Herbal Snake Oil Spill

For more than 50 years, the American Medical Association waged war against chiropractors and other alternative practitioners. Today, graduates of Harvard Medical School practice acupuncture.

Alternative medicine has advanced from marginal to mainstream. It’s not unusual today to find far more skepticism about conventional medicine than about alternative treatments.

Thus it was a terrible breach of trust when, as reported in these pages (Wednesday, February 4), bottles of Walmart-brand echinacea, an herb said to ward off colds and flu, were found to contain no echinacea at all. And bottles of GNC-brand St. John’s wort, touted as a cure for depression, contained rice, garlic and a tropical houseplant, but not a trace of the reputedly healing herb.

It gets worse. DNA testing on hundreds of bottles of store-brand herbal supplements sold in New York as treatments for everything from memory loss to prostate trouble found that four out of five contained none of the herbs on the label. Instead, they were packed with cheap fillers such as wheat, rice, beans or houseplants.

Some AMA members may be snickering at this point. “What’s the difference?” they might ask. Echinacea and St. John’s wort are nothing more than placebos anyway. So what’s the big deal. All these stores did is substitute one fake for another.

Not so fast. Some of the medical old guard still scoff at herbal remedies. But even placebos are now getting reluctant respect. New advances confirm ancient verities. A 2012 Harvard Medical School article reports, “Attitudes are shifting, even in conventional medical circles. Randomized trials, some of them led by researchers at the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter, have deepened the understanding of the placebo effect and its various components.”

Studies have shown that anywhere from 33 to 50 percent of the efficacy of any medication is based on the belief that it will work. Put another way, all medications owe part of their efficacy to the placebo effect.

A favorite put-down of the medical trade of any alternative remedy is to call it “chicken soup.” But even that comment can get you into hot water.

An article in Chest Journal (American College of Chest Physicians) dishes it out to scoffers. Dr. Fred Rosner, director of the Department of Medicine of the Mount Sinai Services at the Queens Hospital Center and Professor of Medicine at New York’s Mount Sinai School of Medicine, wrote: “In a much earlier era, the therapeutic efficacy of chicken, chicken soup and other fowl is extensively described in the medical writings of Moses Maimonides.” And Dr. Rosner adds, “The recent demonstration that chicken soup mobilizes nasal mucus better than other hot liquids, scientific respectability has now been obtained to prove what the proverbial Jewish mother has always known — that chicken soup can help cure an upper respiratory infection.”

The adulteration and mislabeling of herbal remedies are more than a breach of trust. New York Attorney General Eric Schneiderman said they “pose serious risks to people who have allergies or are taking certain medications who can suffer dangerous reactions from herbal concoctions that contain substances not listed on the label.”

In a perhaps not shocking lack of transparency, the herbal supplement industry criticized the method used to analyze the samples and raised questions about the reliability of the findings.

Walmart says the company will comply with the attorney general’s request to stop selling them in New York. But they still maintain their own testing has not revealed any issues with the relevant products.

Coincidentally, the store chain with the poorest showing was Walmart, where only 4 percent of the products tested showed DNA from the plants listed on the labels.

Walmart spokesman Brian Nick said the company is reaching out to suppliers and will take appropriate action. Walgreen and GNC pledged to cooperate with the attorney general, but GNC said that they “stand by the quality, purity and potency of all ingredients listed.”

A key difficulty in maintaining the purity of herbal supplements is the lack of standards and oversight in the industry. The Food and Drug Administration (FDA) requires companies to verify that their products are safe and properly labeled. But supplements are exempt from the FDA’s strict approval process for prescription drugs.

As more people turn to herbal and other alternative health options, the FDA must define and enforce standards. As with pharmaceuticals, there needs to be regulation of claims, ingredients, labeling and more. And the loophole of fast-talking disclaimers has to be closed. Saying “This product has not been evaluated by the Food and Drug Administration. It is not intended to diagnose, treat, cure or prevent any disease,” should be the equivalent of “This gun has not been evaluated by the Bureau of Alcohol, Tobacco, Firearms and Explosives. It is not intended to kill, maim or wound anyone…”

Those top-tier companies whose products do contain the precise substances listed on the bottle don’t deserve that their reputations should be sullied by these unscrupulous businesses. And consumers who shelled out higher prices for reputable brands are more likely to discover that they made a wise investment.