The Australian public is more educated about health than ever before and more than seven out of ten of us now use some form of complementary medicine to support our health. This diverse range of treatments include:
“Australian complementary medicines are among the safest in the world, manufactured to the highest pharmaceutical standards."
A recent newspaper story reports that as well as liver toxic pharmaceutical drugs such as paracetamol and antibiotics, other pharmaceutical drugs and supplements may be involved in liver damage in a small number of cases.
Where referring to complementary medicines, the researchers do not reveal the ingredients in the products or whether these products are single- or multigradient formulations. Further, we are not told whether these products are from Australia or bought from overseas; all of these factors make accurate commentary and response difficult.
What researchers do reveal, is that the products fall into the categories of muscle growth in males and weight-loss in women.
With regards to bodybuilding supplements in males, it is mere speculation as to whether the products examined contained anabolic steroids. There are no Australian complementary supplements listed on the Department of Health’s Therapeutic Goods Administration (TGA’s) Australian Register of Therapeutic Goods that contain such ingredients. For females, the story cites weight-loss supplements. Again, the affected products, their source and the ingredients investigated are not provided, making accurate commentary difficult.
It is known that both bodybuilding supplements and weight-loss supplements are more likely to be imported for personal use and when tested are more likely to include ingredients that are not declared on the label.
Look at the label
Complementary medicines including herbal medicines that are supplied to consumers in Australia (with an AUST L or AUST R number on the label) are regulated to minimise the possibility of liver associated side effects including the absence of herbs with well-known
effects. In those where reactions are very rare and without known cause, they come with consumer safety information or warnings, similar to pharmaceutical medicines that pose a similar rare risk of liver effects.
CMA reiterates the following factors to support health when choosing complementary medicines.
1. Beware of products purchased from overseas that may contain unlabelled and potentially harmful ingredients.
Some overseas-based products may be adulterated and non-compliant with Australian
regulations. The ingredients are may either not be listed or their concentrations inaccurately reported.
2. Trust in Australian made
Australia has the most highly regulated environment in the world for complementary medicines quality and safety. Manufacturing is required to adhere to pharmaceutical standards under principles of Good Manufacturing Practice (GMP) and products meet specific guidelines set by the TGA.
In the Australian regulatory system, all complementary medicines (bearing an AUST L or AUST R number) that contain herbs must undergo identification tests to ensure each herb is what it says it is. This stringent
governing has resulted in discerning consumers choosing Australian-made products and has made the Australians' complementary medicines industry a national and worldwide success story.
3. Follow the instructions on the label
Labels on Australian complementary medicines have clear guidelines on dosage and instruction. These labels provide relevant consumer warnings for well-established information. If unsure of suitability or if other health concerns exist, consumers should seek the help of a healthcare professional before use.
4. Better health literacy for all
The researchers in the above story note that almost half the patients with supplement-induced liver damage were of non-European ethnic backgrounds. They called for more culturally appropriate community education about the risks of supplements. CMA agrees that more education is necessary regarding health literacy among the population including the use of all medicines
particularly in regards to purposeful overconsumption or potentially higher risks of imported products not regulated under the therapeutic goods scheme in Australia.
CMA welcomes greater investment in improving heath literacy. Recent data tells us that only
39% of the population find it always easy to understand health information well enough to know what to do1.It is well known that people with low health literacy are more likely to have worse health outcomes overall and adverse health behaviours, including ability to self-manage care.
Further, targeting health literacy programs at diverse population groups has the potential to reduce health inequalities.
Why it is difficult to agree with Dr Harvey
Self-professed and very vocal critic of complementary medicines and the TGA, Dr Ken Harvey, commented that the study only examined severe cases of supplement-induced liver harm saying that the actual rate of damage was likely to be much higher. This is also difficult to agree with since the studies ingredients are not stated and because all recorded events to complementary medicines are reported and available to the public on the TGA’s Database of Adverse Event Notifications (DAEN).
The published article cited 115 cases of paracetamol induced liver injury in the same time period, and it is not clear whether Dr Harvey also believes that the rate of damage of this substance is also much higher than stated in the study, or which information warrants these types of claims.
Australia takes each report extremely seriously
“Australian complementary medicines are among the safest in the world, manufactured to the highest pharmaceutical standards. We lead the world in adverse reporting process and take each and every single report extremely seriously to ensure consumer safety. CMA welcomes detailed investigation and examination by the research community to inform and strengthen our high-quality standards,” ends Carl Gibson.