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In Reply We thank Mr McGuffin for his interest in our Research Letter1 and agree that illegal dietary supplements pose a significant health risk to consumers. However, we believe that his assertion that the Dietary Supplement Health and Education Act (DSHEA) sufficiently prevents the introduction of adulterated dietary supplements into the marketplace is misguided, since the DSHEA assumes that all dietary supplements are safe until proven harmful.2,3 In doing so, we think that this legislation creates a false sense of security for consumers because there have been cases of dietary supplements adulterated with pharmaceutical compounds entering the marketplace and leading to public harm.4
Harel Z, Harel S, Bell CM. Illegally Marketed Drug Ingredients Are Not Dietary Supplements—Reply. JAMA Intern Med. 2013;173(22):2091. doi:10.1001/jamainternmed.2013.10386