in the past couple of years for misbranded supplements including those containing known carcinogens (not on the label), multiple NSAIDs (up to 6 in the same pill) in arthritis formulas, cialis and viagra in high quantities in "men's health" products, known allergens (not listed), and others. These have caused untold numbers of people to develop cancer, have GI bleeds, asthma and other allergic reactions, hypotension and myocardial infarctions, but the ER docs seeing these patients don't put 2 and 2 together because they also are unaware of the mass mislabeling in the supplement industry. There have been cases where China in particular, where 95% of all raw materials originate for our supplements then are remixed in the US, falsified analysis documents and the US manufacturers never took the time or effort to recheck the contents. When the FDA orders a recall on a supplement, the manufacturers frequently pull it off the shelf, then simply place a new label for a different product on the same bottle, then send it back to the retail store. It is like whack-a-mole, and the FDA lacks the Congressional authority to protect the public from misbranding. Of course there are many products that contain zero amount of the primary labeled ingredient as discovered by the NY State Atty General in an analysis. While this may not harm people (since most supplements have no benefit anyway), it is overt fraud to the public without any accountability by supplement manufacturers. A recall is the only weapon the FDA has at its disposal and only if the supplements are producing harm or are misbranded. Given there are over 100,000 supplements on the market with many new formulations every year, the FDA lacks the resources to test but a small fraction of the supplements. This should change.

FDA sanctions don't have much credibility. If the FDA says a supplement doesn't contain what's on the label, and a supplement company says it does, I'm less apt to believe the government, because they are a mafia of unaccountable thugs with a clear track record of falsely accusing innocent people of wrongdoing. There isn't any evidence that supplements are responsible for causing more than a few isolated cases of harm. You can only cherry-pick these cases and try to blow the numbers out of proportion (even if a few thousand people are harmed by something, that's a very small number). It's unacceptable that the FDA cuts everyone off from products and services that they could benefit from, as this is the greatest evil possible.
 
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FDA sanctions don't have much credibility. If the FDA says a supplement doesn't contain what's on the label, and a supplement company says it does, I'm less apt to believe the government, because they are a mafia of unaccountable thugs with a clear track record of falsely accusing innocent people of wrongdoing. There isn't any evidence that supplements are responsible for causing more than a few isolated cases of harm. You can only cherry-pick these cases and try to blow the numbers out of proportion (even if a few thousand people are harmed by something, that's a very small number). It's unacceptable that the FDA cuts everyone off from products and services that they could benefit from, as this is the greatest evil possible.

did you mean to write this in magenta? b/c if you are serious, then we have some major disagreements
 
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did you mean to write this in magenta? b/c if you are serious, then we have some major disagreements

Feel free to rationally prove any of the following:
  • FDA claims are any more credible than the claims of supplement manufacturers.
  • Supplements are responsible for more than a small amount (i.e. a few thousand cases a year) of harm.
  • The FDA prevents more harm by withholding bad products than it inflicts by withholding good ones.
 
Feel free to rationally prove any of the following:
  • FDA claims are any more credible than the claims of supplement manufacturers.
  • Supplements are responsible for more than a small amount (i.e. a few thousand cases a year) of harm.
  • The FDA prevents more harm by withholding bad products than it inflicts by withholding good ones.

it is YOUR job to prove that they are safe, not MY job to prove they are not. effectiveness is a whole 'nother question.

you make a questionable statement, then challenge me to disprove it? thats not the way this works.

i will say that morbidity from supplements is clearly way under-reported and under diagnosed.

if you are taking a bunch of supplements from the cheapest source (which is what a lot of these elderly, dont-know-any-better, hoarder-types do), you are putting god knows what into your body.

your first and third points cannot be proven anyway.
 
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it is YOUR job to prove that they are safe, not MY job to prove they are not. effectiveness is a whole 'nother question.

you make a questionable statement, then challenge me to disprove it? thats not the way this works.

i will say that morbidity from supplements is clearly way under-reported and under diagnosed.

if you are taking a bunch of supplements from the cheapest source (which is what a lot of these elderly, dont-know-any-better, hoarder-types do), you are putting god knows what into your body.

your first and third points cannot be proven anyway.

YOU are the one making the the positive claim—that regulation is necessary to protect us from the evils you allege. The burden of proof is on YOU to prove these claims. Your inability to recognize this exemplifies the kind of mystical thinking most people have toward the FDA. You expect everyone in the world to prove their claims TO THE GOVERNMENT, which you take for some kind of infallible, omniscient arbiter that doesn't have to prove anything, whose claims and actions are simply above review, like a diety. YOU have to prove that the FDA protects us (requires more than just saying "but but but THALIDOMIDE!!!"), which no one has ever has because it doesn't.
 
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YOU are the one making the the positive claim—that regulation is necessary to protect us from the evils you allege. The burden of proof is on YOU to prove these claims. Your inability to recognize this exemplifies the kind of mystical thinking most people have toward the issue. You expect everyone in the world to prove their claims TO THE GOVERNMENT, which you take for some kind of infallible, omniscient arbiter that doesn't have to prove anything, whose claims and actions are simply above review, like a diety. YOU have to prove that the FDA protects us (requires more than just saying "but but but THALIDOMIDE!!!"), which no one has ever has because it doesn't.

wow. uhhh. ok. somebody needs to take the tack out of their shoe.

the mystical thinking is that these companies are willing to kill you -- literally kill you -- to make more money.

you make a lot of claims about me with which i dont agree. "the government" is certainly not infallible. the FDA has huge problems. i dont really trust the gvt to get things done well, efficiently, or correctly. that being said: the ONLY goal of the nutraceutical companies is to make money. the goal of the FDA/GVT is to at least try to keep us someone safe and somewhat aware of what we put in our bodies. if you trust one of these supplement companies more than you trust the FDA as to what is in their products, then that is an innate character flaw that i cannot rectify. these companies would have you eat rat poison if it meant they could make an extra dime. do you think they care about your health? the FDA/FTC is certainly not perfect, but it is better than the charlatans scrounging for the almighty dollar. i may not have enough faith in capitalism, but you have WAY, WAY too much
 
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wow. uhhh. ok. somebody needs to take the tack out of their shoe.

the mystical thinking is that these companies arent willing to kill you -- literally kill you -- to make more money.

you make a lot of claims about me with which i dont agree. "the government" is certainly not infallible. the FDA has huge problems. i dont really trust the gvt to get things done well, efficiently, or correctly. that being said: the ONLY goal of the nutraceutical companies is to make money. the goal of the FDA/GVT is to at least try to keep us someone safe and somewhat aware of what we put in our bodies. if you trust one of these supplement companies more than you trust the FDA as to what is in their products, then that is an innate character flaw that i cannot rectify. these companies would have you eat rat poison if it meant they could make an extra dime. do you think they care about your health? the FDA/FTC is certainly not perfect, but it is better than the charlatans scrounging for the almighty dollar. i may not have enough faith in capitalism, but you have WAY, WAY too much

Killing your customers is bad for business. The idea that businessmen can make a profit by killing people is anticapitalist stupidity.
 
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Feel free to rationally prove any of the following:
  • FDA claims are any more credible than the claims of supplement manufacturers.
  • Supplements are responsible for more than a small amount (i.e. a few thousand cases a year) of harm.
  • The FDA prevents more harm by withholding bad products than it inflicts by withholding good ones.
a few thousand cases????

are you serious?

a few thousand cases of anything is called an epidemic.

I would also venture that it is in your opinion that it is the "right" of the individual to decide what they can take. that lasseiz-faire attitude is destructive and leads to addiction, as people are blithely unaware of the risks of some of the activities that they do, including ingesting illicit substances. are you advocating that illicit substances (that are DEA monitored, btw, but are "natural") etc. also be available for people to decide whether to take on their own?


FWIW not FDA approved: fentanyl is not under FDA jurisdiction. it is under DEA.
and it isn't just fentanyl that is coming. fentanyl alone is too weak. carfentanil is more like it.
 
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