When herbal remedies have the opposite effect
The Globe and Mail
Monday, January 5, 2004 - Page A12
Herbal remedies fly off the shelf at this time of year, as people seek any available weapons to combat the distressing symptoms of colds, flu, tiredness and overindulgence during the festive season.
More than half of all Canadians consume such products in one form or another. Some of the offerings actually provide relief. Others may not be worth much. Still others may be downright harmful, particularly in higher doses or in the presence of underlying health problems. It has been hard for consumers to know, because of the lack of standards and regulations.
This point has been brought home through numerous health calamities linked to dietary supplements containing ephedra, which acts as a stimulant. Citing 155 U.S. deaths and more than 16,000 "adverse events," including heart attacks and strokes, the U.S. Food and Drug Administration recently banned all such products. Tommy Thompson, the U.S. Secretary of Health and Human Services, bluntly called them "simply too risky to be used."
Yet before the ban, such products, typically peddled as aids in weight loss and muscle-building and extremely popular among young athletes, did not even have to carry labels warning of the risks. That's because, unlike the makers of pharmaceuticals and medical devices, producers of food supplements and herbal remedies have not been required to prove their products are safe.
In Canada, federal authorities issued a warning in January, 2002, not to use certain products containing ephedra, particularly if they also contain caffeine and other stimulants and carry stated or implied claims related to weight loss, body-building or increased energy. Ottawa also recalled those that contained more than the maximum allowable dosage, which makes their further sale illegal. A synthesized version continues to be used legally in both Canada and the United States in cold, allergy and asthma remedies.
Soon after its voluntary recall order, Health Canada discovered that some retail workers were showing consumers how to obtain the same effects from the legal products that they had gained from the prohibited ones. Yet there has been no need for consumers to go that far, because the illegal stuff remains routinely available over the Internet, under the counter, in gyms and through various other means.
Last June, Health Canada's natural health products directorate issued an important set of regulations to govern the manufacturing, packaging, distribution and sale of herbal supplements, vitamins and homeopathic remedies. The regulations went into effect last Thursday, but the rules will be phased in over the next two to six years. The measures include licensing to produce specific herbal products, clinical trials and much more informative and standardized labelling.
This is a good start toward better supervision of a burgeoning part of the health business. But as officials learned from the ephedra experience, it isn't enough to warn people of the risks or to remove products from the shelves. They need to shut down the black-market sources that crop up like mushrooms whenever one of these miracle cures is banned.
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