Word is getting out about dietary supplements.

Dieticians and health officials at Fort Knox are warning users of supplements to be wary of what they can find at local nutritional stores.

"A lot of people don't realize that the dietary supplement industry isn't regulated like they think it is," said Laura Bottoms, dietician, Ireland Army Health Clinic. "A lot of people have the misconception that it's regulated by the [Food and Drug Administration] or even the U.S. Department of Agriculture."

She explained that supplements can make it to store shelves without producers being required to prove that what is listed on the label is actually in a supplement.

Supplements don't even have to be "effective for what they say they are effective for, and they can contain things that aren't even on the label," said Bottoms.

In the 1970s, a weight loss pill later called Fen-Phen hit the market as fenfluramine but received little interest because of its temporary effects, according to a 1997 New York Times article on the subject. In the 1990s, manufacturers mixed it with phentermine and it grew in popularity. Soon after, cases of pulmonary hypertension surfaced and grew in numbers, eventually leading to the pill being banned.

"Lots of people got injured," said Bottoms. "The way it happens is, supplements come on the market, they make outrageous claims -- none of it has to be true, and often the supplements are dangerous to our health -- and only after enough people get hurt and it gets reported enough to the FDA can the FDA do anything about it."

One of the newer ingredients hitting concerned health experts' radars is synephrine or p-synephrine, often labeled as bitter orange.

"It works very similar to ephedra, which is a banned substance," said Bottoms. "It can be pretty dangerous for Soldiers, for any athletes, to take. That's the one that really raised our awareness recently. We found that several Soldiers were taking supplements that contained that."

She said marketers often will target Soldiers with the latest and greatest in fitness and dietary supplements.

"Soldiers are often trying to figure out, 'How can I get the edge on this new [Army Combat Fitness] Test,'" said Bottoms. "We have seen an increase in supplement use in Soldiers trying to get that edge."

Because of these and other concerns, Bottoms and other dieticians at Fort Knox are actively working to get the word out to all who will listen: exercise extreme caution when taking supplements. They offer briefings on the subject, too -- what they and Department of Defense officials are calling Operation Supplement Safety.

One way they communicate to Soldiers about supplements is to conduct briefings at unit-level safety functions. Another way is to provide information to commanders through the Commander's Readiness and Resiliency Council. The council includes a representative from Army & Air Force Exchange Service who works with Bottoms and others to ensure safe products are sold at their facilities.

She said one of the best resources on the subject is the DOD's own extensive website devoted to the subject at the link below. Information at the site is divided into a list of prohibited dietary supplements, a place to check a supplement to determine what's in it, an A to Z index of ingredients, a place to ask an expert about a supplement, some quick facts, and a form to report side effects.

Bottoms urged consumers who choose to continue using supplements to get smart on them by frequenting the website.

"Avoid products that have proprietary blends, as well," said Bottoms, explaining that the companies are not required to divulge what ingredients are in their products.

She also warned that some supplements contain banned ingredients that aren't labeled.

"Ignorance is not an excuse," said Bottoms. "If a Soldier were to pop positive on a urinalysis test for taking a banned substance, even though they're unknowingly taking it because it's in a supplement and is not a listed ingredient, they're still liable."