An old episode of PBS’ NewsHour can prove that chances are high that you have no idea what’s in that pill you’re so dedicated to:

JEFFREY BROWN: Next, NewsHour correspondent Paul Solman on a project aimed at determining what’s really in herbal supplements.

supplements

PAUL SOLMAN: 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.

WOMAN: I have heard that it’s really good with mood swings and with stress.

WOMAN: 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.

PAUL SOLMAN: 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.

PAUL SOLMAN: And how did you react to the apparent contradiction?

DR. DAVID BAKER: I started to think, what were they really using?

WOMAN: 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.

PAUL SOLMAN: 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.

PAUL SOLMAN: But, says botanist Dennis Stevenson:

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.

PAUL SOLMAN: That sounds rather casual.

DENNIS STEVENSON: Well, it is, but these kinds of mistakes can happen fairly easily.

PAUL SOLMAN: 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.

DENNIS STEVENSON: 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.

PAUL SOLMAN: 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.

DENNIS STEVENSON: 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.

PAUL SOLMAN: 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.

PAUL SOLMAN: 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.

PAUL SOLMAN: Inspired by sushi-gate, Stevenson looked into herbal tea.

DENNIS STEVENSON: Almost all the herbal teas, to have enough in the little packet, have a filler.

PAUL SOLMAN: Filler?

DENNIS STEVENSON: Yes.

PAUL SOLMAN: You mean like Hamburger Helper?

(LAUGHTER)

DENNIS STEVENSON: Right. It ends up the filler is chamomile.

PAUL SOLMAN: Chamomile?

DENNIS STEVENSON: 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.

PAUL SOLMAN: Grass, like, that grows?

DENNIS STEVENSON: Grass like mowing your lawn, right, not the other grass.

(LAUGHTER)

PAUL SOLMAN: But Stevenson soon moved beyond tea.

DENNIS STEVENSON: We wanted to build a large database that would cover the thousand or so species used in dietary supplements.

PAUL SOLMAN: 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.

DR. DAVID BAKER: We went on the Internet. We ran around New York and Long Island, and just walked into stores and got 26 different black cohosh.

PAUL SOLMAN: Or at least 26 different preparations labeled as distinct black cohosh brands. All were subjected to the bar coding test.

PAUL SOLMAN: So, 26 samples, and the results?

DR. DAVID BAKER: Thirty percent had no black cohosh at all.

PAUL SOLMAN: None?

DR. DAVID BAKER: None.

PAUL SOLMAN: 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.

PAUL SOLMAN: 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.

DENNIS STEVENSON: And there’s one species, the North American species, quinquefolia, panax quinquefolia, that is the preferred ginseng around the world.

PAUL SOLMAN: Because it’s supposed to have aphrodisiac powers.

DENNIS STEVENSON: It’s supposed to have, yes, the most — be the most effective.

PAUL SOLMAN: 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?

DR. DAVID BAKER: That is correct.

PAUL SOLMAN: A sobering thought, especially as the role of government regulation again becomes a matter of national debate.

JEFFREY BROWN: Paul’s reporting is supported by a grant from the Sloan Foundation, which also funds some DNA bar coding research.

There are a few things about this that are absolutely jarring to me:

1) That gingko bottle not only had no gingko in it, but it was completely rice. I mean, wow. Who would’ve thought?

2) Ingredients in the bottle that aren’t on the label. The issue that I, me, myself, personally have with supplements is the fact that you literally and metaphorically have no idea what’s in the bottle. Even if everything that’s inside of the bottle is there honestly and because it belongs there, the manufacturers are under no obligation to list those ingredients in the label.

And, let’s take it a step further. You have no idea how this stuff – whatever’s in that bottle – will interact with anything else you consume throughout the day, medication or otherwise. The likelihood that modern medicine is capable of testing every single medication against any and everything else is slim to non-existant, and unfortunately it’s cheaper for pharmaceutical companies to just settle with anyone bringing a lawsuit than it is for them to test for dangerous combinations of medicines and supplements.

And, to take it even further, just looking back at that gingko example, if you look at the transcript, the chain of custody is made pretty clear: one person picks the product, one company weighs and sorts the product, one company sells the product to a manufacturer, one company turns it into a pill, and that company sells it to a brand who then sells it to the public in order to turn a profit, and that brand sells it to a health food store so that they, too, can turn a profit. At any point in that chain, they could turn around and point the finger at someone else as being to blame for there being no gingko in the gingko bottle. This could merely be a very long chain of people trusting one another to not make a mistake, or it could be a concerted effort to replace an expensive herb with… well… rice.

I’d like to offer an alternative method of looking at supplementation. In In Defense of Food, Michael Pollan makes an argument against the benefits of supplements, which basically boiled down to “The people most likely to take them are also the people most likely to have a diet so exceptionally healthy that they don’t need the supplements in the first place.” I don’t disagree with that, but what I also wonder about is the need for supplementation in the first place.

Every time I see someone talk about “hair/skin/nail supplements,” and they then tell me they’ve got a breakfast, lunch, and dinner date at McWendy King, I weep inside. Pills for memory, for hair, for “antioxidants” – hi, chamomile! hi, cilantro! hi, basil! – for “heart health,” for “brain health,” for whatever – daily multi vitamins won’t do you the same justice as cleaning up your diet and doing what you can to consume a diverse variety of foods.

You won’t need a “supplement” for heart health – which, the more you learn, the more you realize “heart health” really encompasses everything – when you’re getting your vitamins B, C, D, your lycopene, your calcium, magnesium and everything else from… wait for it… a decked out chicken taco with guacamole.

This is an entirely different rant.

All I’m saying, is that we should be extremely cautious about the things we put in our bodies, and if we desire healthier options, we should consider going straight to the source. Learn about gingko, buy it in small batches, and make tea out of it. Use the tea as a broth for soup. Use it to cook rice. Whatever. Commit yourself to learning about the source of the beneficial item, and avoid the extra foolishness as much as you can. Your money will instead be going towards items that provide multiple vitamins, minerals, antioxidants, gut flora, and any other number of untold benefits, but you’ll also have the added benefit of not consuming something that’s likely to undo all of the positives that you consumed in your “supplement.” As I have always said, your body will thank you for it! 🙂