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Journal gives stern warning on unproven dietary supplements

herbal products September 17, 1998
Web posted at: 9:54 p.m. EDT (0154 GMT)

In this story:

(CNN) -- Amid the growing use of alternative medicine, one of the country's leading medical journals is warning patients against using products that have not been properly researched or proven effective.

An editorial in the prestigious New England Journal of Medicine calls for dietary supplements, which include herbs, vitamins and minerals, to be tested as thoroughly as traditional medicines and warns consumers that there is little research to back the claims of many products.

"There cannot be two kinds of medicine -- conventional and alternative," wrote Drs. Marcia Angell and Jerome P. Kassirer in Thursday's issue. "There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work."

According to the government statistics, more than half of all adult Americans use dietary supplements, including such substances as the herb St. John's wort for depression, and shark cartilage for cancer.

"Patients may postpone getting needed effective treatment, because they are instead relying on alternative remedies that haven't been tested," said Angell, executive editor of the journal. "The second danger is that they may actually be harmful."

The medical journal also published accompanying reports on the dangers of alternative medicine from around the nation, including one from the California Department of Health Services in which one third of 260 traditional Chinese medicines were contaminated with metal such as lead and arsenic or pharmaceuticals not mentioned on label ingredients.

FDA has little power to regulate

The multi-million dollar supplement industry has exploded since 1994 when Congress exempted dietary supplements from Food and Drug Administration regulation.

shark cartilage supplement

"Since 1994, any herbal remedy sold as a dietary supplement -- no matter what their real purpose -- the FDA has no authority over them," Angell said.

Once a supplement is on the market, the government agency carries the burden of proving it is unsafe before it can restrict its use.

Some supplements may be helpful

Forms of alternative medicine have existed for centuries from Chinese herbs to therapeutic touch. Research shows that some do work.

"The literature suggests that acupuncture may be helpful for certain kinds of pain for control of certain kinds of nausea," said Dr. David Eisenberg of Beth Israel Deaconess Hospital.

Still, experts caution medical effectiveness is not a matter of public opinion, it's a matter of scientific fact.

"The more research we have, the better," Angell said. "Those treatments that are found to be effective will, believe me, be incorporated in the mainstream."

Currently, about two thirds of medical schools in the United States offer courses in alternative therapies.

Tips on supplement safety

The National Council Against Health Fraud recommends consumers of dietary supplements use caution. It recommends avoiding products that use words such as "secret" or "magical," and watch for broad claims, especially when they promise a cure.

The council says beware of companies that claim research agencies are suppressing information about their dietary supplements.

Other tips: Consult a physician before taking any supplement and remember that the word "natural" doesn't necessarily mean a product is safe.

From CNN Medical Correspondent Dr. Steve Salvatore and the Associated Press.

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