A consumer guide to herbal supplements
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.
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.
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.
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