Hidden Ingredients Found in ‘All Natural’ Products: FDA

Medicines touted by the manufacturers as being comprised of medicinal herbs and plant extracts are found to have hidden and potentially harmful ingredients.

Signage is seen outside of the Food and Drug Administration (FDA) headquarters in White Oak, Maryland, U.S., August 29, 2020. REUTERS/Andrew Kelly

An arthritis medicine touted by the manufacturer as being comprised of medicinal herbs and plant extracts is found to have hidden and potentially harmful ingredients, including diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), and dexamethasone, a corticosteroid.

The hidden ingredients found in Himalayan Pain Relief Tea, among others, came to light in a new U.S. Food and Drug Administration (FDA) investigation.

“It is clear from the results of our decade of testing that retailers and distributors, including online marketplaces, do not effectively prevent these types of potentially harmful products from being sold to consumers,” the FDA said in a press release.

NSAIDs and corticosteroids are often the standards of care for treating arthritis. Common NSAIDs used for arthritis include ibuprofen and naproxen sodium. NSAIDs are also available as creams or gels, which can rubbed on joints. Steroids, or corticosteroid medications such as prednisone, reduce inflammation and pain and retard joint damage. They are often prescribed as pills or as an injection into the painful joint. Side effects may include thinning of bones, weight gain, and diabetes.

NSAIDs can raise a person’s risk of cardiovascular events, such as heart attack and stroke, and gastrointestinal problems, including bleeding, ulcers, and perforation of the stomach and intestines, which can be fatal.

Likewise, corticosteroids can suppress the immune system, spike blood sugar, and lead to psychiatric problems. When taken for extended periods or at high doses, they can impact the adrenal gland, leading to symptoms such as fatigue, weight loss, muscle aches, diarrhea, and, in women, irregular or no menstrual periods.

Dexamethasone is used to treat inflammatory conditions. It should not be taken with blood thinners, aspirin, warfarin, estrogen, some oral contraceptives, and some anti-fungal medications.

The Problem Is the Newest of Many

During its November investigation, the FDA also tested Tepee Herbal Tea and Notoginseng Formula Special Grout Granule.

The FDA found piroxicam, another type of NSAID, in Tepee Herbal Tea. The ingredient is not listed on the label, the agency said. Piroxicam is typically used to treat arthritis and should not be taken with certain medications, including other NSAIDs like diclofenac.

Additionally, the FDA analyzed Notoginseng Formula Special Gout Granule, a product promoted and sold on the internet, including on eBay, to treat gout and pain relief. The agency found the product also contains the corticosteroid dexamethasone and the NSAID diclofenac. Neither is listed on the product label.

The three products are the newest in a litany that the FDA has found to contain hidden ingredients. Over the past 10 years, the agency has identified 22 arthritis and pain products with ingredients not disclosed on the product label. Other products found in 2023 to harbor hidden ingredients include the following:

• Kuka Flex Forte for arthritis and joint pain. Contains diclofenac.
• Reumo Flex for arthritis and joint pain. Contains diclofenac.
• Tapee Tee for pain relief. Contains dexamethasone and piroxicam.
• Fast-Act Rheuma Capsule for joint pain and rheumatoid arthritis. Contains prednisone-21-acetate, a corticosteroid, and piroxicam.
• New Fast-Act Rheumatism Capsule for joint pain and arthritis. Contains indomethacin, an NSAID.
• UA-Block for joint pain, inflammation, pain from gout and liver detoxification. Contains indomethacin.
• AK Forte for joint pain and arthritis. Contains diclofenac, dexamethasone, and methocarbamol, a muscle relaxant that can cause dizziness, sedation, and low blood pressure.

“These products may cause potentially serious side effects and may interact with medications or dietary supplements a consumer is taking,” the FDA said in the press statement.

The FDA encourages both consumers and health care professionals to report any adverse effects to the agency’s MedWatch Adverse Event Reporting Program so that action can be taken to protect the public from buying unsafe products.

The FDA maintains a complete database of tainted products and supplements marketed for various health benefits, including sexual enhancement, weight loss, bodybuilding, sleep, and arthritis or pain. Many of the drugs or supplements have not been approved by the FDA.