ACP says underregulated dietary supplements endanger public health

PHILADELPHIA, July 13, 2026-Dietary supplements must be more regulated to protect public health, says the American College of Physicians (ACP). In a new paper, "Modernizing the Regulatory Framework for Dietary Supplements: A Position Paper from the American College of Physicians" published today in Annals of Internal Medicine, ACP issues recommendations to strengthen and modernize the manufacturing and marketing of dietary supplements.

Over half of adults in the United States consume dietary supplements, but only one quarter consume supplements that have been recommended by a health care professional. Dietary supplements are defined by the Dietary Supplement Health and Education Act of 1994 (DSHEA) as products for ingestion that contain a "dietary ingredient" intended to supplement the diet. Ingredients in supplements include vitamins, minerals, amino acids, and probiotics and range in intended function-from supplementing one's diet with nutrients to improving athletic performance.

There are as many as 100,000 dietary supplements available, and in 2025, the global dietary supplement market size was estimated to be $209.5 billion. While some dietary supplements, principally vitamins and minerals, are thoroughly tested for safety and efficacy and may aid in ensuring the consumption of essential nutrients, many others are not backed by strong scientific evidence. They may also contain unlisted ingredients, mislabeled dosages or dangerous or illicit substances, and can have harmful interactions with prescription medications.

"Dietary supplement use continues to grow among the public. When taken as directed by a physician, dietary supplements can have material health benefits. However, under the current regulatory framework, supplements are not evaluated for their safety before going to market, unlike drugs and food additives. As a result, patients are vulnerable to potentially dangerous products and drug interactions. Skewed public perception of the safety of supplements and low rates of reporting their use to physicians and other health care professionals only contributes to making the public more at risk for severe adverse outcomes. ACP's recommendations directly address this problem from a public health policy perspective," said Jan K. Carney, MD, MPH, MACP, president, ACP.

In the paper, ACP calls on Congress to modernize the DSHEA to require dietary supplements to undergo evidence-based review, registration and premarket approval with the Food and Drug Administration (FDA) and require them to meet quality standards established by the United States Pharmacopeia. ACP says the FDA should receive adequate funding and resources for the oversight and regulation of dietary supplement manufacturing, quality, safety and labeling and recommends bolstering the FDA's post-market surveillance authority for dietary supplements. Amending the DSHEA to give the FDA the authority to bypass voluntary recall procedures when notified of adverse events or mislabeled products would allow the FDA to more quickly remove compromised or mislabeled supplements from the market.

ACP supports efforts to ensure the Federal Trade Commission has the necessary resources to adequately monitor the marketing and advertising of dietary supplements, particularly those made on social media by paid influencers, and take swift action against violations. There is a need for high-quality, consistent and updated data on dietary supplements that are accessible to the public; ACP urges the FDA to create a national, public, searchable database of dietary supplements that includes information on supplements, their ingredients, and existing scientific research on health impacts and drug interactions. ACP encourages a standardization of language and data sharing to ensure the consistency and safety of products manufactured in a global supply chain. The paper says dietary supplement manufacturers should ensure their products are safe and effective with a secure supply chain, robust clinical research, accurately labeled products, and adherence to Current Good Manufacturing Practices.

ACP urges electronic health record vendors to integrate dietary supplement knowledge databases into their platforms because the lack of standardized supplement documentation procedures leaves patients susceptible to potential adverse events arising from drug interactions with dietary supplements. ACP further supports the education of health care professionals, medical students and patients about the safe use of dietary supplements and urges health care facilities to implement procedures to collect information on patient dietary supplement use parallel to the collection of prescription medication history. Finally, ACP urges Congress to continue funding the National Institutes of Health Office of Dietary Supplements to ensure continued study of the safety of supplements on the market and promote public awareness.

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About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads and LinkedIn, and subscribe to our new RSS feed.

Contact: Laura Baldwin, [email protected], 215-351-2668