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In one of America's fastest-growing but least-regulated industries, consumers face a dizzying array of herbal treatment options. But studies about the effectiveness of these products are inconclusive, and the ingredients listed in labels are sometimes misleading. Paul Solman reports.
Next, NewsHour correspondent Paul Solman on a project aimed at determining what's really in herbal supplements.
Though we rarely do consumer stories, at the New York Botanical Garden not long ago, we happened on one we just couldn't resist: that, in one of America's fastest growing and least regulated industries, medicinal herbs, what you see may not be what you get.
The garden was abound with poet Emily Dickinson's flowers. But we were mainly there because of a woodland plant known variously as bugbane, snakeroot or black cohosh, an herb to treat the symptoms of menopause that has joined ginkgo and ginseng as among America's dietary supplement bestsellers.
I have heard that it's really good with mood swings and with stress.
And I also found out that you could use it for arthritic inflammation.
DR. DAVID BAKER, gynecologist: I was amazed that 35 percent of women that I was seeing as a physician were using these products.
New York gynecologist David Baker says he was even more surprised when he checked the literature on government-funded alternative health research.
DR. DAVID BAKER:
Some of the studies showed that, when women used black cohosh vs. placebo, they did get relief from their menopausal symptoms, but many other studies showed there were no effects whatsoever.
In addition, reports in the literature of severe liver damage, muscle damage and vein and artery damage from the use of black cohosh, and the summary of those articles suggests that it's not from black cohosh, but from adulteration of black cohosh.
And how did you react to the apparent contradiction?
I started to think, what were they really using?
Well, I think if you buy it from a reputable store or if you buy a reputable label, you hope that this product is what you're getting.
But that might not always be the case. Black cohosh is a species in a whole family of plants, many of which look alike and can confuse even experts, a far cry from, say, the putative memory aid the herb ginkgo biloba.
DENNIS STEVENSON, botanist:
There's not any plant out there that looks like a ginkgo. A ginkgo is a ginkgo is a ginkgo.
But, says botanist Dennis Stevenson:
Black cohosh is one of these plants that's collected in the wild and only — if I'm not a trained botanist, I go out: Oh, it looks like cohosh. I will get a bunch of it and sell it to the supplier, and — and we're all happy.
That sounds rather casual.
Well, it is, but these kinds of mistakes can happen fairly easily.
To remedy cases of mistaken identity, Stevenson is working on a quick and easy way to identify plants genetically. Instead of mapping all of an organism's DNA, he and his colleagues are zeroing in on single genes.
We call it DNA bar coding, because we sort of liken that to the bar code we see in the stores as a unique signature for a product.
Just four amino acids, call letters A, G, C, and T, are the building blocks of all life. But every species has at least one unique DNA sequence.
If I found that signature, I would know that I had that species, as distinct from all other species on the face of the Earth.
Now, DNA-barcoding has been getting some high-profile press of late. A couple of years ago, two high school students used it to uncover the fishy truth about New York sushi.
KATE STOECKLE, high school student: One of the most striking results was, we had something labeled as white tuna, and it was actually Mozambique tilapia.
Kate Stoeckle was inspired to do the project by her dad, a molecular biologist.
MARK STOECKLE, molecular biologist: Half of the restaurants, two of our restaurants, and six of 10 grocery stores sold one or more items that were mislabeled.
Inspired by sushi-gate, Stevenson looked into herbal tea.
Almost all the herbal teas, to have enough in the little packet, have a filler.
You mean like Hamburger Helper?
Right. It ends up the filler is chamomile.
Yes. And it's kind of interesting to know that, because this filler isn't listed on the box. In other instances, the fillers were grass, or the whole tea sample was just grass.
Grass, like, that grows?
Grass like mowing your lawn, right, not the other grass.
But Stevenson soon moved beyond tea.
We wanted to build a large database that would cover the thousand or so species used in dietary supplements.
This is a $25 billion industry, according to Baker, famous for loose regulation. So, Stevenson and Baker agreed to collaborate, and start with black cohosh. They sliced and diced eye of bugbane, toe of snakeroot, if you will, and, eventually, they came up with a bar code. Then they went shopping.
We went on the Internet. We ran around New York and Long Island, and just walked into stores and got 26 different black cohosh.
Or at least 26 different preparations labeled as distinct black cohosh brands. All were subjected to the bar coding test.
So, 26 samples, and the results?
Thirty percent had no black cohosh at all.
Baker did the tests anonymously, looking for general, not specific, results. And what he found could explain the variation in the research outcomes, he says.
But Dr. Jack Killen, of the agency that funded the government's black cohosh tests, says he's sure his samples were authentic.
DR. JACK KILLEN, National Center for Complementary and Alternative Medicine: So, I think we have a great deal of confidence that the variability that we see in the research is not attributable to sometimes the black cohosh is there and sometimes it isn't.
At this point, we decided to buy our own samples and have them tested, not just black cohosh, but a couple of other bestselling herbs, ginkgo and ginseng, both of which Stevenson's lab had already DNA bar coded. We bought only four samples of ginkgo biloba, that supposed aid for — What was it again? — oh, yes — memory, and four samples of ginseng, thought to enhance other sorts of performance.
And there's one species, the North American species, quinquefolia, panax quinquefolia, that is the preferred ginseng around the world.
Because it's supposed to have aphrodisiac powers.
It's supposed to have, yes, the most — be the most effective.
Admittedly, our sample size was too small to be statistically significant. But, surely, all the ginkgo would be ginkgo; ginseng, ginseng. And the lab agreed to do the test, so why not?
The results, also reported anonymously. Get this: Only two of our four ginseng samples seemed to contain ginseng, and even that was the Asian species, not the preferred North American variety. The other two contained some complex mixture of DNA, none of which could be confirmed as ginseng.
The four supposed samples of the ubiquitous, unmistakable ginkgo tree? One was legit, another an exact DNA match for common rice, the third a complex mixture of DNA, none of which, the lab report said, resembled ginkgo biloba DNA, and the fourth contained no plant DNA at all.
Our black cohosh samples did better. Seven out of eight did contain the plant, but one didn't. Of 16 supplements, then, bought at random from major retailers in the Washington, D.C., area, six were suspect or outright frauds, prompting one last question for Dr. Baker.
So, dietary supplements are the Wild West of self-medication?
That is correct.
A sobering thought, especially as the role of government regulation again becomes a matter of national debate.
Paul's reporting is supported by a grant from the Sloan Foundation, which also funds some DNA bar coding research.
This story mistakenly referred to the GATC building blocks of DNA as amino acids, when they are actually nucleotides.
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