Do You Take Supplements? Use Generic Drugs? Check Out ConsumerLab.

There is so much information out there about supplements – which ones we should take and how much of each, whether we should take them at all – that it can be different to sort out the facts from the rhetoric and self-promotion. If you want to know what the science says, check out ConsumerLab. Founded in 1999, this organization tests supplements to determine whether they actually contain what the label says and not too much or too little of it, that they aren’t contaminated by toxins such as heavy metals (found in some calcium supplements), and that they can be absorbed by the body. Tod Cooperman, MD, president of ConsumerLab, appeared on Dr. Oz on 4/9/2013 discussing the mission of ConsumerLab and some recent findings. A follow-up article by Dr. Cooperman appears on the Dr. Oz web site.

The same program included a discussion of generic drugs, an area where I’ve had some personal experience. Dr. Cooperman pointed out that the FDA does not test generics for efficacy and safety; in fact it doesn’t test them at all. Manufacturers of generic drugs themselves test their products to ensure that they include approximately the same amount of active ingredient as the original drug.  "Approximately" in this case is defined as 80%-125%. Different manufacturers of generics may contain different percentages of the active ingredient so if you got generics from one place one month and another the next your dosage could vary by as much as 45%! This gets you into trouble with medications where it is important to stay within the same narrow range. Dr. Cooperman listed the following groups of drugs:

1.       Blood pressure

2.       Thyroid

3.       Anti-seizure

4.       Asthma

5.       Blood thinners

6.       Immunosuppressants

7.       Anti-depressants

In these cases generics should be used with caution. The same is true for extended release medications because the pills may differ in technology.  

Dr. Cooperman also recommended identifying the manufacturer of your generic by checking the label and trying to get the same kind each time. He also suggested asking whether there is an authorized generic for your medication. Authorized generics are made by the same company that originally produced the drug but after it has gone off patent. If you switch from a medication to a generic, he said, you should monitor yourself for a month to be sure that nothing has changed.

In my own case, it took years to get my thyroid level stabilized.  A couple of times I was put on generics instead of Synthroid and the results were bad.  These days I have a note in my doctor’s folder for me saying “Do Not Substitute.”

Update: Recent Bloomberg article about people's experiences with generics, https://bloom.bg/2HwQK0w