Each year, ConsumerLab.com surveys its e-newsletter subscribers about the vitamins and supplements that they use. The results below are based on 10,260 responses collected in November, 2011. Continue reading
Once again the European Union (EU) is far ahead of the US when it comes to protecting consumers from unsafe natural medicines (herbs, vitamins, or supplements). Continue reading
About one in ten infants are given unregulated and potentially unsafe herbal products or teas by their moms. Continue reading
In general, we believe that alternative medicine is inappropriate for children. Why? The potential risks are too high. Continue reading
So far in this series on alternative medicine and children, I have been concerned with the chemical aspects of herbal remedies. In this blog, I’d like to address herbalism, which is more like a religious approach to herbs and raises spiritual and pharmacological problems. Continue reading
As pediatric surgeons were performing surgery on children in the 1990s, some noticed an increase in bleeding problems. They could not explain their observations until researcher, led by Kathi J. Kemper, M.D., found a connection between bleeding problems and children’s use of herbal remedies. Continue reading
Long-time readers know of my fondness for ConsumerLab.com. Their independent testing of natural medications (herbs, vitamins, and supplements) guides my teaching and my prescribing. Now, a review by ConsumerLab.com finds 45% of ginseng products don’t provide the full amount of the ingredient indicated on the label, or worse, are contaminated.
ConsumerLab.com is now reporting that five out of eleven of the most popular ginseng supplements in the U.S. were selected for testing and contained less ginseng than expected from their labels or were contaminated with lead and/or pesticides.
Problems with the quality of ginseng supplements have been reported by ConsumerLab.com since 2000. Ginseng is a popular herb with U.S. sales last year of $83 million according to Nutrition Business Journal.
“Consumers need to be wary of the quality of ginseng supplements” said Tod Cooperman, MD, President of ConsumerLab.com.
“People should also recognize that there is enormous variation in the amount of ginsenosides — key ginseng compounds — in marketed supplements. We found most products to provide approximately 10 to 40 mg of ginsenosides per day, but some yielded much higher amounts, including one that delivered a whopping 304 mg. We are not aware of human studies with the higher amounts. The effects might certainly differ from one product to another.”
Ginseng has often been promoted for increasing vitality. While there is not much clinical evidence to support an energy boosting effect, studies indicate that that certain preparations may help prevent colds and flus or keep blood sugar levels down in people with diabetes. A range of other uses have been suggested but lack strong evidence.
The new Product Review of Ginseng Supplements provides test results for fifteen supplements – eleven selected by ConsumerLab.com and four tested at the request of their manufacturers/distributors that passed the same testing through CL’s Voluntary Certification Program.
Also listed are two products similar to one that passed testing but sold under different brand names.
Brands included are Action Labs, Bluebonnet, Good Neighbor Pharmacy, Imperial (GINCO), Nature Made, Nature’s Bounty, Nature’s Plus, NSI (Vitacost), Pharmanex, Puritan’s Pride, Solgar, Spring Valley (Walmart), TruNature, Vitamin Shoppe, Vitamin World, and Whole Foods.
ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester, New York.
Of importance, it has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.
Today I’m in Orlando, Florida, where I’ll be speaking to the Florida Academy of Family Physicians on this exact issue. And, I find that most of my patients and most physicians are simply unaware of the danger. The New York Times is reporting, “Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found.”
Although the “levels of heavy metals – including mercury, cadmium and arsenic – did not exceed thresholds considered dangerous,” almost half of them “contained pesticide residues that appeared to exceed legal limits.”
Notably, “Dr. Joshua M. Sharfstein, principal deputy commissioner of the Food and Drug Administration, said in an interview that he was not concerned about the safety of the supplements tested by the GAO investigators.”
Still, Sharfstein added that “the FDA had increased enforcement actions against supplements spiked with prescription drugs.”
One ginkgo biloba product had labeling claiming it could treat Alzheimer’s disease (no effective treatment yet exists), while a product containing ginseng asserted that it can prevent both diabetes and cancer, the report said.
At least nine misleading health claims were noted in the report. These claims included assurances that the products could cure diseases, such as diabetes, Alzheimer’s disease and cancer, investigators said. In one instance, a salesperson claimed that a garlic supplement could replace blood pressure drugs, the Times reported.
Products that purport to treat or relieve disease must go through strict reviews because they are considered drugs by the U.S. Food and Drug Administration.
HealthFinder reported, “The report findings were to be presented to the Senate … before discussion begins on a major food safety bill that will likely place more controls on food manufacturers.
“How tough the bill will be on supplement makers has been the subject of much lobbying, but the Times noted that some Congressional staff members doubt manufacturers will find it too burdensome.
“‘The oversight of supplements has improved in recent years,’ said Sen. Herb Kohl (D-Wisconsin), who will preside over Wednesday’s hearing. However, the FDA needs the authority and tools to ensure that dietary supplements are as safe and effective as is widely perceived by the Americans who take them, he told the Times.’
One witness scheduled to testify is a friend of mine. Dr. Tod Cooperman, president of ConsumerLab.com, said supplements with too little of the indicated ingredients and those contaminated with heavy metals are the major problems.
In testing more than 2,000 dietary supplements from some 300 manufacturers, his lab has found that one in four has quality problems, the Times said.
According to the newspaper’s account, the proposed food safety bill could require that supplement manufacturers register annually with the FDA and permit the agency to recall potentially dangerous supplements.
It’s estimated that half of adult Americans take vitamin supplements regularly, and about a quarter take herbal supplements at least occasionally. Annual sales are about $25 billion a year, the Times said.
So, what can you do to be sure that any natural medication (herb, vitamin, or supplement) you take is safe. I recommend you consider reviewing those you take at ConsumerLab. For less than the price of a bottle of vitamins, you can find brands of natural medications that have been independently testing for safety.
I highly recommend the site.
Whenever I give talks on natural medications (herbs, vitamins, and supplements), whether to healthcare professionals or laypersons, people seem shocked to learn that these substances are virtually unregulated in the United States. I’ve written about the many problems this causes healthcare professionals and consumers in my book, Alternative Medicine: The options, the claims, the evidence, how to choose wisely. So, I was very happy to read an AP article reporting “Stricter government oversight of dietary supplements is moving closer, thanks to an agreement among senators to include guidelines in” the Dietary Supplement Safety Act.
The report says that in a letter sent to Sen. Tom Harkin (D-IA), chairman of the Senate Health, Education, Labor and Pensions Committee, Sens. John McCain (R-AZ) and Byron Dorgan (D-ND) outlined “four key areas of ‘common ground,'” two of which include “requiring all dietary supplement manufacturing, processing, and holding facilities to register with the Secretary of Health and Human Services,” and “giving the Food and Drug Administration authority to issue a mandatory recall order if a dietary supplement is adulterated or misbranded.”
I hope they are successful. If so, it will go a long way toward protecting consumers from the deceptive practices and advertising used by some manufacturers or natural medications.
The folks at Natural Standard recently sent out a notice of a significant review in the cardiology literature on the potential interactions between herbs and heart medications. A news release on the study can be found here. This new analysis suggests that herbal supplements, such as Ginkgo biloba and garlic, may cause dangerous interactions when combined with heart medications.
Some examples of herbs and their adverse effect on heart disease management include:
- St. John’s wort, which is typically used to treat depression, anxiety and sleep disorders among other problems, reduces the effectiveness of medications contributing to recurrences of arrhythmia, high blood pressure or increase in blood cholesterol levels and risk for future heart problems.
- Ginkgo biloba, which is supposedly used to improve circulation or sharpen the mind, increases bleeding risk in those taking warfarin or aspirin.
- Garlic, which supposedly helps boost the immune system and is commonly used for its cholesterol and blood pressure lowering properties, can also increase the risk of bleeding among those taking warfarin.
The authors searched PubMed and Medline databases for articles about herbs and heart disease that were published in 1966-2008. They identified nearly 30 herbal products that could cause harmful effects and should not be taken with heart medications, including those that lower blood pressure, prevent blood clots, regulate cholesterol and stabilize heart rhythms.
Bleeding was among the most common interactions that were reported. The authors found that alfalfa, angelica (dong quai), bilberry, fenugreek, garlic, ginger, ginkgo and khella may increase the risk of bleeding when taken with anticoagulants like warfarin (Coumadin®). The researchers also identified herbs (such as capsicum, ginseng, licorice, St. John’s wort and yohimbine) that may increase blood pressure.
Grapefruit juice may also cause dangerous interactions. The fruit inhibits an important enzyme that helps break down drugs. As a result, grapefruit may increase the amount of medication in the body to toxic levels.
According to the researchers, grapefruit juice may increase the effects of cholesterol-lowering drugs (statins), blood pressure-lowering drugs (calcium-channel blockers) and cyclosporine (a drug that reduces the risk of transplant rejection).
“There is a clear need for better public and physician understanding of herbal products through health education, early detection and management of herbal toxicities, scientific scrutiny of their use, and research on their safety and effectiveness,” the authors concluded in the Journal of the American College of Cardiology.
“These herbs have been used for centuries—well before today’s cardiovascular medications—and while they may have beneficial effects these need to be studied scientifically to better define their usefulness and, more importantly, identify their potential for harm when taken with medications that have proven benefit for patients with cardiovascular diseases,” said Dr. Jahangir, one of the authors of the study.
“Patients, physicians, pharmacists and other healthcare providers need to know about the potential harm these herbs can have.”
In addition to greater public education about the risks of using herbal products, patients and clinicians need to actively discuss the use of over-the-counter medications, supplements and herbal products in addition to prescription medications.
Dr. Jahanigir also urges the scientific community to commit to conducting studies to test manufacturers’ claims and study the impact of these compounds on heart disease management. He reports no conflict of interest.
Obviously, like conventional drugs, herbs and supplements may cause side effects and interact with other therapies and you should never take natural medications (herbs, vitamins, and supplements) with prescription or even OTC drugs without checking with your physician or pharmacist.
You can read more herbs and natural medicines in my book, Alternative Medicine: The Christian Handbook:
Two products failed to properly list the part of the milk thistle plant used — a FDA requirement. Among the remaining supplements, only one contained the expected amount of silymarin compounds, which are believed to be the active constituents of milk thistle.
Studies suggest silymarin may be helpful in type 2 diabetes and, possibly, certain liver conditions.
While most products claimed that their milk thistle extracts were standardized to 80% silymarin, ConsumerLab.com found actual amounts to range from 47% to 67%.
Sales of milk thistle in the U.S. have climbed for several years, reaching $95 million in 2008 according to the latest figures from Nutrition Business Journal.
ConsumerLab.com’s Vice President for Research, Dr. William Obermeyer, a former scientist with the U.S. Food and Drug Administration (FDA), suggested supplement makers may be relying on non-specific tests, such as UV spectrophotometric analysis, that can falsely inflate a product’s silymarin content by counting other compounds that are not silymarin.
In contrast, ConsumerLab.com used a highly specific HPLC method to test the products.
Some ingredient suppliers offer both a higher priced and a lower priced milk thistle extract. The higher cost product is certified with the HPLC test, while the lower cost product is certified with the non-specific UV test.
The FDA does not set standards for the quality or testing of herbal supplements, so manufacturers may choose either form of milk thistle. Consumers normally have no way of knowing which form they purchase.
An abstract of the Product Review of Milk Thistle Supplements can be found here, however, the full review, including the full results, reviews, and comparisons of ten supplements selected by ConsumerLab.com is only available by subscription.
The Review provides information on how to choose and use these supplements. Brands included in report are 1Fast400, Enzymatic Therapy, Finest Natural, Jarrow Formulas, Natural Factors, Nature’s Plus, Nutrilite, Pharmex, Smart Basics (Vitacost.com), and Whole Foods.
ConsumerLab.com is one of my favorite web sites for evidence-based information on natural medications (herbs, vitamins, and supplements) and a leading provider of consumer information and independent evaluations of products that affect health and nutrition.
Reviews of other popular types of supplements are available from www.consumerlab.com. Subscription to ConsumerLab.com is available online here. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.
You may also enjoy these blogs:
- Trustworthy consumer websites for NATURAL MEDICATION information (herbs, vitamins, and supplements)
- Physician calls for increased FDA regulation of dietary supplements
- Herbal remedies need real regulation
- The Ten Commandments of Preventive Medicine – Part 8 – Alternative Medicine
- Study Links Herbal Medicines to Lead Poisoning. How can you find safe herbs?
Reuters Health carried a very interesting report indicating that some herbal supplements may boost the levels of lead in the blood of women.
A study, published in November showed that among 12,807 men and women age 20 and older, by Dr. Catherine Buettner, at Beth Israel Deaconess Medical Center in Boston, Massachusetts, and colleagues found blood lead levels about 10 percent higher in women, but not men, who used specific herbal supplements.
When they examined herbal supplement use among women of reproductive age (age 16 to 45 years old), “the relationship with lead levels was even stronger, with lead levels 20 percent higher overall, and up to 40 percent higher among users of select herbal supplements compared to non-users,” they report in the Journal of General Internal Medicine.
Lead accumulates in the body over time and may pass from a woman’s placenta and breast milk to developing fetuses and infants. The U.S. Food and Drug Administration does not specify safe lead limits, or even routinely test for this toxin in herbal supplements — but the state of California has established such levels.
Buettner’s team found that women using Ayurvedic or traditional Chinese medicine herbs had lead levels 24 percent higher than non-users, while those using St. John’s wort and “other” herbs had lead levels 23 percent and 21 percent higher, respectively, than non-users.
When combined with prior studies hinting at excess lead in specific supplements, the evidence strongly suggests use of specific herbal supplements may result in higher lead levels among women, Buettner said.
In the current study, Buettner was reassured to find “no evidence of lead toxicity,” she told Reuters Health in an email.
The researchers point out that the use of some herbal supplements among study participants was low, which limited the power to detect associations among specific herbal supplements.
They also emphasize that the current study does not prove that herbal supplements cause higher lead levels. They urge further studies to analyze how other lead exposures, calcium intake, or use of other dietary supplements alter lead levels.
Dr. Adriane Fugh-Berman, at Georgetown University Medical Center in Washington, D.C. concurs in an editorial on the study, and also cautions, “let us not use too broad a brush to tar all herbal products.”
Specific analyses of specific herbal products or the blood of users, Fugh-Berman writes, should be used to establish products containing problematic amounts of lead.
In my book, Alternative Medicine: The Christian Handbook, I lament the lack of regulation of dietary supplements in the U.S. Because of this lack, it’s very difficult for consumers to know, when it comes to herbs, vitamins, and supplements, if what they purchase actually contains what the label says. It’s almost impossible to know if the natural medication is contaminated or not. As a result, there are now other voices beginning to call out for at least some regulation of these substances. Continue reading
In my latest book, 10 Essentials of Happy, Healthy People, I teach people how to utilize these ten essentials that are necessary to live a happy and highly healthy life. Under The Essential of Self-Care, teach what I call “The 10 Commandments of Preventive Medicine. Here’s the eighth installment of this ten-part series. Continue reading
How can you make informed choices about natural medications (herbs, vitamins, and supplements)? For one thing, don’t get your information from ads or labels! There is almost no regulation in the U.S. on these products. So, where can you turn?
More Information: Continue reading
Here are the most popular blogs, based upon blogs that you’ve read, over the first three months of 2009. The most popular blog was “Is It a Cold or Sinus Infection? How to Tell the Difference” and the second most popular blog was “Faith-Based Health and Healing – Part 1 – What does the Bible say about health?” The latter blog is a twelve-part series. I hope you’ll look up any of these you missed the first go round.
More Information: Continue reading
According to HealthDay News, alternative therapies, such as herbal remedies, acupuncture, or acupressure, are becoming increasingly popular. But you should always use caution when experimenting with any alternative therapy, because it is not regulated by any government agency. Here are some tips to avoid quackery and medical fraud for you and your loved ones.
More Information: Continue reading
In an unusual turn of events, a prominent scientist in the United Kingdom is accusing Prince Charles of contributing to the “ill health of the nation” by backing with his name an herbal detox product that sells for about $13.75 per bottle and that he says is “outright quackery.”
More Information: Continue reading
Fox News is commenting on a study published in the August 27 issue of JAMA in which medical researchers say that one-fifth of Ayurvedic herbal medicines sold on the Internet contain dangerously high levels of lead, arsenic and mercury. How’s a consumer to protect themselves?
My Take? Continue reading
The AP is reporting that the Food and Drug Administration (FDA) is cracking down on teas, supplements, creams, and other products that falsely claim to cure, treat, or prevent cancer, even though they are not agency-approved drugs. All are available for sale on the Internet.
The agency has sent 25 warning letters to companies and individuals marketing these products, FDA officials said Tuesday. Twenty-three of the letters went to domestic companies and two to foreign individuals. Continue reading