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The lack of uniformity across these studies highlights concerns about the variable ingredient profiles and online customer reviews claiming that these supplements can dramatically improve ED symptoms. Patients should be counseled that the current body of evidence examining the efficacy of ED-S product ingredients is derived from studies using heterogeneous supplementation protocols. This is particularly significant given a string of recent investigations revealing that some “natural” supplements contain active pharmaceutical ingredients.13,40–43 Patients should also be counseled that these ingredient concerns are not unique to herbal or natural supplements targeted at ED. Although this labeling should be viewed with caution, given that the FDA does not formally review supplements, the lack of any statement regarding standardized manufacturing practices in the remaining ED-S products raises concerns about actual supplement composition. 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Also, findings from toxicological and animal feeding studies supported that maize with TC1507 is as safe and nutritious as conventional maize. Gassmann et al. (2016) recently described a field population with “incomplete resistance” to Cry34Ab1/Cry35Ab1. These results are comparable with other recent work applying meta-analysis to data on Bt-susceptible populations (Tinsley et al. 2016) and research evaluating the mCry3A + eCry3.1Ab pyramid with the addition of soil-applied insecticides (Frank et al. 2015). The addition of a soil insecticide only benefitted pyramided technology when the NIS rating exceeded a 2.0 for the non-Bt treatment.