The herbalist's new clothes?
November 3, 2013 5:17 PM   Subscribe

A new study has identified product substitution and contamination in the herbal supplement industry on a massive scale. As the New York Times reports, one-third of the US herbal supplements tested by researchers had no trace of the advertised herb in the product, and many products were entirely composed of fillers such as rice, or contained dangerous contaminants and allergens. Only two of the 12 companies tested exclusively sold products that did what they said on the tin. Pro-supplement organisation the American Botanical Council has questioned the findings, due in part to what it says are flaws in the DNA technology used to identify herbal ingredients.
posted by dontjumplarry (74 comments total) 34 users marked this as a favorite

 
Waiting for the homoeopaths to say those supplements that are just filler actually do more for you than herbs alone.
posted by thecjm at 5:23 PM on November 3, 2013 [15 favorites]


...or contained dangerous contaminants and allergens.

So powerful they're removing toxins from your body even before you take them.
posted by Wolfdog at 5:23 PM on November 3, 2013 [6 favorites]


Wolfdog: "...or contained dangerous contaminants and allergens.

So powerful they're removing toxins from your body even before you take them.
"

Heck. While you are looking at the bottle in the store...
posted by Samizdata at 5:25 PM on November 3, 2013


Well, hold on a second, now. ""Contained the substances and only the substances they purported to contain" is a very, very different thing from "did what they said on the tin".
posted by kafziel at 5:27 PM on November 3, 2013


"Contained the substances and only the substances they purported to contain" is a very, very different thing from "did what they said on the tin".

Good point. More like "are what they said on the tin".
posted by dontjumplarry at 5:31 PM on November 3, 2013 [1 favorite]


The tin, as it turns out, was actually mostly antimony.
posted by Wolfdog at 5:34 PM on November 3, 2013 [23 favorites]


Snake oil...
posted by jim in austin at 5:37 PM on November 3, 2013


I don't take herbal supplements, but I do take some vitamins, and I wonder whether the same level of fraud is also going on in that sector too. In Australia, at least, they're often the same companies making both herbal and vitamin supplements.

This reminds me of the story which broke a year or two ago on reddit/r/fitness where a redditor tested the major protein powders on the market and found (according to a fairly rudimentary home testing kit) some had only a small proportion of the advertised protein in them.
posted by dontjumplarry at 5:39 PM on November 3, 2013


More snake oil...
posted by mcstayinskool at 5:40 PM on November 3, 2013


My first reaction was wanting to know which two companies were found to have all their products pass the screens done in the paper. Wouldn't that be useful to know? I wasn't able to find identification of the companies involved in the paper or the New York Times article. Did anyone else find company names?
posted by medusa at 5:43 PM on November 3, 2013 [5 favorites]


I am so glad to see this article in print. I have various reasons to know how venal, corrupt, unregulated, and dangerous the nutritional supplement industry is a little more than the average bear, and I have for years been ranting about this subject (including on AskMe).

There is no such thing as "alternative" or "complementary" or "integrative" or "natural" medicine. There is evidence based medicine, and there is quackery and bullshit.

These fuckers need to be regulated out of business. You do not need their products. At best they are a waste of money. At worst they could seriously harm you, and you have no way of knowing what risks you take because the sector is politically protected from the regulation that is imposed on every actual pharmaceutical product available over the counter or by prescription. Not that those products can't be dangerous too, because of course they can. But they are also proven to do what they say and contain what they say, and regulated to make sure it stays that way. Watching even educated people fall for the "natural" supplement woo over the last 20 years has been appalling.

The majority of "nutritional supplement" products don't work as they imply they do, or do what they suggest they might do. You cannot "boost your immune system" with any supplement. You cannot treat "natural" as a synonym for "safe." You don't need supplemental vitamins or minerals. Herbal medicine can work, but if it works, it can be proven to work and becomes part of the legitimate pharmaocopeia. There is no conspiracy to suppress these products, only what sure looks like a political conspiracy to protect their manufacturers from having to prove their implied claims or prove their products are safe.

People who take these products are falling for lies and quackery. There is increasingly no excuse for educated people to fall for this nonsense. The evidence is mounting by the month. I really hope someday that there will be no more aisles of "vitamins and supplements" in any drugstore.
posted by spitbull at 5:43 PM on November 3, 2013 [49 favorites]


At first, I was a bit disappointed that they didn't name names. But maybe casting a pall over the whole industry is for the best in the long run.
posted by Tsuga at 5:43 PM on November 3, 2013 [1 favorite]


This article is not an indictment of herbal medicine. It is an indictment of poor (and likely unscrupulous) manufacturing processes. From the text of the study under discussion:

Currently there are no standards for authentication of herbal products. Although there is considerable evidence of the health benefits of herbal medicine [53,58-66], the industry suffers from unethical activities by some of the manufacturers, which includes false advertising, product substitution, contamination and use of fillers.

posted by Wordwoman at 5:51 PM on November 3, 2013 [9 favorites]


Product substitution occurred in 30/44 of the products tested and only 2/12 companies had products without any substitution, contamination or fillers.

yikes, that metafilter blue plate special of beans is looking better all the time
posted by jetlagaddict at 5:52 PM on November 3, 2013 [1 favorite]


The same people producing the adulterated products are also the ones making the majority of claims about the efficacy of even the unadulterated versions of these products.

This is an indictment of the industry, but the industry has propagandized the shit out of claims that at best have one or two small studies to support them, and usually not even that.

If they are willing to put wheat in place of St. John's Wort, what does that tell you about the efficacy of St. John's Wort? It suggests the actual product has no actual measurable effects (or as the studies suggest a trivial, marginal effect at best, far excelled by a wide range of pharmaceutical products that are proven to be relatively safe and regulated to very precise tolerances in manufacturing). Because if the product "worked" in its unadulterated form, then consumers would start to notice it *not* working in adulterated forms.

That consumers don't seem to notice any difference is in a way the most powerful indictment possible of this industry. This study, in speaking to the honesty of supplement manufacturers, actually condemns the entire supplement industry and most of its medical claims.
posted by spitbull at 5:57 PM on November 3, 2013 [21 favorites]


And goddamn, look at the comments already on that Times article. Many of them are very, very clearly written by shills for the industry who are frantically trying to poke holes in this very definitive study. Two words that strike fear into the heart of any supplement advocate: scientific testing.
posted by spitbull at 6:03 PM on November 3, 2013 [3 favorites]


Shouldn't we just let the market sort this out?

/hamburger

Guaranteed to contain no actual hamburger!
posted by rtha at 6:07 PM on November 3, 2013 [3 favorites]


spitbull: You don't need supplemental vitamins or minerals.

I agree with most of your rant, but I do actually need supplemental B12. I don't get it from any dietary sources, and if I don't take it, I will get pernicious anemia and die. I'm also way, way off the RDA for calcium if I don't take supps.
posted by dontjumplarry at 6:08 PM on November 3, 2013 [14 favorites]


The same people producing the adulterated products are also the ones making the majority of claims about the efficacy of even the unadulterated versions of these products.

That needs a cite; the article seems to suggest that supplement makers are downplaying the adulteration, not trying the "well, even these adulterated versions are good for you" defense.
posted by Going To Maine at 6:08 PM on November 3, 2013


And the fact that I do need particular vitamins is why I'm so angry that this industry is run by fraudsters and charlatans, and not regulated like conventional medicine.
posted by dontjumplarry at 6:10 PM on November 3, 2013 [15 favorites]


Shhhhh, no one mention honey/olive oil/etc!
posted by blue_beetle at 6:12 PM on November 3, 2013 [2 favorites]


I work for a big international herbal supplement manufacturer, and my job is to substantiate the safety and efficacy of the ingredients in our products by searching the scientific literature and writing up what I find. The difficulty is that if we have the amount of herb that has been traditionally used and is believed efficacious, it's hard to prove safety. If we have less than that, we can show that it's safe, but the efficacy is now doubtful. In our products, mostly we have, shall we say, the safest amount. Moreover, identity testing of herbal ingredients is kind of a new idea in the industry. My company identity-tests all its herbal ingredients, but few other companies do. Hell, the fact that they have a few people like me doing this work tells you that my company at least takes safety and efficacy seriously. That said, sometimes my job is easy -- proving efficacy of green tea, for example, or phytosterols or DHA. Sometimes my job is really hard, and I just write up what I can -- dong quai, for example, or aloe.
posted by pH Indicating Socks at 6:12 PM on November 3, 2013 [11 favorites]


Wow spitbull, I couldn't disagree more. Signs of prevalent adulteration or mis-labeling should be cause for some regulation. But I have come to completely different conclusions regarding the efficacy of intelligently selected and high quality herbal treatments. How hard is it to understand that there are gradations between the benefits of healthy foods and the specific aims of medicines? I'm all for science and evidence but the context of pharmaceutical practice is that drugs are promoted through advertising, through propaganda aimed at doctors, through manufacturer sponsored studies that sometimes show only a slim statistical benefit over placebo, through mechanisms that are later found to be misunderstandings.
posted by Schmucko at 6:12 PM on November 3, 2013 [2 favorites]


"That consumers don't seem to notice any difference is in a way the most powerful indictment possible of this industry. This study, in speaking to the honesty of supplement manufacturers, actually condemns the entire supplement industry and most of its medical claims."

I'm overall on your side here, however I am in favor of more quality research into herbal medicine and nutrition and it's potential for positive impact on health in prevention and potentially to alleviate some conditions.

I feel like tossing out the entire concept of healthy living, quality foods, and potential health benefits of herbs or some supplements because of a corrupt industry is getting a bit over-reactive.

Anyone who is opposed to evidence based assessment of herbal medicine or therapeutic techniques to promote physical or emotional wellness is promoting a harmful ideology and possibly selling dangerous or ineffective products. I saw a HOMEOPATHIC asthma inhaler the other day and I was like WHAT THE F are they allowed to sell this? Asthma can be serious shit, what the hell? That said if there were any benefits to doing breathing exercises, exercise, specific diets, reduced allergens for managing asthma I would like to see research done on those things and I do think it's harder to get good research done on these strategies or any herbal supplements that might help with some conditions we currently don't actually know how to cure or help people with.

We have a lot of sick people western medicine is failing and I'm sympathetic that they should be allowed to try new things-- make trials with some of these herbs/supplements/alternative therapies and let people try them but let them be monitored and the results measured (and dangerous products removed from the market entirely).
posted by xarnop at 6:13 PM on November 3, 2013 [3 favorites]


dontjumplarry, this is a good post.
posted by JHarris at 6:17 PM on November 3, 2013 [3 favorites]


There is no such thing as "alternative" or "complementary" or "integrative" or "natural" medicine. There is evidence based medicine, and there is quackery and bullshit.

"What do you call alternative medicine that works? Medicine."

I'm all for science and evidence but the context of pharmaceutical practice is that drugs are promoted through advertising, through propaganda aimed at doctors, through manufacturer sponsored studies that sometimes show only a slim statistical benefit over placebo, through mechanisms that are later found to be misunderstandings.

And how is this different for the herbal industry? Hell, the industry itself publishes its own fake, industry-specific, non-peer-reviewed "scientific" journals.

Look, we know "natural" ingredients have physiological effects on the body. Willow bark works. We know the mechanism, we isolate the active active substance, huzzah, we have aspirin that works even better and doesn't include a range of other inactive / unhelpful / dangerous chemicals in it as well.

If herbal supplements work, then the promoters should at least, at least be able to name the actual chemical compound that has the active medicinal properties.
posted by Jimbob at 6:20 PM on November 3, 2013 [7 favorites]


There is no such thing as "alternative" or "complementary" or "integrative" or "natural" medicine.

Strong words.

There is evidence based medicine, and there is quackery and bullshit.

But if "alternative" or "complementary" or "integrative" or "natural" medicine have positive outcomes for some in "proper studies" - would that be evidence-based like Ranbaxy?

These fuckers need to be regulated out of business.

Why not allow a class action lawsuit and just use the legal system to beat 'em to death?

You do not need their products. At best they are a waste of money.

You seem rather sure. Ok, why should you be the voice of reason?

Watching even educated people fall for the "natural" supplement woo over the last 20 years has been appalling.

Given the flawless record of pharmaceutical companies - no wonder one might feel appaled.

You cannot "boost your immune system" with any supplement.

What do you define as "boost"?

Because in my little world "boost" is "help or encourage" and Garlic and "vitamin" D3 sure do seem to have studies as having an effect. In fact - Doctors now test for D3 levels.

(and because I'm willing to back up my claims with a link VS hadwaving - here's a list of 30 spices one might want to consider adding to your diet.

You don't need supplemental vitamins or minerals.

And yet the hormone D3, commonly called a vitamin has an effect.

Same with "Russian penicillin" - Garlic.

Herbal medicine can work,

Wait a sec - which is it? They don't work at all, or can work perhaps maybe?
posted by rough ashlar at 6:23 PM on November 3, 2013 [3 favorites]


Jimbob, yeah of course there are problems with the alternative medicine industry as well. Markets corrupt. And no, it does not make sense to say that anything that works would have automatically entered medical practice, as pharmaceutical companies are not interested in substances that can't be patented. In many cases, the chemical compounds with active medicinal properties are being promoted by supplement makers (that you ask the question makes me wonder if you've even looked into the matter if only in a cursory way). For example, turmeric may have some benefits, and the active ingredient is thought to be circumin. Then it's also possible that a mixture of different compounds found together in a plant can be of greater value than a single isolated ingredient (this is, after all, what we find for food).
posted by Schmucko at 6:25 PM on November 3, 2013 [1 favorite]


Health Canada says Vega One Vanilla Chai and Vega Sport Performance Chocolate Contaminated with Chloramphenicol: Potentially Poses Serious Risks to Health
posted by dobbs at 6:26 PM on November 3, 2013


My understanding is the supplement industry is largely unregulated. While pharmaceutical companies must prove their drugs are safe and work, the supplement industry is under no such restrictions and can claim pretty much anything they want without proving any of it is true or that their supplement actually contains what they say it does (see: every workout supplement label ever).
posted by schroedinger at 6:27 PM on November 3, 2013 [2 favorites]


Why not allow a class action lawsuit and just use the legal system to beat 'em to death?

That does not seem to be how class action suits work for most things that I've (automatically) been a party to. Usually, if the class "wins", everyone gets a check or credit for some teeny amount of money, and the company keeps on keepin' on.

Can you explain why they shouldn't be regulated like food or drugs are regulated?
posted by rtha at 6:30 PM on November 3, 2013 [3 favorites]


While pharmaceutical companies must prove their drugs are safe and work, the supplement industry is under no such restrictions and can claim pretty much anything they want without proving any of it is true

Not so, the supplement industry is required to substantiate any claims made on the product -- and there are pretty strict rules about the kind of claims we can make -- and to substaniate safety as well. The FDA gets mad if we don't.
posted by pH Indicating Socks at 6:33 PM on November 3, 2013


That's why the claims on the labels are so vague and non-specific as to be meaningless.

There are absolutely different legal standards for products sold as "nutritional supplements," thank you Orrin Hatch.

Nice to see the industry is represented here too, however.
posted by spitbull at 6:36 PM on November 3, 2013 [9 favorites]


While pharmaceutical companies must prove their drugs are safe and work,

Must? That implies a duty and if that was the case, why would pharmaceutical firms need immunity from claims as they have been given in the US of A?
posted by rough ashlar at 6:37 PM on November 3, 2013 [1 favorite]


Here's information on the only kind of claims we can make, "structure/function" claims, and here's information on how claims must be substantiated.
posted by pH Indicating Socks at 6:38 PM on November 3, 2013 [6 favorites]


Can you explain why they shouldn't be regulated like food or drugs are regulated?

If what they say on the tin isn't what's inside the tin - how is that not already subject to the law as it exists today? What purpose would additional regulation change the issue of what is labeled as being the content matches the content?
posted by rough ashlar at 6:40 PM on November 3, 2013 [1 favorite]


jetlagaddict: "Product substitution occurred in 30/44 of the products tested and only 2/12 companies had products without any substitution, contamination or fillers.

yikes, that metafilter blue plate special of beans is looking better all the time
"

Speaking of accuracy in labelling, are those GMO beans?
posted by Samizdata at 6:41 PM on November 3, 2013 [1 favorite]


I went to the local organic grocery yesterday, to buy some thyme. And went to the aisle marked "herbs". Only to find shelf after shelf of fake medicines, patent nonsense. And now you're telling me the fake medicine don't even contain the untested product it's advertising just this side of legally skirting the FDA's requirements not to sell things with unverified health claims?

At least I found the thyme. It's gluten free, it says.
posted by Nelson at 6:43 PM on November 3, 2013 [8 favorites]


But I have come to completely different conclusions regarding the efficacy of intelligently selected and high quality herbal treatments. How hard is it to understand that there are gradations between the benefits of healthy foods and the specific aims of medicines? I'm all for science and evidence but...

Given the flawless record of pharmaceutical companies - no wonder one might feel appaled.

Pay no attention to the man behind the curtain.

Must? That implies a duty and if that was the case, why would pharmaceutical firms need immunity from claims as they have been given in the US of A?

This is a strictly false statement of the law, and demonstrates only regurgitation of recent uninformed talking points about who should bear liability in the tightly regulated generic drug market. There is an interesting and subtle legal point at play in that case and it has nothing to do wih ooga booga big pharma.
posted by Inspector.Gadget at 6:46 PM on November 3, 2013 [4 favorites]


The difficulty is that if we have the amount of herb that has been traditionally used and is believed efficacious, it's hard to prove safety.

I could go look up the claim that Aspirin would not be able to be approved today due to safety concerns but instead I'll just make the bald-faced claim and let others go look it up as its a good story.

Look, we know "natural" ingredients have physiological effects on the body. Willow bark works.

And yet there is one poster who's staked out its all fraud.
posted by rough ashlar at 6:47 PM on November 3, 2013


Immunity from claims? What are you talking about rough ashlar? The law is complicated and drug companies have lots of possible defenses, but I haven't heard of some general immunity for drug companies. I think you misunderstood something you read.

There is lots of drug company litigation. Think of all the Phen Fen cases.
posted by Area Man at 6:48 PM on November 3, 2013 [1 favorite]


why would pharmaceutical firms need immunity from claims as they have been given in the US of A?
This is a strictly false statement of the law,


Hrmmmm. Guess NBC is a liar then.
posted by rough ashlar at 6:50 PM on November 3, 2013


I work for a big international herbal supplement manufacturer, and my job is to substantiate the safety and efficacy of the ingredients in our products by searching the scientific literature and writing up what I find. The difficulty is that if we have the amount of herb that has been traditionally used and is believed efficacious, it's hard to prove safety. If we have less than that, we can show that it's safe, but the efficacy is now doubtful. In our products, mostly we have, shall we say, the safest amount. Moreover, identity testing of herbal ingredients is kind of a new idea in the industry. My company identity-tests all its herbal ingredients, but few other companies do. Hell, the fact that they have a few people like me doing this work tells you that my company at least takes safety and efficacy seriously. That said, sometimes my job is easy -- proving efficacy of green tea, for example, or phytosterols or DHA. Sometimes my job is really hard, and I just write up what I can -- dong quai, for example, or aloe.

pH regulating socks, does the company you work for sell dong quai, aloe, etc., or once they get your reports, do they not decide to make those products? Because if they do, I would disagree that they take efficacy seriously.
posted by Tsuga at 6:52 PM on November 3, 2013


That NBC story is just about vaccines. There is a special court for those claims. That's not some general immunity.
posted by Area Man at 6:54 PM on November 3, 2013 [3 favorites]


I haven't heard of some general immunity for drug companies.

That is because they don't seem to have a general immunity at this time that I am aware of. Congress is willing to hold harmless in one case and I'm awaiting for more holding harmless as a result of the ACA.

That's not some general immunity.

And did I state any general immunity?
posted by rough ashlar at 6:55 PM on November 3, 2013


The comparison you were making doesn't make much sense if you are just talking about vaccines, which are only a small part of the pharma business.
posted by Area Man at 6:58 PM on November 3, 2013 [1 favorite]


Hrmmmm. Guess NBC is a liar then.

Ah. So that's what you were talking about. The NBC article is specifically about the flu vaccine, which was being made at the request of the federal government, and for which the government would provide compensation should anyone have been harmed by the vaccine.

On preview: rough aslar, I also got the impression you were talking about a general immunity in your earlier post. Thanks for clarifying this.
posted by Tsuga at 7:01 PM on November 3, 2013


Hrmmmm. Guess NBC is a liar then.

A liar by omission, certainly. Having drug makers contribute a fixed sum to a reimbursement pool for distribution by the United States Court of Federal Claims is a funny definition of "immunity". Then again, anything that involves vaccines and smells like a conspiracy to the ignorant is guaranteed to suck in viewers for those lucrative Enzyte banner ads.
posted by Inspector.Gadget at 7:06 PM on November 3, 2013 [4 favorites]


My killer app story of supplements probably has to do with the GERD I came down with a couple of years ago. My primary care physician prescribed a proton-pump inhibitor. These are usually only short-term fixes, and have all sorts of side-effects to boot. Looking around the internet, I discovered D-limonene, the active ingredient in citrus peel. It worked thoroughly. This was no placebo effect. Before I'd go out to Chinese food with my parents and I'd have to excuse myself to go to the bathroom to double up in pain. D-limonene is dirt cheap (certainly cheaper than proton-pump inhibitors). It's used to scent liquid soaps (that cirtus-clean smell). I don't think they could find anything to adulterate it with that would be cheaper. There are preliminary studies that show D-limonene has other benefits too and so far the only side-effect is orange-tasting burps.
posted by Schmucko at 7:07 PM on November 3, 2013 [2 favorites]


> And did I state any general immunity?

That's how I read this:

> Must? That implies a duty and if that was the case, why would pharmaceutical firms need immunity from claims as they have been given in the US of A?

which did not seem to be vaccine-specific.
posted by rtha at 7:09 PM on November 3, 2013 [5 favorites]


These fuckers need to be regulated out of business.

There is no conspiracy to suppress these products....

People who take these products are falling for lies and quackery. There is increasingly no excuse for educated people to fall for this nonsense.


The problem is that regulating them out of business means that people will think there's a conspiracy. They want to believe that they're smarter than doctors, and they are somehow going back to what's 'natural.' Just because people are educated means nothing (I'm looking at you, anti-vaccers.)

We have a lot of sick people western medicine is failing...

We have a lot of sick people US medicine is failing--hopefully with the Affordable Health Care Act this will change. I know folks that take this crap, hoping and praying it works, because they think they can afford a $10 bottle of magic pills, but are strapped to afford a $200 doctor bill with no insurance. Other people, supposedly educated people, are just plain dumb.

I have a friend who has had four years of college as a nutritionist who sent me a *warning* on a certain food. She does 'research' constantly. She read the info on the intarnet (so it must be true.) My first reaction was bullshit, so I did some research, also on the intarnet. Found and emailed her a couple abstracts to scientific journals, a link to a blog written by one of the foremost authorities in that field, as well as a few articles debunking the warning and discussing the (lack of) qualifications of the author. Her only response was to let me know that she has seen so many health benefits since cutting out that item, and she sent me a link to the website she on which she found the information--a website with--so help me god--sparkly unicorns on the top. OoooKaaay. What's not to believe about sparkly unicorns?

In the US--most of the developed countries--we have a fantastic diet and access to health care (unless, you're one of the poor, of course.) We seem to think it's just not enough. I think a lot of this mistaken belief in different things, often placebos or gimmicks, whether it be supplements or diet, exercise, whatever, has to do with a major fear of disease and death. If we could just find, eat, do, the right thing, we could be immortal.

Ain't gonna work, folks.
posted by BlueHorse at 7:11 PM on November 3, 2013 [6 favorites]


pH regulating socks, does the company you work for sell dong quai, aloe, etc., or once they get your reports, do they not decide to make those products? Because if they do, I would disagree that they take efficacy seriously.

I do determine what claims they make on the products. If I can't substantiate a claim marketing wants, they can't use it. And when that happens after the fact, they will have to go through and print new labels and change the marketing materials and whatever else they have to do to remove the claim. I can also ask for a reformulation to increase the amount of the herb to an effective level, but I don't know how fast that happens -- or, to be honest, if it ever happens.

We have a product called (something like) "Herb X Power." Unfortunately, there are no claims I could substantiate on Herb X -- I couldn't find evidence that it did anything. We still make and sell Herb X Power, but with no claims. For dong quai and aloe, there is limited evidence that does show the one is effective for PMS and the other is effective for digestive complaints. Not enough to convince me, but some. The fact is that people want these products, and as long as there are no false or misleading claims about what they do, as long as they are safe, and as long as they actually are what we say they are, I think we're on the side of the angels.

If anyone is wondering why dietary supplements are regulated more like foods and not like drugs, DSHEA is your answer.
posted by pH Indicating Socks at 7:15 PM on November 3, 2013 [1 favorite]


The fact is that people want these products, and as long as there are no false or misleading claims about what they do, as long as they are safe, and as long as they actually are what we say they are, I think we're on the side of the angels.

I've used the odd store bought product over the years and having it contain what it says it contains and nothing else is the only thing I care about. I'm not surprised at these findings at all, just from my experience with valarian and willow bark. These two plants do have some scientific back up for their claims and contrary to what a poster up thread stated it isn't hard to figure out that there is something wrong with the brand you bought. They simply don't work and in the case of valarian I don't get the dopey, relaxed, dozy feeling that the real thing brings on. I've used the actual root that I dug out of the ground myself so have a pretty good idea with what is supposed to happen. Not being able to rely on the store bought products sucks because I don't necessarily want to make it myself all of the time.

It's the same with willow bark. So far I've found one brand that seems to be any good in processed pill like form or at least not as good as just making a tea from actual pieces of the bark you use does. Not that it's really that big a deal because regular aspirin works fine enough.
posted by Jalliah at 7:52 PM on November 3, 2013 [1 favorite]


I ran into a product in the vitamin store* called DGL Ultra Fructose-Free / Sugarless Deglycyrrhizinated Licorice. Went to check the label -- the very first ingredient is "organic agave syrup," which is the richest natural source of fructose in the world. I called the company to say "How on earth can you claim this is fructose free and sugarless?! That's like saying something is gluten free when the first ingredient is high protein bread flour!" The rep assured me that they take these sorts of concerns very seriously and would have an answer for me within two days. That was six weeks ago, and I've heard nothing. Needless to say, it's hard to take anything else they have to say very seriously.

*My husband needs to take enormous doses of folate and Vitamin D to help counteract the side effects of the methotrexate he takes for an autoimmune disorder. While I agree that supplements are mostly useless in healthy adults, there are people who do need to take them. Also, there seems to be some solid evidence in favor of D supplementation for nearly everybody.
posted by KathrynT at 7:59 PM on November 3, 2013 [10 favorites]


(and because I'm willing to back up my claims with a link VS hadwaving - here's a list of 30 spices one might want to consider adding to your diet.

...

posted by rough ashlar at 6:23 PM on November 3 [1 favorite +] [!]


Science daily? Impressive! There's one source named in that link and its a study on the effect of spices on the spoilage of stored food. Nice try, though.
posted by klanawa at 8:11 PM on November 3, 2013 [2 favorites]


I've been using nettle extract for my seasonal allergies for a long while now, and am happier using it then generic oral antihistamines.

That said, the government really needs to start regulating herbs and such-like, at the very least addressing drug purity and some of the health claims. Oh, and just nuke homeopathic medicine from orbit.

While the nettle extract has been helpful, I'm extraordinarily disgusted by the entrenched inability of alternative medicine to police itself regarding unverified claims, woo thinking, efficacy, and so on. One would think that alternative medicine practitioners would would eventually purge useless or harmful medicines and treatments in some sort of systematic way. For example, colleges of Naturopathic medicine would scientifically investigate and eliminate (or validate) stuff like homeopathy and iridology, and then train practitioners accordingly. But instead, this nonsense persists, decade after decade, generation after generation.
posted by sebastienbailard at 8:27 PM on November 3, 2013


I once met a distant relative of my husband's at a family gathering. He was a retired Health Canada inspector, and his portfolio had included health products.

He told me about shutting down an organic cooking oil plant--they were tipped off because the shelf life of the oil in question without preservatives would be 1 week or so, so it was not possible that it wasn't going rancid before getting to the customer if it was truly without preservatives (or that was my understanding) -- in any case their surprise inspection found a factory with dirt floors filling bottles labelled "organic hazelnut oil", and etc. with Mazola.

shudder

And yes, "Western Medicine" has its failings... IMO this is largely due to industry funded research, failure to report negative results, and decreasing independent funding for health research.

My rule these day is to check the Cochrane Reports for everything health related--be it massage or prescriptions drugs. What do we want? Safe effective health care! When do we want it? After peer review!
posted by chapps at 9:21 PM on November 3, 2013 [5 favorites]


It's not hard to make people stop complaining about the supplement industry. Just do high quality research, and produce products justified by that high quality research. Evidence based supplements would be entirely welcome.
posted by jaduncan at 12:31 AM on November 4, 2013


Reading the actual damn paper there are some serious methodological constraints to what the study itself can actually say, that the authors are entirely honest about, but that the magicians and their admirers in unfortunately ill-fitting lab coats who make up the skeptical community seem to be categorically incapable of communicating. The techniques they used are very basic, and have been foundational to our understanding of biology for thirty years, but unfortunately require some explanation for most.

The basic idea is to use a technique called PCR, Polymerase Chain Reaction (here is a helpful animation), to amplify pieces of DNA with sequences that vary between critters enough to be able to tell them apart from the sequence alone. Performing PCR, however, requires that you know the sequences on either side of the piece you want to amplify so as to be able to target that region specifically. With this kind of exploratory PCR, that means that you have to find regions with a hyper-variable piece flanked by two very conserved parts that are found in all of the rage of critters you are looking at. This is very easy to do in Bacteria and Archaea, as they have 16S ribosomes that are perfect for this, but a lot more complex in the Eukaryotes the authors are looking at. The authors would then try the technique and then sequence the results, if they get any, to get a sting of letters that they can compare to stings of letters in their own and public databases.

There are however many things that can go wrong with this kind of analysis, especially when you don't have access to the specific plant you are trying to prove isn't there as these authors don't leading to there being all kinds of trivial explanations for the author's results that they cannot eliminate. If the specific strain of plant that the company is using happens to lack either of the two conserved regions being used, or they are mutated enough, than this test would come back as if the plant is not there at all. Also, without a defined and available target strain to use as a control, it is difficult to know how sensitive you should be able to expect the assay to be. Also, the methodology is entirely dependent on the accuracy and completeness of GenBank (The NCBI's database of genome sequences that everyone has access to) for knowing what the hyper-variable regions that they sequence mean - if sequences in GenBank are annotated incorrectly or if they lack enough diversity then the analysis will give back incorrect results. The big advance in this paper is that the authors built their own library of vouched for sequences that they compared their results to, which helps but does not completely address the concern.

This is, however, a very cool paper in its own right because it demonstrates that this kind of analysis may soon be reliable and useful on a commercial and regulatory level, as well as because it does both give an indication of massive levels of fraud and provide clear evidence of dangerous adulteration.
posted by Blasdelb at 2:18 AM on November 4, 2013 [12 favorites]


This all also reminds me of something that Ben Goldacre said in his book "Bad Pharma",
"Alternative therapists who sell vitamins and homeopathy sugar pills, which perform no better than placebo in fair tests, have no role to play in fixing these problems. These business people often like to pretend, with an affectation of outside swagger, that their trade somehow challenges the pharmaceutical industry. In reality, they are cut from the same cloth, and simply use cruder versions of the same tricks, as I have written many times elsewhere. Problems in medicine do not mean that homeopathic sugar pills work; just because there are problems with aircraft design, that doesn't mean that magic carpets really fly."
posted by Blasdelb at 2:21 AM on November 4, 2013 [9 favorites]


Yeah what I find amusing is that people in the "nothing herbal or supplement oriented can ever work" camp use something like this to prove there's no point in researching nutrition herbs supplements and their role in health. l it proves is that industries are bad at regulating themselves and doing nominated research on their products or ideologies. That both sides are bad at this doesn't make either form of treatment more worthwhile. I've seen doc's my whole life and they didn't cure my ibs or panic attacks or trauma symptoms where diet and breathing exercises was much more helpful.The lack of oversight and science based understanding of "natural healing" techniques is frightening but the reality that pharmacy does not cure everything, has side effects, and can make some people worse means we trying to find non pharma healing techniques and take preventative health research seriously in terms of access to health building activities and environments in social policy. People using this study to make a claim of proof we shouldn't. bother to research nutrition,herbs, or supplements are being as reactionary and unscientific as people claiming the harms of big pharma make any "unnatural" substance useless. If you want to prove a supplement is harmful or ineffective, go find good research on it. If none has been done than you don't have evidence either way.
posted by xarnop at 3:29 AM on November 4, 2013 [2 favorites]


If you want to prove a supplement is harmful or ineffective, go find good research on it. If none has been done than you don't have evidence either way.

Lisa, I want to buy your rock.
posted by eugenen at 3:52 AM on November 4, 2013 [3 favorites]


I ran into a product in the vitamin store* called DGL Ultra Fructose-Free / Sugarless Deglycyrrhizinated Licorice. Went to check the label -- the very first ingredient is "organic agave syrup," which is the richest natural source of fructose in the world. I called the company to say "How on earth can you claim this is fructose free and sugarless?! That's like saying something is gluten free when the first ingredient is high protein bread flour!"

You should send them a nice, delicious bag of sugarless gummi bears.
posted by JHarris at 4:09 AM on November 4, 2013 [3 favorites]


If I had an entrepreneur's spirit, I'd sell small chocolate pills and call them "placebo - when pills don't work, let the mind do it for you." of "When it tastes good, you'll feel better, and you'll BE better."

I'd get really good chocolate.
posted by john wilkins at 5:52 AM on November 4, 2013 [1 favorite]


My in-laws recently got into some woo like this, with the supplements but also with those silver-laced towels that have magic antibacterial properties so you can wipe up raw chicken on the counter without using harsh chemicals, and it's perfectly safe! I should buy some for my house.

Nope nope nope. Also now I worry a little about eating at their house.

Even if pills have the ingredients they are supposed to, it can be a problem. My husband gave himself a Vitamin A overdose (complete with full-body hives) from taking pumpkin extract that was supposedly good for his digestion. No warnings about this anywhere on the bottle of course.
posted by emjaybee at 7:05 AM on November 4, 2013 [3 favorites]


For those of you still thinking about buy supplements, I would recommend Now Foods. I worked in the pharmaceutical industry and I was interviewing with them for a possible job at their quality control laboratory. I didn't get the job, but from talking to the scientists at the company I was very impressed with their quality system. All the senior scientists understand the rigorous FDA regulations for pharma and they apply the system to their supplements business.
posted by Carius at 8:11 AM on November 4, 2013 [1 favorite]


People seem to be equating herbal supplements with homeopathy, which it isn't. While there are a lot of unproven and questionable claims made about various supplements, more than a few of them actually do work as advertised, with real SCIENCE!!! to back them up.
That said, studies of contamination and poor quality control are essential. My only problem with this study is the fact that they didn't name the manufacturer's that 'passed'. That makes it seem like it was designed to discredit the entire industry. Ask yourself who would benefit most from that?
posted by rocket88 at 9:57 AM on November 4, 2013


the "nothing herbal or supplement oriented can ever work" camp

There is no such camp.
posted by klanawa at 9:57 AM on November 4, 2013 [4 favorites]


Well maybe not here on metafilter, I'll give you that. I do actually know people who profess that it's not worth doing research on herbs or supplements or plant/animal based molecules etc or trying to apply them to expand the types of services offered under medical services. What's more a MAJOR problem I think fuels the snake oil sales people is that people do not have reliable medical professionals to offer sound guidance about using lifestyle choices, exercise, physiotherapy, diet, supplements etc to cope with and manage their health. I think people want to know how to live a healthy life, and need detailed guidance with what that means, particularly in relation to specific conditions they have with that there are currently no cures for or symptoms sets that western doctors currently don't treat as worthwhile of being addressed.

If people don't have access to licensed professionals who will help them with this (and it's a fair goal for people to want to reduce dependance on or use of pharmaceuticals with high side effect profiles or long term risks associated with use)-- then the quacks will. And they will turn to the internets and each other and a sensationalist media for the next NATURAL miracle cure! And yes I think that's because our current health system doesn't offer access to in depth lifestyle consultations about health choices and managing conditions which GPs DO NOT have time for and can't be expected to do a good job of even if they want to. We need a better referral system and license process to help people have access to trustworthy professionals to help them create a health plan for themselves if they are interested in using lifestyle choices to heal from/manage specific conditions and that might include body work, targeted exercise, physical or occupational therapy, nutritional advice, breathing exercises, neurofeedback, therapy/CBT/emdr/etc, meditation or yoga, etc. It would not include things like homeopathy or pills filled with rice/toxic filler or a huge list of supplements with questionable research profiles behind them.
posted by xarnop at 11:03 AM on November 4, 2013


I don't think the "herbal supplements don't work" argument is interesting or valuable here (it is elsewhere, but not here). This story isn't about the efficacy of supplements.

What IS valuable here is the argument that if a consumer buys a bottle labeled "Echinacea 400 mg, 250 capsules" for whatever reason, stupid or otherwise, it ought to contain 400 mg of Echinacea per capsule every bit as much as it ought to contain 250 capsules.

What is especially worrisome is the news that MOST of these products contain fillers that are at least theoretically extremely harmful to certain allergic persons. I know that a lot of the "gluten free" hullabaloo is BS, but there are, in fact, people who can die from a surprise dose of wheat.

It's stuff like this (and the cooking oil story above) that makes me laugh in the face of people who are always so quick to jump on the latest food-adulteration story out of China to "prove" that those rotten commies can't be trusted, as if our own system wasn't full of at least as many horror stories.

It's also another data point for the idiocy of the Republican "regulation is killing business" point of view.
posted by Fnarf at 12:19 PM on November 4, 2013 [6 favorites]


"What do you call alternative medicine that works? Medicine."

This constantly gets repeated on Metafilter and elsewhere, but it is well documented that non-pharmaceutical therapies fail to gain traction in clinical practice even when they are well established in conventional medicine. Examples include pulmonary rehabilitation in COPD, ketogenic diets in epilepsy, cognitive therapy for insomnia and cardiac rehabilitation. There are many more. Of course there are valid criticisms to be made for many and perhaps most "alternative" therapies -- but the fact they aren't commonly used in current medical practice is not a reliable gauge of their effectiveness.
posted by Wordwoman at 3:08 PM on November 4, 2013 [4 favorites]


Blasdelb: "Reading the actual damn paper there are some serious methodological constraints to what the study itself can actually say, that the authors are entirely honest about, but that the magicians and their admirers in unfortunately ill-fitting lab coats who make up the skeptical community seem to be categorically incapable of communicating. The techniques they used are very basic, and have been foundational to our understanding of biology for thirty years, but unfortunately require some explanation for most.

The basic idea is to use a technique called PCR, Polymerase Chain Reaction (here is a helpful animation ), to amplify pieces of DNA with sequences that vary between critters enough to be able to tell them apart from the sequence alone. Performing PCR, however, requires that you know the sequences on either side of the piece you want to amplify so as to be able to target that region specifically. With this kind of exploratory PCR, that means that you have to find regions with a hyper-variable piece flanked by two very conserved parts that are found in all of the rage of critters you are looking at. This is very easy to do in Bacteria and Archaea, as they have 16S ribosomes that are perfect for this, but a lot more complex in the Eukaryotes the authors are looking at. The authors would then try the technique and then sequence the results, if they get any, to get a sting of letters that they can compare to stings of letters in their own and public databases.

There are however many things that can go wrong with this kind of analysis, especially when you don't have access to the specific plant you are trying to prove isn't there as these authors don't leading to there being all kinds of trivial explanations for the author's results that they cannot eliminate. If the specific strain of plant that the company is using happens to lack either of the two conserved regions being used, or they are mutated enough, than this test would come back as if the plant is not there at all. Also, without a defined and available target strain to use as a control, it is difficult to know how sensitive you should be able to expect the assay to be. Also, the methodology is entirely dependent on the accuracy and completeness of GenBank (The NCBI's database of genome sequences that everyone has access to) for knowing what the hyper-variable regions that they sequence mean - if sequences in GenBank are annotated incorrectly or if they lack enough diversity then the analysis will give back incorrect results. The big advance in this paper is that the authors built their own library of vouched for sequences that they compared their results to, which helps but does not completely address the concern.

This is, however, a very cool paper in its own right because it demonstrates that this kind of analysis may soon be reliable and useful on a commercial and regulatory level, as well as because it does both give an indication of massive levels of fraud and provide clear evidence of dangerous adulteration.
"

And once again MeFi comes through with something that makes me proud to have been a member as long as I have.
posted by Samizdata at 3:10 PM on November 4, 2013


This story isn't about the efficacy of supplements.

It pretty much is - the study demonstrates a lack of difference in efficacy between supplements and placebos - it was DNA testing (not a difference in efficacy) that unveiled a vast swathe of supplements as not even supplements.
(That said, I agree with your wider point.)
posted by anonymisc at 3:58 AM on November 5, 2013


To follow up on wordwoman: Spitbull, I myself have used these phrases ("What do you call alternative medicine that works? Medicine." / "there is no 'alternative' medicine") when trying to convince friends that reiki and other magic is bullshit. I've been trying hard to figure out what irks me so much about your use of it. Here's the difference:

When I say it, what I mean is that everything is subject to the same burden of proof. If something works, let's see the evidence, then let's use it! From my research, vitamin D seems to do good stuff, so let's use appropriately. Apparently willow bark does good stuff, so let's use appropriately. Cool.

In your use of the phrase here, it sounds like you're saying "all alternative medicine is bullshit" and "mainstream medicine has a monopoly on stuff that works". Well, that just isn't so. At a minimum, there are things that work that have not yet made it into mainstream medicine because we don't know about them. Moreover, things like vitamin D and valerian root (a few years ago) or fecal transplants (currently) definitely aren't mainstream medicine because they're in the process of being proven. Yoga helped me fix a hip problem that more than half a dozen medical professionals charged me a lot of money to throw their hands up at. So what do we call yoga, vitamin D, valerian root, and fecal transplants right now? One might call these "alternative" treatments, since you find them where hippies congregate and your doctor thinks they're bullshit. Just kidding--we call them that because they're an alternative to what mainstream medicine prescribes for a given issue. That doesn't mean they don't work, and it certainly doesn't mean they're exempt from proving their efficacy, but it does mean they qualify as "alternative medicine that works".

On that note, as someone who cares about science while seeing the usefulness of vitamin D, yoga, and valerian root, it really aggravates me that these things that work are lumped in the same category as reiki, sound healing, and, well, all the incoherent pseudo-physics lessons that my yoga teacher gives while I mutter curses under my breath. They're lumped together by the hippies ("valerian root works, so homeopathy must work too!") and they're lumped together by Very Serious Scientific Folk ("silly hippies and their alternative-medicine valerian root; why don't they just get a Medical Professional to prescribe some Ambien?"). That's not cool. (Not that I'm saying anyone here is taking that position, though they might. I'm merely saying I've encountered that view in person.)

Is the term "alternative medicine" so poisoned by homeopathy and reiki masters that we must toss it out and find another word? I'm not sure that will help; hippies will be onto the next working-but-not-quite-established treatment too, and then it'll be "alternative" (or whatever we call it) too.
posted by daveliepmann at 4:21 AM on November 5, 2013 [2 favorites]


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