We all like to have some control over our own health, which is one of the strong appeals of complementary medicines. You can readily find complementary medicines carefully categorised by disease or symptom in one of the larger sections of your local pharmacy or health food shop.
There are vitamins and other products claiming to help you lose weight, be in a better mood, experience less digestive problems, feel stronger, more s-xual, help prevent or treat the symptoms of colds and flu, even have more energy. Many Australians say “yes please” to these products, with over a billion dollars being spent on complementary medicines each year.
Health professionals have generally adopted the view that although there are many unanswered questions about whether complementary medicines offer any real health benefits, these products are fairly harmless. Some consumers believe they feel better by using complementary medicines and perhaps they do, even if some of the effects may be a result of their belief in the products.
There is good clinical evidence supporting the prescription of a limited number of complementary medicines for very specific symptoms, but these are unusual cases that often involve some form of severe deficiency and they make up a very small minority of the vast numbers of consumers of these products.
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The “largely harmless” view of complementary medicines is now being challenged by emerging international research.
A US study published in the Archives of Internal Medicine looked at the use of vitamin and mineral supplements in relation to total mortality in 38,772 older American women (with an average age of 62) and found that the use of multivitamins, Vitamin B6, folic acid, iron, magnesium, zinc and copper were associated with an increased risk of total mortality when compared with corresponding non-use.
The study controlled for key health factors and concluded that the regular use of complementary medicines is a direct contributor to poorer health outcomes. This follows on from another study showing that healthy men who take Vitamin E have an increased risk of prostate cancer.
In Australia it is the Therapeutic Goods Administration (TGA) that is responsible for regulating complementary medicines. More than 10,000 complementary medicine products are listed on the TGA Aust-L list.
For most Australians, this is a source of some comfort. However, the reality is that the TGA does not test complementary medicines to see if they do what they claim to do. Nor do they test every product to see if it is safe.
The listing is largely a self-report process and the only real check is the occasional audit of the information provided by manufacturers on the forms. Less than 5% of products are audited and the last time such an audit was conducted on a limited number of complementary medicines, more than 90% failed to comply with the regulations.
Complementary medicine manufacturers go to some lengths to create the illusion that their products have been tested by authorities for efficacy, that is, whether or not they work as they claim to. Complementary medicine manufacturers also draw on well targeted marketing, product placement, celebrity and sports hero endorsements to give the impression their products really work.
Australia is not as litigious as the US where the need to protect governments from legal action has informed labelling decisions. This does not mean Australian authorities should ignore their responsibilities.
We need to adopt a sensible approach to the labelling of complementary medicines based on the principle of consumers having the right to know whether or not a product has been properly tested.
Australia should follow the lead of the US and clearly label all complementary medicines: “This product has not been tested by Australian authorities.”
Labels may not significantly change consumer behaviour in purchasing and using complementary medicines. At the same time, it is not acceptable that complementary medicines are able to imply through their packaging and marketing that they have been tested or endorsed by the TGA or other authorities.
The complementary medicines industry will resist the labelling of their products, but given emerging concerns about the possibility that some of these products may cause harm, it is almost inevitable that governments will be forced to protect their own interests as a regulator of medicines.
The reality is that many of these products have very little clinical evidence to support the claims they make, they have not been tested by the TGA or any other government authority, and they adopt misleading marketing strategies to imply their clinical effectiveness has been established.
At the point where there is evidence that some of these products may be contributing to a reduction in life span or harming people’s health, it is time consumers were given the information they need to make an informed choice.
Anything less than full disclosure about the lack of testing compromises the capacity of health consumers to appropriately purchase and use complementary medicines.
The government can no longer put the complementary medicines industry into the harmless category and ignore its responsibility to properly inform Australia’s health consumers.