Amazon receives FDA warning letter for supplements with undeclared ingredients

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.

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.

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.

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.

Unfortunately all this would result in is everything being labeled unsafe.

See California and cancer.

Label the things unsafe that are currently banned. Not everything is currently banned, is it?

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.

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?

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.

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.

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.

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.

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.

My argument is that you are picking a specific group and saying the law is only for them.

I'm saying that people can make mistakes and incur the consequences of those mistakes. The only way to prevent this is to remove all choice.

This has nothing to do with whether you have some kind of disability. Have someone read it to you, use a magnifying glass, look it up on the internet with a screen reader, buy it from a store you trust not to carry controversial products, do as you like.

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.

Guardrails are for preventing accidents, not purposeful action. You can't convert the entire world into a padded room. Suicide guards are a political maneuver meant to demonstrate something being done when politicians don't want to address underlying causes, not any kind of solution when there are an unending number of other bridges or tall buildings etc.

Their purpose is to prevent enough people from jumping off the same bridge for a newspaper to put a morbid number in a headline, when they should be addressing why those people wanted to jump.

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.

Excellent example of regulation created by the need of legislators to be seen doing something even when nothing needs doing.

Poisons aren't rare. You can also buy a bottle of methanol, or various cleaning solvents, petroleum products, coolants etc. Many over the counter drugs are fatal in high doses.

Someone could drown, in water. Which is also fatal if you drink too much. Or too little.

Danger is everywhere and it's fine.

The same can't be said in reverse, we don't have a real, pressing problem with an overabundance of safety.

That's exactly what we have. Safety measures with body counts. Mandating inaction in cases of uncertainty is a harm in every case where something is better than nothing.

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.

It seems like the main issue here is that the level of "informed" has to scale with the level of danger and surprise. If the product is bread and "wheat" is listed as an ingredient, someone with a gluten allergy can be reasonably expected to suss this out. If the product is a granola bar and it contains shellfish, maybe this should be separately noted and not just somewhere in the middle of the ingredients list. If the product contains unsafe levels of mercury, the words "This Product Contains Unsafe Levels Of Mercury" better be featured at least as prominently as the name of the product.

Do you really have any idea what a body of laws would look like that treated the public as though everyone has "dementia, ... a stroke," and "macular degeneration"?

"Everyone has" goes beyond what the op wrote.

"Anyone could have" is closer.

From what little of various laws I've looked at (with the huge caveat that I'm not a lawyer), I think they are written to assume the general public doesn't know what's going on most of the time.

Perhaps one day someone you know will get dementia

To further this point with anecdotes, both my mother and my grandmother had dementia.

Gran started a pot of water boiling, left the room, forgot about it, and thought the subsequent smoke alarm was her neighbours'. Mum stopped being able to count past four, and lost general concept of things existing on the left side of objects from her PoV[0].

When my mum noticed my gran had forgotten to renew her road tax (and noticed this six months after it had expired), she hid the car keys until gran forgot she had a car. When my mum got dementia herself, a similar thing happened.

[0] https://en.wikipedia.org/wiki/Hemispatial_neglect which is distinct from https://en.wikipedia.org/wiki/Homonymous_hemianopsia — eating dinner, thinking she'd finished, but left half of her plate was full of food she couldn't see until we rotated it 180°, sketching my face and missing my right (her left), that thing with the clock: https://en.wikipedia.org/wiki/File:AllochiriaClock.png

“regulators say you have to label this” and “regulators say you cannot buy this even with informed consent” are two different things

They are the same issue, because labels get applied even when not needed which destroys informed consent.

Allergies cover a huge range of sensitivities. People with quite severe allergies can consume small quantities and not notice when someone else with the exact same allergies just in a more severe form would die from consuming it. Thus ‘may contain nuts’ isn’t informed consent what’s needed is a sliding scale of risks not CYA language on basically every package.

So the labeling requirements need a sliding scale. There still isn't anything to ban.

Not just a sliding scale but an accurate sliding scale with inaccurate labeling resulting in a ban.

However, allergies aren’t universally harmful. There’s no compelling reason to allow food products with high levels of heavy metals.

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.

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.

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?

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.

Like boiled cow bone and skin derivatives in yoghurt.

Yogurt is already made out of bovine bodily fluids. Why is it so shocking and disgusting for another bovine product to be used in it as well?

When you were an infant, did you drink just your mother's milk, or was it thickened with extract of her bones?

If you really don't get why the addition of bones turns "normal" into "horror story", I don't know what to add.

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.

But people with allergies don't disregard the labels, they buy a different product.

I have a nut-allergic friend who has given up on reading the labels and relies on his own common sense, because the labels are on everything now. (Worse, if you look at what's happened with sesame, manufacturers now deliberately incorporate sesame into their recipes so that they can put the warning labels on, because that's cheaper than the risk of selling a product that doesn't contain sesame).

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.

How do you imagine that this might be accomplished? If manufacturers have the choice of a) go through an approvals process b) put a warning label on their product, they're going to pick b, every time.

We didn't ban cigarettes, we informed people of the risk:

And the result is that smoking has fallen a lot more slowly than predicted and millions of people have died.

I have a nut-allergic friend who has given up on reading the labels and relies on his own common sense, because the labels are on everything now.

There is a difference between containing nuts and being processed on equipment that also processed nuts. The difference matters more for some people than others.

Worse, if you look at what's happened with sesame, manufacturers now deliberately incorporate sesame into their recipes so that they can put the warning labels on, because that's cheaper than the risk of selling a product that doesn't contain sesame

This is what happens when you have bad rules.

They have a machine which has processed nuts in the past, it isn't cost effective to remove every trace of nuts from it, so they accurately labeled their product as one processed on equipment that has processed nuts. Maybe the trace amounts aren't enough to matter, but the consequences can be dire so they're cautious. Isn't this supposed to be about safety?

They only added nuts to the product after you prohibited them from being conservative. And they're being atypically conservative because the "dangerous" label isn't applicable to most of their customers who they then don't have to worry about being deterred.

How do you imagine that this might be accomplished? If manufacturers have the choice of a) go through an approvals process b) put a warning label on their product, they're going to pick b, every time.

Why is the company even involved in the process? They produce a new product and it initially gets a label that says it hasn't been tested, which will rightfully deter customers when most existing products don't have that label. The government performs its testing to check if it's harmful, prioritizing based on which new products are expected to be popular, and once published their results go on the label one way or the other.

If the company wants to get rid of the untested label or not have it present at release they can pay for expedited evaluation and go to the front of the line, but all popular products get tested relatively quickly and so untested products are suspect, and products evaluated as unsafe then have to be labeled as unsafe.

And the result is that smoking has fallen a lot more slowly than predicted and millions of people have died.

As compared to the times when we've prohibited other substances and people all stopped using them immediately?

Why is the company even involved in the process? They produce a new product and it initially gets a label that says it hasn't been tested, which will rightfully deter customers when most existing products don't have that label. The government performs its testing to check if it's harmful, prioritizing based on which new products are expected to be popular, and once published their results go on the label one way or the other.

This a fundamental point of misunderstanding. The government in case of the FDA doesn't test products. They just review the documentation that manufacturers submit. In case of medical devices which are similar to an existing approved medical device (a 410k) for instance the FDA charges $21,760 for this review ($5,440 if you are a small business) and under law has to have the review complete within 90 days.

To compare: performing just one of the required tests such as biocompatibility often costs more.

The FDA also doesn't write labels for you. That is entirely your responsibility as a manufacturer and frankly impossible without having complete insight into manufacturing and design.

Maybe the trace amounts aren't enough to matter, but the consequences can be dire so they're cautious. Isn't this supposed to be about safety?

Safety should be about safe outcomes, not about maximising the number of warnings.

They only added nuts to the product after you prohibited them from being conservative. And they're being atypically conservative because the "dangerous" label isn't applicable to most of their customers who they then don't have to worry about being deterred.

There's nothing atypical about it. They're finding the cheapest way to avoid liability and they genuinely don't care whether that means "being conservative" or poisoning their customers, and it's not going to result in good outcomes for the customers.

Why is the company even involved in the process? They produce a new product and it initially gets a label that says it hasn't been tested, which will rightfully deter customers when most existing products don't have that label. The government performs its testing to check if it's harmful, prioritizing based on which new products are expected to be popular, and once published their results go on the label one way or the other.

Presumably you're going to campaign for the massive increase in taxation that would be necessary to enable the government to do testing comparable to what's currently done in any remotely reasonable timeframe? (And some kinds of testing simply can't be done fast - if you want to test for negative after-effects that may take years to show up, there's no way to make that not take years).

As compared to the times when we've prohibited other substances and people all stopped using them immediately?

As opposed to market consensus on what was expected. And yeah, frankly, banning substances generally does reduce consumption; not to zero, but to significantly less than without the ban.

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?

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.

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.

This is assuming the parents are rubes and the government is competent, ignoring the cases when it's the other way around.

In practice parents and the government agree most of the time because it's established science that no one contests, and cases where the government got it wrong are a large class of exceptions. Then people see the government forcing its rules even when they're in the wrong and lose faith in the whole system, including the general consensus. Then you get more counter-culture types fooling around with weird plants.

Whereas in the absence of coercion, the people who are right when the government is wrong are able to openly prove it without being punished, which allows the government to improve its recommendations more rapidly, which reduces how often their recommendations are wrong and thereby the number of people disregarding them wholesale after watching them be incompetent pigheaded bullies.

With the established science thing many counterexamples exist, also recent ones. We are now seeing bad outbreaks of preventable disease in undervaccinated communities, because parents increasingly subscribe to unscientific antivax theories.

Or corporal punishment, where scientific consensus since 1990s is that it is harmful. The countries which have banned it since did so ahead of change in public opinion.

There are times when the government is wrong, but it is by far more right than wrong. Thanks to government intervention we saw childhood mortality drop from the high levels in previous centuries, and letting parents just do their thing would eliminate much of that progress.

The Libertarian view is that children are property, in that the gov't. should not interfere in child-rearing.

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.

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.

We sold a highly radioactive substance to Jim, and endanger more than Jim.

Gasoline + air is a high explosive. Most fluids at a hardware store are poisonous and some of them taste sweet. The MSDS for the things under your sink will tell you all the ways they can destroy you.

You can have hydrofluoric acid send to your front door. It can kill someone if you spill it on them, but it also has legitimate uses and is such a simple compound that there is no point in prohibiting it because anyone can make it themselves.

Dangerous things are widely available and everywhere and it's rarely a problem.

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!").

https://www.amazon.com/Belladonna-Seeds-Atropa-belladonna-Fl...

There's a middle ground here, where if it's dangerous enough, we don't allow it to be sold.

Many of the things all around us are even more dangerous than the things that have been banned.

If you ask someone to choose a central example of things they think should be banned, they'll often start with military explosives like C-4. Military explosives are designed to be stable. You have to use a blasting cap to set them off because the last thing you want is unintentional detonation.

If you fill your house with propane or natural gas, the slightest spark from anything will vaporize the entire building and everyone inside. Natural gas is dramatically more dangerous than C-4.

But C-4 is scarier because Hollywood shows it being used in a different context, and that's how politics decides what's banned.

And once you get into the banning things business (because you have to ban C-4, don't you?), people relentlessly want to add more things to the list. Which doesn't happen in any more principled a way.

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?

The government's got to pay for the road the ambulance drives you on when you stop breathing.

A regulatory state where a government agency has to decide whether every product is sold in a way that accurately describes its risk to the consumer is going to be bigger, more expensive, and more intrusive than one where sufficiently dangerous products are banned outright.

Is the product's seller paying for the "recipient's" ER visit, hospitalization, autopsy, or any other possible externalities of the purchase?

Basically for the same reasons they don't let you buy other toxins/dangerous materials with almost no alternative use?

"A business should only be permitted to exist if the government allows it."

What could go wrong?

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.

I didn't make a judgement, was just pointing out the slippery slope of your argument. If you place someone in charge of allowing things to come to market, particularly those in the role of safety, their safest option will always be to say no.

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.

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.

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.

>>> 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 ?

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".

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.

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.

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?

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?

It depends on the context.

In many, many contexts, people are explicitly not the people with the most knowledge about their circumstances. When I'm crossing a pedestrian foot-bridge, I have much less knowledge about whether this particular bridge is safe or not than the people who built it and the regulators who regulated it. The same is true when I drive my car, take medication, eat food, etc. etc. etc. I make risk decisions every day, but those decisions occur within a societal context, and part of that context is a general regulatory framework.

We are not all experts in everything. Which is why we (The People) gather together and delegate that responsibility in general to bodies of experts who try to make context-aware determinations about what in general should be allowed, what shouldn't be, and what should be left up to the end-user. It's a vast spectrum, and people often disagree about what goes where - this is fine! But if you want to get rid of the spectrum and have everything decided by people who should have "the most knowledge of their own circumstances", then it sounds like you're in favour of people dying and then blaming them for it.

When I'm crossing a pedestrian foot-bridge, I have much less knowledge about whether this particular bridge is safe or not than the people who built it and the regulators who regulated it.

Which is why we communicate. If the bridge has loose stones, you put up a sign that says the bridge is hazardous and has loose stones and provide a map with an alternate route. Now the person who comes up to the bridge knows that a professional evaluation designated the bridge as hazardous and why.

Most of the time that means you'll want to go around. But if the bridge is only two feet off the ground and you can see your lost dog on the other side, you might reasonably be willing to exercise careful footing and risk twisting your ankle to get to your dog.

Whereas if it's a hundred feet off the ground, you can try to get your dog later. But you might still cross if was something more serious, like you're in the woods alone and injured, you have to get across to call for help before you bleed to death and the alternate route is several hours longer.

It's a lot easier to get general information to the person in the situation than the other way around.

But if you want to get rid of the spectrum and have everything decided by people who should have "the most knowledge of their own circumstances", then it sounds like you're in favour of people dying and then blaming them for it.

If a person in a situation makes a judgement call and they're wrong, they could die. If a legislator makes a judgement call for everyone all at once, people will die because different people will be on different sides of the trade off, possibly more of them than would otherwise if they'd each been able to make their own decision in context, and certainly some of them who would have lived if they'd been able to choose for themselves and choose differently.

It sounds like you want to trade the lives of people who choose well for the lives of people who choose wrong without even knowing which number is bigger. Or considering that the number of people who choose well could be increased in various ways other than coercion.

If the bridge has loose stones, you put up a sign that says the bridge is hazardous and has loose stones and provide a map with an alternate route.

This is quaint, but not actually the problem. The problem is that every bridge manufacturer will cut corners on materials and design (because it's cheaper) meaning that there will be zero safe bridges. The bridge manufacturer's incentives do not line up with its users.

When I walk up to a safe-looking bridge, how am I supposed to know it's been made with insufficient rebar or dodgy concrete until it's collapsed on top of me? A sign?

If a person in a situation makes a judgement call and they're wrong, they could die. If a legislator makes a judgement call for everyone all at once, people will die because different people will be on different sides of the trade off, possibly more of them than would otherwise if they'd each been able to make their own decision in context, and certainly some of them who would have lived if they'd been able to choose for themselves and choose differently.

Like I said, it's a balance of harms. There's both appropriate and inappropriate places for government intervention, and we're already legally not prevented (encouraged, even) from engaging in a bunch of very dangerous activities.

But the assertion that legislative intervention will always result in more deaths than letting people "decide for themselves" seems highly dogmatic and unsupported.

It sounds like you want to trade the lives of people who choose well for the lives of people who choose wrong without even knowing which number is bigger.

We know which number is bigger. Go look at non-natural death rates in much countries with much smaller governments / regulatory frameworks.

“Expert” is a bit strong. FDA reviewers aren’t exactly Nature editors. It’s kind of a coast job. Outside of biologics I think you just need a bachelor’s.

Even that depends on the scale of the risks involved.

In my opinion, this the best type of argument for a liberal, free society that is possible within a utilitarian moral framework.

Generally speaking, each person is best aware of their own context and can choose best for themselves how to take care of themselves and those in their family.

I'm not arguing against regulatory oversight of the free market - the FDA should exist. But there's a lot of talk about "harm reduction" and even "nudging" or "shaping" of society that I think needs to go away. I'm fine with billboards being banned (along with corporate lobbyism); but don't tell me I can't buy something because some other people could hurt themselves with it if they use it in the wrong way.

It's almost like there's a balance of harms to be evaluated.

Yes, and I don't trust that the government can generate a one size fits all model that universally reduces harm. They're just not capable of it, and yet they comfortably assert their authority as if they are, and so they act without actually taking any measure of the impact of their own actions.

It's the problem with any agency. Sometimes the best answer is actually "do nothing" or most likely "regulate elsewhere through different authority."

So, I don't think the FDA paying an oversized amount of attention to one retail segment is going to do anything meaningful in the long term and we shouldn't have to pay for their amateur expeditionary efforts here, both in terms of funding the agency, and in allowing them to control markets on their own without any request or complaint process driving their actions.

Paracetamol is one of the most dangerous OTC drugs on the market, with one of the narrowest theraputic ranges and almost certainly would not be approved today. However, as the article mentions the FDA tends to lean strongly towards grandfathering existing things regardless of risk, unless they're "the fun drugs" or pose a manufacturing/diversion risk somehow.

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.

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.

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.

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.

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-d1235448e...

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.

Sorry, I do not quite follow. FDA regulates the marketing of drugs, biologics, medical devices, etc. They do not regulate the practice of medicine. Your doctor can prescribe whatever they want “off label”.

So for example, manufacturers cannot market erbitux as a cure for migraine headaches because no sponsor has submitted an application to FDA with compelling evidence that it is safe and effective for that particular indication. However, your doctor can still prescribe it for migraines if they so choose. Whether your insurance will pay for it is a different story.

Your doctor can prescribe whatever they want “off label”.

They can prescribe a drug which is not FDA approved, can they?

You also have the question of which drugs need a prescription or are considered a controlled substance, which is certainly government regulation regardless of whether or not the regulatory agency is the FDA.

They can prescribe a drug which is not FDA approved, can they?

Yes they can. They can give you whatever medical advice or prescribe whatever regimen they want. They could tell you to drink bleach and the FDA would be powerless to do anything about it.

I think the strongest argument for you would be a drug approved in another country; but not in the US. Your doctor can still prescribe it; and under the right conditions that prescription can allow you to obtain the drug in a foreign country and bring it back to the US.

https://www.fda.gov/consumers/consumer-updates/5-tips-travel...

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.

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.

If the people advocating for this position aren't in favour of full legalization of narcotics they're complete hypocrites. If you want a total free for all of "anything accurately labeled is a-okay, let the consumer weight the risk/reward", then I don't want to hear a peep from the "moral majority" about my vices.

Listing what is in a product isn't necessarily as easy as one might think.

Certainly if an elemental analysis is required to ensure that the heavy metal content is lower than 1 ppb, it means something like a comprehensive SEM-EDX is required for every single batch. This should be required to avoid things like not noticing the enormous addition of lead chromate into turmeric, but it does require caring a bit about quality, and caring about quality in this way won't occur in a free market economy without some checks.

The examples of this are everywhere, even in things as basic as water. If you ever want to worry yourself, learn a bit about characterization techniques for determining the amount of heavy metals or organic molecules ("forever chemicals") are in water to ppt levels. It's astounding how much different techniques will provide wildly different answers, and it's unclear which method to believe.

When you look closely enough, it can get pretty scary how little we know about what is in our products.

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).

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/

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.

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.

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 still requires supplements to follow safety standards and be properly labeled, but you do not need approval to make them.

Requiring someone to follow safety standards but never spot checking them to ensure they are might as well be not having any safety standards.

See

https://inspection.canada.ca/food-safety-for-industry/food-c...

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

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.

The FCC should be going after them too. A lot of the wireless stuff they sell isn't registered.

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.

Edit: it seems obvious to me that the CBP should be partially responsible verifying that stuff going through customs subject to FCC or FDA jurisdiction complies with FCC or FDA regulations, or at least to forward the question to the appropriate agency.

Customs is only barely about checking for prohibited items. It's primarily about collecting the proper revenue for goods. The US isn't very protectionist so customs is extremely loose. In Mexico they are far more concerned about collecting revenue from customers of US businesses so the customs is more thorough. Based on my experience importing there's about a 2-3% chance any sort of inspection is done at all and that's generally just cursory to compare with the stated manifest classification. Not a search for contraband.

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.

Absolutely. And Amazon should also pay for it!

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.

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.

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.

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.

Let’s assume that the FDA doesn’t shut Amazon down.

When that happens, what would it take to convince you that the reason for the FDA’s decision is Amazon’s compliance with the law, rather than Jeff Bezos’s influence over the government and news media?

Well, how much information about Amazon's behavior prior to this are you allowing us to take into account in that determination?

Sure; if the only piece of information under consideration is "the FDA did not shut Amazon down," Occam's Razor says that we should expect that to be because Amazon did not do anything that would lead to them being shut down.

But if we get to bring in all the information we have about what Amazon did do, much of which certainly appears to be conduct that would lead to some kind of regulatory penalty...well, then, it seems like it might be reasonable to consider alternative explanations for the outcome.

It’s usually a good idea to be open to alternative explanations, but that wasn’t my question.

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.

It's a good thing that regulatory actions are slow going and difficult to prove under the law, otherwise the commons would be subject to powertripping leaders above clouds far more than they are already.

It also means that if things do get to such a point, then the action will come down swift and heavy in a manner generally agreeable to the majority of the commons.

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.

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.

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.

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.

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.

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...

Policy arguments don't depend on what the law is in a particular jurisdiction. Laws are often malleable enough that if you can convince the judge of what should happen, they can reach the corresponding outcome. When that isn't the case, the legislature can change the law. In either event the first step is to figure out how things ought to work and making them work that way comes after.

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).

Amazon is kind of a third thing though. They're a warehouse in addition to a marketplace like eBay. If you buy a thing from an auction site and it's defective, the site might be able to get you a refund (or not, if you didn't pay through them), but they can't get you a replacement product unless the seller has one. The site has none to send you.

Amazon will send you another one, possibly from a different seller. That's... weird. It's like they inverted the model where the wholesaler sells to the retailer who sells to the customer. Instead the retailer sells to the customer through the wholesaler, combining different kinds of products into a warehouse instead of splitting up a warehouse with large quantities of the same product into smaller retailers.

But you still want to put things like this on the "retailer" because they're the one who knows anything about the product. It's the same reason you don't put it on eBay or UPS or a self-storage place. And the same reason you don't need to -- you want to shut down or punish the retailer selling the fraudulent product, not all the other retailers or the surrounding infrastructure providers.

It's not.

Walmart is not a 'marketplace', yet they could easily give you a replacement product from a different 'wholesaler', just like Amazon can give you a replacement from a different 'retailer'. There is no material difference here. Amazon owns everything about the interaction, they have just creatively outsourced creating product listings and a bunch of product risk.

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.

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.

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.

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.

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.

It is an interesting question.

How much cocaine goes via Amazon?

Or ephedrine, or ecstasy... Etc

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.

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.

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/

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

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.

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.

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.

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.

Innocent until proven guilty only applies to individual people, not corporate entities.

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.)

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.

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.)

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.

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.

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.

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.

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.

I'd say step 1 would be respecting the bodily autonomy of citizens to put what drugs they want into their own body.

Given the bipartisan war on drugs, I think we are a long ways off.

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.

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.

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.

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.

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.

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

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).

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.

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...

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.

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.

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.

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.

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.

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?

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.

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.

Could be genetics, could be low T, could be depression, could be some other uncovered issue. Should probably discuss this with their doctor.

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.

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.

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.

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.

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.

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.

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?

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/

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.

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").

Are you saying there could be Viagra in my Endurance 2Nite?

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.

If you replace the Calcium with chalk you would still have a source of calcium so it wouldn't be that bad :D

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.

Animals eat naturally-occurring chalk (and other substances) to regulate key minerals. It's called geophagia.

https://en.wikipedia.org/wiki/Mineral_lick

geophagia

Animals are eating the world

With different bioavailability

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

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.

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.

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.

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.

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?

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.

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?

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...

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.

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.

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...

This makes it rather attractive for sellers to add in some cheap fakes - thanks for the explanation.

It's an inventory management exploit that Amazon seems in no hurry to fix.

https://www.redpoints.com/blog/amazon-commingled-inventory-m...

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.

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?

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.

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.

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.

Time and availability are expensive commodities. Who's paying for that?

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.

Personal injury is serious business, and many personal injury attorneys work on contingency. Amazon has "deep pockets," so I doubt this is the reason.

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.

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.

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.

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?

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.

implement regulations requiring they be honest about products?

Surely the US has regulation requiring this? So if it’s being ignored, what does the state do?

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.

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?

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.

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.

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.

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.

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.

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.

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.

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.

>...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)

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.

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.

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.

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.

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?

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.

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…

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.

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?

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.

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.

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.

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?

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.

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/

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

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?

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.

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-...

As for that "100% safe" homeopathic stuff... https://www.fda.gov/news-events/press-announcements/fda-conf...

A middle ground is to let a pharmacist dispense it after going over side effects, instructions, interactions and existing conditions (without a Rx).

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.

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.

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.

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.

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.

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.

This is how it is in the UK now, it's an OTC drug, so you can simply buy it in pharmacy or online.

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.

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.

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-...

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.

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.

I'll go Aliexpress, eBay

Do you know who sells on Aliexpress, and to a large extent on eBay? The very same shady Chinese/Indian sellers peddling counterfiet products you are seeking to avoid by not shopping on Amazon.

Aliexpress was literally set up as a direct-to-US-market Chinese factory marketplace, which results in 99% counterfeit and knock-off products being pushed directly to consumers.

Sure, but it's obvious, unlike Amazon where you get duped. So if you want a real name brand product you shop at none of the above, and if you want cheap junk you go to AliExpress. There's not a large reason to roll the dice on something in between (Amazon) unless you want junk with much faster shipping and streamlined returns (at double the price of AE).

It's just super ironic the parent post said they avoid counterfeits and knock-offs by shopping on Aliexpress. Aliexpress is basically counterfeit and knock-off central...

On Amazon, look at who the seller is. If it's Amazon or the actual manufacturer, you'll be fine. For the rest, you need to do some additional research on the seller's business - but it's understandable to not want to do that effort.

With that said, you can't actually lose on Amazon. Just return the item for a full refund and select "not as advertised" as the return reason. You'll get a free pre-paid return label, or drop off at a local store. I've bought plenty of expensive electronics on Amazon without reasonable fear.

It's just super ironic the parent post said they avoid counterfeits and knock-offs by shopping on Aliexpress. Aliexpress is basically counterfeit and knock-off central...

It doesn't. You read it wrong. Read it again.

Uh...

Here's my list of things I won't buy on Amazon.com

However, [Amazon.com is] no longer my first source. I'll go Aliexpress, eBay, and Walmart first.

You said "the parent post said they avoid counterfeits and knock-offs by shopping on Aliexpress" which I'm afraid is incorrect given that the post in question said "Amazon [is] no longer my first source [for] generic gizmos, [...] I'll go Aliexpress, eBay, and Walmart first" (if I may rearrange for clarity without changing the meaning).

"Generic gizmos" roughly equates to "counterfeits and knock-offs" in my book, and that commenter isn't trying to avoid them when shopping at AliExpress and formerly Amazon. That's separate from the situations where they do want to avoid knock-offs, listed separately from all of this.

Read the full paragraph yet again, carefully and closely:

Reading comprehension questions:

* Amazon is a source for the author for what type of products?

* Author prefers Aliexpress and eBay over Amazon. Therefore, what types of products does the author buy there?

* Does preferring those vendors over Amazon mean or imply that the author will buy things he does not buy on Amazon there instead?

I apologize, in advance, by the didactic approach. Some people, especially from some high-context American communication styles, will believe it implies that I'm being patronizing. However, it is not intended to be; I'm from a different culture with different communication styles. I am using it since it is effective for identifying miscommunications and / or explaining misconceptions. Given that this is my third shot now, I thought it made sense to give it a shot, at the risk of offending people across cultural backgrounds.

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.

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.

Yes you are correct. I thought you meant you now go to Ali/eBay/walmart.com as first choice for any purchase. My mistake.

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

From much experience, AliExpress customer service is 100x better than Amazon. Very prompt refunds and dispute resolutions.

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.

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.

Can you name any specific instance where people were harmed by toxins in clothing? The skin tends to be a pretty good barrier. Creams and cosmetics are often designed to penetrate it, but clothing fits within my risk profile. I come in contact, skin-ways, with all sorts of nastier things day-to-day, even when working on my house.

My concerns around clothing have more to do with durability, comfort, and quality. For example, bad pyjamas can be not very breathable or collect sweat.

That's pretty easy to tell, though.

So that's shady clothing fits in my risk profile.

As a footnote: I'm not implying it should fit into your risk profile; I'd avoid based on hypothetical risks like lead contamination, PFAS, and other hypotheticals if I earned perhaps 50% more than I do today. I'm asking since if there are specific instances (not of contamination but of harm), I might change my risk profile.

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.

I almost never buy fancy clothes with materials like linen. I do buy fancy sheets :)

With work-at-home, most of my work day is spent in fluffy cotton pyjamas in the winter and simple underpants in the summer from basic-but-large companies like Hanes, Fruit-of-the-Loom, and similar. I'll put on a plain cotton t-shirt and a pair of jeans to go out to the store or whatever. If it's cold, I'll toss on a worn-out long-sleeved t-shirt (the good ones see very little use) and/or a jacket of some kind.

I do have fancy clothing for business meetings, as well as for specific types of exercise, but the total number of hours of usage on those is quite low.

Post-covid life is good!

- 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

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.

Did you take any action at all? Sounds serious enough for legal action.

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.

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.

what about brand name items?

or left plugged into the mains unattended

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.

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.

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.

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.

I have heard similar stories of Amazon fraud like you describe. I don't know if everything is true, but this is a problem which can be solved with PKI.

With PKI, the customer reviews a product, and puts the hash of his review somewhere on the internet. The hash might be the hashed version of a JSON like so: {company: "Stuffed Animal company", product: "Stuffed Animal", review: "Very good stuffed animal toy"}

When the buyer tries to buy the product, he will verify each review against a public key, and check if all info in JSON verifies correctly. If it does not, then something fishy is going on.

The only problem is where to put the hash of the review. An official database of some kind is required, by a government or something like blockchain. That's why some people refer to blockchain as a "source of truth". It has the potential to contain information no human power can delete from the internet or modify in any way.

Another problem solved by decentralization! You should sell some NFTs to celebrate.

Centralization or decentralization is a mute point. The problem is solved using PKI, which was defined as a theory back in the 90's. PKI can be supported by any government or official with some computers, even private companies can offer support for PKI.

There are multiple solutions, but the cheaper solution will be offered by a perfect competition system as economic theory suggests. Anyone is free to choose the most expensive solution if so desires. I don't mind at all if someone pays 1000 times more for the same PKI and uses a more expensive system than a blockchain one.

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

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.

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.

Not the internet. Just Amazon. Buying direct from the manufacturer / a trusted store is better than ever.

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.

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.

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.

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?

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.

The seller often swaps the product description for some other product, capitalizing on the reputation of the first to sell the second.

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.

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.

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.

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.

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.

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.

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.

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?

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?

At minimum Amazon should be banned from co-mingling. Its blatant false advertisement for consumers. If you buy from a trust source like Amazon, your product should come from them. They can't be both a marketplace and retailer with co-mingled inventory, its all the same inventory and should forgo the protections of being a marketplace.

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...).

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.

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.

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.

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?

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.

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.

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!

Unfortunately my example of "low price from crappy seller" has largely been books :(

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.

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.

I have never had that problem and have probably returned ~100 items over the years. YMMV I guess.

My example regarding customer service kinda makes me feel that their CS isn't so amazing.

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.

The gap has been widening for years. Because Amazon keeps getting worse.

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.

Any even remotely WADA compliant drug testing uses chromatography, this story is most likely false.

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.

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)

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.

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...

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...

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.

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.

Wait. "some new supplement that was giving them results"? Testing positive for meth?

So, a performance enhancing drug, probably some kind of amphetamine if not straight meth, and it is fine? The story may be true but blaming Amazon sounds like a lousy excuse. Someone must know what he is doing.

Cool! Now do their crappy cords that are likely to burn down your house.

Amazon Basics should be terminated with prejudice.

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/...

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.

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.

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"?

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.

Nanny state socialism! The market should take care of dangerous products. Nobody is going to buy such a cord twice.

Of course nobody will buy a dangerous product twice. You can’t buy another product after being burned to a crisp!

without regulations the next differently branded unregulated cable might also burn your house down.

None of the dick pills mentioned are AmazonBasics brand.

Do American grocery stores have better controls or does their broker model just happen to filter the junk?

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.

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).

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.

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.

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.

Grocery stores have buyers who decide which suppliers to work with and select the products they think their customers will want to buy, they don’t let random fly by night businesses just come to the store and put whatever products they want on the shelves, which would be the equivalent of Amazon’s third party sellers where these supplements came from.

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)

Grocery stores typically have an extensive if not integrated supply chain they have absolute control over.

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.

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.

Did you get it to make cheese sauce with?

Actually, I got it for making bread, because someone recommended it to me. I didn't really test the difference though. I didn't know about cheese sauce, I may take a look at it.

I have 250g of the stuff, probably enough to last me a lifetime considering the quantities used.

When I reviewed a product as obviously fake they also removed my review. The company as a whole really kind of disgusts me now.

yeah they are kind of the last resort for me at this point when buying online.

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.

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

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.

A lot of the garlic in yhe US is from China, so if you ate in a restaurant you likely had some already.

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...

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.

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.

That is the one light in the darkness that is amazon.com

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.

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.

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.

Cull the herd.

Certainly one of the most sadistic ways to say "dangers like that are well within the risk factors of most of the people willing to use them, and at some point you're responsible for paying attention to how your own medications interact".

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.

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.

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!

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.

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!”

The product reviews would be interesting to read.

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

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...

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/).

They're probably faked certs.

if only the FDA cared about vitamins this much

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).

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).

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.

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.

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.

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.

Lol, looks like these guys the FDA wrote the letter about were selling absurdly cheap generic viagra and cialis.

Big Pharma using their bought and paid for henchmen to protect their turf. The mob wishes they were ever this successful.

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).

Biochemist here: for a whole bunch of biology & administrative reasons, the supplement industry is more scam than science.

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?

About 15 years too late. Wonder what they'd find if they tested the protein, creatine, etc on Amazon.

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.

Amazon is totally jam packed with scams, it's actually pretty shocking.

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.

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).

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?

Way too late. Way too little. This is honestly pathetic.

Supplements on Amazon have been a disaster for the better part of a decade, maybe longer.

It's painful to see abuse after abuse and little regulatory action.

Except in a very small handful of situations, the best case scenario is that the company pays a small fine.

That fine gets announced years after the abuse, then, that pittance gets litigated down over even more years.

The risk adjusted present value might as well be zero.

Why would any company ever do the right thing?