We all like to have some control over our own health, which is one of the strong appeals of complementary medicines. You can readily find complementary medicines carefully categorised by disease or symptom in one of the larger sections of your local pharmacy or health food shop.
There are vitamins and other products claiming to help you lose weight, be in a better mood, experience less digestive problems, feel stronger, more s-xual, help prevent or treat the symptoms of colds and flu, even have more energy. Many Australians say “yes please” to these products, with over a billion dollars being spent on complementary medicines each year.
Health professionals have generally adopted the view that although there are many unanswered questions about whether complementary medicines offer any real health benefits, these products are fairly harmless. Some consumers believe they feel better by using complementary medicines and perhaps they do, even if some of the effects may be a result of their belief in the products.
There is good clinical evidence supporting the prescription of a limited number of complementary medicines for very specific symptoms, but these are unusual cases that often involve some form of severe deficiency and they make up a very small minority of the vast numbers of consumers of these products.
The “largely harmless” view of complementary medicines is now being challenged by emerging international research.
A US study published in the Archives of Internal Medicine looked at the use of vitamin and mineral supplements in relation to total mortality in 38,772 older American women (with an average age of 62) and found that the use of multivitamins, Vitamin B6, folic acid, iron, magnesium, zinc and copper were associated with an increased risk of total mortality when compared with corresponding non-use.
The study controlled for key health factors and concluded that the regular use of complementary medicines is a direct contributor to poorer health outcomes. This follows on from another study showing that healthy men who take Vitamin E have an increased risk of prostate cancer.
In Australia it is the Therapeutic Goods Administration (TGA) that is responsible for regulating complementary medicines. More than 10,000 complementary medicine products are listed on the TGA Aust-L list.
For most Australians, this is a source of some comfort. However, the reality is that the TGA does not test complementary medicines to see if they do what they claim to do. Nor do they test every product to see if it is safe.
The listing is largely a self-report process and the only real check is the occasional audit of the information provided by manufacturers on the forms. Less than 5% of products are audited and the last time such an audit was conducted on a limited number of complementary medicines, more than 90% failed to comply with the regulations.
Complementary medicine manufacturers go to some lengths to create the illusion that their products have been tested by authorities for efficacy, that is, whether or not they work as they claim to. Complementary medicine manufacturers also draw on well targeted marketing, product placement, celebrity and sports hero endorsements to give the impression their products really work.
Australia is not as litigious as the US where the need to protect governments from legal action has informed labelling decisions. This does not mean Australian authorities should ignore their responsibilities.
We need to adopt a sensible approach to the labelling of complementary medicines based on the principle of consumers having the right to know whether or not a product has been properly tested.
Australia should follow the lead of the US and clearly label all complementary medicines: “This product has not been tested by Australian authorities.”
Labels may not significantly change consumer behaviour in purchasing and using complementary medicines. At the same time, it is not acceptable that complementary medicines are able to imply through their packaging and marketing that they have been tested or endorsed by the TGA or other authorities.
The complementary medicines industry will resist the labelling of their products, but given emerging concerns about the possibility that some of these products may cause harm, it is almost inevitable that governments will be forced to protect their own interests as a regulator of medicines.
The reality is that many of these products have very little clinical evidence to support the claims they make, they have not been tested by the TGA or any other government authority, and they adopt misleading marketing strategies to imply their clinical effectiveness has been established.
At the point where there is evidence that some of these products may be contributing to a reduction in life span or harming people’s health, it is time consumers were given the information they need to make an informed choice.
Anything less than full disclosure about the lack of testing compromises the capacity of health consumers to appropriately purchase and use complementary medicines.
The government can no longer put the complementary medicines industry into the harmless category and ignore its responsibility to properly inform Australia’s health consumers.
Have been using herbal products for years and find them very effective. However, I agree greater attention to quality control measures and education of consumers in Australia would be all to the good. I would also like to see the TGA give greater attention to imported products e.g. imported raw herbs from China, given the amount of pollution now evident in China. The notion of being careful with the use of vitamins and minerals certainly makes sense, but I would also like to see a much wider critique of the use of pharmceutical drugs. I understand the Pharmaceutical Benefits Scheme now costs taxpayers more than $9 billion per annum, and I question how much of this results in clear benefits. Side-effects from pharmaceutical drugs are common and sometimes serious, and it is mostly just treating symptoms and not getting to basic causes. Pharmaceutical drugs also tend to be sledge hammer in approach, whereas many herbs can work more kindly on the body. A useful reference work for herbs, vitamins, minerals including contra-indications and interactions with pharmaceutical drugs is “Herbs and Natural Supplements: An Evidence-based Guide” by Lesley Braun and Marc Cohen. Marc Cohen is Professor of Complementary Medicine at RMIT University in Melbourne.
The thrust of this article is quite a red herring. My understanding is that neither the Australian nor the US government actually test pharmaceuticals, either. Rather, as I understand it, the USFDA audits the manufacturers’ “clinical evidence”, and the Australian TGA generally awaits the FDA’s stamp of approval. In both cases we’re faced with a classical case of government regulatory bodies that have been rendered largely impotent through under funding by neo-liberal governments’ assaults on adequate taxation and overriding faith in the market. I’m not objecting to the idea that complementary medicines should have labeling that informs that it is untested by the government — I’m objecting to the implication that pharmaceuticals are in a different category and should remain exempt from such testing.
A couple of additional thoughts following on from my original post above. Re the book I mentioned, Marc Cohen is trained in both sides of the fence so to speak. He is a registered medical practitioner, and has two PhDs – one in Traditional Chinese Medicine and one in Biomedical Engineering. On the critique of pharmaceutical drugs, follow as one example the recent critique of the widespread use of statins. Beatrice Golomb MD, PhD is an Assoc Professor of Medicine at the Uni of California and one who has done a good deal of work on this. She demonstrates clearly how the research on statins including via publication in relevant journals and via funding is heavily manipulated by the drug companies. Her material is readily available on the web. Another example is how the drug companies are changing the recommended thresholds for the recommended use of their drugs – so that someone regarded as previously healthy is redefined as someone who now requires a drug. No doubt good for the bottom line.
Yep Muzza and FFS those antiretroviral drugs that have changed HIV from a death sentence to chronic manageable disease in a decade (for those fortunate enough to have access to them) are really no better than over-priced ‘herbs’ – we certainly have no evidence to suggest otherwise…etc. etc. Spare me.
Here’s some evidence for you. For millenia we relied solely on herbal and folk medicine as therapeutic response and mortality rates were through the roof. Surprisingly, all this changed when modern medicine and effective pharmaceutical therapy came along. But go for it. Keep chug a lugging: if nothing else, the billions we waste on ‘natural remedies” annually does provide a lovely bronze tint to the national urine.
From Muzza-Pharmaceutical drugs also tend to be sledge hammer in approach, whereas many herbs can work more kindly on the body.
Or you could say that pharmaceutical drugs have active ingredients and herbs don’t.