Most supplements sold through reputable South African retailers contain what the label says. The risk is not evenly spread, though, and a few categories account for most of the serious problems.
The specific danger is undeclared ingredients: products that contain an active pharmaceutical substance not listed on the label. Someone taking what they believe is a herbal product may be taking a medicine, at an unknown dose, with no warnings and no interaction information. That is a fundamentally different risk from a supplement simply not working.
Common side effects reported with this supplement or ingredient
The higher-risk categories, consistently, are:
- Weight loss and slimming products. Have been found internationally to contain undeclared stimulants and appetite suppressants withdrawn from the market for safety reasons. See slimming pill side effects.
- Sexual performance products. Have been found to contain undeclared erectile dysfunction medicines, which are dangerous with nitrate heart medicines and can cause a severe drop in blood pressure.
- Bodybuilding and muscle products. Have been found to contain undeclared anabolic substances or their analogues. See sports supplement side effects.
- Energy and pre-workout products. Stimulant content that is far higher than labelled, or not declared at all. See pre-workout side effects.
Effects that suggest something undeclared: palpitations, a marked rise or fall in blood pressure, unexpected sedation, agitation or insomnia well beyond what the product should cause, or a dramatic effect that seems too strong for a supplement.
Possible interactions with medicines, chronic conditions or pregnancy
An undeclared ingredient is an interaction nobody can screen for. A pharmacist checking your medicines against a supplement label cannot warn you about something the label does not mention, which is why buying from a source you trust matters more than any checking you can do yourself.
This matters most if you take heart, blood pressure or diabetes medicines, blood thinners, or anything for a mental health condition.
Who should speak to a healthcare professional before using it?
Anyone considering a product in the categories above, particularly if you take regular medicines, are pregnant or breastfeeding, or have a heart condition.
Anyone subject to drug testing for sport or employment should be aware that undeclared substances have caused positive tests in people who believed they were taking only a supplement.
Dose, product-quality and stacking risks
Warning signs that a product is worth avoiding:
- Dramatic promises, particularly rapid weight loss or results comparable to a prescription medicine
- Claims to treat or cure a named disease, which a supplement should not be making
- Sold only through social media, messaging apps or informal traders, with no verifiable company behind it
- No full ingredient list, or a proprietary blend that hides amounts
- No local contact details, batch number or expiry date
- Imported with labelling in a language you cannot read, or no South African labelling at all
- An effect noticeably stronger than a supplement should produce
Supplements in South Africa are regulated as complementary medicines, which involves less pre-market evaluation than prescription medicines receive. See how supplements are regulated and supplement safety in South Africa.
SAHPRA publishes warnings about specific products through its safety alerts and product recalls pages. See how to check safety alerts.
When to stop and get medical advice
Get emergency help for chest pain, a racing or irregular heartbeat, fainting, difficulty breathing, severe headache, or collapse.
Stop and seek advice for yellowing of the eyes or skin, dark urine, persistent nausea or unusual tiredness, all of which can indicate liver injury and are a recognised consequence of some of these products.
Keep the product and its packaging. If a supplement caused a serious effect, reporting it with the batch number is how the product gets identified and others are warned. See reporting a supplement side effect.
Related supplement safety guides
- Supplement side effects
- Supplement and medicine interactions
- How to check supplement labels
- When to see a doctor about a supplement
- Report a supplement side effect
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.