A Credible Data Base for Natural Products

Sandra G Boodman of The Washington Post has found a boon to those seeking reliable wellness references ...

Consumer Reports, the bible of independent consumer ratings, has introduced a new database of information on thousands of herbs, dietary supplements and other natural medicines, a response to the enormous growth in the use of these products.

The new database -- unveiled last month and believed to be the most comprehensive of its kind -- contains detailed and easily accessible information on the safety, effectiveness and possible harmful interactions of nearly 14,000 supplements. It is available for a $19 annual fee, which also gives users access to Consumer Reports guides to prescription drugs and medical treatments.

The database, officially known as the Natural Medicines Comprehensive Database, is the product of the Therapeutic Research Center in Stockton, Calif., which analyzes prescription and over-the-counter drugs. Like Consumers Union (CU), which publishes the monthly Consumer Reports magazine and does not accept advertising, the center receives no funding from pharmaceutical companies, according to its chief, Jeff Jellin.

Jellin, a former professor of pharmacy, said that the center is funded by subscriptions to two newsletters it publishes: the Prescriber's Letter and the Pharmacist's Letter. The consumer database is adapted from these newsletters, which circulate to medical schools, hospitals, doctors and pharmacists.

For several years CU has provided information to subscribers about prescription drugs through a partnership with the Bethesda, Md.-based American Society of Health-System Pharmacists.

"We decided to do this because we get calls all the time" about natural medicines, said CU project manager Nancy Metcalf.

Demands for Supplements

A 2002 survey found that an estimated 19 percent of Americans take at least one supplement -- ranging from ginkgo to improve memory to St. John's wort to treat depression.

Many users erroneously regard these products as safe because they are "natural" and do not consider them to be drugs, Metcalf noted. In fact, the efficacy of many products is untested, their purity unknown and their safety uncertain because they are largely exempt from the scrutiny of the Food and Drug Administration.

Even so, demand for natural medicines seems insatiable: Americans now spend an estimated $20 billion annually on herbal remedies for weight loss or to treat back pain, dementia or cancer, studies have found. Yet credible information about supplements remains scarce and what exists may require parsing complicated scientific studies. Many Web sites and guides offer information about such medicines, but much of it is produced by groups that have a financial interest in selling the products, experts say.

"CU does a good job," said Candy Tsourounis, an associate professor of pharmacy at the University of California, San Francisco. Tsourounis, an expert in the use of herbs and natural medicines, called the guide informative and "very user-friendly."

CU's database lists approximately 100 brands of supplements that contain garlic, often taken to reduce cholesterol or blood pressure, for which it is rated "possibly effective." The site warns users that garlic supplements could interfere with the effectiveness of birth-control pills because they speed the breakdown of estrogen and may interact with statins, which are broken down by the liver.

Theoretical vs Actual Harm

Alternative medicine specialist Adriane Fugh-Berman, an associate professor of complementary medicine at Georgetown University School of Medicine, said that while the CU directory is " much more accurate than many other resources," it fails to distinguish between theoretical risks various supplements may pose at a cellular level and actual harm seen in human studies.

"Extreme caution can work against public-health outcomes," said Fugh-Berman, who has written about the benefits of some herbal medicines. If consumers are told "everything interacts with everything, people will just stop listening."

Jellin said that such distinctions appear on the professional version of the database, but not on the consumer Web site.

"We put forward what we think is the best advice," he said. If a theoretical harm is deemed potentially significant, such as increased bleeding associated with ginkgo ingestion, it is posted in the interest of consumer protection.

A distinctive feature of the database is its ability to quickly check interactions between herbal supplements and prescription drugs.

The listing for the popular antidepressant Zoloft, for example, shows interactions with more than 80 supplements and herbs, including vitamin E, which is often taken to protect the heart.

Jellin said his employees combed through 1,450 scientific studies of supplements last year, and he expects the number to be higher this year because of growing scientific research in herbal medicine. The guide is continuously updated.

"Had I known 10 years ago how much work this would be," he quipped, "I never would have done it."