Getting savvy with health supplements

What are health supplements?

Health supplements are commonly taken for the purpose of supplementing the diet to enhance or support health, and their ingredients are generally recognised to be safe for consumption. They typically contain vitamins, minerals or substances derived from plant or animal sources, or are synthetic duplicates of the naturally occurring ingredient.

Health supplements are usually presented in dosage forms such as tablets, capsules or liquids in small, measured doses. Unlike medicines, they are not meant to prevent, treat, cure or alleviate symptoms of medical conditions and diseases. Some examples of health supplements include vitamins, minerals, amino acids, and glucosamine joint supplements.

What do I need to know about health supplements marketed in Singapore?

As ingredients used in health supplements are generally well-established through experience of safe use and are not intended for medicinal purposes, health supplements do not require approval and are not evaluated by HSA before they can be sold locally. Our regulatory approach for health supplements is similar to that adopted by the United States, European Union countries and Japan.

Although health supplements are not subject to evaluation, approvals or licensing by HSA, there are safeguards in place:

• Prohibited substances - HSA prohibits the addition of medicinal ingredients such as steroids in health supplements. HSA also sets strict limits on toxic heavy metals in these products. Dealers (which include manufacturers, importers, distributors and retailers) are responsible for the safety and quality of their health supplements and have to ensure that the products meet HSA's stipulated safety and quality standards.

• False or misleading product claims - Dealers should also ensure that the product claims on labels and advertisements are not false or misleading, and their product advertisements do not make claims for treatment or prevention of diseases.

• Post-market surveillance programme to monitor the safety of health supplements and to initiate timely product recalls - This includes sampling of products in the market and adverse reaction monitoring, which draws on HSA’s network of healthcare professionals and international regulatory partners to pick up signals of adverse reactions to products.

• Local database of safe and good quality health supplements – In August 2022, HSA introduced a voluntary notification initiative for companies dealing with health supplements. This allows companies to submit voluntary declarations on their health supplements to show that they comply with the published guidelines. The inclusion in this database should not be misconstrued as HSA's endorsement of these products. You can find the list of health supplements that are voluntarily notified with HSA here. More products that meet the safety and quality requirements will be added to the database over time.

What can go wrong?

Even with these safeguards in place, you should practise personal caution. Here's why:

• While most dealers are ethical, honest and responsible, there may be a few who only care about increasing their product sales without regard for consumers’ health and safety. Such unethical dealers may not take responsibility for the safety and quality of their health supplements.

• Advertisements of health supplements do not need approval from HSA before publication. The responsibility for ensuring that the information provided for advertisements and promotional materials is clear, accurate and truthful lies with the dealers and advertisers.

• Natural ingredients do not mean no risk. Overdosing, combining supplements or taking them with some medicines may cause harm. In general, patients scheduled for surgery should inform their doctor about any supplements they are taking. They may be required to stop taking them before the operation.

• Benefits from the consumption of health supplements are gradual, not immediate and usually not obvious. Any health supplement that claims to produce rapid results should be viewed with caution.

• Health supplements may not mix well with some medicines – Although health supplements generally contain well-established ingredients such as vitamins, minerals or substances derived from natural sources, this does not mean they are risk-free. Overdosing, combining supplements or taking them with certain medicines may cause harm.

Case 1: Slimming product claimed to be “natural” and “safe” led to anxiety, dizziness and lethargy

In June 2018, a woman in her 20s experienced rapid heartbeats, anxiety, dizziness and lethargy after consuming ‘Nutriline Bluvelle’. She had purchased the product from an online shop based in Malaysia. The product was tested by HSA to contain a banned ingredient, sibutramine, which has been withdrawn from Singapore since October 2010 due to an increased risk of heart attacks and strokes.

Case 2: Two health products led to severe gastric pain and facial swelling

A man in his 60s took ‘LONGRED Oyster-x’ to prevent prostate problems, and ‘LifeSparks 100% Natural PAIN RELIEF SUPPLEMENT’ for his leg pain and gout. Within a day, he experienced rapid pain relief. However, after a week, he developed severe gastric pain and facial swelling. HSA tested the two products and found that ‘LONGRED Oyster-x’ contained a chemical compound similar to an erectile dysfunction medicine, while ‘LifeSparks 100% Natural PAIN RELIEF SUPPLEMENT’ contained a potent steroid.

Misleading claims

Unethical marketers prey on the hopes, fears and anxiety of consumers. To convince consumers to buy their products, they may make claims that are not backed by robust evidence or clinical studies. They may also present personal testimonies, case studies or statistics that cannot be easily verified.

Any health supplement that claims to act rapidly should be treated with caution, as it may contain undeclared potent medicinal ingredients to enhance its effects.

Examples of exaggerated or misleading claims includes:

• "HSA-approved" - This is a false claim. Health supplements and their dealers are not required to be approved or licensed by HSA. While there is a local database for voluntarily notified health supplements that comply with safety and quality standards, it should not be misconstrued as HSA's approval or endorsement of these products.

• "100% safe" - This is a misleading claim. No product can offer such a guarantee, including health supplements made with all natural ingredients.

• "Efficacy or effectiveness guaranteed or clinically proven" - Efficacy of the product cannot be guaranteed without stringent clinical studies. Be mindful that health supplements, including their clinical trials, are not evaluated by HSA.

• "... strengthens your immune system against recurring infections and diseases" - This is misleading as health supplements may support or maintain the healthy functions of the human body but do not protect against recurring infections and diseases.

• "... burns fat fast and helps you to slim down quickly" - This is usually an exaggeration. The product may contain prohibited potent ingredients that can cause dangerous side effects.

• "... reduces cholesterol effectively and prevents heart diseases" - There are usually no stringent clinical studies behind such effectiveness in health supplements.

• "Detoxify your body" - Some of these products work by promoting water loss or stimulating bowel movements, and may not be safe or suitable for everyone. They can cause adverse effects such as headaches, fatigue, dehydration, gastro-intestinal cramps and even decreased bowel function and dependency in the long run.

• "Contains stem cells", "A stem cell therapy" - These claims are not substantiated by scientific literature. There is no scientific evidence that proves that oral cell therapy products can address health issues. Furthermore, “live” cells are delicate and the process of manufacturing and digestion in our stomach and gut would have destroyed them.

Be a smart consumer when purchasing health supplements

Here are some tips for you:

• Find information on health supplements that are voluntarily notified with HSA here.

• Buy from reliable sources such as a pharmacy or an established retail store. If buying online, buy from websites with an established retail presence in Singapore. 

• Be cautious when purchasing health products online or from unfamiliar sources, even if they are recommended by well-meaning friends or relatives. You cannot be certain what these products contain, and where and how they were made. They could potentially be counterfeits or adulterated with undeclared potent or banned ingredients which can seriously harm your health. 

• Avoid purchasing and consuming health supplements with exaggerated claims. Any health supplement that claims to produce rapid results to improve health should be viewed with caution.

• Get advice from your doctor or pharmacist when unsure of the right products for a particular need.

Always remember – health supplements should not replace prescribed treatment or medication from your doctor, nor can they treat or manage a medical condition.

If you suspect that the health supplement you are taking is making you unwell, see your doctor or pharmacist immediately.

You can help us combat adulterated, counterfeit and substandard health products. Report any suspicious sale or advertising of health products to HSA through e-mail or phone at 6866 3485.