Why is there a supplement craze if they don’t even work?

Summary

---

Planet Money: "Why is there a supplement craze if they don’t even work?"

Air date: June 5, 2026
Hosts: Sarah Gonzalez & Jane Black
Featured Guests: Frank Cantone (SMP Nutris CEO), Melanie Benesh (Environmental Working Group), Marion Nestle (nutrition expert)

---

Episode Overview

In this episode, Planet Money dives into the booming $70 billion U.S. dietary supplement industry, questioning why so many Americans buy and use products with little scientific evidence of benefit. The hosts embark on an experiment to see how easy it is to create and market a supplement, unpacking the historical, regulatory, and psychological forces behind America's supplement obsession.

---

Key Discussion Points & Insights

1. America’s Supplement Craze

• Market explosion: 75% of Americans take supplements; over 100,000 options on the market. (Jane Black, [01:07])
• Industry scale: $70 billion in annual U.S. sales, projected to double in seven years. (Jane Black, [06:01])
• Supplement types: From protein powders to niche blends for "gut health," "mental focus," "glowing skin," and more.

2. How Easy Is It to Launch a Supplement Brand?

• Host experiment: Sarah and Jane explore launching a "Planet Money" supplement, brainstorming gummies that boost focus and hair thickness. (Frank Cantone, [03:04])
  • Creatine, lion’s mane, and collagen discussed as ingredients.
  • Green tea extract considered for “energy/fat burning.”
• Simple process: Supplement contract manufacturers offer:
  • Fully customized products, or
  • White-label (stock) formulas ready for private branding.
  • Entry cost as low as $5,500 for minimum orders. (Frank Cantone, [04:44])
• Label flexibility: Claims like “supports metabolism” are easy to add without scientific proof; explicit disease treatment claims are forbidden. (Frank Cantone, [05:36])

Notable Quote

“You could try that energy gummy on the website. Even though this exact same gummy…is being sold already by someone else under a different label.”
— Frank Cantone ([05:15])

3. Prevalence of Supplement Use and Industry Origins

• Insider testimony: Frank describes the ease of pivoting other business ventures to supplements due to their repeat-purchase model. ([10:43])
• Surge during COVID: Sales rose 50% after the pandemic, driven by health anxieties, wellness influencers, and growing distrust of traditional medicine. ([11:14], [11:33], [11:48])

Notable Quote

“Yoga mats or, you know, water bottles... I can sell him the same green Superfood powder every month.”
— Frank Cantone ([10:43])

4. Regulatory Wild West

• Lax oversight: Supplements occupy a legal “no man’s land;” FDA regulation is minimal unless a supplement is shown to be hazardous or includes a new, unproven ingredient. ([13:05])
• Consumer resistance: Decades of American pushback have watered down every serious attempt at tougher rules. Over 2 million letters to Congress defeated 1960s-1970s attempts at warnings. ([14:04])
• Dramatic industry PR: The supplement lobby used tactics like Mel Gibson commercials portraying vitamin users under attack. ([16:19]-[17:10])
• DSHEA (1994 law): Loosened rules, allowing vague health claims (“supports memory”) as long as they avoid treatment/cure language. ([17:10]-[17:40])

Notable Quote

“This is the thing…the supplement maker Frank was kind of like guiding us on, right? You can’t say it burns fat. You gotta say it supports metabolism.”
— Sarah Gonzalez ([18:19])

5. Loopholes and Dubious Ingredients

• Prevagen case: Story of a jellyfish-derived “memory pill,” repeatedly rejected by FDA, but marketed using a legal loophole (“generally recognized as safe” or GRAS) by first selling it in a food shake. ([20:11]-[25:00])
  • Result: $165M in sales before FTC forced relabeling for deceptive claims—still, the product remains a top seller. ([25:21]-[26:28])
• Unreliable “natural” labels: Even familiar-sounding ingredients (e.g., turmeric, green tea) are often lab extracts in doses above safe limits, sometimes leading to liver damage. ([27:13]-[32:08])

Notable Quote

“Your turmeric supplement may or may not have turmeric in it.”
— Marion Nestle ([30:15])

6. The Real Risks Behind Supplements

• Quality control: No government agency systematically verifies the contents or dosage of supplement products unless prompted by lawsuits or safety crises. ([30:55])
  • ConsumerLab found most elderberry, echinacea, turmeric products don’t match their labels.
• Health risks: 20% of liver toxicity cases tied to supplements; supplement-related liver failure up 8x in 30 years. ([32:01]-[32:29])

Notable Quote

“If there's no lawsuit involved, there's nobody minding the store.”
— Marion Nestle ([30:31])

7. Psychological Drivers and the Power of Placebo

• Why do people keep buying? Experts agree: belief trumps evidence.
  • Supplements provide the comfort of action and control—even with little or no actual effect.
• Placebo effect: Taking a supplement can make a person feel better, which is a real, measurable outcome, however irrational.
  • “Supplements make people feel better. There’s absolutely no question about that. … There’s plenty of evidence that supplements are fabulous placebos.”
    — Marion Nestle ([34:32] & [35:01])

---

Quote Highlights

| Quote | Speaker | Timestamp | |---------------------------------------------------------------------------------------------|-------------------------|------------| | "I feel very aware of my gut health right now. It's true. The supplement industry is a $70 billion industry..." | Sarah Gonzalez | [00:47] | | "75% of Americans take supplements." | Jane Black | [01:07] | | "We'll guide you down the right way to say it. Might say supports metabolism..." | Frank Cantone | [05:36] | | "It's hard to say exactly why supplements are so popular right now." | Jane Black | [11:14] | | "Yoga mats or water bottles... I can sell him the same green Superfood powder every month." | Frank Cantone | [10:43] | | "Supplements make people feel better. There's absolutely no question about that." | Marion Nestle | [34:32] | | "If there's no lawsuit involved, there's nobody minding the store." | Marion Nestle | [30:31] | | “This is like religion. ... If people believe that these things are doing them good, I'm not gonna argue with that.” | Marion Nestle | [33:28] | | “You can't say it burns fat. You gotta say it supports metabolism.” | Sarah Gonzalez (paraphrasing Frank Cantone) | [18:19] | | “Just cross your fingers, Jane.” | Sarah Gonzalez | [35:37] |

---

Timestamps for Key Segments

• Supplement industry snapshot & types: [00:37]–[01:32]
• Planet Money’s supplement experiment: [01:32]–[05:47]
• U.S. supplement history & COVID boom: [11:14]–[12:07]
• Regulatory loopholes, Mel Gibson ad, and DSHEA: [14:04]–[17:23]
• Prevagen/Jellyfish loophole story: [20:11]–[26:28]
• Green tea/turmeric/ingredient risks: [27:02]–[32:08]
• Marion Nestle on supplement realities: [28:34]–[35:26]
• Final reflections and placebo effect: [33:28]–[35:26]

---

Tone and Takeaway

With their trademark curiosity and humor, the hosts illustrate how easy it is to create and sell supplements regardless of scientific evidence, and how a century of regulatory loopholes and consumer demand has made the U.S. uniquely devoted to "magic pills." The expert voices—especially Marion Nestle—bring nuance: while most supplements probably do nothing (or can even be harmful in some cases), they persist because they fulfill a powerful psychological need for hope, agency, and the placebo effect.

Final Insight: Even armed with science, “nothing is gonna come between Americans and their supplements.” ([36:01])

---

For Further Listening

• Skip supplement ads and product pitches—focus on expert interviews, policy history, and the psychological revelations about why the supplement industry endures.
• If you want reputable supplements, look for NSF or USP certification, but keep your skeptic’s hat on.

---

Note: All timestamps (MM:SS) refer to the episode's core content, skipping ads and non-editorial content.

Transcript

[Thumbtack Ad Voice]

This message comes from thumbtack. Recommendations can be great. Maybe someone recommended this podcast and here you are. But home projects are different. If a podcast isn't your thing, you lose a few minutes. If you hire your cousin's neighbor to mount your tv, you might end up with a lopsided screen and wall damage. That's why thumbtack works. It matches people with top rated local pros with photos, reviews and credentials all in one place. For your next home project, try thumbtack. Hire the right pro today.

[Sarah Gonzalez]

This is Planet Money from npr.

[Jane Black]

You may have noticed we are living in the midst of a supplement craze. People are vitamaxing biohacking so they can live longer. Everyone's talking about gut health.

[Sarah Gonzalez]

I feel very aware of my gut health right now. It's true. The supplement industry is a $70 billion industry in the United States and growing fast. We are talking protein powders, pre workouts, probiotics, fat burners.

[Jane Black]

There's joint health, gut health. There's glowing skin. I love glowing skin.

[Sarah Gonzalez]

Better sleeves, stronger nails, all of that.

[Jane Black]

75% of Americans take supplements.

[Sarah Gonzalez]

A lot of people, yeah.

[Jane Black]

Like 100,000 different options you can choose from now.

[Sarah Gonzalez]

Supplements are everything from creatine or bovine colostrum, sometimes put in a martini, to your daily vitamin C, gummies or echinacea. And because there are so many supplements out there, we kind of wanted to see, like, how easy it is to get a new supplement, pill or gummy on the market.

[Jane Black]

Like, could we make a supplement?

[Sarah Gonzalez]

Okay, what if we want to make a supplement? Okay, Like a real NPR Planet Money branded supplement.

[Frank Cantone]

Awesome.

[Jane Black]

This is Frank Cantone, the chiseled CEO of SMP Nutris supplement manufacturing partner.

[Frank Cantone]

They make supplements, capsules, tablets, powders, soft

[Jane Black]

gels, gummies, and then brands or influencers or podcasts sell them under their own labels.

[Sarah Gonzalez]

I think it would be cool to have like a little microphone shaped gummy or a little planet or a little money gummy. A money gummy.

[Frank Cantone]

We could do those.

[Sarah Gonzalez]

Or maybe we do a powder that you just like add water to and down it real quick.

[Jane Black]

And it's called the money shot.

[Sarah Gonzalez]

The Money shot is the perfect name.

[Frank Cantone]

First and foremost. I think what's important would be to define the market.

[Sarah Gonzalez]

Frank really wanted us to think about our Planet Money audience and what supplement you find people might want. You know, smart, busy, capable people.

[Frank Cantone]

So do we want something that helps people focus? Right. Do we want to help people have more energy? Is that the type of product that we want to offer?

[Sarah Gonzalez]

That sounds great. I'm always tired.

[Jane Black]

There are so many supplements already out there that claim to help with brain function or focus. There's ashwagandha or things like.

[Sarah Gonzalez]

But for our potential focus, gummy or shot, Frank actually suggests creatine or lion's mane or other mushrooms if we want.

[Jane Black]

Focus, focus would be awesome. Also, I would like thicker hair.

[Sarah Gonzalez]

Okay.

[Jane Black]

Can I do that?

[Frank Cantone]

Yeah. I mean, we could add collagen to this cocktail, which would help with hair growth and hair thickness.

[Sarah Gonzalez]

Hold on. We're gonna have a gummy that's like, it gives you focus and it gives you thicker hair.

[Frank Cantone]

It's doable for sure.

[Sarah Gonzalez]

Is it smart?

[Frank Cantone]

I feel like it hits two needs that everyone really has a problem with. Right.

[Jane Black]

I love how Frank just wants to make things happen for us.

[Sarah Gonzalez]

I know if there is something that you want your mind or your body to do, Frank will find the ingredient for you. Like, you want to burn fat, maybe throw some green tea in there.

[Jane Black]

Frank says people associate it with weight loss.

[Frank Cantone]

It's typically found in weight management products, so they can kind of put it in that boat if they want to. But the green tea's really there for some energy benefits.

[Jane Black]

We walk through all the things, ingredients, shapes, flavors.

[Sarah Gonzalez]

Kiwi for sure. Honeydew. Honeydew is a super.

[Frank Cantone]

No one does just kiwi. Oh, they do strawberry kiwi.

[Sarah Gonzalez]

We docked colors. Ours would be green, of course. And right there on the spot, we got an estimate for the smallest possible order of our fully customized, I would argue, very tasty supplement.

[Frank Cantone]

It's going to be around 8,333 bottles based upon the ingredients we're talking about. It's going to range from like $4.50

[Sarah Gonzalez]

to $7$4 times 8300ish bottles to 33,000. And then you do half up front,

[Jane Black]

which is not that bad if you're looking to start your own business. But there is a cheaper option, too,

[Frank Cantone]

for our stock formulas. You're in the game for, you know, 5,500 bucks.

[Sarah Gonzalez]

Yeah. They do have more than 800 gummies and pills and powders ready to go already. These are their stock options that we can just slap our own Planet Money label on and call it our special Planet Money energy supplement. Even though this exact same gummy, same color, same flavor, same shape, is being sold already by someone else under a different label.

[Frank Cantone]

Be happy to send you samples right after this call. And you could try that energy gummy on the website.

[Jane Black]

Yep. They even had an energy gummy with green tea in it.

[Sarah Gonzalez]

So could we say on the label like this will help with mental clarity and burn fat.

[Frank Cantone]

We'll guide you down the right way to say it might say supports metabolism or, you know.

[Sarah Gonzalez]

Okay, supports metabolism.

[Frank Cantone]

Exactly.

[Sarah Gonzalez]

Hello and welcome to Planet Money. I'm Sarah Gonzalez.

[Jane Black]

And I'm Jane Black.

[Sarah Gonzalez]

Jane is a food politics reporter in dc. She has been watching what people call big wellness get bigger and bigger and more and more powerful.

[Jane Black]

And if you think supplements are popular now, just wait. Sales are expected to double over the next seven years.

[Sarah Gonzalez]

Now we are not going to make our own supplement.

[Jane Black]

We are not gonna sell one.

[Sarah Gonzalez]

We were gonna do it.

[Jane Black]

We were gonna do it.

[Sarah Gonzalez]

We were gonna do it.

[Jane Black]

You know, it started to make us a little bit nervous, which is kind

[Sarah Gonzalez]

of a bummer because we do want

[Jane Black]

more energy and thicker hair.

[Sarah Gonzalez]

And thicker hair. Apparently.

[Jane Black]

It was so tempting, especially because it's just so easy to make one.

[Sarah Gonzalez]

The supplement industry has been fully cashing in on our love of silver bullets and a magic pill.

[Jane Black]

Today on the show, how lax regulations are making that possible and why Americans

[Sarah Gonzalez]

wouldn't have it any other way.

[Jane Black]

Yeah, like, what do you take?

[Frank Cantone]

Definitely taking a multivitamin. Taking magnesium before, before bed. Berberine typically before a heavy meal. I'm taking trace minerals. Take some di andolomethane, boron, K2 and D3 in a fat soluble soft gel. 15 grams of creatine before my second coffee.

[Sarah Gonzalez]

Frank, this is so many supplements.

[Frank Cantone]

It's not as many as you would think. It's like on a given day, six or seven.

[Apple Card Ad Voice]

This message comes from Apple Card. For a limited time, you can get a new Apple card and purchase AirPods Pro 3 at Apple to earn back the cost up to 250 daily cash subject to credit approval limitations and spend requirements apply. Apple Card is issued by Goldman Sachs Bank USA, Salt Lake City branch terms and more at Apple CoAirPods. This message comes from Instacart. Everyone prefers things a certain way, like groceries. If you want groceries just how you like them, you gotta try Instacart. They have a new preference picker that lets you pick how ripe or unripe you want your bananas. Shoppers can see your preferences up front, helping guide their choices. Because when it comes to groceries, the details matter. Instacart get groceries just how you like.

[NPR Newsmakers Host]

This week on the NPR Politics podcast, catch up on the week's big primary election news. How things played out with newly drawn districts in California and an increasingly competitive Senate race in Iowa. Plus, we unpack the latest redistricting news that may benefit Republicans in the fall. Listen every afternoon to the NPR Politics podcast. Find us on the NPR app or wherever you get your podcasts.

[Jane Black]

Okay. We are not here to prove or disprove whether supplements work, but we do want to say that experts and scientists tend to agree there is no evidence that supplements make healthy people healthier.

[Sarah Gonzalez]

Now, if you're pregnant, there is evidence that folic acid decreases the risk of certain birth defects. And if you have a condition or you're deficient in something, like you're anemic or deficient in iron, then, yeah, sure, an iron supplement could help with that if a doctor recommends it. But if you're not deficient, then you probably don't need it. Frank Cantone, the supplement maker who takes not that many supplements every day, he is a big believer in supplements. Frank came to the supplement business from the real estate and clothing and thoroughbred racehorse trainer business. And his social media is still pretty horse heavy.

[Frank Cantone]

I just get vitamins ads and horse ads. That's all I do.

[Sarah Gonzalez]

Oh, okay.

[Jane Black]

But now Frank knows a lot about supplements. He has built this huge supplement factory in Florida that he says makes millions of supplements a year. And he wants the industry to be reputable and safe. When people ask for something impossible, even us, he says, no, I would like

[Sarah Gonzalez]

to sleep better at night and have more energy during the day.

[Frank Cantone]

Yeah. So you're not gonna be able to make one product that puts you to sleep and then wakes you back up. We've had people try to do that.

[Sarah Gonzalez]

Really?

[Frank Cantone]

We definitely got that request before.

[Sarah Gonzalez]

Frank says he also gets requests all the time to like, jam packed supplements with so much of one ingredient that it becomes unsafe. And he will say no to that too.

[Frank Cantone]

You do have your bad actors where someone comes to us, we want to make this, and we say, well, that is not exactly possible. So they'll go to someone else and they'll say, hey, can you make this? Someone says, yes. All of a sudden it's in the market, but no one's checked what's really in it.

[Jane Black]

Frank says a lot of people selling supplements came to this business because supplements are a good business. Often the people who come to the industry used to sell some other less profitable products.

[Frank Cantone]

Yoga mats or, you know, water bottles, anything that it might be. They wind up coming to supplements at some point because it's something people take every month and they reorder. Right. So it attracts entrepreneurs from different markets to say, hey, I can only sell this guy so many, you know, water bottle, yoga mats, right? Yeah, he's gonna use it once or twice. I can sell him the same green Superfood powder every month. And that customer lifetime value is gonna go way up.

[Sarah Gonzalez]

It's hard to say exactly why supplements are so popular right now.

[Jane Black]

Frank told us that the supplement business really, really took off during COVID In fact, supplement sales have increased around 50% since before the pandemic. There's also the wellness influencers on TikTok and Instagram. They've also contributed to the jump in sales.

[Sarah Gonzalez]

And then there's also just like, a lot of distrust in institutions and the government and the pharmaceutical industry right now. And even though supplement makers are companies too, people feel like they're this more natural, anti establishment alternative.

[Jane Black]

Even our own health and human services secretary, RFK Jr. He's a big fan of supplements. His acting FDA commissioner wants to make them even easier to make and to sell.

[Sarah Gonzalez]

And there's a long history of people in the United States trying to test the limits of the free market and sell you some magic pill.

[Jane Black]

One of my favorite stories IS in the 1910s, there was this really popular supplement. It was claiming it could cure malnutrition using strychnine, which is in rat poison.

[Sarah Gonzalez]

Sounds lovely. In the 1920s and 30s, people were tinkering with yeast, trying to supercharge it with vitamins, claiming it would solve a bunch of things, including something called furry tongue, which is what it sounds like.

[Jane Black]

And around that same time, a guy entranced with the power of radiation sold radioactive water as a cure for fatigue, which was popular until a New York tycoon's jaw fell off.

[Sarah Gonzalez]

His jaw fell off?

[Jane Black]

Just disintegrated. It just completely disintegrated.

[Sarah Gonzalez]

50s doctors are calling all of this medical quackery. Wonder why.

[Jane Black]

But it was really hard to do anything about it.

[Sarah Gonzalez]

Yeah, the growth of the industry isn't just about how badly Americans want a magic pill. It's also thanks to years of lax regulations.

[Jane Black]

Supplements have always been really hard to regulate. They're kind of a food because, you know, they're designed to supplement your diet, but they're also pills or gummies or powders. You know, they come in a jar with a label claiming to address your health problems. They feel like a drug. But drugs have to go through this really rigorous testing to prove that they work. Supplements do not. Supplements live in this weird no man's land.

[Sarah Gonzalez]

When the Food and Drug Administration was created in 1906, there was no mention of supplements. But over the years, the FDA has tried to regulate them many times. Like in 1966, the FDA proposed a disclaimer be displayed in prominent type like Right there on the supplement bottle, basically saying that you can get your vitamins and minerals from the foods we eat and that there is no scientific basis for routine use of supplements.

[Jane Black]

But people did not like that.

[Sarah Gonzalez]

They did not.

[Jane Black]

And Congress got more than 2 million letters, which was actually more than they ever got during Watergate. So no disclaimers.

[Sarah Gonzalez]

Yeah, didn't go through. In the 70s. The FDA's official position was still that supplements are, quote, nutritionally irrational.

[Jane Black]

And that's like a giant government exclamation point.

[Sarah Gonzalez]

Yeah. But it didn't matter to anyone. Every time the FDA and Congress has tried to make supplement rules, the thing that got in the way was you, the consumer.

[Melanie Benesh]

Massive consumer backlash.

[Jane Black]

This is Melanie Benesh.

[Melanie Benesh]

The public really, really loves their supplements.

[Thumbtack Ad Voice]

Yeah.

[Jane Black]

Melanie is a lawyer who focuses on food and drug regulations at the Environmental Working Group, which has for years advocated for safer consumer products and more regulation. She says the last time Congress even attempted to regulate supplements was in the early 90s. And the consumer revolt that followed basically killed any serious effort to regulate supplements ever again.

[Sarah Gonzalez]

That story starts in Kent, Washington. There was some alternative medicine clinic, and the proprietor there was accused of illegally injecting patients with these high dose concoctions of vitamins and minerals that the FDA repeatedly told them were unsafe.

[Jane Black]

One day, FDA agents show up with the local police and kick down the door of the clinic. It makes the front page of the New York Times. And the supplement industry sees this big newsy raid as an opportunity to fight back. They launch an incredibly effective counteroffensive.

[Sarah Gonzalez]

They got people to write thousands of letters to President George H.W. bush to Congress and the FDA saying like, please, please, please, please, please do not touch our supplements. They even got health food stores to join in on the revolt.

[Melanie Benesh]

Health food stores put black curtains over the supplement aisle and the vitamin aisle and said, this is the future you're looking at if Congress gets its way.

[Jane Black]

Some stores even refuse to sell supplements on certain days to, you know, make people really live out the nightmare of this world without vitamins.

[Melanie Benesh]

They got Mel Gibson to do an ad.

[Sarah Gonzalez]

In the ad, you see a SWAT team kicking open the door of their SWAT band. They rush toward, I guess, Mel Gibson's mansion in full SWAT gear. They're scaling the side of the building. They get inside, night vision goggles through the living room, guns drawn. And then they spot Mel Gibson.

[Frank Cantone]

Freeze.

[Sarah Gonzalez]

Drug enforcement.

[Melanie Benesh]

He's standing in his bathrobe and the FBI swoops in and knocks the vitamins out of his hands.

[Frank Cantone]

Oh. Oh, guys. Hey, it's Only vitamins. It's only vitamins.

[Sarah Gonzalez]

On the screen it says, protect your right to use vitamins. Call Congress now.

[Frank Cantone]

Vitamin C. You know, like in oranges.

[Sarah Gonzalez]

Congress gets an earful. And Congress gets the message. Supplements are kind of untouchable in the US technically.

[Jane Black]

Congress did pass a big supplement law in 1994. It's called the Dietary Supplement Health and Education Act. But it is so lax that experts in this field don't even consider supplements to be regulated almost at all.

[Sarah Gonzalez]

In fact, the law gave supplement makers more freedom, including something they'd always wanted, the legal right to claim on their labels, that supplements were actually improving your health. And they could now claim this as long as they avoided a couple keywords.

[Jane Black]

Okay, So a supplement maker cannot say their pill diagnoses, prevents, cures, treats, or mitigates a disease like Alzheimer's, but they can say it helps improve your memory, which is a pretty subtle distinction.

[Melanie Benesh]

You know, it's not always clear to me what the difference is between, say, helping to maintain your blood sugar levels versus using it as part of a healthy diet to help maintain healthy blood sugar levels.

[Sarah Gonzalez]

Wait, is one of those okay and the other one is not okay?

[Melanie Benesh]

Yeah, yeah.

[Sarah Gonzalez]

They sound exactly the same.

[Melanie Benesh]

Yeah. So I have trouble distinguishing.

[Sarah Gonzalez]

This is the thing that the supplement maker Frank was kind of like guiding us on, right? He's like, you can't say it burns fat. You gotta say it supports metabolism. So here's a little news you can use. Melanie says, if the front of your supplement bottle says supports X or promotes Y, that should be a signal to you that it is not actually proven to do anything. If you turn over your supplement bottle right now, you will even see in tiny fine print that the claims on the bottle have, quote, not been evaluated by the fda.

[Jane Black]

And sure, the supplement makers are supposed to have something to back up their claims. And there are a bunch of studies out there that say these things work. But you have to look at how good those studies are and who's funding them. There's a lot of conflict of interest. There's. There is nothing in the regulation that requires supplement makers to prove their product does what it says it does.

[Sarah Gonzalez]

So what's the point? What's the point of a supplement if it's not supposed to actually work on the thing it's claiming to work on?

[Melanie Benesh]

Hopes and dreams.

[Sarah Gonzalez]

The law also says you don't even have to prove your supplement is safe before you sell it to people. Unless there's one. Unless. Unless it is a brand new, never before used ingredient in a Supplement, then you do need to show some paperwork.

[Jane Black]

We have finally stumbled on an actual rule here. I'm excited. If your supplement includes a totally brand new ingredient, that is one of the few times the company has to notify the FDA and show them their safety studies. Now, they don't have to prove that it's safe. This is supplement regulation. So that would be a wicked high standard. The law just requires that a supplement will, and quote, reasonably be expected to be safe.

[Sarah Gonzalez]

And if that doesn't make you feel super safe, then you should know that there's also a workaround to this rule. And there's one supplement more than any other supplement, according to Melanie, that really exemplifies this fun workaround. How companies can get their supplements onto store shelves without proving that they're even reasonably expected to be safe. It involves glowing jellyfish.

[Jane Black]

It all started with a young man

[Melanie Benesh]

from Wisconsin who I think had this epiphany and really homed in on jellyfish.

[Sarah Gonzalez]

Every good supplement starts with an epiphany. This was in the 90s. The young man was named Mark Underwood, and he had an idea for a new supplement that would improve memory. And the story goes that the idea came from the this moment with his mom, who had ms, multiple sclerosis.

[Jane Black]

And the details come from this really great article in Wired. We pulled it up in the studio with Melanie, and apparently this guy's mom was always looking out for things that could help her since the disease had limited her body. Diane, the mother, says that she was attracted to the way jellyfish seemed to move so easily, and that's what led her to wonder if the marine animal might hold the key to a medical breakthrough.

[Sarah Gonzalez]

Diane, the mom apparently tells her son

[Jane Black]

about this, and he took to it like a dog with a bone.

[Sarah Gonzalez]

Hold on, hold on, hold on.

[Melanie Benesh]

So it wasn't even about memory. Why did we think that jellyfish have good memory?

[Sarah Gonzalez]

Don't they, like, famously not have brains?

[Jane Black]

Yeah, exactly. They don't have brains. But despite jellyfish not having brains or hearts or hearts, Mark wants to make his memory boosting jellyfish supplement anyway.

[Sarah Gonzalez]

Yeah, and he's not gonna use jellyfish from, like, the ocean for this. Okay. He wants to use something that mimics the protein found in glowing jellyfish because

[Jane Black]

they have to be glowing.

[Sarah Gonzalez]

So this is a synthetic made in a lab version of the protein that causes jellyfish to glow. Okay. And he sets out to now sell that product, and on his marketing material, he promises his supplement will, quote, not cause any glowing. Wow. So it will not make you glow. But it will apparently improve your memory.

[Jane Black]

So what does it take for him to get that into stores or sell it online?

[Sarah Gonzalez]

Well, the jellyfish company first went to the fda, but the FDA was like, yeah, no, it doesn't meet our safety threshold, which is honestly a pretty low threshold.

[Jane Black]

And when the company ran it by the FDA again a few years later, FDA says, nope, we still don't think it's safe enough.

[Sarah Gonzalez]

But there is a way around that pesky little FDA objection. There is a law from the food regulation world that supplement makers can take advantage of. If you've heard our recent story on how untested chemicals sneak into our food, this might sound familiar. But if you are a food maker and you've just invented a new chemical or new ingredient that has never been used in food before, you can just declare that your own brand new ingredient is safe, that it's generally recognized as safe or gras g r a s.

[Jane Black]

So if you're having trouble getting your new supplement ingredient like glowy jellyfish stuff past the FDA's review process, Melanie says you can just put it in a food product first.

[Melanie Benesh]

So put it in a protein shake or something else. And then now it's part of the food supplies.

[Sarah Gonzalez]

Hold on. Melanie pointed to a supplement trade article that says industry lawyers even advise their clients to do this. Like, you can skip that pesky FDA hurdle. Just put your new ingredient in a food product first, and now you can add it to your brand new supplement as a generally recognized as safe product. Ta da. And that is exactly what the glowy jellyfish guy did.

[Melanie Benesh]

They said, aha, we'll put it in food. And that was the birth of the prevagen shake.

[Jane Black]

The prevagen shake, they called it neuroshake. And the jellyfish company did formally notify the FDA they were now introducing the jellyfish thing as a food ingredient. The FDA again questioned the safety of the ingredient in the shake. But once you're talking about food ingredients, companies can actually ignore the FDA's concerns as long as they self certify that their ingredient is safe.

[Sarah Gonzalez]

Yeah. That safety self certification allows them to bypass the FDA's review process. So the jellyfish company self certified that their synthetic lab made jellyfish stuff was safe to drink in a shake. Totally legal because we're talking about food products now.

[Jane Black]

And once they got into food, that gave them the right to add it to the supplement. That is the getaround.

[Sarah Gonzalez]

That is how we have this synthetic jellyfish shake and the synthetic jellyfish pill. And actually the pill was on the market the whole time, no one stopped them. Through all the back and forth with the FDA expressing concerns and all of that, they were just selling it anyway.

[Jane Black]

Between 2007 and 2015, the Jellyfish Company racked up more than $165 million in SAL. Meanwhile, people were reporting side effects to the company that they were having chest pain and seizures and strokes while taking this supplement. But unless the FDA is aware of an imminent hazard or they do their own testing and can prove that a supplement is unsafe, which takes years and lots of money, the FDA can't take a product off the market. But the Federal Trade Commission can bring a case against them for false advertising.

[Sarah Gonzalez]

And the FTC did that with the Jellyfish supplement. They sued in 2017, and just a short, almost eight years later, the FTC won its case. The company was claiming that their product was clinically proven to improve memory. And the FTC said there's one clinical trial and it did not show their supplement improved memory. So now the label just says Prevagen for your brain.

[Jane Black]

Nice vague promise there, but people are still buying it. It's currently in the top five of Amazon's list of blended vitamin and mineral supplements.

[Sarah Gonzalez]

And listen, maybe synthetic lab made glowy fish stuff is one thing, right? Like maybe that feels totally different from, say, fish oil or collagen or herbal supplements like turmeric pills. But Melanie says even the ones that seem all natural or super familiar may not be what you think.

[Jane Black]

Take green tea supplements. That sounds like a thing that just grows in nature. But the green tea in your supplement is rarely the actual leaves that you see in your tea bag.

[Sarah Gonzalez]

It's an extract made by bathing the tea leaves in a solvent, usually ethanol, to extract a particular antioxidant called egcg, which is all the rage among influencers. But high concentrations of lab processed green tea, EGCG extract is linked to acute liver damage and sometimes death or turmeric supplements.

[Jane Black]

They often contain 10 times the amount recommended by the World Health Organization. After the break, we're talking about the regular, everyday familiar herbal supplements and vitamins that so many of us have in our kitchens right now.

[Sarah Gonzalez]

Yeah, you're probably not going to want to hear this next part.

[NPR Newsmakers Host]

This week on NPR's Newsmakers, former first lady Jill Biden. She reveals Joe Biden's 2024 debate performance was so alarming, doctors checked him after he got off the stage.

[Marion Nestle]

I was terrified. I thought, oh my God, what's happening? Is this a stroke? What is this?

[NPR Newsmakers Host]

Inside the dramatic month that followed, leading to one of the Biggest decisions of Biden's presidency to walk away this week on Newsmakers. You can listen or watch wherever you get your podcasts.

[Sarah Gonzalez]

So I have these, like, gummies, vitamin C, Adult gummies. C is what they're called.

[Marion Nestle]

Why are you taking that?

[Sarah Gonzalez]

It's like a little treat, you know, it's like a gummy bear, except maybe there's some vitamin C in there and

[Marion Nestle]

you feel like you're making yourself healthy.

[Sarah Gonzalez]

This is Marion Nestle.

[Marion Nestle]

If you're vitamin C deficient, it could be quite useful. I don't know anybody who's vitamin C deficient. If they eat any fruits and vegetables at all. Scurvy is not a major problem in the United States. It's not a public health problem.

[Jane Black]

Yeah, Marion is basically a legend in the food nutrition supplement world. She has a background in molecular biology, has written 17 books on the politics of food and supplements, and has been a public health advocate for decades.

[Marion Nestle]

I'm 89.

[Sarah Gonzalez]

89.

[Marion Nestle]

Good nutrition.

[Sarah Gonzalez]

Good nutrition. Is that what you. So there's nothing really bad you buy?

[Marion Nestle]

I buy tortilla chips. I buy ice cream. I buy all kinds of things. I eat my share of junk food.

[Sarah Gonzalez]

But vitamins, supplements.

[Jane Black]

Do you take any?

[Sarah Gonzalez]

No, no.

[Marion Nestle]

Vitamin D. Vitamin D is not a vitamin. It's a hormone that you get from exposure to the sun.

[Sarah Gonzalez]

Sick burn, Marian.

[Marion Nestle]

Sorry.

[Sarah Gonzalez]

So, yeah, no vitamin supplements for this true legend.

[Marion Nestle]

I wouldn't take it because I don't know what's in those packages. What it says on the label is not what's in the package.

[Jane Black]

For Marian, it's not just that supplements are unregulated when it comes to the safety of their ingredients. She's worried about an even more basic problem. Like what even are the ingredients?

[Marion Nestle]

Your turmeric supplement may or may not have turmeric in it.

[Sarah Gonzalez]

Don't you check the ingredient list and say, does it say turmeric as an ingredient?

[Marion Nestle]

It doesn't matter. It doesn't have to have in it what it says on it.

[Jane Black]

Technically, supplements are supposed to contain what they say they do.

[Marion Nestle]

But nobody has the resources to check and see whether those supplements have in them what it says on the label. Unless somebody sues the company. If there's no lawsuit involved, there's nobody minding the store.

[Sarah Gonzalez]

Is it the same way with food? Like if you read an ingredient in a food product.

[Marion Nestle]

No, no, no, no, no, no. That will be accurate.

[Jane Black]

Yeah. Because the FDA will sometimes spot check food ingredients to make sure they're for real.

[Sarah Gonzalez]

But on a supplement, you have no

[Jane Black]

way of knowing and, and sometimes supplements have stuff in there that really shouldn't be in there.

[Marion Nestle]

Lead, arsenic or other heavy metals.

[Sarah Gonzalez]

There is a private supplement testing lab called Consumer Lab that Marian points to a lot. Its whole business is testing supplements to see what is actually in them. And recently they tested a bunch of turmeric pills on the market and found that one had no turmeric, basically, and others had more than even advertised.

[Jane Black]

And they have found similar variations in echinacea supplements and elderberry supplements. Consumer Labs found that more than 2/3 of elderberry supplements sold on Amazon did not contain authentic elderberry at all.

[Marion Nestle]

This is true of every supplement.

[Sarah Gonzalez]

Maybe not every, but I can't think

[Marion Nestle]

of a single supplement that Consumer Lab has investigated where it hasn't found wide variation.

[Jane Black]

According to a 2017 study, 20% of liver toxicity cases were tied to herbal and dietary supplements.

[Sarah Gonzalez]

Over most of the last 30 years, supplement related liver failure increased Eightfold. So much so that people started having to be put on wait lists for liver transplants. Now that might be because of user error, like people taking a bunch of these supplements in a day, thinking more must be better. But maybe it's other reasons. It's really hard to pinpoint.

[Jane Black]

Marian says there are some supplements on the shelves that are maybe more trustworthy than others. If they're marked with an NSF or usp, that indicates that they've been third party tested, that the supplements do contain the ingredients listed, and that the amounts are accurate and not at harmful levels. Remember Frank, our supplement maker? His supplements are NSF certified.

[Sarah Gonzalez]

And Marian thinks it is pretty important to point out that most supplements, whether they are certified or not, likely are not causing any real harm, even if they likely aren't causing any benefit.

[Marion Nestle]

Some of them are harmful and that's a problem. But most of them are not particularly harmful. So there's a little risk, but it's not a big.

[Jane Black]

I mean, to be honest, that kind of surprised me. I mean, Marion Nestle, woman of science, you would think would be rabidly anti supplement. Honestly, she's kind of like, do whatever you want.

[Marion Nestle]

People, you know, this is like religion. You don't argue with people about religion. There's no evidence that they make healthy people healthier. But if people believe that these things are doing them good, I'm not gonna argue with that. There's nothing I can say to dissuade them and I'm not even gonna try.

[Jane Black]

Marian wrote the history on this. She knows that even when people see the science, it rarely makes them throw out their supplements.

[Sarah Gonzalez]

I must admit, I have not thrown out my vitamin C gummies or my turmeric pills, though. I don't know, Jane. Maybe I just won't buy them again.

[Jane Black]

Yeah, we were surprised that some, some of the experts. We talk to experts who advocate for supplement regulation and are well aware of all of these problems. They still take some supplements too.

[Sarah Gonzalez]

Maybe it's totally irrational of us, but maybe it's not. Because there is one good thing that supplements do sometimes do for us, says Marian.

[Marion Nestle]

Supplements make people feel better. There's absolutely no question about that.

[Sarah Gonzalez]

Did she just say supplements make people feel better?

[Jane Black]

Yeah, but it's not necessarily because their ingredients actually do what they say they'll do.

[Sarah Gonzalez]

Yeah, it's this other thing.

[Marion Nestle]

It has a fabulous placebo effect.

[Sarah Gonzalez]

Yeah. You feel like your vitamin C gummy helps you not catch a cold, and then you don't catch a cold. Placebos, Baby magic.

[Marion Nestle]

There's plenty of evidence that supplements are fabulous placebos. And in fact, I can tell you a story about a study that proved that. But it doesn't matter. Life is really hard these days. And if all it takes is a supplement pill to make people feel better, I'm, you know, I'm not gonna argue too much about it.

[Sarah Gonzalez]

I love placebos.

[Marion Nestle]

Yeah, I do too.

[Sarah Gonzalez]

They're so powerful.

[Marion Nestle]

I do too. I do too. So if you're gonna buy supplements, you buy from the most reputable company you can find. And keep your fingers crossed.

[Sarah Gonzalez]

Just cross your fingers, Jane.

[Jane Black]

Thank you so much. I'm feeling, feeling good about those.

[Sarah Gonzalez]

I'm feeling really good. You know what gets me about all this, Jane? If supplement makers were to just be like fully transparent, right, they put on the bottle, there might not be that much turmeric in here and it may cause liver damage and it may not even be anti inflammatory like we're suggesting. I don't even think that would stop people from buying them.

[Jane Black]

Yeah, probably not. I mean, we've got a hundred years of history that says nothing is gonna come between Americans and their supplements.

[Sarah Gonzalez]

But you don't even take supplements, Jayne.

[Jane Black]

Right, I know. I mean, nothing's gonna come between you and your supplement.

[Sarah Gonzalez]

Yeah. Yeah. This episode was produced by Sam Yellowhorse Kessler Takes Fish Oil edited by Marianne McCune Daily Multivitamin and fact checked by Sierra Juarez with help from Beedo Emanuel, who do not take any supplements because of course, our fact checkers don't. It was engineered by Robert Rodriguez with help from Jimmy Keeley and Alex Goldmark is our executive producer.

[Jane Black]

Special thanks to Jensen Joes at the center for Science in the Public Interest, and Kiara Eisner, who wrote that great Wired article and now works for npr.

[Sarah Gonzalez]

I'm Sarah Gonzalez.

[Jane Black]

And I'm Jane Black. This is npr. Thanks for listening.

[Thumbtack Ad Voice]

This message comes from Thumbtack. Some tasks can feel easy, but home projects can bring second guesses. Is that noise normal? Is that water damage? Who should be called? That's where thumbtack comes in. Just upload a photo or voice note. And it uses AI powered search to match with the right top rated local pro. So instead of guessing, there's clarity and confidence when hiring for your next home project, try thumbtack. Hire the right pro today.

[NPR Newsmakers Host]

This week on NPR's Newsmakers, former first lady Jill Biden. She reveals Joe Biden's 2024 debate performance was so alarmin doctors checked him after he got off the stage.

[Marion Nestle]

I was terrified. I thought, oh my God, what's happening? Is this a stroke? What is this?

[NPR Newsmakers Host]

Inside the dramatic month that followed, leading to one of the biggest decisions of Biden's presidency to walk away. This week on newsmakers, you can listen or watch wherever you get your podcasts.