Herbal medicine chaos a recipe for risk

MILLIONS of Australian consumers who buy natural health products to relieve ailments including arthritis, depression, stress and fatigue may be unwittingly buying inferior and ineffective substitutes which are a waste of money.

A lack of universal regulations in the alternative and complementary medicine sector — an industry that generates up to $3 billion a year — means that consumers are at risk of unscrupulous marketing by companies and from rogue or unqualified practitioners, the Federal Government has been warned.

Jon Wardle, a naturopath and researcher in the school of population health at Queensland University, says people have no guarantee that the natural health products they are buying are what the labels claim them to be.He says such products — including vitamins and minerals, herbal, Chinese and homeopathic medicines and nutritional supplements — vary in quality and their active ingredients often are substituted by cheaper, less effective alternatives.

In a report to federal parliamentary health secretary Senator Jan McLucas, Mr Wardle says "consumers may be purchasing ineffective and poor-quality products whilst under the impression they are … a legitimate product".

In the past decade, 62 deaths in Australia have been linked to complementary and alternative health treatments and an average of 400 adverse reactions a year are reported to the Adverse Drug Reactions Advisory Committee. These adverse outcomes are usually the result of people mixing alternative health remedies with prescribed pharmaceutical medications, often without their doctor's knowledge.

His report calls for the registration of practitioners and for natural health products to be assessed like conventional drugs, with tests for efficacy, standardised product and possible contamination.

He cites the following examples of how people are being misled:

- Naturopaths know that Namibian devil's claw, used to treat arthritis, rheumatism and other conditions, is far more effective than the cheaper Angolan variety, yet the Angolan blend accounts for almost half of all Australian imports.
One form of glucosamine is superior to the other two varieties available in Australian health stores, supermarkets and pharmacies, yet half of the supplements on sale are of the cheaper, less useful variety.

- A Canadian study of St John's wort, used for depression, found that of 54 commercially available brands, only two had levels of the active ingredient that were within 10% of that stated on their labels.

Mr Wardle said that while Australia had one of the world's best complementary and alternative medicine practitioner education standards, the current regulatory mess "rendered this achievement worthless" because anyone could practise, whether trained or not.

His call for greater restrictions on and monitoring of natural health products and practitioners echoes the concern of Ken Harvey, from LaTrobe University's school of public health, who wrote in The Medical Journal of Australia earlier this year that consumers were not being protected sufficiently under the current "weak" regulatory system.

Dr Harvey and his co-authors found the national complaints system for complementary medicine to be overloaded, under-resourced and slow. They say "marked variations of chemical constituents" existed in products labelled as containing the same amounts of a herb.

Australia's biggest consumer group, Choice, also wants complementary medicines — more than 16,000 are listed — to be evaluated in the same way as pharmaceutical drugs, which require more scrutiny.

However, Complementary Healthcare Council of Australia executive director Dr Wendy Morrow rejects the need for a system overhaul, saying natural health products are low risk and already face regulations. She concedes the complaints process could improve.

She says the amount of active substances in herbal products can vary due to the region in which the plant is grown and the climatic conditions at the time. And with some herbs, such as St John's wort, there is uncertainty about which plant element provides the health benefit.