Web skips ephedra warnings
Internet marketers of herbal supplements containing ephedra frequently make false claims and fail to offer complete information about potentially dangerous, even life-threatening, side effects, finds one of the first studies to focus solely on e-commerce and the herbal supplement business.
Despite being linked to elevated blood pressure, strokes and heart attacks, the popular stimulant, used by millions primarily for weight loss, was touted on one Web site as a beneficial treatment for hypertension and coronary disease, according to an article published this month in Mayo Clinic Proceedings.
Other problems identified in the Internet promotion of ephedra ranged from wrongly implying governmental approval to falsely claiming the product had no adverse side effects. In all, the study scrutinized 32 Web sites selling products with ephedra in July 2002.
“This confirms what I think most physicians knew intuitively -- that there’s a lot of misleading, sometimes just bad, information on the Internet,” said Dr. Bimal Ashar, the study’s lead author and an assistant professor of medicine at Johns Hopkins University in Baltimore. “But to most of the public, including many of my patients, they really don’t know about these dangers.”
Suspicions about the claimed benefits of dietary and herbal supplements, made both on and off the Internet, were heightened further last week after an article in the Journal of the American Medical Assn. reported that guggulipid, advertised as a cholesterol reducer, instead slightly raised cholesterol levels. The same study also found that the supplement, made from the resin of the mukul myrrh tree, gave one in 10 users a skin rash.
In a random sampling of Web sites selling guggulipid last week, neither the JAMA study nor the rash side effect was mentioned. Makers of the herbal supplement, however, criticized the JAMA study as being too limited in scope and for failing to test the product for its effectiveness in treating other heart disease risks.
The studies highlight the need for consumers to exercise caution when purchasing such items via the Internet, critics of Internet marketing say.
“There’s no guarantee of effectiveness or safety with these kinds of products,” said Nicolas Terry, co-director of the Center for Health Law Studies at Saint Louis University in Missouri. “Never mind if they’re going to kill you, you really don’t know what’s in them.
“My advice would be not to buy any of these products without first talking to your doctor,” he added.
A 1994 federal law allows makers of dietary supplements to place their products on the market without testing their safety or efficacy, as is required for drugs. Also, it is incumbent upon the government to prove an herbal or dietary product is dangerous to regulate or ban it.
In the face of calls during congressional hearings held last month to ban or at least to more strictly control the supplement, makers of ephedra continued to claim the substance is safe when used as directed and is beneficial for weight loss and improving athletic performance. Even so, Illinois already has banned ephedra sales, and the American Medical Assn. and the National Football League have prohibited its use.
If regulating over-the-counter sales of herbal supplements is challenging, critics say, the task is greatly magnified when it comes to the Internet.
Because of the Web’s relative anonymity, it can be hard to know who is operating the e-business. And even if the identity is discovered, critics say, if the operator is located outside the United States, it’s not bound by U.S. law.
“The Internet clearly facilitates small-level fraud, because just as it reduces transaction costs for legitimate commerce, so it also removes a lot of barriers for legally marginal businesses, too,” Terry said. “I would not buy these kind of products over the Internet unless I was buying it from one of the recognized on-line drugstores. Otherwise, you really don’t know what you’re buying.”
