Douglas Lobay, BSc, ND
I had the good fortune to visit New York City and walk on the iconic Brooklyn Bridge in August 2019. The Brooklyn Bridge was opened in 1883 and was the longest suspension bridge in the world. It was an engineering marvel that spanned the East River and linked lower Manhattan to Brooklyn. At that time, it was a toll bridge and pedestrians paid one cent to cross the bridge. A horse and rider paid five cents and a horse-drawn wagon paid 10 cents. The toll charges were later rescinded. The numerous steel cables fan out in an amazing web-like pattern that attaches from neo-gothic arches above to girders below. You are also treated to amazing panoramic views of the Manhattan skyline. On that afternoon the bridge was congested with many pedestrians and street vendors trying to sell souvenirs. If you ventured across into the bike lane, a cyclist in true New York fashion would let you know what he or she thought. It has also been said that the Brooklyn Bridge has been bought and sold many times by hucksters and con artists to unsuspecting tourists and immigrants. It is a prime example of the oft-used idiom “if it sounds too good to be true, it often is.”
Unfortunately, the same cliche can be applied to the field of natural medicine. There have been more than a few examples of fraudulent scoundrels and scallywags tainting so-called nutritional supplements with undeclared pharmaceutical drugs in the name of profits and clinical efficacy. In thirty years of practice, I have encountered several products that seemed “too good to be true.” They were often touted as “amazing” and “miraculous” in unsupported advertising claims that were not backed up with adequate scientific research. And they seemed to work “amazingly” well, above and beyond what would be expected from a vitamin or herbal formula. I would often look at the ingredient list, scratch my head, and wonder aloud why this formula or blend worked so well. However, unbeknown to me, the product was often mislabeled and was often purposely adulterated with an enhancing pharmaceutical ingredient.1,2
The U Dreams debacle is a classic example of a natural herbal product that was tainted with an illicit pharmaceutical that was not declared on the label. U Dreams was a popular Canadian herbal supplement that exploded on the health food scene and had a meteoric rise and precipitous fall. Its label said it was a mixture of different herbs, including passionflower, loquat, lion’s mane, jujube, schisandra, rehmannia, and a small amount of l-tryptophan. It was touted as “all natural” and “sleep naturally,” and it worked amazingly well. It flew off the shelves in health food stores and our office couldn’t keep enough stock to meet demand. Patients loved it and said it worked surprisingly well and, of course, it was natural.
After U Dreams was removed from the Canadian marketplace by Health Canada, I tried to make a generic equivalent. Again, I couldn’t understand how this product worked so well. I was familiar with most of the herbs in this product. I recommended other natural formulas that were somewhat similar, and they did not work as effectively as this formula. Health Canada later disclosed that U Dreams was found to be tainted with zopiclone and eszopiclone. Now it made sense. And looking back some patients did complain about a metallic taste in their mouth, and some people had trouble getting off this product.
For many years I used a popular thyroid glandular support formula whose label disclosed that it contained 100 milligrams of thyroid glandular extract that was T4 or thyroxine free. The formula seemed to work well, patients liked it, and lab tests confirmed its clinical utility. I was intrigued at how they were able to get the thyroid glandular extract thyroxine free. I did research, consulted chemist friends, and contacted glandular supply companies to no avail. I could not find an extraction technique or wholesale company that had or made thyroxine-free thyroid glandular extract. I was stumped. At a chance private meeting with one of this company’s ex-vice executives at a naturopathic conference in Vancouver, he disclosed that in fact the glandular was not thyroxine-free and was added to the formula in a dose less than what was listed on the label. I was crushed and disheartened, but this ultimately explained things.
Buster was an older well-to-do businessman who was also a chelation client of mine who went on to develop prostate cancer. He introduced me to a product called PC-Spes, which was an eight-ingredient herbal formula containing herbs that included saw palmetto, skullcap, reishi mushroom, licorice, chrysanthemum, and panax ginseng. The formula was touted as an effective treatment for prostate cancer. He took the product for several years with very good results. It reduced and maintained his PSA at a low level. I recommended the formula to several other prostate cancer patients with good results.
One patient who had a particularly aggressive form of prostate cancer came to our clinic one day. He was under sixty years of age, was a very fit and active martial artist and was a Chinese medicine practitioner. He hobbled in one afternoon, complained of bladder-area pain, donated a urine sample full of blood. I asked him the last time he went to see a doctor for a checkup. He said he didn’t believe in doctors and hadn’t had a checkup for probably ten years. We sent him for some lab tests. His PSA reading was over 3000. We immediately sent him to see an oncologist at the local cancer center. They did some more testing, determined he had an aggressive stage 4 prostate cancer, and recommended hormone chemotherapy. He refused the treatment. I told him about some patient’s results with PC Spes. He ordered it and started to take it. Within one month his PSA dropped from 3000 to a little over 100. The doctors were amazed and he was even starting to feel some better. Six months later he had a mild stroke that affected his speech, and he developed weakness on one side of his body. He was a smoker. He stopped the herbal formula.
PC Spes was later found out to be tainted with warfarin and the synthetic estrogen analogue DES or diethylstilbesterol. For a long time I couldn’t understand how this special herbal formula worked so well. I recommended similar products with saw palmetto and the other ingredients in this formula, but they didn’t lower PSAs like PC Spes. Now it made sense. And now I know why Buster always had a little blood in his urine sample following chelation therapy.
One male patient came in our office with a so-called natural product he had picked up in a pharmacy while on vacation in Mexico. The product claimed to cure pain and had herbal ingredients that included yucca. When the patient took this product, the pain in his hands and hips went away. He had previously tried other products that contained glucosamine, willow bark, turmeric and other herbs, but they never worked as well as this product. After doing some internet web research this product was found to contain the pharmaceuticals diclofenac and prednisone.
Another female patient came in with a product for sleep that she had picked in a natural health food store in England. She scolded that I didn’t have anything as effective for her in my natural dispensary. The ingredients listed some common sedative hypnotic herbs like valerian, hops, and skullcap. After sleuthing around the internet, I discovered that the product was tainted with a pharmaceutical benzodiazepine drug bromazepam.
And unfortunately, I have come across other dubious examples of natural products that appeared to be too good to be true. There have been energy and sports-enhancing products that have been adulterated with stimulants like ephedrine or a variety of different anabolic steroids like nandrolone or stanozolol. Other times there have been other natural libido-enhancing products that have been tainted with phosphodiesterase inhibitors like sildenafil, tadalafil and vardenafil.
In one study from 2007 to 2016 the FDA identified 776 dietary supplements that were tainted with illicit pharmaceutical products from 146 different companies. The FDA reiterated that these stealth products have the potentiality to cause serious side effects and interact deleteriously with other prescription medicines. It was pointed out that natural health products are widely available to consumers without prescription and strong regulatory oversight. The adulteration of supplements with prescription medicine while still claiming that they contain only natural ingredients is dishonest and borders on criminality. Honesty, full disclosure, and truthfulness are tantamount to good manufacturing practices in the health food industry.3,4,5
A little mixture of curiosity and a background in chemistry have blended together in my naturopathic practice. When I was a child my parents purchased a chemistry set through the Sears and Roebuck Christmas catalogue for me. I thoroughly enjoyed mixing things, creating potions and balancing formulas. I since have researched, sourced out ordered, and mixed different herbal blends that have been professionally processed and encapsulated for my patients. Some of the formulas contain unique blends of hard-to-get herbs and others are blends with pharmaceuticals that have been fully disclosed on the label. I think that mixing pharmaceuticals with different herbal and vitamin supplements has its place in modern naturopathic medicine. I believe in blending science with nature.
Hybrid nutritional supplements can be made that contain a blend of over-the-counter medicine and prescription pharmaceuticals along with natural ingredients. Adding a vitamin, mineral or herbal to a prescription might be a good thing. Why not add a blood pressure medicine along with garlic and magnesium, for instance? It might be a good idea and it might be more effective than each ingredient on its own. Why not add a little bit of prescription sleeping medicine to some valerian and melatonin? It might be just as effective as a stronger dose of the isolated pharmaceutical by itself. Why not mix arnica with an anti-inflammatory like diclofenac and see how it works?
Of course, so-called experts, naysayers and stakeholders may argue against this. And some old-time naturopathic purists may adamantly shun any allopathic drugs and may roll over in their graves and admonish me for suggesting such an idea. But with some common sense, background in chemistry and pharmacognosy and compounding knowledge the merging of the two schools of thought at some common ground is possible and exciting.
Maybe I am a “bad” naturopath who has been poisoned with the ideology of mainstream medicine. However, as a practitioner in the trenches for thirty years, I believe that it is what is in the best interest of the patient that is the most important, identifying what they want, giving them choices and supplying them the best medicine that is possible that gets the best results. I have no firm indoctrination in one camp or another. It is whatever works the best, with least amount of side effects that may be most effective. I believe in the healing power of nature, but sometimes nature needs a little help.
Ponce de Leon was a 16th century Spanish explorer and first governor of Puerto Rico that searched for mythical spring water that beheld the “the fountain of youth.” Those who drank the water were blessed with good health and longevity and freedom from disease and illness. Ponce de Leon travelled to Florida and later to Bimini in the Bahamas in search of this miraculous elixir. It is not known whether he actually found the magical blend or not. But many after him have searched for this “fountain of youth.” And many other scoundrels and scallywags have sold so-called “cures” and “elixirs of youth” to a gullible and uninformed people.
In my years of experience in practicing naturopathic medicine, I have learned that there are very few magical potions and cures. Good health and longevity are often the result of hard work, good diet, proper nutrition, healthy lifestyle habits, and maybe lucky genetics. But I suppose like everyone else I will keep on searching for “the fountain of youth.”
As practitioners we are the hallowed gatekeepers of natural medicine, and it is our job to make informed and critical decisions in the best interest of our patients. And if something sounds “too good to be true,” it is imperative that we critically and skeptically evaluate it before we recommend to patients with confidence.
References
- Tucker J et al. Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings. JAMA Netw Open. 2018 Oct 5;1(6):e183337.
- Wheatley VM and Spink J. Defining the Public Health Threat of Dietary Supplement Fraud. Compr Rev Food Sci Food Saf. 2013 Nov;12(6):599-613.
- Hamidi S. Assessment of Undeclared Synthetic Drugs in Dietary Supplements in an Analytical View: A Comprehensive Review. Crit Rev Anal Chem. 2021 Nov 10;1-11.
- Rocha T. Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review. Compr Rev Food Sci Food Saf. 2016 Jan;15(1):43-62.
- Vaclavik L et al. Mass spectrometric analysis of pharmaceutical adulterants in products labeled as botanical dietary supplements or herbal remedies. A review. Anal Bioanal Chem. 2014 Nov; 406(27):6767-90.
Published May 20, 2023
About the Author
Douglas G. Lobay, ND, is a practicing naturopathic physician in Kelowna, British Columbia. Dr. Lobay graduated with a Bachelor of Science degree from the University of British Columbia in 1987. He then attended Bastyr College of Health Sciences in Seattle, Washington, and graduated with a Doctor of Naturopathic Medicine in 1991. While attending Bastyr College, he began to research the scientific basis of natural medicine. He was surprised to find that many of the current medical journals abounded with scientific information on the use of diet, nutrition, vitamins, and botanical medicines. Besides practicing naturopathic medicine Dr. Lobay enjoys research, writing and teaching others about the virtues of good health and nutrition. He has authored several books, numerous articles, and papers and has taught many courses at seminars and colleges throughout his career. He is married to Natalie and has two daughters, Rachel and Jessica. He also enjoys hiking, hockey, skiing, tennis, travelling and playing his guitar.