Herb Product Labels Vary Greatly

By Adam Marcus
HealthDay Reporter

MONDAY, Oct. 27 (HealthDayNews) — The next time you head to the store to restock your diet aid supply, consider stopping by your nearest pharmacy school bookstore first.

A new study finds that herbal supplements rarely meet textbook benchmarks for ingredients and dosages, which is considered critical information that could have serious consequences for people who mix diet aids (news - web sites) with prescription drugs. According to one recent estimate, one in five Americans taking prescription drugs also uses “natural” remedies like supplements and vitamins or both.

Consumers who look to product labels before buying have the right impulse, but they’re not likely to learn much by doing so, the new study found. Fewer than half of the almost 900 herbal products the researchers studied met standards for both ingredients and recommended dosage.

“Unless [consumers] consult a textbook or two or three, they don’t know what kind of plant parts should be in there,” says Judith Garrard, a psychologist at the University of Minnesota School of Public Health and leader of the study. And even if they do know what’s supposed to be in the bottle, there’s no guarantee that what’s on the label is truly inside, she adds. Other researchers have found that supplement labels on bottles often don’t accurately reflect their contents.

There may be one way to increase your odds of buying the right product. Diet aids that cost more usually, but not always, met the textbook standard for consistency of ingredients. However, this test was far from a firm rule, says Garrard, whose study appears in the Oct. 27 issue of the Archives of Internal Medicine (news - web sites).

Diet aids exist in a regulatory limbo in this country. The U.S. Food and Drug Administration (news - web sites) has relatively weak oversight of the industry compared to its control over prescription drugs. A 1994 law exempted herbal and related supplements from strict supervision as medication. Instead, supplements are considered food products as long as their makers don’t make specific claims about their potential health benefits.

The new study looked at 10 leading herbal treatments in 1998, including echinacea (news - web sites), St. John’s wort, Ginkgo biloba, garlic, saw palmetto, ginseng, goldenseal, aloe, Siberian ginseng, and valerian. Garrard says she and her colleagues were expecting to find perhaps 10 to 15 varieties of these products for sale at 20 local stores, including grocery stores, pharmacies, discount stores, and health food stores. They were surprised to turn up 880 formulations.

Using an academic pharmacy textbook as a reference, they compared what the product labels said about a given herb with the available research in the book on active ingredients and recommended daily dosages.

Label information for ingredients and doses agreed with the benchmark 43 percent of the time. Ingredients alone met the test in 20 percent of cases, while 37 percent of product labels were either inconsistent or incomplete, the researchers say.

“What a consumer really needs is three pieces of information,” Garrard says: what plant parts should be in the bottle, what does the label say about those ingredients, and is the label telling the truth about what’s inside.

The first two questions usually go unanswered, Garrard says. Her study doesn’t address the third question, but other researchers have shown that many diet aid labels are misleading.

Given the vagaries of product labels, Garrard says, consumers need to do more than simply tell their doctor they’re taking supplements — especially if they’re also taking prescription drugs.

“You have to take the [supplement] bottle in and show the doctor,” she says. “Even that might not be sufficient to find out what’s inside, but the doctor may be in a position of being able to find out.”

Michael McGuffin, president of the American Herbal Products Association, a trade group based in Silver Spring, Md., dismisses the report as “meaningless and irrelevant criticism.”

Although a few labeling problems might be significant, McGuffin says, the vast majority are not.

“Consumers should be concerned about it if they think that herbs are drugs, but herbs aren’t drugs,” adds McGuffin, who calls the notion of a benchmark recommended daily dose of supplements “inconsistent with our history” of using the products. “Our product selection is diverse and I’m unembarrassed by our diversity. It provides consumers with choices.”