[HN Gopher] Amazon receives FDA warning letter for supplements w...
       ___________________________________________________________________
        
       Amazon receives FDA warning letter for supplements with undeclared
       ingredients
        
       Author : mkmk
       Score  : 424 points
       Date   : 2023-12-28 15:07 UTC (7 hours ago)
        
 (HTM) web link (www.fda.gov)
 (TXT) w3m dump (www.fda.gov)
        
       | kayodelycaon wrote:
       | I'm glad the conclusion says the products lists are not the only
       | ones to which this letter applies. Otherwise Amazon could just
       | remove the products mentioned and make the FDA play wack-a-mole.
       | 
       | As a side note, this letter is exactly why I think a regulatory
       | agency like the FDA is absolutely necessary. This stuff can kill
       | people and it is impossible for the average person to protect
       | themselves.
        
         | toomuchtodo wrote:
         | The FDA likely needs a data team if they don't have one already
         | to monitor Amazon for ongoing compliance. Similar to the SEC's
         | data team that monitors capital market data flows for anomalies
         | that would indicate illegal behavior.
         | 
         | My two cents: good market to be looking for good data folks who
         | might want a (potentially remote) federal agency data job with
         | shakiness in tech.
         | 
         | https://usajobs.github.io/microsite-data-science/
        
           | bilbo0s wrote:
           | If you've ever been with a startup that needed a 510k, you'd
           | know that the FDA regularly monitors everyone for compliance.
           | At least in my narrow domain of medical imaging and treatment
           | planning devices they do. I'd be surprised if they didn't
           | have similar mechanisms in place in every area of their
           | 'jurisdiction'.
           | 
           | It doesn't really hurt the Amazons, they're just
           | distributors. Doesn't really even hurt me. If RTP is a part
           | of my software product I _should_ be under a microscope. It
           | 's going to be small people who try to market supplements who
           | will get trounced now. Because every report will, by law,
           | have to include the source of the product. And that source
           | company or individual is in for a long year. Even shutting
           | down won't end their legal obligations in a lot of cases.
           | 
           | On the other hand, that was, in part, the original point of
           | the FDA. To stamp out the snake oil salesmen. So, yeah. I
           | guess they're just carrying out that mandate in new and
           | updated ways.
        
             | toomuchtodo wrote:
             | I am not unsympathetic to the disparity you mention, but am
             | advocating that distributor gorillas (like Amazon, but
             | others as well) need strong controls (both regulatory and
             | technical) due to their incentives to not be compliant and
             | the potential negative outcomes (illness, perhaps death
             | even, depending on material and consumer) from non
             | compliance.
        
               | tacheiordache wrote:
               | Absolutely. And Amazon should also pay for it!
        
             | LeifCarrotson wrote:
             | > It doesn't really hurt the Amazons, they're just
             | distributors.
             | 
             | I'm doing my first FDA-monitored automation project at a
             | local brewery, and am quickly becoming familiar with the
             | abundant controls that the FDA puts on domestic producers.
             | 
             | But the FDA is an American organization. Amazon or Ebay or
             | Aliexpress or whoever may be just distributors, but they're
             | international distributors. They're _fully-automated_ self-
             | service distributors for manufacturers in China and Russia
             | and Indonesia and India who aren 't subject to FDA
             | jurisdiction, who sometimes aren't subject to any oversight
             | at all.
             | 
             | The only entity that the FDA can go after here is Amazon,
             | so this should hurt Amazon.
        
               | galangalalgol wrote:
               | The FCC should be going after them too. A lot of the
               | wireless stuff they sell isn't registered.
        
               | LeifCarrotson wrote:
               | Yes, the FCC should be going after Amazon as well. I have
               | more experience with that as an electrical engineer who's
               | just getting into FDA-adjacent work.
               | 
               | But the FCC's position is that if I as an electrical
               | engineer want to sell my neighbor here in the US some
               | custom PCB with an antenna, I need to go through testing
               | that costs many thousands of dollars.
               | 
               | If an EE in Shenzhen wants to sell my neighbor the same
               | PCB over Alibaba, Aliexpress, Banggood, Wish, Temu,
               | Shein, Gearbest, or whatever new discount importer is hot
               | I can't keep up anymore, or
               | Ebay/Amazon/Target/Walmart.com, they're just going to
               | create a listing and import it. The FCC simply cannot
               | keep up.
               | 
               | What I don't understand is how they're getting through
               | Customs and Border Patrol. If I want to ship a spare off-
               | the-shelf PLC digital input card for a machine to one of
               | my customers who has a satellite facility in Mexico,
               | there's a 50% chance it gets held up for a month or more.
               | Meanwhile these big distributors have no issues with air-
               | freight shipments of a GPS jammer or raw testosterone
               | direct to American doorsteps in 3 days.
        
             | pfisherman wrote:
             | They do not for supplements. Supplements fall under the
             | office of the Director, which is not funded by PDUFA /
             | MDUFA. Supplements are basically the Wild West.
        
             | jacurtis wrote:
             | As someone who worked at a startup that grew to a
             | significant size in the "Nutraceuticals" industry (the
             | fancy name for supplements), I can tell you that the FDA
             | has nearly zero regulation or monitoring of supplements.
             | 
             | I'll omit brand names here, but I can tell you some sketchy
             | stuff happens in supplement manufacturing all the time.
             | During the ~6 years I worked there, only one letter came
             | from the FDA after a whistleblower at a competitor's
             | company came forward. The FDA sent a warning letter out to
             | several of the large competitors in the industry to "don't
             | do it or else" and never followed up again. The company
             | that got in trouble got a few hundred thousand dollar fine
             | for using mislabeled and toxic ingredients. They had one
             | follow up inspection about 6 months after the warning and
             | that was the end of it. For comparison that company was
             | making ~$600M a year at the time of the fine and is now
             | making $1B+. We carried on and never heard from the FDA
             | again despite being equally guilty in our own company.
             | 
             | The guilt is what eventually led me away from the cash cow,
             | where I went on an 18 month sabbatical to get away from any
             | corporate greed for a little bit. I legitimately had
             | nightmares that I would be complicity guilty of several
             | crimes if I stayed there long enough.
             | 
             | I promise you, there is no oversight in supplements. There
             | are a handful of posted guidelines. If a whistleblower
             | comes forward the FDA might react to that single case, but
             | they are so understaffed; the team that manages
             | nutriceuticals is marked in the "tens" of people, not the
             | thousands dedicated to proper medical equipment and
             | medicines.
        
               | thfuran wrote:
               | It seems like a bizarre gap between food and drugs that
               | shouldn't exist. If it's meant to be eaten, the FDA
               | should definitely be regulating it thoroughly.
        
               | kayodelycaon wrote:
               | The FDA still requires supplements to follow safety
               | standards and be properly labeled, but you do not need
               | approval to make them.
        
               | dataflow wrote:
               | > It seems like a bizarre gap between food and drugs that
               | shouldn't exist. If it's meant to be eaten, the FDA
               | should definitely be regulating it thoroughly.
               | 
               | The FDA _did_ try regulating supplements. They were
               | legally prohibited from doing much.
               | 
               | You can thank Senator Orrin Hatch (who was the longest-
               | serving Republican senator in history until recently) for
               | preventing the FDA from regulating supplements back in
               | 1994. [1] [2]
               | 
               | [1] https://www.youtube.com/watch?v=WIT5_SMIaHE&t=6m46s
               | (watch a few minutes of it from here)
               | 
               | Edit: Posted it here for those interested:
               | https://news.ycombinator.com/item?id=38797162
               | 
               | [2] https://www.congress.gov/bill/103rd-congress/senate-
               | bill/784
        
             | BobaFloutist wrote:
             | > Because every report will, by law, have to include the
             | source of the product.
             | 
             | I don't think it's an undue burden that if you're going to
             | sell things people are ingesting, you have to know and
             | communicate where they came from.
             | 
             | And I feel like small people that try to market supplements
             | won't be especially damaged by this. It feels like as much
             | as anything this would "hurt" small people that try to
             | start a supplement manufacturing cottage-venture on a shoe
             | string, over which I don't expect to lose any sleep.
        
           | altairprime wrote:
           | If Amazon fails to comply with the auditing requirements
           | imposed by law, their entire retail shipping business could
           | be closed by the US federal government. The FDA need only
           | prove that Amazon has a pattern of negligence in their
           | product auditing duties under law, in order to impose severe
           | penalties, up to and including shuttering Amazon FBA. The FDA
           | is not required to perform inventory assessments as a free
           | service for Amazon in order to reach that final outcome. This
           | letter is the first, necessary, step towards doing so.
        
             | serial_dev wrote:
             | I assume it's still a move with lots of politicking
             | involved, so they need to stand on solid grounds, proof and
             | all, I don't think they would every take lightly closing
             | down vone of the biggest companies of the country (and the
             | world).
             | 
             | If it ever happened, I can already see the endless coverage
             | by Sean Hannity and similar about how it's governmental
             | overreach that risks destroying an important US company
             | with X thousands employees...
             | 
             | However, I don't think it will ever happen, in the end it's
             | one of the richest men, Jeff Bezos behind Amazon with
             | significant influence on news reporting, who seems to be on
             | good terms with both the Republicans and Democrats, and the
             | regulatory agencies in the US just didn't show a pattern of
             | going too hard against US companies.
        
               | altairprime wrote:
               | I definitely don't have a well-formed opinion on how
               | _likely_ such an outcome is, but I absolutely believe
               | that discussing that outcome as a serious concern is
               | _necessary_ discussion to have.
        
         | fallingknife wrote:
         | I'm certainly in favor of these regulations that require
         | supplements and food products to accurately list ingredients.
         | I'm also in favor of the FDA coming down hard on violators.
         | 
         | But it seems perfectly reasonable that law enforcement should
         | have to play whack a mole. That's kind and of how it works with
         | innocent until proven guilty. I'm not a fan of the whole "you
         | enforce it for us or we come after you" approach. In reality
         | what it means is that gate keepers like Amazon have to put in
         | place policies that are much more strict than the actual rules
         | in order to avoid even a chance of getting hit. Agencies like
         | the FDA know this and use it as a way to put in place de facto
         | policies that are much stricter than they could legislate.
        
           | werico wrote:
           | I totally get where you're coming from, but the problem with
           | enforcement-by-whack-a-mole is that some crimes are very
           | cheap and easy to carry out and very difficult to detect and
           | prosecute. The asymmetry means criminals are incentivized to
           | commit those crimes, and can even become fantastically
           | wealthy by doing so. If there isn't an offsetting risk for
           | them (or control), then they're going to do it. Some of those
           | crimes can ruin victims' lives, and in some cases (like this)
           | people can die. We simply can't afford to use no other
           | enforcement strategies.
           | 
           | A good example of where we threw out the upfront controls was
           | COVID relief money, and that was a disaster in terms of
           | fraud. (Admittedly a purely government program, but the same
           | principle applies.)
        
           | bumby wrote:
           | I think it's a distinction in risk philosophy. The whack-a-
           | mole approach is "continue until we find you unsafe" while
           | the other approach is "don't start until you prove you're
           | safe". I think both approaches can be reasonable depending on
           | the level of risk. When it comes to supplements tainted with
           | unlisted ingredients that can have harmful or deadly effects
           | for consumers, I personally think the latter is the better
           | approach.
        
             | fallingknife wrote:
             | But the risk level is very low. The stats I see show less
             | than 20 hospitalizations and 2 deaths per year due to bad
             | supplements. https://time.com/5602125/dietary-supplements-
             | kids/
        
               | bumby wrote:
               | That article is just a subset of the overall data because
               | it only focuses on those under the age of 25. [1]
               | suggests there are almost 25,000 ER visits and over 2,100
               | hospitalizations per year due to supplements (although
               | adverse reactions don't necessarily mean tainted or
               | poorly controlled dosage).
               | 
               | [1] https://www.nejm.org/doi/full/10.1056/NEJMsa1504267
        
               | hammock wrote:
               | How many of those are due to unknown, unlabeled risks?
               | 
               | I'm willing to be that there are far more than 25,000 ER
               | visits a year due to OTC drugs.
               | 
               | Sometimes the risks are labeled. Other times they aren't.
               | And still other times people just didn't follow the
               | labeled directions.
               | 
               | You can't assume that every supplement ER visit was
               | because of off-label ingredients or what FDA is saying
               | here. That's too far of a leap.
        
               | bumby wrote:
               | > _You can't assume that every supplement ER visit was
               | because of off-label ingredients_
               | 
               | I already acknowledged this in the previous post.
               | 
               | However, if you look at the rates of tainted supplements
               | it probably isn't a leap to assume a fair number can be
               | attributed to unlisted ingredients. Some studies show
               | contamination rates of nearly 60%. Again, I think the
               | mitigation should be proportional to the risk. We might
               | be about to debate what the acceptable threshold is (and
               | I think most would agree it's lower than the current data
               | suggests) but I don't think accuracy in labels is too big
               | of an ask.
        
               | hammock wrote:
               | >Some studies show contamination rates of nearly 60%.
               | 
               | And what % of "contamination" is dangerous ingredients
               | (when directions are followed) vs harmless? You can't
               | assume that every contaminated supplement is dangerous.
               | Fraudulent, maybe. Mislabeled, yes.
        
               | bumby wrote:
               | Those rates are from prohibited substances. Meaning there
               | is the possibility a strong enough effect to be
               | concerning (otherwise they wouldn't be prohibited as a
               | PED), but you're correct that dosage matters too. But I
               | already addressed that in the first post. Regardless,
               | there is a truth in labeling standard that many believe
               | should extend to supplements. I'm probably in that camp.
               | If you're not, I'd be interesting in hearing why.
        
           | callalex wrote:
           | Innocent until proven guilty only applies to individual
           | people, not corporate entities.
        
             | dragonwriter wrote:
             | Incorrect, innocent until proven guilty applies generally
             | (but, as "guilty" applies specifically to criminal law,
             | only there, but to juridical persons as well as natural
             | ones; but the concept is not far removed from that of due
             | process, which applies even outside of criminal law.)
        
               | dctoedt wrote:
               | > _the concept is not far removed from that of due
               | process, which applies even outside of criminal law_
               | 
               | Spot on. How much process is "due" is largely a function
               | of the potential downside consequences of a mistake by
               | the authorities.
               | 
               |  _Examples_ (from U.S. law):
               | 
               | * A police officer can briefly stop you on the street to
               | ask a question such as "did you see what happened?"
               | pretty much at will.
               | 
               | * To detain you or search your person or property, the
               | officer (with some exceptions) needs probable cause, in
               | most cases confirmed by a neutral, independent judicial
               | authority (that's the warrant requirement).
               | 
               | * To imprison you or fine you, the government must
               | affirmatively establish your guilt beyond a reasonable
               | doubt, to a neutral jury of your peers, using evidence
               | that meets established legal standards of reliability.
               | 
               | * In all civil cases, a claimant seeking damages must put
               | on admissible evidence affirmatively showing facts that
               | legally entitle the claimant to the requested relief.
               | 
               | * In certain grave civil matters, such as claims of
               | fraud, the claimant must prove the claim by clear and
               | convincing evidence, the highest standard of proof in
               | civil law. (The usual standard in civil cases is
               | "preponderance of the evidence," i.e., more likely than
               | not.)
               | 
               | * In some cases, the testimony of witnesses "having an
               | interest" (e.g., an agenda to advance, an axe to grind, a
               | score to settle) must be supported by corroborating
               | evidence because the law recognizes that such witnesses
               | can sometimes be, ahem, unreliable.
               | 
               |  _Usual caution to readers: IAAL but not_ your _lawyer._
        
           | kayodelycaon wrote:
           | Frankly, it is absolutely ludicrous to limit the FDA to
           | telling Amazon to remove a product _by name_ and then having
           | to do that again each time someone resells the same product
           | under a different name.
           | 
           | In this case the FDA is saying everything that includes
           | regulated medications in non-regulated products must be
           | addressed.
           | 
           | Seems reasonable to me. If a company completely ignores
           | regulation, the FDA should have to power to enforce its own
           | regulations.
        
         | 1920musicman wrote:
         | I searched for all products mentioned in the letter - they are
         | all gone. Amazon is quick to react to such public letters to
         | pretend that they are a responsible company.
         | 
         | Saying that, the search returns hundreds of other supplements
         | in the same category, with similar nonsensical names. They are
         | certainly attempting to play wack-a-mole.
        
           | ssgodderidge wrote:
           | I think the speed to remove the noted items isn't suspect;
           | it's what I would expect a responsible company to do in this
           | scenario.
           | 
           | However, I am curious to see how Amazon handles the other
           | drugs. Seems like pausing the sale of the entire category is
           | the right call
        
             | 1920musicman wrote:
             | The category these supplements were listed under is "Sports
             | Nutrition Endurance & Energy Products" with some legitimate
             | products listed under it. I doubt Amazon would delist the
             | entire category. But also, something tells me that sellers
             | would just list products under a different category without
             | any meaningful consequences.
             | 
             | E.g. these or similar tainted supplements could be listed
             | under "Health, Household, and Body Care" (a very broad
             | category that already has products like "stripfast5000 Fire
             | Bullet Capsules with K-CYTRO for Women and Men" listed
             | under it), etc.
        
             | treprinum wrote:
             | Amazon bans all sellers that ever attempt to sell/list
             | anything Amazon bans even if the ban was not made public
             | (unless they pay their "consultants" closely connected to
             | managers to unban them of course).
        
         | stickfigure wrote:
         | Genuine question: What level of scrutiny do you think Amazon
         | should provide here? In vaguely increasing level of
         | detail/effort, it could be...
         | 
         | * Checking the published label of items for illicit content
         | 
         | * Checking the contents of one bottle for undeclared
         | ingredients
         | 
         | * Checking the contents of all bottles for undeclared
         | ingredients
         | 
         | * Checking the contents of all pills in all bottles for
         | undeclared ingredients
         | 
         | ...etc. I guess what I'm wondering is, what course of action do
         | you think is reasonable for Amazon to take here? It's easy to
         | say "don't allow this to happen"; I'm curious about what that
         | actually translates to in practice.
        
           | Baldbvrhunter wrote:
           | It is an interesting question.
           | 
           | How much cocaine goes via Amazon?
           | 
           | Or ephedrine, or ecstasy... Etc
        
           | giarc wrote:
           | GNC (and likely other online supplement stores) have an
           | online presence and likely has some QA for the products they
           | sell. Amazon just insists on having 1,000,000+ listings for
           | supplements rather than a more curated list. Perhaps some
           | categories shouldn't have endless list of products.
        
             | lotsofpulp wrote:
             | The only QA in the "supplement" and "vitamin" business I
             | know of is USP:
             | 
             | https://www.quality-supplements.org
             | 
             | Although, I have no clue if USP simply rubber stamps it
             | once time, or if they do continuous testing of the
             | products. If I were to bet, I would say they probably do
             | not test often enough after initial certification.
        
           | verall wrote:
           | Supplements should probably not be sold in a marketplace
           | fashion by fly-by-night distributors by a major trusted brand
           | (amazon).
           | 
           | Businesses that sell supplements should create trusted
           | relationships with their suppliers to not break the rules and
           | to limit their own liability.
        
             | AnthonyMouse wrote:
             | For products like this what you need is some entity in the
             | destination jurisdiction responsible for asserting
             | regulatory compliance. That doesn't necessarily have to be
             | Amazon -- it wouldn't be Visa, for example -- as long as
             | there is some domestic manufacturer or domestic importer
             | the FDA can go after instead. And the latter is really what
             | you want, because otherwise _Amazon_ has to play whack-a-
             | mole as the perpetrators just create new accounts, whereas
             | the government could charge them with a crime to actually
             | deter them.
             | 
             | The only reason you'd need to go after Amazon is if they're
             | selling products dropshipped from another country, which
             | they could avoid by simply requiring sellers of products
             | meant for human consumption to have a domestic presence.
             | They wouldn't even have to ship from here, just have
             | somebody here who gets arrested if they break the law.
        
               | verall wrote:
               | Every brick and mortar store has to assert the safety and
               | legality of everything they sell or else risk serious
               | liability.
               | 
               | From what I can tell, Amazon does not present itself as a
               | farmer's or flea market, yet it tries to limit its
               | liability by pretending it does. To the average consumer
               | things purchased from it come "from amazon", as compared
               | to ebay which makes it much more obvious you are
               | purchasing from a particular person or shop.
               | 
               | Amazon really tries to have its cake and eat it too here,
               | and it sort of blows my mind that consumer product safety
               | regulators haven't clamped down on this.
               | 
               | It's really one thing to have basically anything
               | available on ebay/aliexpress/others (consumer trust is
               | much lower) and another to be a huge retailer (just like
               | walmart) and yet to be able to sell whatever unsafe stuff
               | you want (unlike walmart).
        
               | cool_dude85 wrote:
               | >And the latter is really what you want, because
               | otherwise Amazon has to play whack-a-mole as the
               | perpetrators just create new accounts
               | 
               | How can they just create a new account to sell
               | supplements without thorough testing, vetting, control
               | processes, etc. by Amazon, the business actually selling
               | the stuff? If Amazon doesn't have such controls in place
               | to stop people from "just creating new accounts" then
               | hold Amazon liable.
        
               | AnthonyMouse wrote:
               | > How can they just create a new account to sell
               | supplements without thorough testing, vetting, control
               | processes, etc. by Amazon, the business actually selling
               | the stuff?
               | 
               | Because they, not Amazon, are the business actually
               | selling the stuff. Amazon is a payment processor and a
               | warehouse provider.
               | 
               | You go after the person who knew they were breaking the
               | law, not their landlord or their bank or the dealership
               | where they bought their car by accusing them of not
               | thoroughly investigating their customers. Criminal
               | investigations are the role of law enforcement, not
               | private businesses.
        
               | Animats wrote:
               | > Because they, not Amazon, are the business actually
               | selling the stuff. Amazon is a payment processor and a
               | warehouse provider.
               | 
               | That is legally questionable. When Amazon was losing on
               | that issue in Pennsylvania higher courts, they settled to
               | avoid having an on the record decision that Amazon was
               | liable.[1]
               | 
               | [1] https://www.villanovalawreview.com/post/890-oberdorf-
               | v-amazo...
        
           | blagie wrote:
           | Whatever level is needed, so that if I'm buying a product
           | made be Nestle, I know that it was made by Nestle.
           | 
           | I think the policy mechanism here should be liability:
           | 
           | * If I buy a counterfeit memory card on Amazon, and it loses
           | my photos, Amazon should be liable for the cost and effort of
           | those photos. If I am poisoned with bad medicine, Amazon
           | should be liable for the damages.
           | 
           | * If I spend money on 400TC cotton sheets, and get 300TC
           | cotton/poly blend ones.
           | 
           | * If I write a book, and Amazon sells pirated copies, I
           | should receive damages.
           | 
           | * If a bad medical product injures me, or doesn't have the
           | intended effect, Amazon is liable (with standard astronomical
           | damages)
           | 
           | Critically:
           | 
           | * It should be easy to extract those damages (Amazon can't
           | tie me up in court or arbitration), and when this happens at
           | scale, this should be class action or federal / state
           | enforcement.
           | 
           | * Damages should include reasonable costs of enforcement.
           | They should also be set at a minimum at treble damages, since
           | not all instances will be caught / enforced.
           | 
           | At that point, the actuaries can do their thing on reasonable
           | level of effort Amazon should put in. That may be shutting
           | down all fulfilment-by-Amazon, co-mingling, and marketplace
           | sellers, very different fee structures, inspections /
           | enforcement, or something else. I don't know.
           | 
           | I actually think the most likely outcome is a verified supply
           | chain, where Nestle (or any other manufacturer) sends to
           | Amazon and Amazon to me with no middlemen. Vendors in
           | compatible enforcement regimes with appropriate treaties
           | (e.g. US and EU) are allowed in, so long as they have
           | everything in order (corporate registration, etc.) and are
           | selling under their own name. Vendors where the long arm of
           | my local justice system doesn't quite reach aren't allowed
           | in, at least directly, unless Amazon does a lot more scrutiny
           | to the level to the point where I have similar guarantees
           | about product safety, quality, environmental impact, labor
           | laws, IP, etc.
           | 
           | I would not set a similar bar for eBay or Aliexpress, which
           | claim to be marketplaces and not stores. However, when I buy
           | from Amazon, Walmart, Target, etc., I believe that I am
           | buying from a store (even if the fine print says otherwise).
           | I'd want a very clear distinction between the two. Part of
           | the way Amazon got itself into deep trouble is by trying to
           | mix the two up. If I'm shopping at a flea market, it's
           | _caveat emptor_ , and those can be fun for some things. If
           | I'm shopping at a store, I expect a certain level of trust.
           | 
           | What is clear, though, is that Amazon isn't self-policing,
           | and we need regulatory enforcement.
        
           | zopa wrote:
           | > It's easy to say "don't allow this to happen"; I'm curious
           | about what that actually translates to in practice.
           | 
           | It translates into "don't allow this to happen," because any
           | other standard can and will be gamed. So for instance testing
           | a bottle or two at random would work fine if Amazon really
           | does test a random and representative sample of what's being
           | sold, and to me that's a reasonable level of diligence to
           | expect. But if Amazon Testing emails the supplier: "Please
           | send over a batch of X MAX SUPER ENERGY so we can test if for
           | these substances which we hope we won't find, and make
           | absolutely sure what you send is the same thing you're
           | selling!" -- then that will work somewhat less well. There
           | are endless ways for Amazon and sellers to wink and nod and
           | skirt the intent of the rules, if Amazon is just checking a
           | box for the FDA, and doesn't actually care.
           | 
           | The way to get Amazon to care is to hold it responsible for
           | the outcome. Of course there will be sellers that find a way
           | to skirt whatever process Amazon puts in place, but that
           | needs to be Amazon's problem. Amazon can survive taking its
           | lumps when it messes up.
        
           | kayodelycaon wrote:
           | They don't need to inspect individual products, but they
           | should be able to verify anyone selling supplements is who
           | they say they are.
           | 
           | Verification only needs to be good enough to stop low effort
           | fraud. This is entirely doable.
           | 
           | They also need to ensure the product you buy comes directly
           | from the seller you bought from.
           | 
           | They need to prevent counterfeits from random sellers getting
           | added to inventory of legitimate companies.
           | 
           | Separating inventory by seller is 100% doable. My company
           | manages it. It just costs more.
        
         | nradov wrote:
         | The FDA does some good work, but they have no authority to
         | specifically approve or certify most types of nutritional
         | supplements. If you want to know what you're actually getting
         | and avoid contamination, then only buy supplements when have
         | been certified by the NSF.
         | 
         | https://www.nsf.org/consumer-resources/articles/supplement-v...
         | 
         | https://www.nsfsport.com/
         | 
         | Amazon.com does have their own certification program for
         | dietary supplements, but it seems like the rules aren't
         | consistently enforced.
         | 
         | https://blog.ansi.org/anab/requirements-sell-dietary-supplem...
        
         | loeg wrote:
         | > As a side note, this letter is exactly why I think a
         | regulatory agency like the FDA is absolutely necessary. This
         | stuff can kill people and it is impossible for the average
         | person to protect themselves.
         | 
         | The mislabeling is certainly a problem, but really these drugs
         | (sildenafil and tadalafil) should be over-the-counter and
         | cheaply available on Amazon as generics. That they are not is a
         | failure of the same FDA. They have a great safety profile and
         | limited contraindications, comparable to many other OTC drugs.
        
         | AnthonyMouse wrote:
         | > As a side note, this letter is exactly why I think a
         | regulatory agency like the FDA is absolutely necessary.
         | 
         | This isn't what anybody objects to about the FDA. "You have to
         | list what's in the product" is a simple rule that every knows,
         | is easy to comply with, and doesn't require any government
         | interaction even in the case of a suspected violation because
         | the FDA can just buy the product to test it and compare the lab
         | results to the label.
         | 
         | What people object to is when someone wants to sell an
         | _accurately labeled_ product with a risk-benefit trade off, the
         | customer knows what the product is and is exercising informed
         | consent, and the government says they can 't have it anyway.
        
           | wredue wrote:
           | >doesn't require any government interaction
           | 
           | Dude what? Government around the world are constantly
           | catching corporations for lying on their product lists.
           | 
           | As for controlled substances, on this topic is a completely
           | fine line which I'd probably tend to agree is not treaded
           | properly. There are risk trade offs to allowing open markets
           | on classes of drugs.
           | 
           | With that said, the massive propaganda campaigns corporations
           | get up to completely subvert that risk, and 100% leaves
           | consumers uninformed even with the proper information at
           | their fingertips: as a major example, the opioid crisis,
           | leaded fuels, leaded paints, carcinogenic materials handling.
           | I mean, the list really goes on and on.
           | 
           | The issue with the FDA has time and time and time again been
           | demonstrated to be how toothless it is. Corporations
           | constantly ignore regulation for billions in profits, only to
           | receive a sternly worded letter and MAYBE a 0.01% of profits
           | fine.
        
             | nickff wrote:
             | Governments around the world are terrible at 'catching
             | corporations for lying' in any way. There are manifold
             | examples in every regulatory field, in every country.
             | Examples include Wirecard, Theranos, Volkswagen, Johnson &
             | Johnson talc, etc. In most cases, the regulators are handed
             | the evidence, and take a long time to do anything about it.
             | 
             | In my mind, the question is whether the massive regulatory
             | burdens which protect incumbents and inhibit liberty are
             | worth it. This is not an all-or-nothing question, and might
             | be answered field-by-field, but regulators have not covered
             | themselves in glory.
        
               | wallaBBB wrote:
               | The list of caught ones is immensely longer. It's a cat
               | and mouse game, it doesn't really stop. Big pharma spends
               | a lot of money on training the employees on how not to
               | get caught. I worked 5 years in big pharma and it took me
               | almost a year to understand why are the constantly
               | repeating compliance and fair practice trainings. Giving
               | examples how others failed, etc. Those were not there to
               | tell you not to do it, but what to watch out for. And the
               | sale targets and incentives are there to motivate you to
               | cross the lines. I'm just grateful I was not in sales but
               | application training.
               | 
               | Btw how is a government responsible for Theranos? There
               | was never a product there, just promises burning VC
               | money. Wirecard is more a failure of trusted independent
               | auditors (one of the big 4) that failed to do a proper
               | international audit.
        
               | nickff wrote:
               | The FDA was the regulator for Theranos' products, which
               | were used by customers, and the SEC was the regulator for
               | Theranos' securities.
               | 
               | https://theconversation.com/how-theranos-faulty-blood-
               | tests-...
               | 
               | https://www.sec.gov/litigation/litreleases/lr-24069
               | 
               | Wirecard was actually a much worse regulatory failure in
               | that the regulator _attempted to prosecute the reporters
               | which revealed the affair_. Not only did the regulator
               | fail to uncover either side of Wirecard 's illegal
               | behaviour, they went after the people who did.
               | 
               | https://www.ft.com/content/4ebd9032-d3d1-4a9e-976c-d12354
               | 48e...
        
             | AnthonyMouse wrote:
             | > Government around the world are constantly catching
             | corporations for lying on their product lists.
             | 
             | Obviously you have to interact with the government if they
             | catch you lying. You're not intended to lie.
             | 
             | The point is that you can have a labeling requirement and
             | businesses can comply with it without having to make
             | regulatory filings or prohibiting products.
             | 
             | > There are risk trade offs to allowing open markets on
             | classes of drugs.
             | 
             | Which is why you have labeling requirements. _This is
             | cocaine, it 's highly addictive, you probably want to try
             | ibuprofen first._
        
           | kayodelycaon wrote:
           | Having things unnecessarily banned is a trade off of
           | enforcing regulations effectively.
           | 
           | Someone has to decide what substances safe and prevent them
           | from sold.
           | 
           | The FDA could do better but you'll never fix that problem
           | unless you don't allow the FDA to enforce regulations.
        
             | AnthonyMouse wrote:
             | > Someone has to decide what substances safe and prevent
             | them from sold.
             | 
             | No they don't. If a product has a label that says "this
             | product is considered unsafe by the Food and Drug
             | Administration" and explains why and you buy it anyway, you
             | got what you paid for.
        
               | kayodelycaon wrote:
               | Unfortunately all this would result in is everything
               | being labeled unsafe.
               | 
               | See California and cancer.
        
               | AnthonyMouse wrote:
               | Label the things unsafe that are currently banned. Not
               | everything is currently banned, is it?
        
               | VBprogrammer wrote:
               | I don't think you've understood the, very valid arguement
               | in my opinion, that everything would end up with an
               | unsafe label. In the same way that almost everything you
               | buy either may contain nuts or is made in a factory which
               | might process nuts - a practise which provides exactly
               | zero useful input for the people it's intended to
               | protect.
               | 
               | Why would this happen for things which aren't currently
               | banned? An abundance of caution - better to claim it's
               | potentially unsafe than pay the claims later. Or
               | economics - why pay more for a safe sweetener when you
               | can use the cheap and cheerful one and just label it
               | unsafe.
        
               | AnthonyMouse wrote:
               | You're assuming that people would disregard the labels.
               | But people with allergies don't disregard the labels,
               | they buy a different product. Most others don't care if
               | it has traces of nuts or not because nuts aren't going to
               | kill them, so those products find a wide market of people
               | who are perfectly safe eating them.
               | 
               | California says that everything causes cancer because
               | everything kind of causes cancer and their labeling rules
               | are stupid. If the label was only on products with a
               | _significant risk_ of causing cancer _from ordinary use_
               | , it would be rare and people wouldn't ignore it. In
               | other words, if it was only on the products that would
               | otherwise be banned.
               | 
               | This would only be a problem if you would otherwise have
               | banned lots of things people would still want to buy
               | given a free and informed choice, in which case actually
               | banning them is even worse.
               | 
               | We didn't ban cigarettes, we informed people of the risk:
               | 
               | https://www.lung.org/research/trends-in-lung-
               | disease/tobacco...
               | 
               | And that's one of the most addictive products known.
               | Around the same percentage of adults smoke cigarettes and
               | use illegal drugs. So what good is the ban?
        
               | ben_w wrote:
               | > But people with allergies don't disregard the labels,
               | they buy a different product.
               | 
               | And sometimes you get people like me, who eat yoghurt
               | without checking the ingredients because you shouldn't
               | need to, only to then find out that for some crazy reason
               | American food companies put beef gelatine into theirs.
               | 
               | For me vegetarian is a choice rather than mandatory, but
               | if you rely on "common sense" people will die, and have
               | died. It's happened with surprise nuts, despite that one
               | being well known.
        
               | AnthonyMouse wrote:
               | > And sometimes you get people like me, who eat yoghurt
               | without checking the ingredients because you shouldn't
               | need to, only to then find out that for some crazy reason
               | American food companies put beef gelatine into theirs.
               | 
               | They made a product and told you what was in it. You're
               | not required to read the ingredients first but you have
               | the opportunity to. Are you proposing that we ban beef
               | gelatin?
               | 
               | > if you rely on "common sense" people will die, and have
               | died. It's happened with surprise nuts, despite that one
               | being well known.
               | 
               | But what are you even suggesting here? That you can't
               | make a product with nuts if someone might not expect it,
               | even if you labeled it?
        
               | ben_w wrote:
               | > Are you proposing that we ban beef gelatin?
               | 
               | Although I would in general, that wasn't the point being
               | made in that comment. The point was: nobody expects
               | surprises.
               | 
               | People mostly don't read lists to confirm the absence of
               | things they think would be crazy to find.
               | 
               | Like _boiled cow bone and skin derivatives_ in _yoghurt_.
               | 
               | > But what are you even suggesting here?
               | 
               | The specific thing that I actually said, with no extra
               | hidden implications between the lines: common sense gets
               | people killed.
        
               | AnthonyMouse wrote:
               | > common sense gets people killed.
               | 
               | That isn't a policy proposal.
               | 
               | If you're in a cornfield next to a farm road that only
               | sees one truck every six months, common sense says you're
               | not at a busy intersection, but if you step into the road
               | without looking and there _is_ a truck, that 's not the
               | truck's fault. You can be cautious all the time or you
               | can take a risk once in a while; it's your choice because
               | it's your life.
               | 
               | It's also not clear how it applies to the topic. If you
               | went to the store and asked for some MDMA and they gave
               | you some MDMA, you are not going to be _surprised_ that
               | the contents is MDMA. That 's not why it's banned.
        
               | Retric wrote:
               | > You're assuming that people would disregard the labels.
               | 
               | People _do_ disregard labels including those with
               | allergies.
               | 
               | > If the label was only on products with a significant
               | risk of causing cancer from ordinary use, it would be
               | rare and people wouldn't ignore it. In other words, if it
               | was only on the products that would otherwise be banned.
               | 
               | Ahh, but the risks are high enough that companies will
               | still put that label on everything unless companies where
               | required to only put such a label on products with
               | significant risk which then gets back to regulators.
        
               | AnthonyMouse wrote:
               | > People _do_ disregard labels including those with
               | allergies.
               | 
               | Exception that proves the rule.
               | 
               | The purpose of the law is to protect people who act
               | within reason. If you have an allergy and don't read the
               | label, that's on you, not the company or the government.
               | 
               | > Ahh, but the risks are such companies will still put
               | that label on everything unless companies where required
               | to only put such a label on products with significant
               | risk which then gets back to regulators.
               | 
               | The entire point is that "regulators say you have to
               | label this" and "regulators say you cannot buy this even
               | with informed consent" are two different things.
        
               | riversflow wrote:
               | > The purpose of the law is to protect people who act
               | within reason.
               | 
               | This is just flat out wrong, and pretty gross.
               | 
               | The purpose of the law is to protect _people_. Not
               | _white_ people, not _land-owning_ people, not _smart_
               | people, not _literate_ people, not _able-bodied_ people,
               | not _" reasonable"_ people. _People._ Full stop.
               | 
               | Assuming people are reasonable is a recipe for disaster,
               | and ablest. Perhaps one day someone you know will get
               | dementia, or have a stroke, or get macular degeneration,
               | or any of the number of ailments that can relieve you of
               | your ability to read and comprehend long texts, lists,
               | and warnings, then maybe you will understand how
               | ridiculous this view is.
        
               | AnthonyMouse wrote:
               | I hope your argument isn't that only white people can
               | exercise reason.
               | 
               | If you have a mental illness you can go to the store and
               | buy rat poison and eat it. The law doesn't address this
               | by prohibiting rodenticides. If you think you can fly and
               | jump off the roof of a parking structure, the government
               | can't disable gravity.
               | 
               | Acting within reason in that context is getting
               | treatment, which is a whole different set of laws.
        
               | Retric wrote:
               | This isn't about extremely dumb behavior, this is about
               | extreme consequences for reasonable actions.
               | 
               | If you walk up to a food truck you shouldn't need to
               | worry about long term mercury exposure from a single
               | lunch. But the same is true if you happen to eat the same
               | item from the same truck for 30 years.
               | 
               | The maximum allowable exposure from food is very
               | different between those two cases. But the second case
               | isn't unreasonable so that's what the standard should be
               | set for.
        
               | riversflow wrote:
               | My argument is that you are picking a specific group and
               | saying the law is only for them.
               | 
               | >If you think you can fly and jump off the roof of a
               | parking structure, the government can't disable gravity
               | 
               | The law can make it so you have guardrail on your roof if
               | it is publicly accessible. The law can also make you put
               | up suicide guards if it's really a problem, all of my
               | favorite bridge have them now.
               | 
               | > The law doesn't address this by prohibiting
               | rodenticides.
               | 
               | Rat poison has actually been getting more scrutiny
               | lately, the traditional pellet form was banned this year
               | in favor of bricks in the US, and non-professional
               | exterminators are limited to buying it a pound at a time.
               | Also, rats are a real pressing problem that is being
               | handled with rat poison. Without it, we go back to food
               | security problems related to controlling pest
               | populations. The same _can 't_ be said in reverse, we
               | don't have a real, pressing problem with an overabundance
               | of safety.
        
               | VBprogrammer wrote:
               | You are being extremely naive I'm afraid. People with
               | allergies have to disregard labels every day. Almost
               | everything edible in the UK had these labels.
               | 
               | I just looked at the back of the chocolate wrapper I just
               | ate and it "may contain nuts, eggs and peanuts." None of
               | those things are ingredients and the warning is just
               | there to prevent a law suit. My friend who has a severe
               | allergy to eggs and nuts would eat it - otherwise he'd
               | have a very bland diet indeed.
        
             | RobotToaster wrote:
             | > Someone has to decide what substances safe and prevent
             | them from sold.
             | 
             | Why?
             | 
             | If someone buys deadly nightshade, and gets deadly
             | nightshade, why should the government care?
        
               | Eji1700 wrote:
               | Basically for the same reasons they don't let you buy
               | other toxins/dangerous materials with almost no
               | alternative use?
        
               | diob wrote:
               | I mean, can't you take this to the extreme and see why it
               | is a bad point of view. Anything is sell-able as long as
               | we slap a warning label on it. That seems like a recipe
               | for disaster, right? We sold a highly radioactive
               | substance to Jim, and endanger more than Jim.
               | 
               | Consequences are often far beyond the individual, and I
               | think folks believe they're too smart to get caught in
               | the fallout of someone else's decisions. Oops, Karen from
               | HR brought in deadly nightshade muffins to share ("small
               | amounts are said to be good for the liver, I heard it on
               | my favorite podcast!").
               | 
               | There's a middle ground here, where if it's dangerous
               | enough, we don't allow it to be sold. It's not one way or
               | the other. That's dangerous thinking in and of itself.
        
               | iakh wrote:
               | I'm assuming you agree the FDA shouldn't allow somebody
               | to sell deadly nightshade to somebody that doesn't know
               | that nightshade is deadly, but then how do you tell the
               | person that knows the nightshade is deadly apart from the
               | person that doesn't know that the nightshade is deadly?
        
               | bell-cot wrote:
               | Is the product's seller paying for the "recipient's" ER
               | visit, hospitalization, autopsy, or any other possible
               | externalities of the purchase?
        
               | ben_w wrote:
               | My mum was a big believer in homeopathy and Bach flower
               | remedies.
               | 
               | The homeopathic sodium chloride and silicon dioxide sugar
               | tablets probably didn't hurt me, but given how dumb Bach
               | flower remedies are it's entirely possible she randomly
               | and unwittingly dosed me with a small quantity of ground
               | up _something_ in the Solanaceae family.
               | 
               | Governments care because well meaning hippy parents who
               | don't know any better feeding snake oil to their kids
               | gets headlines in newspapers.
        
               | msla wrote:
               | And this is something the "Freedom!"-yelpers don't
               | mention: Yes, adults can be "Free!" to do crappy and
               | dangerous things to themselves, but when it's parents
               | poisoning children, you have to be pretty damned
               | sociopathic to only consider how the rights of the
               | parents are being infringed by regulation. I honestly
               | think some people consider children to be property.
        
               | CapitalistCartr wrote:
               | The Libertarisn view is that children _are_ property, in
               | that the gov 't. should not interfere in child-rearing.
        
               | diob wrote:
               | Yeah, these folks are basically naive libertarians (I
               | know, repetitious). There's a middle ground, yet they go
               | slippery slope and think the government is going to take
               | their freedoms.
        
               | growse wrote:
               | The government's got to pay for the road the ambulance
               | drives you on when you stop breathing.
        
             | psychlops wrote:
             | "A business should only be permitted to exist if the
             | government allows it."
             | 
             | What could go wrong?
        
               | kayodelycaon wrote:
               | That's a bit of a stretch. You're not allowed to start a
               | business selling cocaine.
               | 
               | You're not allow to start an airline without adhering to
               | regulations.
               | 
               | You're not allow to sell certain unapproved
               | pharmaceuticals or medical devices.
               | 
               | This is a relatively narrow scope.
        
               | AnthonyMouse wrote:
               | Pharmaceuticals and medical devices have life and death
               | implications. But prohibiting a life-saving product is
               | just as deadly as allowing an unsafe one, and there are
               | existing mechanisms that punish the sellers of dangerous
               | products (it comes out and they lose their customers and
               | get sued).
               | 
               | This comes from a facet of human psychology: If you do
               | something and people die then you're a murderer, but if
               | you do nothing and people die you're allowed to shrug and
               | go home. This may be a reasonable heuristic when deciding
               | whether you should do something but it isn't when
               | deciding whether to prevent someone else from doing
               | something.
        
               | davidthewatson wrote:
               | The problem is that some medical devices are approved
               | despite their being demonstrably deadly as they are
               | designed, manufactured, shipped, and used without
               | sufficient oversight by the governing body of apologists
               | put in place to oversee them. This pattern has only
               | worsened since therac 25.
        
             | IG_Semmelweiss wrote:
             | >>>> Someone has to decide what substances safe and prevent
             | them from sold.
             | 
             | That's an odd take.
             | 
             | Where do these uncorruptible angels live ? Who are they?
             | Who put them there?
             | 
             | Because we all know you are not corruptible, its always the
             | other guy, right?
             | 
             | What about by rights , by the way ?
        
             | LoganDark wrote:
             | > Someone has to decide what substances safe and prevent
             | them from sold.
             | 
             | Plenty of substances are risky, but can be worth the risk.
             | For example, psychedelics, for the wrong person or in the
             | wrong situation, can cause psychotic episodes or lasting
             | trauma, but psychedelic therapy has already been legalized
             | in at least 1 US state, because it can also be extremely
             | helpful.
             | 
             | I'm still not able to buy it and take it home (at least
             | legally), but in my honest opinion, I should be.
        
           | 2devnull wrote:
           | I disagree. I think the best generic argument against the FDA
           | is that government isn't very capable of doing the many
           | things we want it to. I would love perfect security when it
           | comes to foods, drugs and supplements but even with
           | regulations a lot of bad stuff slips through. Imo, that's a
           | better argument than that the fda keeps us from having nice
           | things. The fda fails to protect us because perfect security
           | isn't possible, and past a certain point it's all diminishing
           | returns if not actually counterproductive (consider the
           | effects of prohibition).
        
           | Veserv wrote:
           | The problem is that the risk-benefit tradeoff is not
           | accurately labeled and presented.
           | 
           | Advertising laws in the US mean manufacturers can and should
           | do everything in their power to obscure and mislead about the
           | tradeoff. A person purchasing a unverified product should
           | have tremendous misgivings. They should only purchase it _in
           | spite of tremendous misgivings_. Anything less is not
           | informed consent; it is deception masquerading as informed
           | consent.
           | 
           | Until you fix that you get companies downplaying risks and
           | overstating potential benefits. Fix that and informed consent
           | becomes a real possibility and a much more attractive
           | proposition.
        
             | Spivak wrote:
             | > Anything less is not informed consent; it is deception
             | masquerading as informed consent.
             | 
             | Which is why I think the model for such things should just
             | be "informed consent." It's a concept that already exists
             | in the medical practice with a well-defined procedure.
             | Someone who your state medical board has deemed competent
             | and responsible has to explain in painfully explicit detail
             | all the tradeoffs and answer any and all questions. If you
             | still want to do it you sign some forms and go on with your
             | day.
        
           | rchaud wrote:
           | > accurately labeled product with a risk-benefit trade off,
           | the customer knows what the product is and is exercising
           | informed consent, and the government says they can't have it
           | anyway.
           | 
           | The FDA's regulatory purview is to limit the collateral
           | damage (negative externalities) of even accurately labeled
           | products.
           | 
           | Informed consent from the customer is one side of the
           | equation. Unfortunately they cannot consent to conditions
           | like "Don't burden the hospital system if you take the wrong
           | dosage".
        
             | AnthonyMouse wrote:
             | > Unfortunately they cannot consent to conditions like
             | "Don't burden the hospital system if you take the wrong
             | dosage".
             | 
             | By this logic the FDA would have to ban Tylenol and
             | Robitussin. Tens of thousands of ER visits every year.
             | 
             | The government should generally be concerned with
             | preventing deception and coercion and pricing
             | externalities, because otherwise people have the incentive
             | to do them and they would be prolific.
             | 
             | Things nature punishes directly don't need the state to
             | deter them. They happen by accident rather than by motive
             | and we choose purposely to spread the cost of this across
             | the population as a form of insurance and a cost of living
             | in a free society, sometimes even when the misfortune is a
             | result of their own stupidity. Other times we send them a
             | bill for costs.
        
               | growse wrote:
               | > By this logic the FDA would have to ban Tylenol and
               | Robitussin. Tens of thousands of ER visits every year.
               | 
               | It's almost like there's a balance of harms to be
               | evaluated.
               | 
               | I'd bet the cheap availability of paracetamol etc. saves
               | more hospital visits than it causes, but I don't have the
               | data to hand.
        
               | AnthonyMouse wrote:
               | > It's almost like there's a balance of harms to be
               | evaluated.
               | 
               | Which is a highly context-specific evaluation, so is it
               | better decided by the person with the most knowledge of
               | their own circumstances, or across the board with no
               | context at all?
        
             | fluidcruft wrote:
             | I'm not really sure what you're referring to, but the
             | closest I can interpolate is that you are probably
             | confusing the FDA with the DEA.
        
         | ineedaj0b wrote:
         | I don't want to sound like a nut job, but please look into how
         | much the FDA hampers drug trails.
         | 
         | If you understand how tough it is in one case, think how many
         | trails yearly never get done because of the FDA.
         | 
         | The amount of benefit vs. the amount of deaths caused by the
         | FDA being slow likely means many more are deaths at the hands
         | of the FDA than you expect.
         | 
         | Cracking down on supplements that people take voluntary hardly
         | seems like something I'm pleased they meddle with too.
        
           | neaden wrote:
           | You're only taking them voluntarily if they are what they say
           | they are, if as in this case they aren't you aren't
           | meaningfully taking them voluntarily.
        
             | Tao3300 wrote:
             | Buying shady penis pills on the Internet is a voluntary
             | risk. Play stupid games, win stupid heart attacks and
             | priapisms.
             | 
             | Though I do think Amazon should have a share of the blame.
             | Buyer and seller are both wrong here.
        
           | hibikir wrote:
           | It's possible, and even a good idea, to say that the FDA
           | massively overregulates drug trials, while at the same time
           | also say that the current supplement market is almost just as
           | massively underregulated, and would be far healthier with
           | more oversight. Organizations, just like people, can do good
           | and bad things at the same time.
           | 
           | I am very happy they crack down on supplements, a kind of
           | product that is filled with fraud and that I lack the
           | resources to make informed purchases on. I would also be just
           | as happy if they started cross-approving drugs with the EU
           | and Australia. They are neither angels nor the devil.
        
         | pardoned_turkey wrote:
         | Well, on the flip side: the whole reason these are sold is that
         | the FDA is _preventing_ the substance from being sold OTC. This
         | is not an example of a manufacturer putting something unwanted
         | in the product. It 's all just a wink-wink-nudge-nudge kind of
         | a deal with willing buyers. It creates _some_ risk of
         | accidents, but I doubt there were any.
         | 
         | I'm not sure the regulation here is great. As with Rx-only
         | contraception, these regulations force patients to spend money
         | and discuss their intimate life with a doctor for no real
         | reason, which many people find difficult. And it's not like you
         | undergo thorough screening to get Viagra anyway. A doctor is
         | not gonna say "no".
         | 
         | The problem with bodies such as the FDA is that once they
         | address grave risks, they seldom reach this point of "OK, we
         | fixed the problem of arsenic in patent medicine, so let's scale
         | back for now." Instead, the bureaucracies only grow. Today, far
         | too many drugs are Rx-only and stay this way for too long. The
         | need for prescriptions for equipment such as eyeglasses or
         | contact lenses is hard to justify too.
        
           | lwhi wrote:
           | It's the job of a regulatory body to reduce risk.
           | 
           | If wrongly prescribed equipment can cause harm, it's very
           | justifiable that a license scheme is put in place.
        
             | bjt wrote:
             | > It's the job of a regulatory body to reduce risk.
             | 
             | Sure, and the parent comment's point was that there's a
             | line where further risk reduction doesn't make sense
             | anymore. The agency doesn't have the right incentives to
             | stop at that line.
             | 
             | Plenty of very significant risks aren't regulated to the
             | degree that Viagra and Cialis are. You don't need a note
             | from a doctor or a govt-issued permit to buy kitchen knives
             | or a table saw or a Bic lighter, for example.
        
               | lwhi wrote:
               | Kitchen knives have multiple uses and discretion through
               | education is expected as standard.
               | 
               | Viagra and Cialis have a singular use and
               | contraindications aren't likely to be understood through
               | cultural osmosis.
        
         | adolph wrote:
         | A regulatory agency was fine for a world with a finite number
         | of trusted vendors working operating in the the agency
         | jurisdiction. Reliable consumer owned/operated molecular
         | characterization is needed for a future that moves faster and
         | farther than an agency or regulation.
        
       | jeffrallen wrote:
       | Cool! Now do their crappy cords that are likely to burn down your
       | house.
       | 
       | Amazon Basics should be terminated with prejudice.
        
         | gruez wrote:
         | I checked a random amazon basics powerstrip and there's an ETL
         | certification mark on them. As much as it's popular to hate on
         | amazon for fakes/subquality products, your particular example
         | is a poor one.
         | 
         | https://m.media-amazon.com/images/W/MEDIAX_792452-T2/images/...
        
           | noodlesUK wrote:
           | Funnily enough AmazonBasics is probably the safest set of
           | products on Amazon, as nobody but Amazon is allowed to sell
           | those products. A brand name item might be a fake, but
           | AmazonBasics is always the original (potentially crappy
           | anyway) product.
        
           | floatrock wrote:
           | EV Chargers then. Search for Level 2 EV Charger. The number
           | of generic chineesium chargers available that will move
           | 40amps of power in your garage without UL or ETL
           | certification is mind-boggingly high.
           | 
           | I've seen some advertise "UL Safety Report", which I assume
           | is weasel-words for "We failed UL certification so we can't
           | actually say the magic phrase 'UL Listed'".
           | 
           | I've seen some claim to be UL Listed without being able to
           | find them on the UL site.
           | 
           | Sure, it's nice to buy a cheap chinesium drone, but something
           | moving 40amps of power and heat in your home without accepted
           | safety checks? That feels like something that should have
           | some liability on the merchant's side when it burns something
           | down.
        
             | gruez wrote:
             | >EV Chargers then. Search for Level 2 EV Charger. The
             | number of generic chineesium chargers available that will
             | move 40amps of power in your garage without UL or ETL
             | certification is mind-boggingly high.
             | 
             | Sounds like you're talking about third party EV chargers.
             | What does this have to do with amazon basics? Or are you
             | pulling a motte and bailey, going from "amazon basics is
             | going to burn down your house" to "third party EV chargers
             | are going to burn down your house"?
        
             | neither_color wrote:
             | I went down a small rabbit hole of Amazon electrical
             | products once. You truly are better off at the big orange
             | or blue hardware store for anything electric. Might cost a
             | few bucks more but you don't have multiple suppliers
             | referencing the same fake certificates and skimping on wire
             | gauge to save a few cents.
        
         | dboreham wrote:
         | Nanny state socialism! The market should take care of dangerous
         | products. Nobody is going to buy such a cord twice.
        
           | risho wrote:
           | without regulations the next differently branded unregulated
           | cable might also burn your house down.
        
           | voidee wrote:
           | Of course nobody will buy a dangerous product twice. You
           | can't buy another product after being burned to a crisp!
        
         | astura wrote:
         | None of the dick pills mentioned are AmazonBasics brand.
        
       | throw__away7391 wrote:
       | Nothing bought on Amazon should be consumed or applied topically
       | or otherwise come into prolonged contact with your body. I
       | learned this the hard way a few years back with some counterfeit
       | shampoo that severely burned my scalp after a single use.
        
         | enlightenedfool wrote:
         | Did you take any action at all? Sounds serious enough for legal
         | action.
        
           | inetknght wrote:
           | > _Did you take any action at all? Sounds serious enough for
           | legal action._
           | 
           | A lot of people don't have time, or money, to risk legal
           | action.
        
         | asquabventured wrote:
         | I had the similar experience back in 2018... Led to temporary
         | hair loss (I remember my hair falling out in tufts) from what I
         | believe was counterfeit hair gel (it smelled different from
         | same product I've used for years). Stopped using the product
         | from Amazon and only ever order from reputable sites like
         | Sephora and Nordstrom now.
         | 
         | Amazon has lost all of my business for consumable goods. It's
         | not worth the convenience to risk my own or my families health.
         | Fuck 'em.
        
         | y-c-o-m-b wrote:
         | I stopped buying health and beauty stuff on Amazon altogether
         | due to the counterfeits or people returning items by replacing
         | the actual product with something else which I ultimately end
         | up getting. I had too many instances with vitamins and such
         | where the labels and seals were sketchy, damaged, or didn't
         | exist. Same with shampoos, lotions, face-washes, soaps,
         | detergents, hot-tub supplies, etc. Reporting to the seller or
         | Amazon was a pointless exercise as often times they'd shrug it
         | off.
        
         | blibble wrote:
         | or left plugged into the mains unattended
        
         | blagie wrote:
         | Here's my list of things I won't buy on Amazon.com:
         | 
         | - Anything which goes in or on my body (foods, medicines,
         | etc.).
         | 
         | - Anything which is easily knocked off (SD cards, memory, SSDs,
         | etc.)
         | 
         | - Bed sheets (oddly enough, you'll often get lies on materials
         | and fabric)
         | 
         | - Thing I need reliably / reliably on-time (I cancelled Prime
         | after several shipping issues)
         | 
         | Since I cancelled Prime, things added to this list include:
         | 
         | - Most digital content (they added ads to music I paid for as
         | soon as I cancelled Prime, and many newer Kindle books are hard
         | to back up into non-DRMed formats)
         | 
         | Most of what I will buy on Amazon are generic gizmos, like kids
         | toys, cables, generic keyboards, battery chargers, basic tools,
         | and basic clothing (kids pyjamas and that sort of thing).
         | However, it's no longer my first source. I'll go Aliexpress,
         | eBay, and Walmart first.
         | 
         | I now have Walmart's equivalent of Prime instead. It's not
         | great, but it's better. There is zero customer service, but
         | shipping times are more accurate than Amazon, generally faster,
         | and they'll actually let you know if something is running late
         | or early (which is huge, if you're planning a project).
         | Walmart's selection is worse than Amazons, but I'm hoping it
         | will catch up. I also am starting to go to local stores again.
        
           | giarc wrote:
           | Hate to break it to you, but Aliexpress is likely less
           | reliable than Amazon (or have the exact same products). eBay
           | is likely the same and Walmart allows 3rd party sellers so
           | it's pretty much the same as Amazon unless you source the
           | products curated by Walmart.
        
             | emayljames wrote:
             | From much experience, AliExpress customer service is 100x
             | better than Amazon. Very prompt refunds and dispute
             | resolutions.
        
               | blagie wrote:
               | I agree with the math, but not the spirit.
               | 
               | 0*100 = 0.
               | 
               | Aliexpress is fast, efficient, but completely random and
               | automated in resolution. Products from Aliexpress are
               | great 50% of the time, non-working or not shipped 10% of
               | the time, and somewhere in between 40% of the time. It's
               | cheap and complete roulette.
               | 
               | That's okay for a lot of things.
        
             | blagie wrote:
             | I think you misread my comment.
             | 
             | I'll go to Aliexpress and eBay first for: "kids toys,
             | cables, generic keyboards, battery chargers, basic tools,
             | and basic clothing."
             | 
             | I have the exact same list for them as for Amazon. I'll go
             | there first for those products since Aliexpress has much
             | better prices than Amazon. eBay has better seller reviews.
             | I certainly wouldn't buy food or medicine from them,
             | though, or even bedsheets or SD cards.
             | 
             | Walmart is a lot better than Amazon. They do have a search
             | filter to disable marketplace sellers, and if buying from
             | Walmart proper, I do trust them to still get supply chains
             | adequately right. Amazon did okay here too, even a half-
             | decade ago; it crapped out with Covid and never fixed
             | itself. Perhaps Walmart will crap out too, but it hasn't
             | yet.
        
               | 1905 wrote:
               | > I'll go to Aliexpress and eBay first for: "kids toys,
               | cables, generic keyboards, battery chargers, basic tools,
               | and basic clothing."
               | 
               | I do too. I don't use Amazon Prime and can usually find
               | the same products for cheaper on ebay with free shipping.
               | The competition among other sellers is greater on ebay so
               | the price will often be lower. It is difficult to do
               | returns though
        
           | 1905 wrote:
           | > - Bed sheets (oddly enough, you'll often get lies on
           | materials and fabric)
           | 
           | It makes you wonder about all those masks people were buying
           | online and wearing 14+ hours a day
        
             | blagie wrote:
             | I don't wonder. Fakes and knock-offs were rampant on Amazon
             | -- for a long time, more common than genuine product.
             | People tested them. That's especially true for brand names
             | like 3M.
             | 
             | I only bought through trusted supply chains. My masks were
             | made in South Korea, and I bought directly from the
             | manufacturer's US-based distributor.
        
           | RobotToaster wrote:
           | > Bed sheets (oddly enough, you'll often get lies on
           | materials and fabric)
           | 
           | Happens with clothes too, had to return several linen shirts
           | for this reason.
        
           | jetanoia wrote:
           | Agreed with your post - except on the "Kids pajamas" - they
           | should probably be reclassified under the "Anything which
           | goes in or on my body" list you made.
           | 
           | Whether it's undisclosed flame retardants, toxic dyes, or
           | other harmful substances, kids bodies are generally more
           | susceptible to harm via environmental pollutants. Such harms
           | may not be at all obvious in the short term, but could still
           | be very harmful over the long-term.
           | 
           | I wish I knew of a vastly superior option (ie, safer option)
           | for buying kids or baby clothes. (Anyone have suggestions on
           | this?)
           | 
           | That said, I believe Amazon is probably at the riskier end of
           | this spectrum vs.traditional stores because of their
           | distributor-centric structure.
           | 
           | Basically, if a harmful product were to receive any negative
           | press, it would more easily be equated with a single
           | company/seller from another country, and probably one with an
           | odd-sounding name.
           | 
           | With a more traditional brick and mortar store, the product
           | may be sourced from the exact same producer, but the
           | reputation hit will be greater to the brick and mortar store,
           | because the customer tends to equate the product more closely
           | with the the store itself. Often, they present themselves to
           | the public as the "seller" of the product whereas Amazon will
           | more give the presentation of "distributor" on behalf of
           | "(_insert_generic_inscrutably-
           | named_foreign_corporation_name)". Fly-by-night seems an apt
           | description for these companies most the time.
           | 
           | This seemingly reduced level of accountability is the biggest
           | problem I have with trusting them but it's not the only one;
           | it's just compounded by the often fraudulent reviews, their
           | practice of taking down authentic but critical reviews, and
           | of selling counterfeits - even occasionally when one orders
           | via a "Prime" option, or fulfilled by Amazon, or seemingly
           | buys an item directly via the manufacturer's Amazon 'store'.
           | 
           | Of course there are many other issues as well but these are a
           | few that have created headaches for me in the past to the
           | point that I now avoid them for most purchases.
        
         | jejeyyy77 wrote:
         | what about brand name items?
        
       | Sanzig wrote:
       | > FDA confirmed through laboratory analyses that the "MANNERS
       | Energy Boost," "Round 2," "Genergy," and "X Max Triple Shot
       | Energy Honey" products, purchased on www.amazon.com, contained
       | the active pharmaceutical ingredient (API) tadalafil; and the
       | "WeFun," "Big Guys Male Energy Supplement," and "Mens Maximum
       | Energy Supplement" products, also purchased on www.amazon.com,
       | contained the API sildenafil. These ingredients are not declared
       | on the products' labeling. Sildenafil and tadalafil are
       | phosphodiesterase type-5 (PDE-5) inhibitors and the active
       | ingredients in the FDA-approved prescription drugs Viagra and
       | Cialis, respectively, used to treat erectile dysfunction (ED).
       | 
       | So Amazon was literally selling Viagra and Cialis disguised as a
       | supplement. Wow.
        
         | EA-3167 wrote:
         | Not just Amazon, every time these "ED supplements" are tested,
         | most of them turn out to have actual pharmaceuticals in them.
         | 
         | Here's a similar article from 5 years ago:
         | https://www.wired.com/story/dietary-supplements-can-contain-...
        
         | bpodgursky wrote:
         | Can we have an honest conversation about whether there's any
         | good reason for Viagra to require a prescription?
         | 
         | The barrier right now is that you have to waste 2 hours and
         | $100 to tell a doctor that you have ED. What's the point? It's
         | not stopping anyone except people too poor or busy to jump
         | through the hoops.
        
           | lokar wrote:
           | A middle ground is to let a pharmacist dispense it after
           | going over side effects, instructions, interactions and
           | existing conditions (without a Rx).
        
             | Sanzig wrote:
             | Yeah, I think this is the most reasonable approach. ED
             | medication can have some nasty side effects and
             | interactions, so a medical professional should be in the
             | loop - but that professional could easily be a pharmacist
             | who already has a copy of all the other Rx drugs the
             | patient is taking.
        
             | peyton wrote:
             | Feels a little silly to be forced to have a chat with the
             | lady at the grocery store pharmacy about dick pills
             | whenever I might need them. I can just order it on Amazon
             | apparently.
        
             | dreamcompiler wrote:
             | That would work. Viagra is a blood-pressure lowering drug
             | (that was its original purpose). If you take it with other
             | BP-lowering drugs like nitroglycerin etc, you could pass
             | out or even die.
             | 
             | So some degree of oversight by a medical professional is
             | warranted.
        
           | dec0dedab0de wrote:
           | The reason is to check for preexisting conditions and
           | negative interactions with other medicines. Also, the barrier
           | is even lower than what you say with companies like blue
           | chew, hims, etc.
        
           | dahart wrote:
           | If we're going to have an honest conversation, Sildenafil
           | does have some serious potential side effects and
           | contraindications. Googling "why does viagra require a
           | prescription?" I get an answer attributed to Healthline: "due
           | to these severe (but rare) side-effects, Viagra requires a
           | prescription". At least acknowledge that, it is a good
           | reason.
           | 
           | A doc visit does take time but it neither takes 2 hours nor
           | costs $100 for me, co-pay is still $20 I think (or maybe
           | covered 100% once a year), and the visit might be 45 minutes
           | when the clinic is pretty busy. There is _plenty_ that's
           | messed up and wrong with our health care system and
           | insurance, but maybe the minor hurdle of having to require a
           | doc to check on the potential for side-effects really is
           | justified?
           | 
           | Another decent reason, I speculate, is that the drug is
           | relatively new and we don't know the long term effects of
           | overuse, nor all of the contraindications. If it's available
           | over the counter and many men use it when they don't _really_
           | need it, just because it's available and easy, there could be
           | dramatic unforeseen consequences. Like a lot of drugs, Viagra
           | might be something that people look to as an easier
           | alternative to changing habits or doing preventative work.
        
             | JumpCrisscross wrote:
             | > _maybe the minor hurdle of having to require a doc to
             | check on the potential for side-effects really is
             | justified?_
             | 
             | Viagra is trivially available on the black market because
             | many people don't want to put up with that B.S. Antibiotics
             | have a public interest in being gatekept; they harm
             | everyone if abused. A similar argument can be made for
             | addictive substances.
             | 
             | Merely-harmful drugs, on the other hand, can be disclaimed
             | and, where the clinical and fatal doses are close, diluted.
             | Beyond that, we're manufacturing busywork.
        
               | dahart wrote:
               | Everything is available on the black market, that doesn't
               | mean regulations are BS, it means people are willing to
               | risk breaking the law to avoid being tracked. The demand
               | for Viagra might have more to do with being embarassed
               | about ED or other fears than with concern about the
               | difficulty of getting it legally. (As another commenter
               | pointed out, the bar is extremely low when using online
               | remote clinics.)
               | 
               | What does "merely-harmful" mean? What do you mean it can
               | be disclaimed? If it were over the counter, how will
               | people know when and how to avoid fatal doses? Why do you
               | assume it might be either effective or safe if diluted?
        
               | JumpCrisscross wrote:
               | > _What does "merely-harmful" mean?_
               | 
               | Drugs that really only harm the person who takes them if
               | abused. Alternatively, drugs which are unproblematically
               | sold over the counter the world over.
               | 
               | > _Everything is available on the black market_
               | 
               | Available versus commonly procured.
               | 
               | > _that doesn't mean regulations are BS, it means people
               | are willing to risk breaking the law to avoid being
               | tracked_
               | 
               | It means they're willing to break regulations to get it.
               | We can't impute motivation.
               | 
               | > _how will people know when and how to avoid fatal
               | doses_
               | 
               | Same way they do for _e.g._ Tylenol.
               | 
               | > _Why do you assume it might be either effective or safe
               | if diluted?_
               | 
               | I don't. Dilution is a common (and obvious)
               | pharmaceutical tool for increasing the distance between
               | the therapeutic and harmful dose.
        
               | lostlogin wrote:
               | > What does "merely-harmful" mean? Drugs that really only
               | harm the person who takes them if abused. Alternatively,
               | drugs which are unproblematically sold over the counter
               | the world over.
               | 
               | In the extreme case where someone ends up being injured
               | or dead, friends and family are most definitely affected.
               | There are few people this would not apply to.
               | 
               | Aside from that, the healthcare system takes a hit,
               | employers do too and a thousand other little ripples
               | spread out.
               | 
               | Some drugs are over-regulated and this is why I'm a fan
               | of the middle line where some are sold at a pharmacy with
               | no script needed and they can partially control the
               | purchasing.
        
               | dahart wrote:
               | > We can't impute motivation.
               | 
               | Correct, you're right, I was speculating on alternative
               | reasons people might avoid the doctor. We also don't have
               | evidence that the cost or time of a doctors visit is the
               | reason for the existence of the black market demand,
               | contrary to your claim above.
               | 
               | Of course, a huge risk for black market purchases is that
               | they turn out to be fake and/or have unlisted harmful
               | ingredients. It's already happening with black market
               | Viagra. You get what you pay for, which is people who are
               | breaking the law, are secretive and unaccountable, and
               | putting anything they want in those pills. Good luck with
               | that. A co-pay and a quick Zoom call with a doc seems
               | like a safer choice to me...
        
               | JumpCrisscross wrote:
               | > _co-pay and a quick Zoom call with a doc seems like a
               | better choice to me_
               | 
               | Nobody is arguing it isn't. The point is the forced
               | choice is flawed. There wouldn't be a market for the
               | adultered stuff if the medicine were OTC.
        
               | dahart wrote:
               | > The point is the forced choice is flawed. There
               | wouldn't be a market for the adulterated stuff if the
               | medicine were OTC.
               | 
               | You haven't convinced me that there's anything wrong with
               | the regulation. There might be, but again, the existence
               | of a black market is not a valid reason to relax the
               | regulation. The black market exists for guns and heroine
               | and antibiotics and certain types of illegal porn too,
               | not to mention crazier things like bazookas. You wouldn't
               | argue any of those should be less regulated just because
               | you can buy them on the black market right? What actual
               | reasons justify deregulating Sildenafil?
        
               | JumpCrisscross wrote:
               | > _wouldn't argue any of those should be less regulated
               | just because you can buy them on the black market_
               | 
               | I'd use that as evidence there is demand. Then I'd
               | consider the harm of looser controls. The harm balance
               | for Viagra seems minimal, particularly given so many
               | people take it without bothering with a prescription. If
               | you think Viagra is in the same harm bucket as guns and
               | heroin, then yes, it makes sense to regulate it.
        
               | dahart wrote:
               | Demand is not a valid reason to deregulate, that's
               | exactly the same argument as the existence of a black
               | market argument. And it doesn't have to be in a severe
               | harm bucket as heroine to deserve deregulation, it has to
               | be relatively _safe_ , and not have big contraindications
               | with others commonly used medications.
               | 
               | Better reasons to deregulate would be that it's shown as
               | safe or safer than existing OTC products, that many other
               | countries offer it OTC, or that Viagra provides a
               | compelling health benefit when used safely. The benefit
               | is there for some specific cases, but quite questionable
               | broadly speaking, given that it often gets used casually
               | and to help men who don't truly need it, to party when
               | they're drunk or whatever. The safety has been reviewed
               | and deemed worthy of a prescription gate, and it's not a
               | hard gate to get through at all, the top comment
               | exaggerated it. Maybe it'll change and get deregulated,
               | but I guess I don't really even see why deregulating
               | Viagra would be a net positive for anything other than
               | Pfizer's pocketbook.
        
               | sdbrown wrote:
               | How, in your view, does dilution change the therapeutic
               | index of a chemical? If a drug is effective at 20
               | milligrams, but at 60 milligrams has a steep rise in the
               | incidence of hypotension, how does taking that same 60
               | milligrams in a larger volume of filler (e.g. water, or
               | spread across more physical pills) change the fact that
               | you've just taken 60 milligrams?
        
               | JumpCrisscross wrote:
               | > _how does taking that same 60 milligrams in a larger
               | volume of filler (e.g. water, or spread across more
               | physical pills) change the fact that you 've just taken
               | 60 milligrams?_
               | 
               | It increases tolerance to mismeasurement and mistake.
               | Same reason many pharmaceuticals require multiple pills
               | for minimum dosing despite a concentrated form existing.
               | A child eating a single pill, or you missing that you
               | popped an extra pill into your hand, causes less damage.
        
               | sdbrown wrote:
               | That doesn't change the difference between effective and
               | toxic doses, it changes the potential scale of off-by-one
               | user error. If 20 milligrams is delivered in 1 tablet,
               | then 3 tablets is the toxic dose. If 20 milligrams is
               | delivered in 5 tablets, then 15 is the toxic dose. A
               | single daily tablet is far superior to multiple daily
               | tablets in terms of patient adherence and hence disease
               | management.
               | 
               | Can you name specific examples where the number of
               | pills/capsules/tablets has been increased to improve drug
               | safety? Increased pill counts historically reduces
               | patient adherence, which worses disease management. This
               | is just the first example I found which measured it:
               | https://pubmed.ncbi.nlm.nih.gov/31298592/ This review
               | explicitly states it in the abstract even:
               | https://pubmed.ncbi.nlm.nih.gov/30561486/
        
               | JumpCrisscross wrote:
               | Idk what to say, this is established medicine [1]. When
               | you have a small TI you dilute to make measurement
               | tolerances wider in absolute terms. This is a motivating
               | factor behind prescription-strength medicine.
               | 
               | > _Increased pill counts historically reduces patient
               | adherence_
               | 
               | Of course. There are tradeoffs. You want to know what
               | also increases burden? Requiring a prescription.
               | 
               | [1] https://en.m.wikipedia.org/wiki/Therapeutic_index
        
               | sdbrown wrote:
               | I don't see dilution anywhere on that page, and
               | increasing volume of administration at a lower
               | concentration to achieve the same effective dose does not
               | alter the dose itself. You are not interpreting TI
               | correctly.
               | 
               | Edit: further, to your comment about "prescription
               | strength" nomenclature, look at section 14 of the
               | Cialis/tadalafil prescribing information, IIRC, table of
               | clinical studies, where they have the second two outcomes
               | of the clinical studies broken down by dose. Efficacy
               | increases pretty directly with increasing dose, and these
               | are where the observed side effects show up. It seems
               | like patients may well self-escalate. Maybe the OTC
               | countries have public data on this?
        
               | JumpCrisscross wrote:
               | NTI drugs, a/k/a critical dose drugs, can avoid titration
               | requirements through dilution. It's harder to fuck up a
               | 500 mL difference than a 1 mL difference. Again, this is
               | why most OTC versions of prescription drugs are different
               | in only one way: concentration.
        
             | cheald wrote:
             | Aspirin has "severe (but rare) side effects", too. Many of
             | the OTC pharmaceuticals we take have potentially nasty side
             | effects. The only 100% safe stuff is homeopathic, and
             | that's because it's not actually chemically active. I'd be
             | a lot more convinced by the argument if it weren't widely
             | OTC in most of the rest of the world.
             | 
             | Interestingly, there do seem to be long-term side effects
             | of sildenafil/tadalafil - though they seem to be positive.
             | There is a possible link between long-term usage of ED
             | drugs and cognitive protections in old age:
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705107/
             | 
             | https://content.iospress.com/articles/journal-of-
             | alzheimers-...
        
           | beejiu wrote:
           | This is how it is in the UK now, it's an OTC drug, so you can
           | simply buy it in pharmacy or online.
        
           | eggy wrote:
           | But then you cut off the career path of an FDA lackey in
           | becoming a big pharma exec after they've served big pharma so
           | well. Curious if they went after supplements that don't step
           | on big pharma products, but are actually harmful to the
           | public they supposedly serve.
           | 
           | Reminds me of the X-Ray glasses and aphrodisiac ads from old
           | magazines and comics when I was a kid.
           | 
           | Cosmetics get away with anti-aging and beautification claims,
           | but I believe they are not regulated by the FDA for thise
           | claims, because a lot if it is hogwash.
        
             | sdbrown wrote:
             | Tadalafil (Cialis) is available as a generic in the United
             | States. If you think "big pharma" is served by drugs going
             | off-patent, you may want to re-evaluate your perspective.
             | 
             | If you want to get more reasonably unhappy with market
             | exclusivity, look at Celgene's grip on
             | thalidomide/lenalidomide/pomalidomide for the treatment of
             | multiple myeloma.
        
         | jcampbell1 wrote:
         | They are practically OTC everywhere in the world. A huge pain
         | in the add to get in the US where the MD cartel engages in rent
         | seeking by claiming every pharmaceutical is dangerous and they
         | need $200 every quarter to let you buy the meds at hyper
         | inflated prices.
        
           | Sanzig wrote:
           | Well, sure, but the solution to that is to make it OTC or
           | added to the list of medications that pharmacists are allowed
           | to prescribe by themselves. That way the medication dispensed
           | is still coming from an authorized and inspected facility
           | with adequate quality control. Mixing it with dodgy
           | supplements is not the solution.
        
       | FartyMcFarter wrote:
       | Anyone have an idea of what's likely to happen here? Fines or
       | something more serious such as being barred from selling whole
       | categories of products?
        
       | pbj1968 wrote:
       | Heard a talk once by someone that managed nutrition for an NFL
       | team. She said periodically clusters of players would pop
       | positive for meth and inevitably it would be some new supplement
       | that was giving them results and they told all their teammates
       | about it. They'd just tell them to quit using it and move on.
       | Interesting story, possibly true.
        
         | BolexNOLA wrote:
         | And I imagine a lot of nutritionists on teams kind of know
         | what's going on, but are disincentivized from looking too
         | closely at it unless it could really hurt somebody. Or rather,
         | it could hurt somebody enough for someone to notice immediately
         | or impact their performance in the short term. This is
         | obviously armchair speculation, but I've seen it in other
         | industries, time and time again. Everyone kind of knows, but
         | nobody wants to be the squeaky wheel that gets the star player
         | - or major piece of equipment - out of commission.
        
           | LargeTomato wrote:
           | It's possible the nutritionists are also duped. They know
           | that giving their athletes X mg of Y gives them better
           | performance. They don't know that their particular X
           | supplement is really just sugar pills and meth.
        
         | dopa42365 wrote:
         | Any even remotely WADA compliant drug testing uses
         | chromatography, this story is most likely false.
        
           | hotpotamus wrote:
           | I don't really know the details, but I assume chromatography
           | can detect meth no problem, so I assume that's not the
           | problem with the story. The skepticism on GP's part is mostly
           | that the meth was consumed unwittingly; perhaps that's just
           | the story the players tell. But it seems plausible at least.
        
             | ta988 wrote:
             | Yes a 3-5 min UHPLC/MS (and even a UHPLC/UV which is
             | cheaper) can tell you that. Cost of experiment? $10 (not
             | including human cost) Cost of equipment $200k-$400k for
             | this kind of things. One machine and one operator can
             | analyze hundreds of samples a day (once the sample is ready
             | you don't have to stay in front it is fully automated).
             | 
             | For just detecting Meth there are much faster and cheaper
             | methods. But the one I am talking about has the advantage
             | to also allow for detection of other things like steroids
             | (extremely common in supplements), opioids (same) etc
             | 
             | The only thing it will not work well for is anything
             | inorganic, so if they put lead or chrome salts you will not
             | see them and really small (solvents for example) and really
             | large (proteins, large sugars etc)
        
           | baby-yoda wrote:
           | As of a couple years ago the NFLPA doesn't comply with WADA
           | (the current CBA runs until 2030)
           | 
           | https://journals.library.columbia.edu/index.php/lawandarts/a.
           | ..
        
           | jdietrich wrote:
           | The (intentional or unintentional) contamination of dietary
           | supplements with performance-enhancing drugs is a widespread
           | problem.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691710/
           | 
           | https://www.frontiersin.org/articles/10.3389/fspor.2022.8682.
           | ..
        
           | stefan_ wrote:
           | That's the joke, they are non-WADA compliant on purpose -
           | American NFL and other sports leagues are rotten with steroid
           | abuse and more. And the reason the teams run their own "anti-
           | doping" is so they can know about it before, not because they
           | are beacons of purity.
        
       | duxup wrote:
       | More and more Amazon just seems like a "you're on your own" scam
       | site. I can't figure out what I'm getting anymore.
       | 
       | Half the listings are sponsored ads when I search. I searched for
       | "Lego" this past Christmas and on the first page I got a bunch of
       | products that were in what looked just like Lego boxes with Lego
       | fonts and numbering ... but were not made by Lego and were
       | clearly made to deceive.
       | 
       | I noticed some items I get price alerts now will drop low but
       | only one vendor is actually offering the low price ... who has
       | terrible ratings. But you can't actually know that is happening
       | unless you click through the UI a bunch, if you just buy it
       | you'll see the overall rating that is fine... but you get it from
       | some vendor with terrible ratings.
       | 
       | I bought something last spring that was never delivered, turns
       | out it was some random Chinese company. The item even says it
       | wasn't delivered and yet I couldn't get a refund if I went
       | through the order status page. It just sent me to one automated
       | customer service who sent me to a different customer service who
       | sent me back.
       | 
       | Someone on HN had to tell me to go to the front page and contact
       | "that customer service".... wtf
       | 
       | I used to go to Amazon because it offered better selection and
       | quality products that my local stores didn't sell. Now it's just
       | low quality garbage and scams.
        
         | BolexNOLA wrote:
         | Your comment made me realize that the gap between Amazon and
         | eBay has been steadily shrinking for years now. And it's not
         | because eBay is getting better, that's for sure.
        
           | zargon wrote:
           | The gap has been widening for years. Because Amazon keeps
           | getting worse.
        
         | mrweasel wrote:
         | The good thing about Amazon is that they've made it
         | increasingly easy to stop buying from them. Finding the things
         | you need is increasingly difficult and even if you find it,
         | most of it seems like obvious scams. Amazon went from a
         | bookstore to the "everything store" and back to being just a
         | book store, because those are the only items you can reasonably
         | find and trust to not be scams.
         | 
         | It must be rather difficult to be in the US where Amazon is so
         | dominant, because I given up and just rely on local webshops.
        
           | enlightenedfool wrote:
           | Books cannot be trusted too. I have purchased books which
           | have such cheap paper and bad print and cover that feels like
           | someone makes them in their garage. It wasn't worth the
           | price.
        
             | mrweasel wrote:
             | Oh that sucks, I haven't experienced that... Yet.
             | 
             | I worked for a webshop years ago, they wanted to implement
             | a "marketplace" and I advised against it, but they went
             | forward anyway. A few years later I was contact by someone
             | still working there, they had dropped the marketplace
             | again. They simply could not deal with the amount of
             | absolute shit sellers where shipping and it was damaging
             | their brand. This is a store that was really selective
             | about which products could be sold and what resellers was
             | allowed and they still couldn't do it. So why isn't this
             | damaging Amazons brand to the point of them limiting
             | marketplace?
        
           | duxup wrote:
           | Unfortunately my example of "low price from crappy seller"
           | has largely been books :(
        
           | mackatsol wrote:
           | It's not a reliable book store either! Counterfeits, cheap
           | reproductions, fake publishers, ai generated books, pirated
           | content .. as well as co-mingled SKU's. For physical and
           | e-books!
        
           | wombat-man wrote:
           | It's such a strange assortment of results whenever I search
           | for anything on Amazon now. Buying direct from the producer
           | or even just walking into a local big box store is less
           | stressful if I have the time.
        
           | myaccountonhn wrote:
           | I tried buying audiobooks from Amazon, the version I bought
           | turned out to so obviously be an AI voice reading it.... Just
           | an awful experience.
        
         | jupp0r wrote:
         | The customer service is pretty amazing compared to most other
         | stores, at least in my opinion. Returns are easy and free, and
         | you get a replacement shipped right away but have weeks to
         | return the item.
        
           | LegitShady wrote:
           | returns are not universally free or easy. I bought a power
           | supply for a computer (corsair) and it went on sale a week
           | later. I called to get a price adjustment and amazon told me
           | they don't match even their own prices. So I said I'd return
           | it and order a new one and I was told I'd have to pay return
           | shipping.
           | 
           | I don't buy many products on amazon anymore.
        
             | jupp0r wrote:
             | I have never had that problem and have probably returned
             | ~100 items over the years. YMMV I guess.
        
           | duxup wrote:
           | My example regarding customer service kinda makes me feel
           | that their CS isn't so amazing.
        
       | FartyMcFarter wrote:
       | Yet another reminder that buying so called supplements should
       | almost never be done, except for supplements that have been
       | widely researched like multivitamins or creatine (and then only
       | from reputable suppliers).
        
       | TheCaptain4815 wrote:
       | About 15 years too late. Wonder what they'd find if they tested
       | the protein, creatine, etc on Amazon.
        
       | noodlesUK wrote:
       | I think with the state of things, Amazon should be completely
       | banned from selling anything that might be construed a
       | supplement. They have such lax controls that your protein powder
       | or vitamin pills might contain pretty much anything. Even
       | reputable brands bought from their brand storefront might be
       | counterfeit [1]. You'd be shocked at the number of things that
       | are counterfeit. A friend of mine recently bought a niche optical
       | device, and it turned out it was a fake, despite being allegedly
       | sold by the manufacturer. Amazon needs to stop co-mingling
       | inventory, and it also needs to stop selling things that have no
       | safety testing whatsoever, especially in the food and supplement
       | space.
       | 
       | https://www.inc.com/sonya-mann/amazon-counterfeits-no-starch...
        
         | arcticfox wrote:
         | I used to think my wife was silly for spending more at beauty
         | stores for her skincare products, but after realizing how
         | insane Amazon's quality controls are, I think someone needs to
         | actually shut them down. I wonder if there are any grounds for
         | lawsuits. The number of counterfeit products they sell, even
         | under "Sold by Amazon.com" is WILD. Zero supply chain
         | discipline.
        
           | bryanrasmussen wrote:
           | obviously if Amazon sold something that damaged someone it
           | would be grounds for suit under tort law, in which case the
           | sky's the limit, and guessing the easy to find details of
           | their behavior over the years any American jury would punish
           | them.
        
             | jdksmdbtbdnmsm wrote:
             | Only a tiny few Americans can afford filing such types of
             | lawsuits, and only a tiny few of those people are
             | interested in pursuing such things.
        
               | baryphonic wrote:
               | Personal injury is serious business, and many personal
               | injury attorneys work on contingency. Amazon has "deep
               | pockets," so I doubt this is the reason.
        
               | partiallypro wrote:
               | This isn't correct, most personal injury lawyers don't
               | charge you directly. They take a percentage of the
               | settlement or victory. There's way more money to be made
               | with the "no fee" model than charging hourly in these
               | instances.
        
               | jdksmdbtbdnmsm wrote:
               | Time and availability are expensive commodities. Who's
               | paying for that?
        
               | partiallypro wrote:
               | I literally just said that they make their money on fees
               | from the outcome of the cases. That is how basically
               | every personal injury case works. If they don't think the
               | case will win, they don't take it. Personal injury/tort
               | lawyers do not charge clients in the same way as other
               | types of law. They especially don't do that because a)
               | they'd make less money and b) they are often times
               | dealing with people that couldn't afford hourly rates up
               | front especially as a case becomes more complicated.
        
           | tikkun wrote:
           | Can you elaborate about counterfeit products being sold under
           | "sold by amazon.com"? That's surprising to me, I treat that
           | as a sign of something being non-counterfeit.
        
             | noodlesUK wrote:
             | My understanding is that all sellers, including Amazon
             | itself have co-mingled inventory. Therefore you can't
             | actually guarantee that what you're getting is from
             | Amazon's stock, as opposed to some other random seller who
             | gave the FBA warehouse a truck full of fake products.
        
             | ryandrake wrote:
             | Amazon commingles[1] inventory. So if there are N vendors
             | selling an item, including Amazon.com, all N inventories
             | just get mixed together at the warehouses. So if some M of
             | those N are counterfeit, there's no way to know.
             | 
             | "As an example, if I sell Duracell C batteries on Amazon
             | through their "Shipping Fulfilled by Amazon" -- which I
             | must do to receive Prime shipping designation -- I need to
             | send my batteries to an Amazon warehouse. After receiving
             | my delivery, they will count the number of batteries, then
             | slide the whole stock into a generic shelf labeled
             | "Duracell C Batteries." Any purchaser receives a Duracell C
             | battery from that box, and thus the actual seller is
             | unknown."
             | 
             | 1: https://thetriplehelix.medium.com/your-amazon-products-
             | could...
        
               | lostlogin wrote:
               | This makes it rather attractive for sellers to add in
               | some cheap fakes - thanks for the explanation.
        
             | squidbeak wrote:
             | It's an inventory management exploit that Amazon seems in
             | no hurry to fix.
             | 
             | https://www.redpoints.com/blog/amazon-commingled-
             | inventory-m...
        
             | jonhohle wrote:
             | I've ordered an Apple-brand Lightning cable from Amazon
             | (sold by Amazon), for example, and received a counterfeit.
             | 
             | They replaced it, of course, but had it been a gift, or I'd
             | been in a hurry, would anyone have noticed? If Amazon can't
             | keep counterfeits out of their own inventory, what chance
             | do most buyers have?
        
           | noodlesUK wrote:
           | I think the issue is multifold: a lot of the fake products
           | are not dangerous, but they are either useless, or otherwise
           | inferior. There's essentially no recourse for this as a
           | consumer, and you probably won't even notice that you don't
           | have an original product.
           | 
           | In some cases the fakes are downright dangerous. This is much
           | more the case in supplements, cosmetics, food, and
           | occasionally electrical appliances.
           | 
           | People will only sue them when they get actually dangerous
           | products. Even then it's a difficult process.
        
           | oooyay wrote:
           | Beauty products are in the ballpark but are also a different
           | ball game. Unless you're licensed or very educated on what
           | chemicals and chemical combinations do to your skin picking
           | beauty products can be tough. My partner is an esthetician
           | and most of what she spends her time doing is helping people
           | pick products that won't adversely impact their skin or just
           | do nothing. Beauty is chalk full of fake products and worse
           | influencers who push them onto unsuspecting/unknowing people.
           | It's given rise to an industry of estheticians who don't make
           | money on purchases but who collect a fee to just help you
           | sift through the bullshit.
        
         | uniformlyrandom wrote:
         | > Amazon needs to stop co-mingling inventory
         | 
         | That alone would solve 99% of the problems, as dedicated
         | inventory would allow to quickly weed out the bad actors.
        
           | jonhohle wrote:
           | My understanding is that co-mingling was originally a
           | distribution optimization. I can't remember if I was there
           | under the initial rollout or they had tried it, stopped it,
           | and rolled it out again during my tenure, but when I started
           | in 2009 it wasn't a thing, and people were opinionated about
           | why it wasn't a thing (to protect seller reputation), but it
           | was obvious how it could reduce shipping times (if you have
           | your inventory on the west coast, but a buyer on the east
           | coast, picking from another merchant reduces shipping time
           | and cost and wasted warehouse space partitioning everyone's
           | inventory).
           | 
           | However, Amazon has abandoned any idea of consistent reliable
           | shipping or even delivery "promises", so the only thing co-
           | mingling does is reduce shipping costs and warehouse space at
           | the customer's expense. That's the antithesis of what Amazon
           | delivery used to be. It's sad to see all the work we did on
           | Prime and Delivery Experience get washed down the drain.
           | Prime used to be a no brained for anyone who used Amazon
           | regularly, and now I'm not even sure if there is discrete
           | value there anymore, rather than just a mishmash of
           | unrelated, mediocre up upsell opportunities.
        
         | dawnerd wrote:
         | The solution is to stop allowing third party sellers. The idea
         | that any random person can get an Amazon seller account and
         | scam their way into being approved for certain categories and
         | just send in anything as long as it has a label is insane (it's
         | incredibly easy to forge the invoices they request). There's
         | zero control at Amazon, they frequently put returned products
         | back into new inventory as well which makes buying trading
         | cards and Lego a massive gamble. Computer parts get swapped and
         | resold all the time too. I can't imagine trusting them with
         | anything that goes in your body.
         | 
         | Edit: if anyone hasn't seen just how lax they are, search
         | YouTube for FBA. Literally random people driving around to drug
         | stores picking up nearly expired clearance items to send in for
         | FBA.
        
           | __MatrixMan__ wrote:
           | There are a lot of undesirable side effects with that
           | solution.
           | 
           | You shouldn't have to be tech savvy enough to host a shopping
           | experience that's competitive with Amazon in order to sell
           | things online. You ought to be able to focus solely on your
           | product and if it's a good one you ought to be able to
           | compete with Amazon Basics on a level playing field--even if
           | it's a field served by Amazon metal.
           | 
           | I think we need more separation between the part of Amazon
           | that handles clicking "buy" and printing shipping labels, and
           | the part that comes up with things for sale. So much
           | separation, in fact, that the former considers the latter to
           | be no more trustworthy than any other company or individual.
           | 
           | Seller reputation should be important, and the medium for
           | determining if a seller is trustworthy should be free from
           | conflicts of interest.
           | 
           | If the user facing part was adequately adversarial about the
           | cardboard facing part it would result in a UI which had no
           | reason to encourage the user to trust the contents of the
           | cardboard, and instead simply presented facts that enable the
           | user to apply their own scrutiny.
        
             | tadfisher wrote:
             | Can Amazon even run FBA without comingling? This is the
             | root of the problem; tracing an individual item back to the
             | seller is apparently not possible, so seller reputation
             | doesn't really exist. So either it's not a big enough
             | problem for Amazon to kill comingling, or it's not
             | profitable to do so at Amazon's scale.
        
               | __MatrixMan__ wrote:
               | I'm pretty sure that if we manage to coordinate an
               | existential threat to Amazon, Amazon will respond by
               | finding a way to do it profitably. The problem is that
               | we're not threatening enough because we're uncoordinated.
        
         | lumb63 wrote:
         | Calling for Amazon to be banned from selling supplements is
         | extreme, IMO. But they should be accountable for preventing
         | counterfeit items from being sold or marketed as the items
         | they're counterfeiting. In cases where the authenticity of the
         | item has not been verified, that should be made clear to the
         | buyer. Absence of such an indicator would mean the product is
         | authentic (consumers should IMO be able to rely on products
         | being what they are marketed as by default). That would put
         | them on par with pretty much any other supplement seller, and
         | go a long way toward ensuring people get the items they buy.
        
           | moritzwarhier wrote:
           | Defending the right of a company to profit from selling or
           | mediating sales of products intended for human consumption,
           | without any legal liability for their content or safety, is
           | also pretty extreme.
           | 
           | Nevermind the fact that they pay no taxes, at least not here.
        
           | lostlogin wrote:
           | > Calling for Amazon to be banned from selling supplements is
           | extreme
           | 
           | If a physical store near you sold fake everything, including
           | supplements, you'd think it extreme to shut it down?
        
             | LargeTomato wrote:
             | Step 1: Cease and desist letter
             | 
             | Step 2: Legal action to pursue a change of policy and
             | damages.
             | 
             | Step 3: 2nd legal action if Amazon continues to be out of
             | compliance with the previous ruling.
             | 
             | There's a process here and jumping to the very end is not
             | how it works.
        
               | lostlogin wrote:
               | This seems entirely appropriate, but skip step 2, then
               | start sanctions or shutdowns if the situation persists.
               | 
               | There is surely a template for this - quite possibly it's
               | what you detail?
        
             | lumb63 wrote:
             | Wouldn't it be better for all parties involved to keep it
             | open and implement regulations requiring they be honest
             | about products? The customers could use the marketplace to
             | get the products they actually want, and the business gets
             | to benefit.
             | 
             | Note that idea isn't mutually incompatible with penalizing
             | the company for all the counterfeit products it
             | sold/marketed.
        
           | patmorgan23 wrote:
           | If they sell people counterfeit food and health supplements
           | they should be banned from selling those items (at least for
           | a period of time) until they can figure out proper inventory
           | controls.
        
         | samstave wrote:
         | >> _...the state of things..._
         | 
         | If you're not familiar with Skinny Puppy (industrial band)
         | 
         | There is a lyric in a song "... _define... the state of
         | things..._
         | 
         | https://youtu.be/sDEhCm0pxCo?t=271
         | 
         | " _...that paper shredder, patent tender, puts us back in time
         | again...._ "
         | 
         | https://www.youtube.com/watch?v=5KHDb9xwHvc
         | 
         | Skinny puppy is from an AI cultural perspective, where they
         | audience is a bunch of ~50 year old dorks (yes, population, we
         | are fucking old - but we built things)
         | 
         | 1. the song: https://www.youtube.com/watch?v=sDEhCm0pxCo
         | 
         | 2. Reference: https://youtu.be/sDEhCm0pxCo?t=271
         | 
         | (about to filter this through AI topaz and see if can get a
         | better qual vid - but this song is a Hex on Exxon mobile (in
         | response to valdez spills and oil profit demons)
        
       | deeth_starr_v wrote:
       | It's been common knowledge that any Chinese ED supplement on
       | Amazon that is effective has Viagra in it. This is not a bug but
       | a feature
        
         | tacheiordache wrote:
         | > It's been common knowledge that any Chinese ED supplement on
         | Amazon that is effective has Viagra in it. This is not a bug
         | but a feature
         | 
         | And who knows what else!!!
         | 
         | I'd never ingest anything that has Chinese provenance. Chinese
         | garlic comes to mind as the latest thing to try to avoid. Not
         | sure if true but it seems to be grown in sewage. I'd rather be
         | safe and avoid that altogether.
        
           | ta988 wrote:
           | A lot of the garlic in yhe US is from China, so if you ate in
           | a restaurant you likely had some already.
        
           | gruez wrote:
           | >Not sure if true but it seems to be grown in sewage.
           | 
           | If that's your concern, you shouldn't be worried about just
           | China. It's done in America as well.
           | 
           | https://www.npr.org/sections/thesalt/2013/04/10/176822392/ci.
           | ..
        
       | thedougd wrote:
       | Do American grocery stores have better controls or does their
       | broker model just happen to filter the junk?
        
         | notyourwork wrote:
         | I wonder the same thing. It seems like something that at Amazon
         | scale we pick on but at physical store scale we discard as not
         | possible.
        
           | gehwartzen wrote:
           | I haven't hear about these problems at Walmart and would
           | think the scale of stuff sold is comparable. I think the main
           | problem, as others have mentioned, is that Amazon commingles
           | products from various suppliers (so everything that comes in
           | from a manufacturer or a true vetted wholesaler + 1000's of
           | "flip stuff from china" garage operations get mixed up at
           | Amazon warehouses before being sold).
        
             | arrowleaf wrote:
             | Right. Walmart doesn't let someone drive up with a semi-
             | load of what looks like bags of King Arthur bread flour,
             | mark the pallets with a tag, and cut them a check when they
             | stock the items from that pallet onto the shelf. That's
             | basically what Amazon does.
        
             | toast0 wrote:
             | Walmart is known for having a _very_ tight control over
             | their suppy chains. IMHO, mostly for cost control, but
             | quality control and authenticity are useful side effects.
        
         | wccrawford wrote:
         | IMO, there's a couple things going on there.
         | 
         | First, grocery stores work on a 3% margin, so if they have a
         | ton of returns on something, it costs them a ton of money from
         | credit card fees and wages, and possibly from losing the cost
         | of some portion of the product.
         | 
         | Second, grocery stores have limited space and are picky about
         | what they'll put in their store. They want quality goods that
         | will sell well, and they don't want to cannibalize other
         | products that would make them more money. So random supplements
         | don't find their way to their shelves.
        
         | arrowleaf wrote:
         | Grocery stores typically have an extensive if not integrated
         | supply chain they have absolute control over.
        
         | hx8 wrote:
         | Some of both. I think it's mostly the model.
         | 
         | * All of a single product is from the same vendor. Very often,
         | that vendor is also the manufacturer. (model)
         | 
         | * Grocery stores have limited shelf space, and thus spend time
         | getting to know their products. (model influencing qa)
        
       | dec0dedab0de wrote:
       | I don't think Amazon should have any protections for being a
       | marketplace. Especially since we all found out about co-mingling,
       | and how reviews are transferable between vendors and sometimes
       | between products.
       | 
       | They should be liable for any damages caused by these drugs, as
       | well as patent/copyright/trademark infringement for any
       | counterfeit products.
       | 
       | I don't feel the same for ebay, reverb, or facebook. I'm not sure
       | where the line should be, but I'm certain Amazon crossed it. Plus
       | their business model infected Newegg and even Walmart, and who
       | knows how many others, it just needs to stop.
       | 
       | Maybe it should be that either you're a retailer or a
       | marketplace, but never both? I don't know the answer but it sucks
       | and has sucked for a long time, and im too lazy to stop using it
       | so i guess im part of the problem.
        
         | ta988 wrote:
         | Reviews are transferable? I was wondering because many reviews
         | I have seen don't seem to be for the product I am looking at at
         | all.
        
           | Wingman4l7 wrote:
           | It's a tactic that's been abused by third-party sellers for a
           | long time now. They list a product, organize a bunch of paid-
           | for 5-star reviews on another platform (you buy the product,
           | submit a 5-star review, and they refund you the purchase
           | cost, so you get the item for free), and then once all those
           | 5-star reviews are in place, they eventually re-use the
           | product page for another item entirely.
           | 
           | It baffles me that Amazon's item listing system ever allowed
           | this in the first place.
        
             | rincebrain wrote:
             | Nominally, this might make sense with a "people liked the
             | v1 of this and now it's a different SKU", with a note about
             | it being for something else.
             | 
             | In practice, it seems very likely harm outweighs the
             | benefits for consumers here, and it's just that it
             | encourages more sales that keeps Amazon allowing it.
        
             | macNchz wrote:
             | Perhaps forgivable that it was allowed in the first place,
             | but unacceptable that it was allowed to continue after the
             | first time they noticed the lack of a review requirement
             | for product page changes being exploited in this way.
        
           | 1920musicman wrote:
           | That's the biggest Amazon scam that Amazon itself allows and
           | encourages (indirectly). In my experience, most inexpensive
           | items from unknown brands have transferred reviews.
        
           | supriyo-biswas wrote:
           | The seller often swaps the product description for some other
           | product, capitalizing on the reputation of the first to sell
           | the second.
        
           | dec0dedab0de wrote:
           | There have been articles about it, I don't remember the
           | details, but it is an exploit stemming from wanting the
           | review to be about the product instead of the vendor, and the
           | process of combining reviews from different listings of the
           | same product.
           | 
           | The fact that the reviews are not limited to a single vendor
           | is a major part of the overall problem.
        
           | alexpotato wrote:
           | A personal example:
           | 
           | - I order a large tweezer for cooking etc
           | 
           | - It works great!
           | 
           | - End up losing it so "order again" a year later and it's
           | clearly a different product/manufacturer etc
        
             | asquabventured wrote:
             | Reading reviews of Chinese clone items you'll also start to
             | see people mention an entire different product in the
             | review than what you're looking at.
             | 
             | E.g you're looking at a mattress cover and the reviews and
             | pictures are for a folding chair or a slotted spoon.
             | 
             | The internet of today is total trash.
        
               | reubenmorais wrote:
               | > The internet of today is total trash.
               | 
               | Because despite this behavior we keep giving them money.
               | It's not that hard to stop using Amazon.
        
               | FredPret wrote:
               | Not the internet. Just Amazon. Buying direct from the
               | manufacturer / a trusted store is better than ever.
        
           | gukov wrote:
           | I often see reviews for a model that's similar but still
           | different. Not being a seller, I'm guessing the exploit is
           | around labelling a different model / product as a colour
           | variation of the product they're trying to leech off, and
           | voila: now the crappy product has the same rating / reviews
           | as the original, better product.
        
           | jacurtis wrote:
           | There is a blackmarket of repurposed Amazon Product Pages.
           | This is a problem that Amazon knows about and does nothing to
           | resolve.
           | 
           | So the way it works is that some company makes a page for a
           | stuffed animal for example. They name the product page
           | appropriately and start selling their toys. They push hard
           | and gets lots of reviews and build up the aSEO (amazon search
           | Optimization) for that page. They build up 1,000 positive
           | reviews for their stuffed animal averaging 4.8 stars. Cool.
           | 
           | Now they decide to stop selling that toy and instead start
           | selling fidget spinners. Why start from scratch and go
           | through the work of building up all those reviews again and
           | the aSEO that took years on the stuffed animal product.
           | Instead they just go in and change the title, the URL slug
           | and the images to represent the new Fidget Spinner. They
           | publish the changes and now, within seconds of posting their
           | new Fidget Spinner is one of the best reviewed fidget
           | spinners on Amazon and starts immediately getting sales
           | because the page has strong aSEO and high reviews which makes
           | it present well in search results. Visitors of the page see
           | the high reviews and buy the product. They start selling
           | thousands of Fidget Spinners overnight and build up to 2,000
           | positive reviews.
           | 
           | Now that company sells fidget spinners and then gets sued for
           | using toxic glue in the building of their fidget spinners. No
           | problem. THey change their name from
           | SpinnyAltodaWidgetCorpIncUnlimitedPlus to
           | ShenzenSpinnyWidgetToyPlusUnlimitedCorp. New company, now you
           | can't sue them. Then they change the name on the product page
           | and keep selling the same product with a different name and
           | same reviews, building it up to 3,000.
           | 
           | Now the company goes under. But they have all these high
           | performing amazon pages. Here is where the fun begins, they
           | literally go up for auction. Companies will page hundreds of
           | thousands for a top performing amazon page. They sell the
           | page to the highest bidder. Now a new company
           | ShenzenShitzuSuperCorpPlusMegaChargerMorePlusPlus buys the
           | page and starts selling Fish Oil supplements. They just
           | change the name, images, URL, and company information, but it
           | is technically the same amazon page. Then they start selling
           | Fish Oil supplements with 5,000 reviews averaging 4.8 stars.
           | They immediately shoot to the top of the search results and
           | start selling thousands of bottles overnight because people
           | are overwhelmed by the positive reviews of this product and
           | its age and legacy on Amazon tells Amazon to push it to the
           | top of search results.
           | 
           | This is the black market of Amazon pages. These pages change
           | hands often many times a year. Amazon could easily prevent
           | product changes above a certain threshold or even across
           | categories to prevent or eliminate this, but they don't want
           | to. They are complicit in these behaviors by turning a blind
           | eye to what they know is happening.
           | 
           | Here is a detailed article about Hijacked Reviews from
           | Consumer Reports: https://www.consumerreports.org/customer-
           | reviews-ratings/hij...
           | 
           | For example, in one review they find a phone charging cable
           | that has reviews for zip ties, hand soap, shaving cream, and
           | gaming headsets all in the reviews for a phone charging
           | cable. This page has been hijacked several times by entirely
           | different product types.
        
           | pompino wrote:
           | Amazon tracks the "wrong item was sent" returns to find such
           | items. They outsourced the checking to the customers, but
           | they're eating the cost of processing the returns/shipping.
           | Maybe that is cheaper in the long run?
        
             | pests wrote:
             | You misunderstand. It's the correct item. The old product
             | page was rebuilt for the new product. Users aren't confused
             | or expecting the original product.
        
         | smith7018 wrote:
         | Agreed that they should be held accountable for creating a
         | platform that elevates these scam supplements to the same level
         | as Apple, GE, Google, GNC, etc. I know some people might argue
         | that Amazon shouldn't be responsible for the products that are
         | listed on its site but I think we can just as easily say Amazon
         | shouldn't be able to offer supplements/vitamins if they can't
         | stand by their safety.
         | 
         | All of this is even more troubling when you consider their
         | purchase of One Medical. So my Amazon doctor tells me to ingest
         | more zinc but buying zinc from Amazon might not actually have
         | zinc in it?
        
         | bradfa wrote:
         | At least Walmart lets you easily filter search results for only
         | things sold by Walmart itself. That makes it fine by me to be
         | both a seller and marketplace. Amazon does not make such
         | filtering easy at all.
        
           | schemescape wrote:
           | Anecdote: I filtered to "sold by Walmart" (I forget the exact
           | terminology, but customer support confirmed it was _not_ from
           | a marketplace seller), but the item I received had an Amazon
           | return label and was shipped from an Amazon warehouse.
           | 
           | That was the last time I bought from Walmart in an attempt to
           | avoid Amazon's shenanigans.
        
             | abracadaniel wrote:
             | There is absolutely a tier of marketplace seller that
             | bypasses that filter. I was trying to buy rechargeable
             | batteries just yesterday and noticed this. If you look
             | carefully, they are still listed as sold by a marketplace
             | seller. Very frustrating, as it's gotten nearly impossible
             | to find a retailer that isn't secretly selling me crap from
             | the back of someone's van.
        
               | bradfa wrote:
               | I've given up buying rechargeable batteries online from
               | anywhere except B&H in NYC and then only Panasonic
               | branded ones at that. For a short time Amazon Basics
               | rechargeables were decent but that was quite a while ago
               | and only for a short time.
        
             | bradfa wrote:
             | That's frustrating. I've been pleasantly surprised at many
             | of my interactions with Walmart when ordering online. Once
             | even got same day delivery for free and without requesting
             | it. Maybe I'm an outlier?
        
         | 1920musicman wrote:
         | I am not aware of any lawsuits against distributors/retailers
         | but supplement companies have been successfully sued in the
         | past. One famous case is Yoel Romero vs Gold Star Performance
         | Products (https://bleacherreport.com/articles/2838434-ufc-
         | fighter-yoel...).
        
       | Xeoncross wrote:
       | I purchased a vitamin c supplement that was pure white and
       | odorless/tasteless. I posted a review and photos. Obviously fake
       | filler of some sort, Amazon removed my review as inaccurate when
       | it's obvious whatever was in those capsules was not ascorbic acid
       | of any kind.
       | 
       | They also claimed to have zinc (greenish) and elderberry
       | (purple). It's not safe for Amazon to let any random exporter put
       | stuff for sale without any sanity checks.
        
         | asquabventured wrote:
         | When I reviewed a product as obviously fake they also removed
         | my review. The company as a whole really kind of disgusts me
         | now.
        
           | wombat-man wrote:
           | yeah they are kind of the last resort for me at this point
           | when buying online.
        
         | GuB-42 wrote:
         | Ascorbic acid is cheap in bulk, something like less than $5/kg
         | if you buy it by the ton. Maybe cheap enough to _be_ the
         | filler.
         | 
         | And it is white and odorless in its pure form. It does have an
         | acidic taste though, because it is an acid. I have some of it
         | in my kitchen (pure bulk powder, not bought on Amazon) and I
         | can tell you by experience.
        
         | nostromo wrote:
         | Vitamin C _is_ odorless and pure white, so maybe your review
         | was right to be removed.
         | 
         | It's not tasteless of course, it's sour.
        
       | segmondy wrote:
       | Don't buy anything from Amazon that you would put in your mouth,
       | supplements, food, toothpaste, mouthwash, anything!
       | 
       | I'm even wondering if to do the same for things applied to body
       | as well, my wife recently bought a hair cream because from Amazon
       | because she couldn't find it in stores. It was obvious the one
       | from Amazon was not real when compared with the remaining ones
       | she had. Package was perfect, but the color/texture of the cream
       | was very different.
       | 
       | It's a big chance buying things from online marketplace.
        
         | Beijinger wrote:
         | Well, some stuff you can buy only online.
         | 
         | Anecdote: I tried to market my own dietary supplements in the
         | US for a while. Unfortunately I am poor in marketing but many
         | customers loved it. I bought all the ingredients from a
         | supplier, had it mixed in California and shipped to a company
         | that can package it. For a slight taste I needed a tiny amount
         | of sucralose. Did not want to buy a huge amount. So I ordered
         | it on eBay. I asked the guy to send me a CoA and he did. It
         | said Manufacturere Spectrum and Food grade. Unfortunately I
         | knew that Spectrum was not selling this as food grade. Sure the
         | guy could have made his own tests but how likely is this? I
         | just trashed it and bought it somewhere else. Should have used
         | Stevia anyway.
        
       | TaylorSwift wrote:
       | Most supplements are garbage. Since they don't actually work,
       | most people would never know if you replaced their magnesium or
       | calcium supplement with chalk. Some supplements do work, but
       | since they're not regulated, they're drowned out by nonsense and
       | noise. OK, so you don't want to be a rube?...you do your research
       | and then piece of shit fitness influencers tell you "ohh...that
       | vitamin you bought form Walgreens or Costco didn't work?...of
       | course not, you need to buy mine...it's CHELATED!!!!! thus is
       | more BIOAVAILBLE...or some other random scientific work which is
       | either incorrectly used or outright fraudulent.
       | 
       | Half of my family spends a huge fortune on supplements, most of
       | which are placebos. If you're young, you may not understand, but
       | for us over 40, life starts to suck, physically. When you're
       | young, your body is very fault-tolerant...have 6 beers and a
       | cheeseburger for supper every day for a week?...nothing a few
       | tums can't fix. Now that I'm over 40, I do everything right
       | (daily exercise, eat healthy, get sleep, etc) and still feel like
       | shit most of the day....same with most my age...thus we're
       | desperate for anything that will make us feel better and not have
       | any side effects that make things worse.
       | 
       | Supplements are the dream and an age-old scam. Maybe punishing
       | big retailers who tolerate fraud will not only reduce false
       | claims, but make the public more aware that so called health
       | experts online are ignorant, scammers, or both.
        
         | ta988 wrote:
         | If you replace the Calcium with chalk you would still have a
         | source of calcium so it wouldn't be that bad :D
        
           | achanda358 wrote:
           | With different bioavailability
        
           | dehrmann wrote:
           | It's better than that. According to Wikipedia
           | 
           | > Chalk is typically almost pure calcite, CaCO3, with just 2%
           | to 4% of other minerals
           | 
           | The supplement I just looked up uses Calcium Carbonate. That
           | could just be purified chalk and be in compliance with the
           | FDA. In fact, it probably is just that.
        
             | beambot wrote:
             | Animals eat naturally-occurring chalk (and other
             | substances) to regulate key minerals. It's called
             | geophagia.
        
               | dehrmann wrote:
               | https://en.wikipedia.org/wiki/Mineral_lick
        
               | FredPret wrote:
               | > geophagia
               | 
               | Animals are eating the world
        
         | Wowfunhappy wrote:
         | > Most supplements are garbage. Since they don't actually work,
         | most people would never know if you replaced their magnesium or
         | calcium supplement with chalk.
         | 
         | Whether or not that's true, if you replaced someone's magnesium
         | supplement with _viagra_ , you could seriously hurt them.
         | 
         | >> FDA confirmed through laboratory analyses that the [...]
         | products, purchased on www.amazon.com, contained [...] the
         | active ingredients in the FDA-approved prescription drugs
         | Viagra and Cialis, respectively, used to treat erectile
         | dysfunction (ED). These undeclared ingredients may interact
         | with nitrates found in some prescription drugs, such as
         | nitroglycerin, and may lower blood pressure to dangerous
         | levels.
        
           | epmaybe wrote:
           | holy crap, that's insane. You don't just accidentally add
           | sildenafil or tadalafil to your supplements. Unless the FDA
           | is misidentifying compounds present in the herbs in these
           | supplements, which seems unlikely but I'm no pharmacology
           | expert.
        
             | tonyarkles wrote:
             | Yeah, I don't think "accidentally" is something that
             | happened here. What's the best way to make your "all-
             | natural Viagra" actually work? Make it with real Viagra.
        
               | Scoundreller wrote:
               | I'd be surprised if the buyers were expecting any
               | different.
               | 
               | With the amount of mislabelled product out there in
               | circulation (and presumably a general lack of harm), does
               | it still make sense to require a prescription?
        
               | tonyarkles wrote:
               | I'm personally pretty torn on that. On the one hand I
               | agree with you, especially from a harm-reduction
               | perspective (e.g. people who are on blood pressure
               | medication ordering "natural" Viagra because Viagra's
               | contra-indicated with the medication they're on, not
               | realizing that they're getting something that could cause
               | a very bad situation). On the other hand, requiring a
               | prescription does mean that a physician can ask that
               | question ("are you on blood pressure medication?") and
               | counsel the patient to look at different options instead.
               | 
               | I mean, even though 50% of these are intentional
               | overdoses... the other 50% probably didn't know they were
               | doing something that was going to destroy their liver:
               | https://www.ncbi.nlm.nih.gov/books/NBK441917/
        
               | Scoundreller wrote:
               | It's pretty much just an interaction with "nitrates"
               | which are typically taken by people with pretty serious
               | cardiac issues, and usually educated re: the side effects
               | if taken with viagra or similar compounds (cuz you never
               | know if someone has Viagra in their drawer from another
               | pharmacy or years ago or "natural" Viagra from another
               | source).
               | 
               | The interaction with other blood pressure meds appears
               | additive rather than synergistic and Viagra alone only
               | minimally reduced blood pressure. The cough and cold
               | aisle or a cafe presents more dangers.
               | 
               | https://pubmed.ncbi.nlm.nih.gov/10078539/
               | 
               | At least over the counter Viagra would be properly
               | labelled about these things.
        
             | bumby wrote:
             | Although they are most associated with ED, those
             | supplements are also performance enhancers. For decades,
             | unscrupulous supplement companies have put illicit or
             | prescription drugs in their products. Many of those drugs
             | (not the supplements) do, in fact, work. The rumor was the
             | gameplan was to start with that until you get enough market
             | hype and then remove them, but I've also heard some of the
             | illicit drugs are cheap enough that they could still
             | continue tainting them and make a profit. So even if they
             | work, people deserve to know what they're putting in their
             | bodies.
        
             | 1920musicman wrote:
             | Adding restricted ingredients to generally available
             | supplements is a known tactic that supplement producers
             | utilize extensively. In the past, this has been a well-
             | known "secret" that bodybuilders basically relied on:
             | buying tainted pre- and post-workout supplements that
             | contain illegal steroids and such.
             | 
             | It's a better regulated industry now, but with the
             | explosion in supplement popularity over the last decade I
             | doubt there is an easy way to test and punish all
             | manufacturers. If you look at the list of supplements
             | included in that warning letter, they have classic
             | nonsensical names that Chinese companies are known for
             | (WeFun, Genergy, etc). None are on www.amazon.com anymore,
             | but hundreds of other supplements show up with absolutely
             | no way of telling whether any of them are clean (e.g.
             | "Endurance 2Nite").
        
               | dullcrisp wrote:
               | Are you saying there could be Viagra in my Endurance
               | 2Nite?
        
         | exegete wrote:
         | >Now that I'm over 40, I do everything right (daily exercise,
         | eat healthy, get sleep, etc) and still feel like shit most of
         | the day....same with most my age...
         | 
         | I'm nearing 40. Are you sure it's normal to feel terrible most
         | of the day when eating right, exercising, and getting enough
         | sleep? This doesn't sound normal to me.
        
           | thechao wrote:
           | I'm 45, walk, weight lift, eat well, sleep well, and feel
           | better than I ever have. My dad says he didn't start to
           | "feel" his age until 80: it may just be genetics?
        
           | laweijfmvo wrote:
           | Could be genetics, could be low T, could be depression, could
           | be some other uncovered issue. Should probably discuss this
           | with their doctor.
        
           | 1920musicman wrote:
           | It's not normal. None of my over 40 friends have the same
           | experience. And in general, I doubt that turning 40 is a
           | clear biological threshold regardless of one's lifestyle,
           | diet, fitness level, etc.
        
           | sigmoid10 wrote:
           | Yeah, there's something else going on. If you don't have
           | permanent damage from some injury or disease, you shouldn't
           | feel like 60+ if you barely hit 40. Maybe it's related to low
           | testosterone, but even for that 40 is early.
        
           | jml78 wrote:
           | I am an inactive, 45 year old software developer.
           | 
           | Can I overdo things and feel like shit? Yeah but mostly I
           | feel great.
           | 
           | My knees are kind messed up but that is from running 500
           | miles every summer during middle school and high school.
           | 
           | So no, being in your 40s shouldn't mean feeling like shit.
           | 
           | As to the topic at hand, I use two supplements in addition to
           | prescription blood pressure medications. I take my blood
           | pressure 3 times daily. I can see in the cold hard numbers if
           | I forget to take them.
        
           | jordanpg wrote:
           | I think OP was being a little hyperbolic, but I know what
           | they mean. Little things add up. Certain minor issues become
           | chronic. Waking up with minor aches and pains is somewhat
           | frequent. Sleep issues are common.
           | 
           | It falls short of feeling like shit, but there is a kind of
           | death by many cuts that changes the baseline for feeling
           | normal in the wrong direction.
        
           | libria wrote:
           | GP might have an illness/disease and fully aware of their
           | condition, none of us know. No need to lose the main point by
           | flexing our superior health against them.
           | 
           | That point being: All of us deteriorate. We all reach an
           | age/state where conventional medicine has reached its limit
           | and snake oil begins to be look attractive. Not all of it is
           | proven wrong, none of it is proven right.
        
           | wkjagt wrote:
           | One of the things that really bother me being over 40 is that
           | my body is no longer immune to injuries. I can now throw out
           | my back just my sneezing too enthusiastically.
        
         | malfist wrote:
         | It's funny you mention chelation. The most common method
         | (cheapest) of chelating some metal is with EDTA, which is such
         | a strong bond that it makes it completely bio-unavailable. In
         | fact, if your body was somehow able to break the bond and
         | absorb the metal ion, EDTA would happily go along and find some
         | other metal in your body to bind to. You literally take EDTA
         | for lead poisoning, but it'll happily take calcium, copper and
         | iron out of your body while doing it, it doesn't give a damn.
        
         | hammock wrote:
         | > most people would never know if you replaced their magnesium
         | or calcium supplement with chalk.
         | 
         | Minerals and vitamins come from USP, which is tested and
         | regulated and everyone in the industry gets the same quality
         | (regardless of what they claim). It is what they say it is, if
         | it's USP.
         | 
         | Where is gets sketchy quickly is all the other stuff, like
         | plant extracts etc
        
           | nick__m wrote:
           | USP is an old compendium, it is not an organization! it means
           | United States Pharmacopeia, there is an organization that
           | manages the trademark but they do not produce pharmaceutical,
           | nor do they enforce quality, the enforcement is delegated to
           | the FDA.
        
         | phkahler wrote:
         | I cured my asthma with magnesium and iodine ssupplements. While
         | I agree with you that there are false claims out there, I have
         | data to show stuff worked for me. YMMV of course.
        
         | justinator wrote:
         | _same with most my age...thus we 're desperate for anything
         | that will make us feel better and not have any side effects
         | that make things worse._
         | 
         | The issue is that a chronic mistreatment of your body (similar
         | to what you describe). The solution is a chronic loving of your
         | body. Best time to start was 20 years ago. Second best time is
         | today. I wish you luck and I can tell you: it doesn't have to
         | be the way you describe, but it WILL take patience and a life-
         | long commitment.
         | 
         | And yeah: forget supplements. Focus on good food.
        
         | MarCylinder wrote:
         | Chelated supplements are, generally, more bioavailable than
         | their oxidized counterparts because they are bound to nutrients
         | for which you have transporters. Like amino acids, for
         | instance.
         | 
         | Supplements are absolutely regulated. To say otherwise is just
         | ignorant of the law. Those regulations are not well enforced.
         | That is the fault of the US justice department and Congress.
         | The FDA is under-equipped in the way of funding to enforce
         | regulations. And they're dependent on the justice department to
         | actually follow through on enforcement. The justice department
         | is only really interested in enforcement action where harm has
         | occurred.
         | 
         | Amazon can do better, but why are we exclusively placing the
         | onus on them to enforce federal law? Why is the FDA not going
         | after the brands making and selling this shit?
        
         | hammock wrote:
         | > Most supplements are garbage...
         | 
         | > My family spends a huge fortune on supplements, most of which
         | are placebos
         | 
         | Unless you are just using "most" as a weasel word to hedge the
         | chance that you might be wrong, using "most" would imply that
         | you are aware of some supplements that aren't frauds. Can you
         | share them?
        
         | dec0dedab0de wrote:
         | Have you considered that your expectations of supplements not
         | working have caused a reverse placebo effect?
         | 
         | I don't take many supplements but they all work for their
         | intended purpose.
         | 
         | creatine for muscle recovery and making me a tiny bit stronger
         | 
         | ZMA (zinc, magnesium, b6). for deeper sleep and overcoming
         | multiday hangovers
         | 
         | melatonin for vivid dreams and waking up feeling more
         | refreshed.
         | 
         | b12/d3 for energy
         | 
         | i don't take them all every day, but they have consistently
         | noticeable effects and have improved my quality of life.
         | 
         | i also just use the store brands from major retailers, and have
         | low expectations.
         | 
         | More importantly when I was in my late thirties I also thought
         | feeling shitty was just part of getting older, but it turned
         | out I had cancer. talk to a doctor.
        
       | pfisherman wrote:
       | I had the opportunity to get a peek at the FDA database of
       | adulterated supplements and by far the most common type of
       | adulteration was people spiking with viagra. I asked why and was
       | told:
       | 
       | "Man has been searching for an aphrodisiac for thousands of years
       | and we finally found it. Of course they are going to put it in
       | everything!"
        
         | lostlogin wrote:
         | The product reviews would be interesting to read.
        
       | Blundermuffin wrote:
       | The supplements in the letter say they contain the active
       | ingredients found in many ED medications...
       | 
       | This has been going on for years with those over the counter gas
       | station products as well.
       | 
       | The demand for these products is clearly big enough, and dozens
       | of other countries sell these ED medications OTC at pharmacies.
       | 
       | Maybe it's time the FDA approve those drugs for sale OTC and curb
       | the madness.
        
         | azinman2 wrote:
         | If you did that you'd end up with a lot of deaths. These
         | vasodilators are contraindicated for a wide variety of
         | heart/health issues as well as other prescriptions.
        
           | pbj1968 wrote:
           | Cull the herd.
        
       | oglop wrote:
       | Do not buy supplements or anything you put in your body off
       | Amazon. Just assume everything is made with fiberglass and dick
       | pills, and shop with that mindset.
        
       | partiallypro wrote:
       | I bought a lotion from Amazon recently that smells like Windex. I
       | need to go to the store and see if the lotion in store has the
       | same smell. I have a feeling it could be counterfeit, as I can't
       | see this particular maker making a product with that smell.
        
       | MarCylinder wrote:
       | Looks like a lot of uninformed opinions in here.
       | 
       | As someone who has made a career consulting for supplement
       | companies selling on Amazon, this does not surprise me. When
       | Amazon first instituted testing requirements for supplements
       | (something that already exists under federal law) they required
       | all sellers to provide testing for all of their products. Failure
       | to do so resulted in removal of your products from the
       | marketplace.
       | 
       | Since then, two things have changed. Certain supplement
       | categories have additional testing requirements outside of what
       | is expected by the FDA. Companies have to prove the absence of
       | certain illegal ingredients. But, Amazon has switched to random
       | testing requirements. In the last 3 years, Amazon has not asked a
       | single one of my clients to provide any COAs. I have seen other
       | brands have to provide some, but the requirements are very
       | limited. It is for this reason, unsurprising that illegal
       | products are making it into customer hands.
       | 
       | It is my understanding that the individual who drove the campaign
       | to get COAs, GMP certificates, etc for all supplement listings is
       | no longer with Amazon, and nobody has filled that role since.
       | That should be changed.
       | 
       | But Amazon has always been aggressive over enforcement of
       | marketing claims, and some claims will always instantly flag a
       | COA requirement. Sellers use careful wording to avoid these
       | flags. The solution is to make a COA required for the creation of
       | these listings.
       | 
       | I mean, let's take this one further. Most supplement companies
       | are just marketing companies. They don't formulate the product,
       | they don't manufacture the ingredients, and they don't even blend
       | the powder. They make a brand. But, the FDA doesn't care. As a
       | brand receiving product from a manufacturer, you are still
       | required to test it. The manufacturer is also required to test
       | the raw materials as well as the finished product. Yet, most
       | companies I speak to are not testing product received. They rely
       | solely on the manufacturer testing.
       | 
       | So we should be requiring these brands to do their due diligence.
       | Show me the COA you are supposed to have for every lot you send
       | in. It's already required by the FDA.
       | 
       | As is always the case with supplements, regulation is not the
       | issue. It's enforcement
        
         | Flammy wrote:
         | This is a really high quality comment you've written here,
         | thank you for posting your perspective.
         | 
         | For those of us who don't know about testing, can you explain
         | COA/GMP and how robust the testing process is?
         | 
         | The reason I ask I'm a little concerned about Amazon's
         | incentives not being aligned with consumers priority for high
         | quality and safe product and is letting suppliers choose which
         | product(s) to submit for testing rather than doing periodic
         | random testing which I fear is too much to hope/ask for...
        
       | pama wrote:
       | It is great that the FDA does these random checks and can
       | identify supplement and food items that contained erectile
       | dysfunction drugs in them. It is a tough call to try and
       | completely eliminate such products from all the marketplaces,
       | especially when some approved US drugs may be not controlled in
       | other countries. I'd trust Amazon as more able to do so than a
       | random pharmacy or internet store. Let's see how this story
       | develops.
        
       | jrmg wrote:
       | Not just Amazon. It's very obvious that much of e.g. YouTube and
       | Instagram's funding (and that of creators) comes from ads for
       | fraudulent and/or potentially dangerous medical supplements (not
       | to mention other things like financial schemes or fraudulently
       | described products).
        
       | 1920musicman wrote:
       | Since Amazon removed these products already, here is a link to
       | one of the supplements mentioned in the letter: "X Max Triple
       | Shot Energy Honey" (https://khan-alasal.com/honey-
       | product/3-triple-shot-honey/).
       | 
       | The company looks very shady, with no registered address and no
       | contact details. They list dozens of "male energy" supplements
       | that all apparently have been certified by HAACP (Safe Food
       | Alliance, https://safefoodalliance.com/).
        
         | thorncorona wrote:
         | They're probably faked certs.
        
       | stainablesteel wrote:
       | if only the FDA cared about vitamins this much
        
       | philip1209 wrote:
       | I've had so many issues with Amazon counterfeits lately. Most
       | recently, it turned out that my Coravin cartridges were fake.
       | I've returned to buying direct from the manufacturer for many
       | branded consumables (such as fish oils).
        
       | FredPret wrote:
       | Amazon is a scam site.
       | 
       | I will buy my books from Indigo (Canada) from now on. Electronics
       | and related doodads can come from Costco, Bestbuy, Walmart.
       | 
       | Maybe it's not as convenient, but you know what you're getting.
       | 
       | It's really unfortunate that Audible is in the Amazon family,
       | because I'm not cancelling that any time soon.
       | 
       | I know much of the internet runs on AWS, but I'll never really
       | trust that either.
        
         | maximinus_thrax wrote:
         | > Amazon is a scam site.
         | 
         | It is and I don't understand the downvotes here. With
         | commingled inventory, I don't understand how people are ok with
         | ingesting stuff they buy from Amazon.
        
         | infamouscow wrote:
         | I've purchased quite a few paperbacks and hardcovers from
         | Amazon because the author sidestepped the traditional
         | publishing industry with Kindle Direct Publishing. I've enjoyed
         | a number of book series this way.
        
           | FredPret wrote:
           | That is the one light in the darkness that is amazon.com
        
       | siliconc0w wrote:
       | This is a real risk and why supplementation is probably not a
       | good idea except for like specific conditions as recommended by
       | your doctor (e.g pregnancy). In an unregulated space like this,
       | it's basically impossible to know what you're getting which can
       | range from ineffective to seriously harmful (heavy metals,
       | toxins, or active pharmaceuticals). Better to get micronutrients
       | from bio-available sources and optimize diet, sleep, and
       | exercise.
       | 
       | It's also relatively expensive compared to the usually marginal
       | benefit. Most likely you should sock away that spend into an
       | index so you can afford the more effective and expensive
       | therapies that our healthcare system doesn't give you access to
       | (because it generally won't pay for prevention).
        
       | nblgbg wrote:
       | Recently, I noticed that Amazon removed the listed ingredients
       | for regular items like toothpaste, shampoos, and mouthwashes.
       | Initially, I thought it was a mistake for a couple of items I
       | regularly buy, but it seems they have removed this information
       | for many products. I'm not sure what the intention behind this
       | change is. My suspicion now (after this article) is that they are
       | doing it deliberately, allowing them to claim that the page
       | doesn't list ingredients for any item.
        
       | sameermanek wrote:
       | Amazon was a great site! I still remember buying my first
       | converse from amazon in 2011. Back then, there were no nike
       | stores in my town in India and i badly wanted one. I bought from
       | a few local resellers who sold me duplicate products and i wasted
       | a lot of my money on that.
       | 
       | Now, the tables have turned. If i want a genuine product, i often
       | shop locally rather than amazon. They even messed up my socks and
       | sent duplicate versions of fairly common books like harry potter.
       | 
       | The whole site seems to be promoting bad products, placing
       | something not even Remotely close to my searches. "Looking for a
       | yoga mat? Here's a chinese fitness tracker we think you might be
       | interested in".. the fuck??
       | 
       | On top of that, the bad quality supplements they sell are just
       | nerve wrecking. Almost no information is factual, No usage
       | guidelines, nothing. And the reviews are just another scam by
       | themselves!
       | 
       | All in all, it's a really bad product now!
        
         | Tao3300 wrote:
         | IMO Cons (at least Chuck Taylors) themselves have been
         | counterfeit garbage for a while now. They imbue the soles with
         | paper so they can dodge tariffs by calling them slippers. They
         | don't pass the savings from this on to the consumer, and the
         | traction is terrible.
        
       | NanoYohaneTSU wrote:
       | This is so hilariously pathetic. MISBRANDING???? HOW DARE
       | YOU!!!!! FDA has been worthless for a long time and only acts as
       | a barrier to stop idiots from buying products that lie. Let them
       | die.
        
       | diego_sandoval wrote:
       | So, Amazon sold drugs illegally and all they have to do now is
       | send a letter promising that they won't do it again? No fines, no
       | lawsuits?
        
       | LanzVonL wrote:
       | Amazon is totally jam packed with scams, it's actually pretty
       | shocking.
        
       | narrator wrote:
       | Lol, looks like these guys the FDA wrote the letter about were
       | selling absurdly cheap generic viagra and cialis.
        
       | Groxx wrote:
       | Driving food- and medical-adjacent stuff off of Amazon and their
       | un-checked mixed-binning insanity would be _fantastic_. They 've
       | been allowed to play fast and loose with safety for far too long.
        
       | epgui wrote:
       | Biochemist here: for a whole bunch of biology & administrative
       | reasons, the supplement industry is more scam than science.
        
       | mberning wrote:
       | Big Pharma using their bought and paid for henchmen to protect
       | their turf. The mob wishes they were ever this successful.
        
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