One of the strongest grassroots campaigns in
the history of this country resulted in the Dietary Supplement
Health and Education Act of 1994 (DSHEA). The government was faced,
on one hand, with a U.S. Food and Drug Administration initiative to
control and limit consumer access to dietary supplements such as
herbs and vitamins. On the other hand, it was faced with public
outcry against such limitations. During the months that this issue
was being considered, U.S. congressional representatives received
more mail from concerned constituents than they had received on
any issue in history except for the Vietnam War.
The resulting act bowed to the will of the people by allowing
the unrestricted sale of herbs, vitamins, minerals, and other
substances such as hormones and amino acids–so long as medical
claims aren’t made for these products by their manufacturers. In
other words, a manufacturer may sell a product such as echinacea,
which is useful against colds and flu, so long as the package
doesn’t say it will cure colds and flu.
So what can a manufacturer say about the usefulness of a
product? Descriptions of how the product affects a body’s structure
and the function of that structure can be made, such as claiming
that ginkgo can increase circulation to the brain. But the label
cannot state that ginkgo cures tinnitus. A product label for
hawthorn can state, “Promotes heart health”; it cannot state,
“Cures angina pectoris.”
Beginning last March, all new products were required to avoid
making claims about curing disease and avoid mentioning any disease
in relation to the product, including calling the product by a name
that implies a relationship such as “Arthricure” or “Cold-B-Gone.”
And after March 1999, all existing products whose name includes a
disease condition must be renamed and all nutritional information
must be included on the label.
So what we have is an imperfect compromise between consumers and
government regulatory agencies. Manufacturers can allude to the
possible usefulness of an herb and consumers have to make personal
judgments–based on research, reading or hope–to decide which herb
to use.
Making choices
If three or four different brands or varieties of an herbal
supplement are available, how do you choose which to buy? Unless
you read a lot of books or magazines and get recommendations from a
friend or, better yet, a trained herbalist, you just have to do
your best at deciphering the fine print on the product labels.
As I thought about how to help you understand the intricacies of
labeling, I went to my local health-food store and selected every
echinacea product available in capsule form–seven products in all.
Echinacea is one of the most popular herbs, so I thought it would
make a useful example. Looking at the variations in content,
terminology, manufacturing processes, claims and dosages made me
appreciate anew how confusing the world of herbal supplements has
become. Here’s what I found:
• Three products contained Echinacea angustifolia, two contained
E. purpurea, and two combined those species. Most research has been
conducted on E. purpurea, although that doesn’t prove it’s
better.
• Two products were made from above-ground plant parts, also
called “herb” (stems, leaves, and perhaps flowers); two were made
from roots and/or rhizomes; two were made from herb and root; and
one was made from juice pressed from the flowering plant.
• Two products were standardized extracts, the other five were
not. Standardized means that a product contains certain amounts of
the components thought to be most medically active and that a
certain percentage of the product consists of that component.
• Four products were certified organically grown, three were
not.
• Six of the seven products bore batch numbers for manufacturer
quality control.
• Three products had expiration dates, the others didn’t.
• All of the products had safety seals; two were packaged in
brown glass bottles and five in recyclable plastic.
• One product came in cellulose capsules for vegetarians, the
remainder came in gelatin capsules.
• Both standardized capsules contained around 200 mg each;
whole-plant products contained 380 mg to 450 mg.
• Prices for whole-plant products were $8.29, $10.49, $11.98,
$15.98 and $18.95 for 100 capsules. For standardized extracts,
prices were $20.95 and $21.95 for sixty capsules.
• Recommended daily dosages were one or two capsules a day at
the low end. At the high end, the dosage recommendation was two to
three capsules two or three times daily. Four products recommended
discontinuing use for two weeks after taking the herb for six to
eight weeks.
• One label included a caution that people with autoimmune
conditions shouldn’t use the product, and one included a caution
for pregnant women and nursing mothers.
• Some products were labeled sugar-free; one was “made with
love.” One was cryogenically ground; others were harvested from the
wild.
In other words, these products varied quite a bit, and it wasn’t
easy to select one. Following DSHEA strictures, the labels stated
only how the product affects the body’s structure and function.
Here’s what four labels said:
• Echinacea (Echinacea purpurea) helps promote general
well-being during the cold and flu season.
• Well-researched in Europe, this herbal supplement is commonly
used to promote well-being during the cold and flu season.
• Supports healthy immune function.
• Echinacea is a popular herb, especially during the cold
season.
Each of these labels also included the mandatory disclaimer:
“These statements have not been evaluated by the Food and Drug
Administration. This product is not intended to diagnose, treat,
cure, or prevent any disease.”
In fact, a great deal of solid research shows how effective
echinacea is. German studies show that taking echinacea at the
first sign of a cold or flu boosts the immune system by enhancing
the activity of white blood cells, that during such a time it’s
wise to take as much as 1 g three times a day, and that, after
taking echinacea for two weeks, it’s best to discontinue use for a
few days. Too bad our current laws don’t allow manufacturers to say
so.
How I Would Choose
Because so many options are available but product labels carry
so little information, here’s how I would go about choosing an
echinacea product from among those I’ve described. Mind you, this
is a personal decision and won’t necessarily be the right one for
you.
First, I’d decide whether I wanted a whole-plant product or a
standardized extract. Let’s say I choose a whole-plant product
because of the potential synergy among its various compounds.
Next, I’d look for a product made from the root rather than the
above-ground parts, because I feel that echinacea root has a higher
concentration of useful components than the rest of the plant (this
is not necessarily true for other herbs). Products made from
echinacea root tend to be more expensive, though, because the plant
has to be destroyed to get it.
Additionally, I’d prefer a product made from E. purpurea to one
made from E. angustifolia because most of the research has been
done on the former.
And I’d want an organically grown product because I’m concerned
about the impact of pesticides on my health and on the environment.
On the other hand, even though I’m a vegetarian and prefer capsules
made from cellulose to ones made from animal-derived gelatin, I
wouldn’t base my final selection on those criteria alone because
they’re too limiting.
Of the seven products I looked at, two almost fit my
requirements. One was made from the organically grown herb and root
of E. purpurea, but there was no way of knowing how much herb and
how much root were in each capsule. One was made of the organically
grown root of E. angustifolia. For the same number of capsules, one
cost $8.29, the other $15.98. So my selection came down to which of
my determining factors I valued most–my species of choice, the
amount of root used, or price.
If I had preferred a standardized extract, the choice would have
been less complicated. Standardization offers a greater guarantee
of product consistency (I would know how much of the major active
ingredient each capsule contains) and convenience (I wouldn’t need
to take as many pills per day). Of the products I looked at, two
were standardized to 4 percent echinacosides. Both were made from
E. angustifolia (not my species of choice). They cost about the
same ($20.95 and $21.95), so it wasn’t a clear choice.
I wish I could give you some very simple and straightforward
rules for choosing the best herbal products, but, as you can see,
it’s just not that simple. I can, however, give you a checklist of
things to look for when you’re scanning labels.
•Is the product made from the whole herb or is it a standardized
extract, and which do you prefer?
• Is the plant material grown organically or not, and do you
care?
• Is the amount of active ingredient in each capsule in line
with that of other similar products?
• Does the product contain any ingredients to which you may be
allergic or have philosophical objections?
• If structure and/or function health claims are made, is the
appropriate disclaimer regarding the FDA included?
• Is the package safely sealed?
• Is there an expiration date on the product?
• Is there a batch number on the product in case you want to ask
the manufacturer about it?
• Does the manufacturer list an address, telephone number, or
website address so that you can get more information?
• Is the price consistent with that of other similar products,
or, if it’s more expensive, is there a good reason?
I hope this helps you make intelligent choices when you purchase
herbal products. Happy shopping.
