Letters to the Editor

Townsend Letter for Doctors and Patients,  Feb, 2001  

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Nutrition Should be Prescribed, Not Peddled!

Editor:

Beware of any company that sells opportunity and not product: Nutrition should be prescribed, not peddled! This is one reason why reputable companies sell only to health care professionals, because they want their products properly selected and applied in an appropriate manner, When products are peddled, the focus shifts from quality products and the health of the individual, to marketing and profits.

There are no cookbook approaches to optimal health. Nutrition that is peddled uses a cookbook, or one-size fits all, approach. Functional Medicine Practitioners have the knowledge, skill and tools to individually assess and tailor nutritional programs and they should select only products that are proven safe and efficacious that are in therapeutic strengths. A thorough and careful history should be the basis of all nutritional interventions. The health care professional is best trained to do this. That is why I do not give professional advice over the phone, based on a set of symptoms, and I do not adjust people because they have a "crick" in their neck.

Symptoms are a flag for further evaluation and systematic assessment in order to tailor specific, individualized, intervention programs aimed at addressing the cause, not just the manifestations. To not do so, is, in my opinion, to be guilty of malpractice, puts the patient at risk, and is unprofessional!

Today both health care professional and patient are being bombarded with inflated claims and hyped up advertising from thousands of Nutritional companies. Many practitioners I deal with are just as confused as their clients and although they may feel a particular patient is a candidate for nutritional intervention, they do not know how to discern quality. Also, many doctors feel overwhelmed by requests from their patients to evaluate the quality of latest companies or the latest products.

I always keep an open mind to new products and new companies, but I have found that by just asking a few key questions, I eliminate 95% or more of the companies out there. When a patient asks me to evaluate a new company or product, or if they are trying to sell me on a new company or product (an ever increasingly common phenomena) I ask these few basic questions regarding quality. It is amazing how many companies and people claim quality but when you ask for actual documentation and substantiation, you never hear about it, again - which of course, is fine by me.

Here are some things to look for in order to differentiate between quality nutritional companies and others.

1. Every batch is assayed after manufacturing by a third party for product content. Many companies assay their product before manufacturing and guarantee what they put into the process; however, they don't guarantee what comes out. Many ingredients are unstable and inherently a portion gets lost or destroyed in the manufacturing process. Sometimes, by changing the manufacturing procedure you can minimize this. However, in other situations it is unavoidable and the only way to combat the loss is to compensate by increasing the amount of raw material put into the manufacturing process (which of course, is more expensive). Descartes said, "To measure is to know." Companies that do not do after-tableting assays may unknowingly put products out that contain much less than their label claims. A recent study of 10 different brands of St. John's Wort found that the levels of hypericin, the standardized ingredient, varied greatly among the 10 different brands tested, with some containing less than 1/2 of the label cl aim of the active ingredient. [1] Product assays should be done by scientifically accepted measures such as Thin-layer Chromatography (TLC), High Pressure Liquid Chromatography (HPLC), Gas Chromatography (GC) and Gas Chromatography/Mass Spectrometry (GC/MS) to verify that what's on the label is in the bottle. There is a saying in the Nutraceutical Industry, "they duplicated the label but they did not duplicate the product." One must look beyond label claims and assess the actual content when selecting the most therapeutic products.

2. Products are tested for microbial, pesticide, heavy metal and pharmaceutical adulteration and contamination. Calcium Carbonate supplements on the market are frequently contaminated with lead and companies are not required to put on the label how much lead their product contains. [2] This is why you need to actually see toxicity assays and choose companies that routinely perform them and will provide you with the results. This is also especially important in herbs, which due to improper storage and handling can be infected by various microorganisms and yeasts that can cause ill health. [3] Furthermore, because the rhizomes (roots) of herbs concentrate minerals (and heavy metals) many herbal products on the market are tainted with lead, mercury and other heavy metals. [4-8] A California Health Department analysis of 260 imported traditional Chinese medicines found truly alarming levels of contaminants in almost half of them. [9] Finally, some Chinese herbs are tainted with pharmaceutical drugs and it is imp erative that your source for these herbs screens for these contaminants. [10] It is possible that the few cases of severe reactions to herbal products were actually due to heavy metal or pharmaceutical contamination of these products. It is also possible to get more mercury from one serving of herbal products than from amalgam fillings, yet there is little attention being paid to this phenomena.