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Echinacea Products Often Mislabeled, Survey Says

Research shows some bottles didn't have any of the herb

MONDAY, March 24, 2003 (HealthDayNews) -- When it comes to many echinacea products, consumers may not be getting what they pay for.

Versions of the popular herb sold over-the-counter as a cold fighter and immune booster differ widely in their contents, and the labels often don't reflect what's inside the bottle, says a study in the March 24 issue of the Archives of Internal Medicine.

The authors of the study bought 59 different echinacea products from Denver-area retailers over two days during August 2000. The preparations were then sent to a lab in Connecticut for analysis.

Six of the products, or 10 percent, contained no measurable echinacea at all, according to the investigators. Labeling matched contents in only 52 percent of the samples. Of the 21 "standardized" preparations, 43 percent met the quality standard described on the label. And only 7 percent of the samples met all four of the federal government's labeling requirements.

"I don't think that consumers can guarantee that what you're getting really has echinacea in it," says Dr. Christine Gilroy, the lead author of the study and an assistant professor at the University of Colorado Health Sciences Center in Denver.

The reaction to the new findings drew both praise and defense.

While acknowledging that manufacturers clearly have an obligation to label their products correctly, industry experts are not necessarily surprised that different products vary in composition.

"Some of that doesn't necessarily reflect poorly made products," says John Hathcock, vice president for nutritional and regulatory science at the Council for Responsible Nutrition in Washington, D.C.

No one is sure what the active ingredients in echinacea are, he adds, and the chemicals that the study authors focused on may not be the important ones.

Medical professionals, however, are applauding the results.

"I think it really is another nail in the coffin of the supplement industry, or at least I hope it will be," says Dr. Henry Anhalt, the director of pediatric endocrinology at Infants and Children's Hospital of Brooklyn at Maimonides Medical Center.

"This perception that health food stores are out there for the benefit of the public alone has got to stop. You may die by getting poorly controlled stuff or you may be paying for stuff and not getting what you paid for," he adds.

It's a particularly timely message, given the U.S. Food and Drug Administration's recent push to upgrade labeling for products containing ephedra, a nutritional supplement that has been linked with more than 100 deaths.

Herbal medicines are big business. In 1997, Americans spent $5.1 billion on the products, almost four times as much as they spent in 1990. Echinacea, which supposedly helps treat and prevent the common cold as well as boost immune functioning, accounts for 10 percent of total sales.

Echinacea, ephedra and other related products are regulated under the Dietary Supplement Health and Education Act of 1994 (DSHEA) and so have different standards than either "conventional" foods or drugs, both prescription and over-the counter.

According to the article's authors, many consumers apparently don't realize that there are actually three different types of echinacea with three different effects.

Studies have shown that echinacea purpurea may help with symptoms of the common cold and may even decrease the number of colds you get when taken prophylactically. Echinacea pallida root extract may decrease the duration of common cold symptoms. There's some debate about the efficacy of Echinacea angustifolia.

The issue of "standardization," a term used on the labels of many herbal preparations, is also something that may confuse consumers. It is supposed to indicate that the particular herb is comparable to other preparations of the same herb.

Gilroy, however, is skeptical.

"They're trying to give you a guarantee that there's an adequate amount of active ingredients," Gilroy says. "It's a marketing ploy for quality."

In the research, she adds, the standardized preparations did tend to have better compliance than the non-standardized preparations. And, she says, the store-brand labels tended to do a better job of documenting what was in the product.

The most striking difference was in the "Supplements Facts" box. Seventy-six percent of the standardized preparations made claims about the activity of echinacea, versus 55 percent of the non-standardized preparations. Expiration dates were found on 80 percent of the samples while 47 percent had cautionary statements.

Hathcock says there are "substantial analytical chemistry issues here." In particular, while the primary method of thin-layer chromatography can tell you if a compound is present, it is less effective in pinpointing how much.

Medical professionals are hoping the FDA will pick up on this latest revelation.

"There's this gaping hole of irresponsibility that nobody seems to be willing to challenge," Anhalt says. "It's all fine to say we believe that alternative complementary medicines are good and that products like echinacea can be helpful, but let's regulate them. Let's make sure the consumer is being protected."

More information

For more on echinacea, visit the Herb Research Foundation. The National Institute of Allergies and Infectious Diseases has more on the common cold.

Henry Anhalt, D.O., director, pediatric endocrinology, Infants and Children's Hospital of Brooklyn at Maimonides Medical Center, New York City; John Hathcock, Ph.D., vice president for nutritional and regulatory science, Council for Responsible Nutrition, Washington, D.C.; Christine Gilroy, M.D., assistant professor, University of Colorado Health Sciences Center, Denver; March 24 Archives of Internal Medicine
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