It seems that almost everyone these days is taking something intended to improve their health, protect them from disease, lose weight, treat an “imbalance”, increase energy, or make them smarter or stronger. Parents are even giving their children a variety of supplements from the nutrition shop or taking them to traditional healers (think Chinese or Ayurvedic medicine). In the USA, fear and distrust of pharmaceutical companies partly motivated this change in behavior. Yes, there is good reason to be cautious and thoughtful when it comes to taking “western” medicines, but the widespread use of vitamins, supplements, herbs, and traditional medicines has also turned it into a global industry worth tens of billions of dollars that is almost totally unregulated. So for this week’s post I would like to dispel some myths and make a few things clear for parents. I welcome constructive comments from readers.
1) Natural does not mean safe!
There are thousands of naturally occurring substances that are poisonous to humans. Toxicity depends on the dose and may occur after a single ingestion or accumulate over weeks or months. It also depends on the individual. In some cases such as with lead, children are more vulnerable to poisoning than adults. Even taking something as apparently harmless as green tea extract can lead to serious liver disease.
2) Health supplements and traditional medicines are drugs too
Many people view supplements and traditional medicines as something different than drugs that come from a pharmacy or hospital, but this is simply not accurate. Like western medicines, supplements and traditional medicines are chemicals that interact with the cells in our bodies; each has some sort of impact and consequence, most are unknown. In the US for example, about 55,000 different supplements are sold but only 0.3 percent have been sufficiently studied to know what side effects they may cause. Keep in mind that , just like western drugs, supplements and traditional medicines are all metabolized in our kidneys or liver, and some have potent synergistic (e.g. 2 + 2= 7) effects with other drugs or food we eat.
3) Traditional medicines and health supplements are unregulated
Most countries have government agencies responsible for setting standards of safety and efficacy of medical drugs. These agencies have laboratories to verify the purity, dosage levels and consistency of medicines sold. These institutions cost many millions of dollars to operate and do incredibly important work to protect us from accidental or intentional contamination or production errors that could harm many people. Countries that are too poor to maintain such systems usually adopt the standards of the US FDA or the European Union. Unfortunately, health supplements and traditional medicines are not subject to regulatory oversight. This means that we can never really be sure what is contained in them, if they are really safe, or how well they really work.
4) You really don’t know what you are getting
Because there is no regulatory oversight, the consumer simply has to trust the manufacturer of health supplements and traditional medicine practitioners that what they say is in the capsule or bag of herbs really is there, and in the right ratios, and free from contaminants. Every company will claim their product is the best, but with no independent agency able to verify, the incentives to cheat are very high. Recently, a team of researchers from a Canadian university used a sophisticated DNA test to determine the actual contents inside the bottles. The researchers tested 44 bottles of popular supplements randomly selected from 12 different stores and from different brands. They found that many popular herbs were often diluted — or replaced entirely — by cheap fillers like soybean, wheat and rice. Of 44 herbal supplements tested, one-third showed outright substitution, meaning there was no trace of the herb advertised on the bottle. Many were adulterated with ingredients not listed on the label, like rice, soybean and wheat, which are used as fillers. In some cases, these fillers were the only plant detected in the bottle. The bottom line is that because the supplement industry operates on the honor system, the market has been flooded with products that are adulterated, mislabeled or packaged in dosages that have not been studied for safety.
With traditional medicine practitioners, the situation is probably not much different. Most practitioners will buy their medicines from middlemen, who in turn buy them from various growers and processors. There are few if any quality control systems in place along this chain, which often spans several countries, particularly China and India. Once the herbs are in their hands, very few practitioners have the ability to routinely test the herbs and powders for the concentrations of active chemicals (if they even know what they are). Nor do they test for the presence of fillers (like sugar or starch), or contamination with toxic chemicals such as lead and arsenic. Also, without quality control systems in place there will be very little batch-to-batch consistency; meaning that one week the patient may get a lot more of the active drug(s) than they will the next week.
5) “This treatment is a thousand years old, so it must be safe and effective”
The idea that because something has been done for hundreds or thousands of years means it must be safe and effective is just faulty logic. In some cases this may in part be valid, but in most cases it probably is not. Errors and myths can be passed down for generations quite easily. Blood sucking leaches were applied for a wide variety of illness for centuries, but few people think that is such a good idea now. In contrast, western medicines and treatments are constantly changing and developing as the science behind them advances. This can be confusing to some patients when their doctor changes a medicine or stops a treatment in favor of a newer, safer, better alternative. But this is actually a very good thing as scientists question old ideas, test new hypothesis, and explore new interventions.
6) Health supplements and traditional medicines can be very costly
As with western medicine and medical doctors, there is always competition between supplement companies and between traditional medicine practitioners. As a result the prices seem to go up and up, along with the advertising claims. Insurance companies seldom pay for supplements or traditional medicines, meaning the patient is left to cover 100% of the cost. Curiously, there often is no end to the treatment. Patients are advised to take the supplement or treatment indefinitely to cure or restore an “imbalance” or other problem. Finally, when something does go seriously wrong, the patient usually has no recourse. Supplement companies go in and out of business everyday and traditional practitioners usually operate only on a cash basis and carry no liability insurance.