‘Orchid’ Supplements Often Mislabeled, May Pose Health Risks

Consumers who purchase sports supplements promising the purported benefits of a certain type of orchid may be disappointed, or worse, harmed, researchers have suggested.

Not one of 12 Eria jarensis supplements purchased online was accurately labeled, Pieter A. Cohen, MD, of Harvard Medical School in Boston, and colleagues reported in Clinical Toxicology.

Some contained potentially harmful ingredients, including high levels of caffeine and the banned stimulant 1,4-dimethylamylamine [1,4-DMAA], Cohen and colleagues found.

Indeed, two of the 12 products contained 1,4-DMAA, which has never been approved for use in humans, Cohen noted. And many of the products contained large amounts of caffeine — up to 665 mg per serving, or more than six cups of coffee, he said.

“Consumers could be exposed to unpredictable amounts of caffeine and botanical stimulants as well as hidden ingredients including an FDA-banned synthetic stimulant,” Cohen told MedPage Today. “Combining high quantities of caffeine with unapproved stimulants could strain the body by increasing blood pressure, heart rate, and heart contractions.”

On most labels, Eria jarensis was listed as containing N,N-dimethylphenethylamine, a food flavoring that’s generally recognized as safe. However, there’s no research in humans that supports the use of this flavoring agent in improving athletic performance, the researchers noted.

“The listing of this chemical might be added by manufacturers as a marketing ploy to distract from the high doses of caffeine and other stimulants in the products,” they wrote. “Given the quantities of N,N-dimethylphenethylamine found in these products, it is highly unlikely that this flavoring substance was actually extracted from the Eria jarensis orchid.”

Overall, four of the 12 products did not contain any N,N-dimethylphenethylamine, and among those that did, doses ranged from 0.1 mg to 41 mg per serving, they found.

The ingredients most commonly found in inaccurate amounts were phenethylamine, yohimbine, synephrine, and theobromine. For this latter compound, the actual quantity ranged from 424% to 4,320% of the labeled quantity, they reported.

Cohen and colleagues also found that some products contained relatively large quantities of ingredients without declaring those amounts on the label — in particular, caffeine, which was found at levels ranging from 106 mg to 665 mg per serving.

Four of the 12 products contained a stimulant that wasn’t listed on the label, and two of these were the illegal stimulant 1,4-DMAA, they reported.

“There are pharmaceutical compounds that are not found in any plants, and they’re being sold and promoted as if they’re botanical ingredients that enhance athletic performance,” Cohen said. “And that has been really alarming as a physician to see.”

Joe Schwarcz, PhD, of McGill University in Montreal, who wasn’t involved in the study, noted that supplements are a multi-billion-dollar industry.

“The fact is, everyone wants to be smarter, faster, jump higher, be more athletic,” Schwarcz told MedPage Today. “So it’s very seductive when they make claims that you can have all of that just by resorting to some supplement.”

FDA regulates supplements as food rather than medicine, so they’re easier to manufacture and market, and have less agency oversight. That regulatory framework has been in place since the 1994 Dietary Supplement Health and Education Act (DSHEA), which Cohen says was the result of “very heavy advocacy from the supplement industry back in the 70s and 80s.”

This arrangement does not make sense to Schwarcz. “It has always mystified me that while we have a very rigorous approval system for prescription drugs, the supplement industry is just allowed to fly loose,” he said. However, in Schwarcz’s view, supplements are drugs in that they’re intended to “somehow interfere with biological processes.”

FDA doesn’t often pursue problems with supplements, Cohen said, because when they do, they’re sued by a well-funded and well-organized supplement industry.

It’s important to maintain access to vitamins, minerals, and prepared botanicals, but they should be accurately labeled and properly manufactured, Cohen said. And any supplement should prove its efficacy in a randomized, double-blind clinical trial, Schwarcz added.

Cohen advises that people interested in supplements should choose single-ingredient products rather than those with a long list of ingredients, which is likely to contain “chemical compounds mixed together with, like, a blender.”

For their study, Cohen and colleagues purchased 14 products purporting to contain orchid extract. Two of them did not arrive, so 12 were analyzed using liquid chromatography-quadrupole time-of-flight mass spectrometry. The study was limited because the sample size was small and only one sample of each brand was analyzed. Also, the products were purchased and the analysis was done in 2021, and manufacturers may have reformulated their products since then.