THE RISE OF ‘BIG SUPPLA’
It’s become a part of everyday life for millions of Australians but is the supplement industry actually putting our health in danger? JANE HANSEN reports.
It’s a multi-billion dollar business, and one in three Australians regularly take their products, but health experts are concerned the increasing popularity of herbs and supplements is contributing to a spate of liver transplants. With more and more people turning to supplements for health reasons, general practitioner Dr Sam Manger warned the industry had become like “big pharma’’, employing the same sales tactics as major pharmaceutical companies and selling hundreds of dollars worth of concoctions to vulnerable people who had little understanding of the effects.
“It’s about money, it’s the new ‘big pharma’,” Dr Manger said. “It uses all the same dirty tricks but with far, far, less regulation and very low standards. It’s the Wild West.”
Dr Manger recently y saw a patient who had d spent more than $2000 0 on vitamins, minerals, homoeopathies and various tests when simple lifestyle changes would have fixed her ailments.
“She’d spent thousands s over a month, the supplements caused a wide range of side-effects and she had quite a severe reactive e depression as a result, along with who-knows-what other supplement side-effects that were interacting, and she had lost much of her savings,” he said.
Dr Manger was so shocked he took a photograph of the pyramid of supplements that had been prescribed by an alternative health practitioner. He also recently saw a man who sought alternative therapy for a carcinoma. “He had been using black salve for over a year at the recommendation of his natural therapist, it had grown to over 15cm long and a deep ulcer, I suspect it would be metastatic now and will be too late for him,” he said.
Transplant physician Associate Professor Simone Strasser (inset above), from the Australian National Liver Transplantation Unit in Sydney, said they saw six patients last year who had taken too many supplements, ironically in the pursuit of health.
“We are seeing more and more people developing severe liver injury related to herbal and dietary supplements, supplements taken at the gym, for weight loss, for all sorts of things,” she said. “We are certainly seeing more and more people developing severe liver injury requiring transplantation or a month in hospital to recover and sometimes not recovering at all.
“A patient recently had a transplant, she was in her 40s and took a herbal compound for weight loss and she required a liver transplant. There is very little regulation in the industry. People expect they are safe because they are so-called natural and they are c clearly not.”
Studies have shown that herbs such as garcinia cambogia, Jin bu huan, Ma huang, Pennyroyal and green tea extract can all c cause liver failure, while a 2014 American study found severe liver injury a attributable to health and dietary supplements had increased from 7 per cent t to 20 per cent over the p previous decade.
Sydney mum Ann G Gilberthorpe knows the dangers all too well. She ended up on life support after taking herbal teas and supplements to fight a virus. Her liver was destroyed and she required an urgent liver transplant to survive.
“In intensive care the doctor said everyone thinks these things are natural but so is funnel-web venom,” she said. In 2016, Geraldton man Matthew Whitby, then 27, also suffered liver failure and needed a transplant after buying green tea extract online. “I didn’t really think green tea extract could be harmful,” he said after his lifesaving transplant.
Dr Rosemary Smith, who wrote a research paper on Mr Whitby’s case, said the easy access to such products was part of the reason physicians will start to see more cases.
“These products were previously mostly found in specialist stores or online but increasingly they are available in mainstream supermarkets,” she said.
“This is surely secondary to demand, and demand is not surprising given that such products are marketed as beneficial for health. Indeed, they are often found in the supermarket ‘health food’ section.”
While some supplements like folate for pregnancy are evidencedbased and recommended by doctors, the supplement industry has doubled in value in the past 10 years with an explosion of products with dubious claims, like protecting eyes from smart phones and making kids smarter. According to the Complementary Medicines Australia report 2018, the “number of Australian con-
sumers who used a complementary medicine on a regular basis in 2015 was 8.1 million, up 22.7 per cent from 6.6 million in 2011”. The same report showed most people (41 per cent) purchased their herbs and supplements from pharmacies who are increasingly hiring naturopaths to “achieve sales targets’’ as one recently posted job advertisement for a naturopath in a Newcastle pharmacy said.
Indeed, Taree pharmacist Ian Carr has voiced his concern about the blurring of lines between evidenced-based pharmaceuticals being sold alongside supplements, with naturopaths hired instore to sell them.
“They are subsidised by the supplement companies and they have to meet sales targets” he said. “A lot of the supplement companies are owned by ‘big pharma’ now anyway but the difference is they can make claims that are dubious at best.
“I had a pensioner with a heart condition who was spending over $100 a month on supplements and she could not afford them.”
Naturopaths, unlike doctors, are unregulated which means anyone can call themselves one, even if they have no training. “People are under the misunderstanding that any recommendation (from a natural therapist) is evidence based, but more often than not it is ideological based. It’s very dangerous and it is killing people,” Dr Manger said.
The National Health and Medical Research Council put out a position paper in 2015 after a review of homoeopathy which found zero evidence it worked. Dr Jon Wardle, secretarygeneral of the World Naturopathic Federation, said “corporate pharmacies” who hired naturopaths were problematic and called for regulation.
“These are not meant to be commercial products, they’re actually medicinal products and need to be treated as such,” he said. “The whole rise of corporate pharmacies that are pushing products is where we see the problems happening. It’s all based on sales quotas, I think regulatory attention is needed.
“A lot of pharmacies are placing unrealistic sales quotas on naturopaths. Associations like the Naturopaths and Herbalists Association have been calling for naturopaths not to be used as sales assistants in pharmacies.’’
Professor Ken Harvey, from Monash University, said the Therapeutic Goods Administration (TGA) had failed in its duty to protect Australians from ineffective health products and dangerous supplements which made unsubstantiated claims.
“It’s a combo of promotional hype, quest for profits and a lack of regulation by the TGA,” he said.
John O’Doherty, from Blackmores, one of the nation’s largest supplement manufacturers, said the company discontinued a trial of naturopaths placed in pharmacies in favour of educating pharmacists and sales assistants about their products.
“We provide extensive and ongoing training to pharmacists to help ensure customers receive the best advice and products for their health needs,” he said.
Dr Sam Manger is concerned the supplements industry is becoming like ‘big pharma’ by putting profits ahead of needs.
Ann Gilberthorpe, pictured at home in Hornsby, needed a liver transplant after taking herbal supplements. Picture: Tim Hunter