The supplements scandal: herbal pills do not always contain ingredients on label

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Ginseng root: for real.

Ginseng root: for real.

A new report paints a worrying picture of vitamins and supplements.

The American paper, released on Monday, reveals that many herbal “supplements”, do not contain any trace of those substances.

In fact, many of the tested supplements contained little more than cheap powdered rice, wheat and houseplants.

“Among the attorney general’s findings was a popular store brand of ginseng pills at Walgreens, promoted for ‘physical endurance and vitality,’ that contained only powdered garlic and rice,” reports the New York Times.

“At Walmart, the authorities found that its ginkgo biloba, a Chinese plant promoted as a memory enhancer, contained little more than powdered radish, houseplants and wheat – despite a claim on the label that the product was wheat- and gluten-free.”

Furthermore, they found that three out of six herbal products sold at Target – ginkgo biloba, St John’s wort and valerian root, a sleep aid – contained none of the herbs on their labels.

“But they did contain powdered rice, beans, peas and wild carrots,” The New York Times reveals.

Pills at yet another retailer contained unlisted ingredients including peanuts and soybeans, which are problematic for people with allergies.

The investigation came on the back of a 2013 New York Times article, which revealed a widespread problem of labelling fraud in the vitamins and supplements industry. The article noted research that found as much as one third of supplements tested did not contain the ingredients listed on their labels.

While the industry plans to hit back at the latest findings with testing of their own, how relevant is the supplement scandal to the Australian market?

Complementary medicines, including vitamins and supplements, are worth $4 billion in Australia.

They are regulated by the Therapeutic Goods Administration (TGA) and categorised into two classes; AUSTR and AUSTL.

“The degree of assessment and regulation required to gain registration (AustR) is rigorous – sponsors are required to provide comprehensive safety, quality and efficacy data,” writes Rachael Dunlop, a post-doctoral fellow at the University of Technology, in The Conversation

“This is not the case for AustL. Under the current system, you can get your CAM product stamped with an official-looking number by simply applying online … the TGA does not check any AustL products to see if they work or even if they are safe.”

Dr Vicki Kotsirilos, Melbourne GP and author of A Guide to Evidence-based Integrative and Complementary Medicine, disagrees.

In regards to the American supplements scandal, she says:

“It does not surprise me, but it does not apply to Australia.

“We have one of the highest regulatory systems for complementary medicines in the world.”

Kotsirilos, who has previously worked for the TGA, adds:

“Australian consumers can be confident that, as long as it has been regulated through the TGA – as a AustL (listed) or AustR (registered) product – that they’re very likely to contain the dosage and ingredients recorded on the label.”

For this reason, she advises people against buying their supplements from the internet or overseas.

Kotsirilos also disagrees with another question raised as a result of the  American investigation: whether the goodness of a supplement or vitamin (assuming it contains what the label says it does) is lost through processing.

“There are no clear studies to verify that statement,” she says.

On the contrary, she says, “some complementary medicines, such as evidence-based nutritional and herbal supplements in their final product form have evidence of clinical efficacy for clinical conditions.”

Despite this, recent research suggesting some vitamins are at best a placebo and at worst can do more harm than good, makes them a hard pill to swallow.

“Complementary is unfortunately not a good term because it includes a lot of rubbish and is often grouped with clinical-based products,” Kotsirilos says.

“If you’re a healthy person and eating the perfect diet and can assimilate nutrients from that diet … you have to ask whether you need to be on multivitamins.

“If you’re not absorbing nutrients, there is a role to take nutrients for nutrient deficiencies – where the evidence applies or holds.”

Where evidence applies or holds is the key. Kotsirilos admits that even in vitamins where there is evidence of efficacy, there is variation in ingredients, quality and dosage from one product to another.

There is only one way to separate the wheat from the vitamin chaff, Kotsirilos says.

“It is important that people are guided by professionals who are aware of the evidence and which products carry the evidence.”