Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Despite the claim to the contrary
by Ms Joseph and colleagues, the recently announced ban on ephedra1 provides excellent substantiation that the current
system of postmarketing regulation of dietary supplements does indeed present
a "real danger" to the public. As a result of the challenging legal standard
in the DSHEA, definitive actions to prohibit sales and distribution of this
dangerous product were delayed more than 9 months after clear evidence of
harm was available,2 and while additional
evidence of harm continues to accumulate.3 Products
such as ephedra—like many other dietary supplements—certainly
have biological activity and are marketed as such.4 If
this agent had been regulated with at least the same degree of oversight as
that used for over-the-counter drugs, some ephedra-related morbidity and mortality
most likely could have been prevented.
DeAngelis CD, Fontanarosa PB. Regulation of Dietary Supplements—Reply. JAMA. 2004;291(5):560. doi:10.1001/jama.291.5.560-b