Unregulated Supplement Risks
US Supplement Market Booms as Experts Warn Products Can Harm Health Without FDA Oversight
The US dietary supplement market now holds over 100,000 unique products — and it's still growing fast. The industry was worth $74 billion in 2025 and could hit $131 billion by 2033, according to Nutrition Business Journal. But health experts are raising alarms: some of those products can seriously hurt you.
The FDA does not check whether supplements are safe or effective before they go on store shelves. Jensen Jose, senior regulatory counsel at the Center for Science in the Public Interest, says the system "has repeatedly failed to prevent serious harm" and that "we need to make sure dietary supplements are safe and actually do the thing they claim to do," according to CSPI.
A 1994 Law Left the FDA Watching From the Sidelines
The current oversight gap traces back to one law. In October 1994, President Bill Clinton signed the Dietary Supplement Health and Education Act, known as DSHEA. It classified supplements as "food," not drugs. That meant manufacturers no longer had to prove their products were safe before selling them, according to FDA. Instead, the FDA must prove a product is dangerous after it's already on shelves.
The result was explosive growth. In 1994, roughly 4,000 supplement products existed in the US. By 2014, that number had jumped to over 90,000, according to the Journal of Dietary Supplements. Today it exceeds 100,000. The FDA banned one high-profile ingredient — Ephedra — in 2004 after it was linked to heart attacks and deaths. But that came only after serious public harm had already occurred.
15 Million Americans Are Taking Liver-Toxic Supplements
One of the biggest risks is hidden in products marketed as "natural." A major study published in August 2024 in JAMA Network Open found that 15 million Americans regularly take supplements containing botanicals that can damage the liver. Common ingredients include turmeric, green tea extract, and ashwagandha.
Dr. Marwan Ghabril of Indiana University warned that "there is no compelling data that herbal supplements are needed to maintain general health," according to National Geographic. Liver doctors say supplement-induced liver injury now accounts for a growing share of acute liver failure cases in the US. Beyond liver damage, some products are laced with hidden synthetic drugs not listed on the label.
States Move to Protect Consumers as Federal Rules Stall
In April 2024, New York became the first state to ban the sale of weight loss and muscle-building supplements to minors, citing risks of eating disorders and organ damage, according to the Council for Responsible Nutrition. By February 2026, CSPI's Jensen Jose was urging Connecticut and other states to follow. The FDA also held a public meeting in March 2026 to explore expanded oversight rules.
The industry is pushing back hard. Steve Mister, CEO of the Council for Responsible Nutrition, argues that "the government cannot restrict truthful, non-misleading speech without strong evidence." His group has petitioned the Supreme Court to block New York's age-restriction law. In May 2026, Representative Nick Langworthy introduced the Dietary Supplement Regulatory Uniformity Act to stop states from creating a "patchwork" of different rules, according to WRTV.
74% of Adults Take Supplements, but Risks Stay Largely Invisible
Three in four US adults — 74% — take at least one dietary supplement, according to the Council for Responsible Nutrition. Yet the system for catching problems is badly broken. More than 15,000 health issues linked to supplements were reported to the FDA over one decade. Experts at Pew Charitable Trusts estimate that represents just 1% of actual adverse events.
One proposed fix is a Mandatory Product Listing, which would require manufacturers to register every ingredient in a central FDA database. Right now, the FDA doesn't even have a full list of what's being sold. Without it, regulators are essentially flying blind in a $74 billion market that touches the lives of hundreds of millions of Americans.
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