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Herbal aids come under fire

Cases link supplements to poisonings, deaths

GUY GUGLIOTTA WASHINGTON POST March 19, 2000

Mounting evidence suggests that increasing numbers of Americans are falling seriously ill or even dying after taking dietary supplements that promise everything from extra energy to sounder sleep. The victims include men and women of all ages as well as children whose parents are feeding them snacks, drinks and nostrums made with herbal supplements that are neither regulated by the federal government nor tested for their effects on the young.

While the Food and Drug Administration issues periodic warnings about the dangers of individual supplements, no organization or agency has ever made a comprehensive analysis of the sickness and death associated with them.

But in attempting the first national survey, the Washington Post collected statistical snapshots from health officials, researchers and advocates reaching almost every state in the country. Among the findings:

Abuse of the bodybuilding supplement gamma-hydroxybutyrate and similar substances has skyrocketed in recent years. In 1997-98, Texas recorded 86 hospital visits involving GHB. In 1999, three Florida poison centers logged 549 GHB incidents and two deaths. Last December, Phoenix Suns forward Tom Gugliotta, no relation to this reporter, took a GHB-related supplement, collapsed on the team bus and nearly died.

Tests continue to reveal dangerous contaminants and poor quality control in supplement ingredients. California investigators in 1998 found that nearly one-third of 260 imported Asian herbals were either spiked with drugs not listed on the label or contained lead, arsenic or mercury. Last month, state officials discovered five Chinese herbals that contained powerful diabetes drugs. Health professionals across the country complain they cannot be sure how powerful a supplement is because the actual potency of the pill often doesn't match the legend on the label.

The weight-loss and energy supplement ephedra, also known as ma huang, and its derivatives are producing a stream of complaints from many states, including Minnesota. New, previously unreleased FDA data implicate about two dozen different ephedra products in 134 cases involving everything from jitteriness, chest pains and insomnia to addiction, stroke and death.

Poison control centers in various states are reporting adverse reactions to a broad range of supplements, including ginseng, St. John's wort, ephedra and melatonin.

Children are increasingly becoming the victims of supplement abuse. Last year, pediatrician Hillary Perr reported on children from wealthy California families who were malnourished from eating snack food spiked with supplements. In Long Island, a mother gave her 18-month-old baby a teaspoon of eucalyptus oil last year because a store clerk told her it was good for a fever. The child suffered permanent neurological damage and almost died. Most experts consulted by the Post suspect that data from health care providers vastly understate the incidents that actually occur involving diet supplements.

This is because a 1994 federal law, pushed by the industry through Congress, exempts supplement companies from almost all federal regulation, including any requirement that they file reports when the use of one of their products goes wrong.

Unlike pharmaceuticals or food additives, supplements do not have to be pre-screened by the FDA, nor do they have to demonstrate that they are safe before they can be sold.

And once on sale, the burden of proof is on the FDA to show that a supplement is dangerous before it can be taken off the market. The only tool federal officials have are the sketchy, patchwork reports voluntarily called in to them.

And the industry is expanding rapidly, with hundreds of herbal products and product blends. Since 1994, supplement sales have grown by nearly 80 percent, from $8.8 billion to $15.7 billion projected for 2000, according to the Nutrition Business Journal.

Faced with the federal government's inability to regulate supplements, many states have passed their own restrictive laws. They also are collecting data on an industry that experts such as Lee Vermeulen, director of the University of Wisconsin Poison Control Center, expect will keep growing, along with its attendant problems, until ``the economy goes south.''

In this environment, experts say they are catching only glimpses of supplements' potential dangers: Greene Shepherd, director of the North Texas Poison Control Center in Dallas, said that ``90 percent'' of calls to the center involved only abuse of supplements. ``There's a huge portion that we're missing.''

Also, companies have hastened to take advantage of the dearth of regulation, said Prosy Abarquez-Delacruz, regional administrator for the California Health Services Department's Food and Drug Branch.

``It's the John Wayne industry, like the wild, wild West, and the practices of the few have tainted the many,'' said Abarquez-Delacruz.

Many health professionals, including strong critics of supplements, acknowledge that they can be both useful and safe, if taken in reasonable doses.

But many consumers become victims because they ``believe that if a product wasn't safe, the government wouldn't allow it to be sold,'' said consumer advocate Bruce Silverglade, legal affairs director of the Center for Science in the Public Interest. ``In this case, that's just a false assumption.''

And in essence, added pediatrician Howard Mofenson, director of the Long Island Poison Center in Mineola, N.Y., public consumption of supplements has become a clinical trial: ``Nothing will be done unless a tremendous outbreak occurs,'' Mofenson said. ``This law is the greatest uncontrolled experiment that the United States has ever undergone.

) 2000 PioneerPlanet / St. Paul (Minnesota) Pioneer Press - All Rights Reserved copyright information

-- (Dee360Degree@aol.com), March 19, 2000

Answers

And how many prescription drugs and over the counter drugs, that the FDA approves every year, are people dying from. I don't have the numbers in front of me, but they are very high.

Also, the big drug companies have been trying to get in on the herb, vitamin and alternative medicine connection for years. They want to regulate everything so they can get a cut of the action. Prescriptions in any country besides the U.S. are much cheaper. We the people have to pay for all their R&D. Baloney! The amount of money drug companies contribute to campaigns of congressional candidates is considerable.

People need to use a little common sense with any herb, drug or vitamin. And anyone that gives their small child something prescribed by a store clerk has the brains rock.

Thanks for this post, Dee.

-- gilda (jess@listbot.com), March 19, 2000.

People need to use a little common sense with any herb, drug or vitamin.

Gilda, that's the problem! There's a whole segment of the population who can't be bothered or just plain don't know how to research an herbal remedy. Those herbal teas in the colorful boxes are MEDICINES and need to be consumed with the same care that one takes when administering Advil or anything else.

One of the silly ladies I used to date drank quarts of black cotash (sp?) tea, and then couldn't understand why she had to pee every twenty minutes. On the other hand, had she been retaining water, she would've appreciated being able to get rid of it.

-- (kb8um8@yahoo.com), March 19, 2000.

"Gilda, that's the problem! There's a whole segment of the population who can't be bothered or just plain don't know how to research an herbal remedy."

As A@AisA.com would say "Evolution at work."

-- A drug (by@ny.other.name.is.just.a.drug), March 19, 2000.

Heard from a Pediatrician who was "on Call": Attended a delivery for "baby in distress" . There was no medical reason for this baby to be in respiratory and cardiac distress before birth. Lately there have been too many cases like this. Later found on the hospital chart notes that at admission time the mother stated that she drank some Blue Cohosh Tea in order to speed up the delivery time. Found on "Natural Medicines Comprehensive Database" for Blue Cohosh, among other warnings:"One report attributes the profound congestive heart failure of a newborn to the mother ingesting blue cohosh during labor. (page 140). Black cohosh is there too. Lucia

-- Lucia Bruner (cimbri1@aol.com), March 19, 2000.

Everything has side effects. Have you ever seen what the do. Drug company medicine side effects, oh they are bad very bad. I would check my choices.

-- ET (bneville@zebra.net), March 19, 2000.