Labeling on Herbal Products Differs Widely
Excerpt by Amy Norton, Reuters Health

Different brands of the same herbal supplement can vary widely in the label's recommended dose and listed ingredients, according to a new study.

University of Minnesota researchers found that among the top herbs including echinacea, ginkgo biloba and St. John's wort -- label information differed greatly from product to product. And as far as recommended dosage and ingredients, fewer than half were consistent with certain "benchmark" recommendations.

The benchmark the researchers used was a professionals' handbook on alternative medicine. Because the U.S. does not regulate dietary supplements as it does drugs, there are no standards for ingredients or dosage of herbs. According to the study authors, the handbook -- which was based on what herbal-product research was available -- is one of the few such publications by scientists with no commercial interest in the industry.

For the study, Dr. Judith Garrard and her colleagues in Minneapolis examined product labels for 10 widely used herbs. At the 20 stores they looked at, there were 880 different products, sold under 241 brands, for those herbs.

Overall, 43 percent of the products were consistent with the benchmark in dosage and ingredients, according to findings published in the Archives of Internal Medicine.

The fact that that many products were close to the benchmark is "the good news," Garrard told Reuters Health.

She said that more than one-third of the products had labeling that was too vague to determine the ingredients, meaning the plant species and plant parts used.

When the researchers looked at a given herb's recommended daily dose, they found wide variation among products. For example, dosing for St. John's wort, sold as an antidepressant, ranged from one to six pills per day depending on the product.

For echinacea, marketed as a common-cold fighter, Garrard and her colleagues found 92 products sold under 27 brand names. Two-thirds of these products were inconsistent with the benchmark in both ingredients and dosing recommendations.

At the other end of the spectrum, all of the 113 ginseng products examined were consistent with the benchmark for listed ingredients.

For some herbs, but not all, a higher price meant the product was more likely to match the benchmark recommendations. But consumers aren't left with much more as their guide in navigating the sea of herbal products.

Even the benchmark doses and ingredients standards used in the study are tentative because of the lack of rigorous research into herbs, according to Garrard. Without clinical trials like those required for prescription drugs, she said, it's unclear whether various herbal products are effective at all -- although, she added, some herbs have been more heavily researched than others.

Garrard suggested that for any given herb, consumers should consult several references to find out what parts of the plant are considered useful, and look at whether the different references agree on dosing recommendations. She also advised that herb users tell their doctors what they are taking.

SOURCE: Archives of Internal Medicine, Oct. 27, 2003.

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