How do healthcare practitioners feel about the Dietary Supplement Health and Education Act (DSHEA)?
Holistic Primary Care’s 2018 survey practitioner survey indicates that nearly half of our 469 respondents (46%) do not even know what it is. That's surprising given that 61% of the respondents dispense dietary supplements in their practices, and 94% of those who do not dispense products do recommend at least some supplements to their patients.
For the record, DSHEA is the federal statute, made law in 1994, that regulates the manufacture and marketing of dietary supplements.
Among those who are familiar with DSHEA, there’s a strong sense that the regulations need revision (see, Is the Time Right to Revise DSHEA?).
- Only 7% believe DSHEA is fully adequate and effective to protect public safety.
- 18% believe the law would be adequate if properly enforced
- 29% believe the law is fundamentally flawed and in need of major revision, that’s up from 19% two years ago.
The verbatim comments reflect an ambivalence felt by many holistic and functional medicine practitioners: on the one hand they’re concerned about malfeasance and fraud on the part of the supplement industry, while on the other they fear that the FDA is a puppet of Big Pharma bent on thwarting non-Rx alternatives.
“I have major concerns that DSHEA can be usurped by pharma companies to drive non-pharm options out of existence. On the other hand, proven lack of ingredients listed on supplement labels proves that current oversight and accountability is inadequate,” wrote one survey respondent.
Another points out: “Some claims are outrageous. At the same time, they sometimes inappropriately go after small producers. FDA/FTC are understaffed.”
As with so many federal regulations, the question around DSHEA really comes down to: Who is it in intended to serve?
“DSHEA is good but imperfect,” wrote one clinician. “However, modifications are likely to make it have greater constraints dictated by the Pharma industry, not primarily about public health”