Savvy investors avoid the financial advisor who pushes high commission products.

Peer reviewers give the stink eye to financial interests in medical research.

But what about the supplement industry?

We are expected to trust the same people who stand to profit from the sale of a product to share its safety information. You can thank the Dietary Supplement Health and Education Act of 1994 (DSHEA). It allows supplements to go to market without FDA approval. Only serious adverse effects must be reported. This applies to herbs, vitamins, minerals, botanicals, amino acids and other “natural” dietary substances.

The problem is a “natural” product isn’t always a safe product. Here are a few unsafe, natural products I can think of off the top of my head:

  • Arsenic
  • Hemlock
  • Lead
  • Ephedra
  • Oleander

I’m sure you can easily add to this list. So let’s get rid of the idea that natural equals safe. Safe equals safe.

The DSHEA forces consumers to rely on the product manufacturer who claims his own profit center is safe. Before we go further, let’s take the Lamar Odoms of the world out of this picture. If I were a gambling woman I would bet that herbal Viagra played – at best – a supporting role in Odom’s misfortune. And if I’m wrong, I’m going to assume you aren’t planning a three-day supplement binge.

But, after we eliminate the extreme cases, we are left with this 2013 study in the Annals of Internal Medicine. It showed limited evidence to support “any benefit from vitamin and mineral supplementation for the prevention of cancer or [cardiovascular disease.]”

We’ve also got the new report by Andrew Geller, MD in the New England Journal of Medicine. It estimates supplement use leads to 23,000 Emergency Department visits each year. Weight loss and energy boosters are the big offenders here.

And there’s the September 2015 report by Pieter Cohen that showed pharmaceutical grade yohimbine in the over-the-counter supplement. It also showed higher concentrations than reported by the manufacturer. According to the FDA, hidden pharmaceuticals or steroids have been found in over 170 supplements since 2008.

Expect a lot of noise about reforming DSHEA in the aftermath of this research. But change will happen at the pace of legislation. In the meantime grocery stores, pharmacies, gyms, and brothels have shelves bursting with supplements to “boost your energy” or “enhance your sex life.’’

So how do we consumers go forward? With extreme skepticism.

Only choose supplements listed in the U.S. Pharmacopeia.
These products have been voluntarily submitted for assessment against accepted standards of “quality, purity, potency, performance, and consistency and current FDA good manufacturing practices.”

Avoid products for weight loss, energy, or sexual or athletic performance.
The data suggests these are the most likely to cause dramatic health damage.

Don’t count on the manufacturer’s safety information.
Look up your supplement with the FDA to find negative safety reports.

Limit your need for supplements.
Consume a well-balanced diet from the perimeter of the grocery store or from your local farmer’s market. You’ll feel better and save money. And it casts your financial vote with the producers of whole foods rather than the manufacturers of questionable products.

Discuss supplements with your doctor before you take them.
Like pharmaceuticals, supplements can interact with your other medications. They can complicate medical conditions. They can create new health problems. Your doctor will help determine the safety of a particular supplement for you. And more to the point, he will help you decide if you really need it.

Current regulations start with the premise that supplements are safe. But it’s a rare product – natural or otherwise - that is truly effective without creating some unwanted side effect. And if it isn’t effective, what’s the point in taking it?