What's In Your Herbal Remedies and Supplements?
In the wake of FDA warnings about steroids in nutritional supplements, federal officials are studying ways to improve safety in dietary supplements. Mean time, we've got a few consumer tips for those of you who take supplements, courtesy of the Wall Street Journal:
1) Research, research, research. Before taking any unfamiliar substance (including herbal remedies, of course), check their safety and effectiveness. The law of averages says that whatever you're taking is probably safe—most supplements are—but it's wise to check nonetheless. Government sources are some of the most reliable for medical information. The Wall Street Journal recommends the National Library of Medicine's "Drugs and Supplements" section for evidence, side effects, and interactions. Also two National Institute of Health websites, the National Center of Complementary and Alternative Medicine and the Office of Dietary Supplements contains a wealth of data, without all the hippie mumbo-jumbo.
If your main concern is effectiveness, you may want to subscribe to Natural Medicines Comprehensive Database, which provides effectiveness ratings. With the high-cost of supplements, the $9.97 per month would likely pay for itself it saved you from buying even one product. This database not only includes info about specific ingredients, but brands as well.
2) Read the ingredients.
Potentially dangerous substances often won't be disclosed. But sometimes they are-if you know what to look for. One step is to look for drugs banned for top athletes, or variations on those names. The World Anti-Doping Agency list is at www.wada-ama.org under "Resources for Athletes." Certain suffixes in chemical names are common for steroids or tweaked versions of them. Among them are -one, -ene, -iol and -bol, though these can also appear in the names of legitimate ingredients. Some products also use versions of steroid names in their brands, like "tren" to connote trenbolone.
3) Lookout for symptoms. If you have any serious side effects, report them to the FDA.
(Photo: stevenb ohio)
What's Really in Supplements? [The Wall Street Journal]
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Comments:
Good LAWD, it has Maca. Anybody who knows me knows that I won't buy Horny Goat Weed if it doesn't have Maca.
What's in them? More than likely ingredients of unknown/untested potency/quality/source in dosages that hopefully are what is written on the box [consumerist.com] . Combine that with whatever is floating around the factory / living room of someone paid to make/assemble the pills [consumerist.com] Don't forget to sprinkle in a little unknown results: [consumerist.com]
@GitEmSteveDave_NowW/PantsOfMeat: Damn, finally found this link I was looking for as the site here is slow today: [consumerist.com]
without all the Hippie Mumbo-Jumbo ? I take Hippie Mumbo, but the Jumbo screws with my short term memory
Thanks for letting me know how to identify steroids so now I know what to look for when I want to get all sinewy and angry.
I think the "this statement has not been validated by the FDA" and all the similar statements need to be LARGER THEN THE TITLE OF WHATEVER IS IN THE BOTTLE. All this crap stuff on the shelves that doesn't really do anything because it isn't FDA regulated can be really dangerous.
Is it endorsed by Barry Bonds? It's got to be OK.
@GitEmSteveDave_NowW/PantsOfMeat: A much shorter article could have just read: "Nothing at all of any medicinal value."
Germany regulates herbal supplements a lot more strictly than the US. I look for German reimports on the rare occasions I'm motivated to go herbal.
The only verifiable action any altmed/supplement/herbal remedy/whatever actually performs is removing dollars from the wallets of idiots.
Any other claimed action is untested, unverified, and unlikely at all to exist.
@YouDidWhatNow?: There are exceptions. Acidophilus, for example, really can help prevent yeast infections.
On all the stuff I buy (gluatmine, whey, creatine) it says "HLPC Tested". Is this an actual independent test that means it's legit, or is this just a marketing gimmick?
@lpranal:
Glutamine is an amino acid- one of the 20 amino acids which are building blocks of proteins. Nothing sinister here. I don't know what else they put in glutamine supplements, or why you'd want/need one, but the glutamine itself should not be problematic.
Supplements are regularly being 'spiked' with active pharmaceutical ingredients (i.e. drugs). The worse offenders are 'male enhancement' products (spiked with real viagra or similar drugs) and 'weight loss' products containing sibutramine or diuretics.
Maybe, maybe not. If you can refer me to a properly-controlled clinical study that results in a peer-reviewed publication citing positive results, then I'll believe you.
If you can't, it's altmed, and not worth the time to consider.
@lpranal:
...the entire industry is a marketing gimmick. And no, it doesn't mean that it's any kind of independant test. Google.
@YouDidWhatNow?: How can women bathing in yogurt not have positive results? Maybe you're right...I'll need some test subjects.
@novacthall: But that's not true. There's actual medicine in these things, which is why they ARE dangerous. If it was homeopathic, and thus, water and/or binder, that would be different. But these things contain herbs and chemicals which CAN affect you. Read the last link. A "supplement" that actually made cancer tumors grow FASTER!
@YouDidWhatNow?: To be fair, it's not at all implausible that various herbs could have a pharmacological effect; after all, plants are chemical factories and produce a wide variety of compounds. Still, taking supplements is a pretty unreliable way to treat yourself, even where there are real effects. A major point that people miss about modern pharmaceuticals is that they are carefully designed to deliver a controlled dose in a reliable and reproducible way. Doing the same thing via natural plants is extremely difficult.
@johnva:
Exactly. Enormous amounts of proven modern medicines come (directly or indirectly) from plants of various types. But just going out and starting to eat "Manja Mangrove Leaf Essense Extract Germ" because the bottle says it improves "your essential spirit and magnetic resonance with Gaia" is just dumb.
I don't think I can recommend all of the resources you list here. The NLM website you list is very informative, but provides few citations.
The NCCAM website is not so good, however. Although they are good about providing citations, they always spin things in a very positive light; when small trials show effectiveness but larger, better trials do not, they interpret that as "more study is needed," and you'll see this phrase bolstered throughout their website. The NCCAM has a long history of supporting "alternative medicine," regardless of evidence, to the point of recommending that alternative medicine not be required to meet standard scientific criteria [www.sciencebasedmedicine.org] .
The "Office of Dietary Supplements" seems to have few, easy to navigate reviews, and functions as a blog more than anything else. And if the sample entry is of any indication, the Natural Medicines Database lacks vital citations as well.
But really what these are all missing is testing of specific brands and products, which is the real danger here. Most supplements do little to nothing on their own (good or bad), but as you've pointed out in this article, the greatest risk is intentional or unintentional foreign contamination. Since no one is regulating these supplements and few thorough reviews are available, I can think of no safe way for people to participate in supplementation.
Yes, the resources you mention can be useful in providing the state of some of the evidence (hint: if there actually is good evidence for a treatment, it's no longer called "alternative and complimentary"), they cannot quantify the true safety concerns associated with alternative treatments. You are running high risks taking these, with generally no scientifically supported benefits.
Folks, you can thank the 103rd Congress, then-president Bill Clinton, and the various lobbyists that got them to pass and sign the DSHEA of 1994. It effectively removed herbal remedies from FDA review. Pretty much anyone can make and sell any herbal concoction, and — so long as you don't claim it's a treatment or cure for any specific illness — you're free to sell it.
It doesn't have to do anything for anyone. It doesn't even have to contain what the label says it contains. It doesn't even have to have any active ingredients at all. (As it turns out, not only do some of these remedies have no active ingredient at all — their makers fully admit this and are proud of it!) It doesn't even have to be safe. They can make and sell whatever they want ... and you, the buyer, have NO WAY to know what is actually in those bottles. It's conceivable that someone could make tablets out of sawdust and sand ... and do so without a problem in the world.
Because NO ONE in government can do anything about it. Not one blessed thing. DSHEA removed herbal remedies from FDA review.
Complain all you want about "big pharma" pushing the FDA around and peddling junk to people that don't need it ... and I've made that complaint myself! ... but at least at some point, there's the chance of government intervention (as Pfizer recently found out). The FDA is still there, is still watching, and can act whenever it finds the courage to do so.
But there is nothing comparable to the FDA for herbal remedies. What's worse, there are government agencies engaged in active lobbying on behalf of these companies (i.e. NCCAM) ... but no one to actually police them and ensure that what they sell is safe or effective. (NCCAM also promotes a lot of other types of questionable medicine.)
@GitEmSteveDave_NowW/PantsOfMeat: true enough: anything you put in your body can interact with something or cause a reaction or effect. and there's all kinds of potential complications. people tend think that most over the counter products are safe to take. but as a person with autoimmune diseases, i can't ever take an immune booster, like echinacea, because it could actually help my immune system attack my own cells.
yet i talk to other people with autoimmune diseases all the time who load up on immune boosting supplements because they assume if it says it's good for your immune system that it's good for ANYTHING that's wrong with your immune system.
@johnva: agreed. some apples are sweeter than others depending on the weather during their growing conditions. two capsules of powdered leaf of whatever might have different strengths based on how rainy it was during their respective growing seasons
The BF took Horny Goat Weed for a few months, and it worked wonders. Unfortunately, after about a month, he started losing his hair.
Still think it was a placebo affect - the hair loss was real tho.
Why would I EVER report ANYTHING to the FDA?
These are the same people who pulled the natural hormones that were keeping my mother alive because there was a chemical variation it was competing with.
Yes, I did say WAS keeping my mother alive.
The FDA can burn in a fire.
@HomersBrain: In addition, you get the information in the most user-unfriendly way possible it seems.
Search for a supplement on the site, even filter for conditions relevant to what you want information for, Hit search, and a few seconds later, anywhere from a few dozen to a few thousand results appear.
Most of them will have identical titles, with control numbers and other jargon beneath. You must then add them to a cart like you would an online store, Then choose the file format and click a couple more types before you can actually read the article.
Once there, you'll probably land on a one paragraph absctract about a study, and then you've got to back up and start all over again, hoping to glean usuable info next time. But all your search parameters have been reset, and you must re-enter them all again. ::headdesk::
One would think we could come up with a happy medium between terse, dry, bureaucratic information retrieval systems and late-night informercial pitch-persons screaming at us about how wonderful their product is?
As a chemist, the part of the Wall Street Journal article where it talks about dangerous suffixes...absolutely worthless.
Those classes of compounds are some of the most common on earth. I'm not saying some of them aren't dangerous, I'm saying that without an MSDS (Material Safety Data Sheet, basically a quick rundown of all the hazards a chemical could pose) and a working knowledge of chemistry and molecular biology, knowing the name of a compound is absolutely pointless.
@lpranal: Marketing gimmick. Its actually "HPLC" tested, which is a standard method used to assess the purity of a compound. (HPLC stands for high pressure liquid chromatography, if you're curious). So, really, all it means is that you're getting pure stuff. Whether that stuff will kill you is an entirely separate issue.
@PsiCop: Right on. I was going to say that the thing that would make this crap safe is to have the FDA govern it, and to give the FDA triple the manpower and money it has now to make it happen.
Here's a tip: don't take herbal supplements. Go see a doctor instead.
Herbal medicine is pretty much the same thing as astrology. People finding correlation where there is none and then convincing you of it too. If you enjoy the placebo effect, then by all means continue. If you want to actually be cured of something or treat a disease, get real medicine based on science.
@PsiCop: Well-put & very accurate. I wish more people knew this.
There was a recent (Jan 2009) GAO report on what's going on with dietary supplements, and what specific actions FDA should take (within the limits of current statutes). The summary is relatively short & outlines the problems pretty well. PDF here:
[www.gao.gov]
@sam1am: That's awfully smug. There are a lot of natural substances that have documented beneficial clinical effects. Cranberry juice has been proven to prevent UTIs in women ([www.sciencedirect.com])
Sometimes - like aspirin and quinine - they only need to be refined minimally to be useful for people.
In these cases, it was science proving that 'folk medicine' or herbal medicine knew all along what it was doing.
The issue here are supplements, which often have nothing to do with natural materials, have no quality control, and are heavily marketed to people who generally don't have basic science educations. But to dismiss herbal medicine outright is pretty ignorant.
Wait-goats make WEED o_0