Thread by @Elise_Ackley

Alright fam—grab your coffee and settle in because want to spend a little bit of time today walking through #DietarySupplement oversight, why mandatory product listing would be transformative for the @US_FDA and why it’s a big deal the President put it in his #FY20Budget. 1/

For starters, millions of Americans (as high as 75%) take at least one #DietarySupplement daily—including myself! But the #DietarySupplement industry has grown significantly in the 25 years since the passage of #DSHEA—the last major piece of legislation to regulate supplements 2/

Back when #DSHEA was being considered in 1994, there were ~4,000 supplements on the market and the industry was valued at ~$4 billion.

Fast forward 25 years to now—there *could* be as many as 80,000 #DietarySupplement products on the market, valued at over $40 billion. 3/

Not only has there been a big jump in the amount of products (20x) since 1994—but the range of products, including ingredients, on the market has evolved (hello DMAA, SARMS, and soon-to-be CBD 👋🏻👋🏻). 4/

But notice what I did there in those last tweets? (emphasis on the *could*). There could be 80,000 different #DietarySupplement products under @US_FDA oversight – or there could be more! Or less! Right now, the @US_FDA actually has no definitive way of knowing for sure. 5/

In fact, the agency lacks even the most basic information about #DietarySupplements on the market—things such as name, ingredients, what’s on the label, and claims. 6/

This is, to be honest, not great for public health. Why? Because if an ingredient in a #DietarySupplement harms consumers, the @US_FDA has no efficient way of figuring out which of the thousands of supplements on the market contain it. 7/

Unfortunately, this causes the Agency to be very reactive (some might say slow) versus proactive when things go wrong. It’s impossible to identify – let alone oversee – the highest-risk #DietarySupplements without a clear picture of the marketplace. 8/

This is where mandatory product listing comes in! It would require supplement companies to tell the @US_FDA a little bit of info before going to market. 9/

What exactly is included in this “info” is up for debate BUT a requirement for companies to provide FDA with basic information about the supplements they sell – such as names, ingredients, labels – would be a whole new world for the agency. 10/

Have I convinced you yet? Well, aside from giving @US_FDA a fuller picture of #DietarySupplements on the market, a listing requirement allows the FDA and industry to quickly take steps to protect consumers from potential harm when new safety risks arise. 11/

Listing also enables the agency to direct its resources and expertise accordingly – including giving more oversight to #DietarySupplements that need it most, aka more bang for our buck. And being honest, the FDA could always use more resources but that’s for another thread 12/

So if this is such a great idea, then why isn’t this the law of the land? Well, great question—and a very very simple oversimplification is the fact that the timing just hasn’t been right. 13/

However...we are at the point where things have evolved, ::whispers:: members have retired, and now folks are starting to take this policy idea seriously. If fact, so seriously that the President included #DietarySupplement product listing his #FY20Budget. 14/

Having mandatory product listing for supplements in the President’s Budget is huge—this is one of the strongest signals the administration can send on its support. This is basically the FDA telling Congress that it gives its blessing for product listing legislation. 15/

So what’s next? Well, important conversations are happening, the @US_FDA established a Working Group to explore new authorities like listing, and folks like me are urging Congress to pass legislation that gives FDA the authority to collect basic information about supplements. 16/

It’s a long road ahead, but hopefully at the end we will have forged a way for the FDA, consumers, and retailers to know more about the #DietarySupplements on the market. 17/

Whew, time to bring this party to an end! If you’ve gotten this far, you must be really interested in #DietarySupplement oversight. Thanks for reading and make sure to check out an op-ed from @coukell on this topic — thehill.com/opinion/health… 18/18