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Why doesn't the FDA regulate herbal supplements? · Stuff You Should Know

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  Speaker 1: Brought to you by the reinvented two thousand twelve camera.
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  Speaker 1: It's ready. Are you welcome to Stuff you Should Know
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  Speaker 1: from House Stuff Works dot Com. Hey, welcome to the podcast.
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  Speaker 1: That's Chuck. I'm Josh. This is the Stuff you should Know,
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  Speaker 1: coming to you live from Studio one, a deep within
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  Speaker 1: the bowels of How Stuff Works corporate headquarters in Atlanta,
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  Speaker 1: Georgia's gross. Yeah, I like to do that once in
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  Speaker 1: a right, Nice, Chuck. My father spent the better part
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  Speaker 1: of the late nineties is kind of um well. He
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  Speaker 1: took a lot of pills. Okay, they were all herbal.
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  Speaker 1: They were all herbal supplements, mind you. But he would
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  Speaker 1: take like um uppers in the morning, like herbal uppers. Interesting.
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  Speaker 1: And then he'd take like herbal downers like two oh
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  Speaker 1: twos or four or four as I can't remember what
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  Speaker 1: they're called um in the evening, you know, to relax.
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  Speaker 1: And I call him the herbal Elvis and uh and
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  Speaker 1: I kid you not. He did this like he up
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  Speaker 1: and down and up and down, and finally he kick
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  Speaker 1: the habit. I guess, I don't know if he takes
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  Speaker 1: I know he takes a lot of vitamins and stuff
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  Speaker 1: but I think it's it's healthier. Um. And plus now
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  Speaker 1: he's retired, he has less reason to wake up in
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  Speaker 1: the morning as long as he didn't pass away on
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  Speaker 1: the toilet, you know, he hasn't. He hasn't, and thank god.
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  Speaker 1: But the thing is that it kind of points out
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  Speaker 1: like herbs can really pack a punch, you know. UM.
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  Speaker 1: Like take mahuiang for example, um mahuang, better known in
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  Speaker 1: this country as a fedra or a phedron, which is
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  Speaker 1: actually the alkaloid, the isolated alkaloid of mahuang, which actually
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  Speaker 1: in Chinese means bitter yellow, mahuyang bitter yellow at points.
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  Speaker 1: It's to the the color of this little evergreen shrub
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  Speaker 1: in the horrible taste of its leaves. Um mahwang has
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  Speaker 1: a terrible taste, bitter yellow taste. UM. So you know,
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  Speaker 1: the Chinese have been using the shrub for like five
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  Speaker 1: thousand years, right, and they're not really having a lot
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  Speaker 1: of trouble with it. Um. It comes to the United
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  Speaker 1: States and the nineties, and all of a sudden, between
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  Speaker 1: like the early nineties and two thousand three, there's like
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  Speaker 1: sixteen thousand cases of death and injury reported to the
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  Speaker 1: Federal government. Right, you've got truckers and college students popping
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  Speaker 1: white crosses. It's uh. They're also a key ingredient in
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  Speaker 1: so I mean, what happens what happened, right? I mean
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  Speaker 1: the Chinese will happen to stuff for five thousand years,
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  Speaker 1: it comes to the US and within a decade, sixteen
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  Speaker 1: thousand people dropped like flies. I'll tell you what happens.
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  Speaker 1: Americans love to get high. It's as simple as that.
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  Speaker 1: Abuse exactly. It's abuse. It's a lack of understands, the
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  Speaker 1: lack of respect um to the Chinese. What what we
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  Speaker 1: consider herbs they consider drugs, and what we consider herbs
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  Speaker 1: we don't really fear. We find them all natural, we don't.
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  Speaker 1: You know, it's not regulated by the FDA, so how
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  Speaker 1: could it be harmful? That's one of the interesting things
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  Speaker 1: that I think you pointed out was if something is
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  Speaker 1: the more heavily something is regulated, the more people will
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  Speaker 1: fear less something is regulated, the more they think it's
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  Speaker 1: just fine. Exactly. Like think about how you perceive tile
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  Speaker 1: and all, and then how you perceive taile and all three.
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  Speaker 1: That's stuff with codeine, which is pretty much like eight
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  Speaker 1: milligrams of taile and all think something like that, really
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  Speaker 1: not that big of a difference. If you've ever taken them,
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  Speaker 1: the difference isn't significant. But yet ones like under lock
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  Speaker 1: and key behind you know, the pharmacists counter, and the
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  Speaker 1: other ones is right out where God and everybody can
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  Speaker 1: shoplift it exactly. So, I mean you perceive them as
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  Speaker 1: different because they're regulated, because the government's like whoa, whoa,
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  Speaker 1: whoa pal. You just need to kind of back off that.
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  Speaker 1: With herbs, there's no regulation whatsoever. They don't even sell
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  Speaker 1: them in the same place as the taile and all,
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  Speaker 1: so they seem even less significant as far as the
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  Speaker 1: health risks go. But that's not true. There's plenty of
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  Speaker 1: herbs out there that are just crazy potent um like detera.
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  Speaker 1: You know, you know what an angel's trumpet is? Uh No,
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  Speaker 1: I don't. It's not an article. Don't boither looking for it.
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  Speaker 1: You can find an angeal angels trumpet plant in um
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  Speaker 1: just about any southern backyard. They have like these long
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  Speaker 1: trumpet shaped flowers, hence the name um. And if you
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  Speaker 1: eat one of those flowers within an hour, you will
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  Speaker 1: be baying at the moon and beating up the cops
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  Speaker 1: who come to arrescue. It will drive you nuts. And
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  Speaker 1: this is just an ornamental plant in US, no one
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  Speaker 1: has any clue about it. Sounds like, yeah, I've never
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  Speaker 1: I've never had the gall to actually eat one because
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  Speaker 1: I don't like eating grass, which is apparently another side effect.
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  Speaker 1: I think you might have licked a toad or two
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  Speaker 1: in your data. Well. Actually, I've seen warnings to gardeners
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  Speaker 1: saying if you have an Angel's trumpet plant and you're
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  Speaker 1: messing with it, especially the flowers, like do not rub
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  Speaker 1: your eyes, wash your hand, it will send you on
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  Speaker 1: a wild ride. It's interesting. That's just one of many
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  Speaker 1: um monkshood. It's one of the most potent chemical compounds,
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  Speaker 1: naturally occurring compounds known to man. Can kill you, oh
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  Speaker 1: very easily, stop your stop your heart and lung function,
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  Speaker 1: just from handling it. Yeah. So, I mean there's a
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  Speaker 1: lot of potent herbs out there because they grow from
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  Speaker 1: the ground. Right. Because we have been wean we've been
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  Speaker 1: at the forefront of modern medicine, we kind of disregard herbs.
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  Speaker 1: That's another one that was an interesting one, wasn't Yeah,
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  Speaker 1: that's the hallucinogenic uh. And I think you mentioned Jamestown
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  Speaker 1: in your article. Yeah, detachment of the Jamestown Colony militia
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  Speaker 1: ate a bunch of that, and it's salad. Uh, and
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  Speaker 1: we just went crazy. We're just basically tripping for several days.
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  Speaker 1: I think the guy who described it said they turned
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  Speaker 1: to natural fools upon it for several days. So all
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  Speaker 1: but that was quite a shock to them. Yeah, but yeah,
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  Speaker 1: they didn't get a lot of work done those days.
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  Speaker 1: But Okay, so I think we've established the argument that
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  Speaker 1: herbs are potent very much. And the problem is as
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  Speaker 1: Americans don't have a an ingrained respect for their potency
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  Speaker 1: as do some of the older cultures. Right and beyond
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  Speaker 1: that Americans, Uh, in the in the nineteen nineties and
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  Speaker 1: uh into the two thousands, uh, traditional Chinese medicine became
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  Speaker 1: more and more popular. So not only are these herbs
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  Speaker 1: packing a punch and not regulated, but people really started
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  Speaker 1: getting into it. Yeah, and and uh, what's the one St.
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  Speaker 1: John's wort? You know, people think that these are just
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  Speaker 1: cure alls. Well, and and it's not that they're not.
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  Speaker 1: It's not that they don't have properties. This isn't like
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  Speaker 1: snake oil that we're talking about. Um, it's that since
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  Speaker 1: they're not regulated since they're not really looked into. Uh,
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  Speaker 1: you have to effectively self medicate or listen to some
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  Speaker 1: jerk at the health food store who may or may
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  Speaker 1: not have any idea what he or she's talking about. Right, Um,
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  Speaker 1: so it can be kind of dangerous. The problem is
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  Speaker 1: is because of you know, the the arrogance of Western
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  Speaker 1: medicine that it's the only true, viable and effective medicine. UM.
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  Speaker 1: People pick up on that. So when people started taking herbs,
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  Speaker 1: just average Joe's patients will call them um when they
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  Speaker 1: started taking herbs. A two thousand three survey found that
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  Speaker 1: seventy of people who take herbs don't tell their doctors
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  Speaker 1: about them, right, because they're afraid they're going to be
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  Speaker 1: told to not take them anymore. Right, which is a
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  Speaker 1: which is a good fear, because you know, doctors don't
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  Speaker 1: understand herbs anymore than the guy at the health food
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  Speaker 1: store doesn't probably last. Um. So you've got that problem
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  Speaker 1: and as a result, this thing called complimentary and alternative
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  Speaker 1: medicine came about. It was basically saying, look, people are
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  Speaker 1: running around taking herbs. We need to incorporate these other
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  Speaker 1: medicines into western modern medicine. And see what we can do.
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  Speaker 1: It's probably a good idea. It was a great idea
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  Speaker 1: because traditional medicines generally are best at curing chronic diseases,
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  Speaker 1: are handling chronic diseases, whereas western modern medicine is best
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  Speaker 1: at acute diseases or acute you know, uh, conditions. So
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  Speaker 1: my rule of thumb has always been rheumatoid arthreadis traditional medicine, right,
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  Speaker 1: shot in the leg? You want to go with the
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  Speaker 1: western medicine? Yeah, so gunshot wounded, Western medicine a good rule.
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  Speaker 1: Rheumatoid arth threats, Yeah, do you want to go with
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  Speaker 1: the traditional mission. So there was a movement to incorporate
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  Speaker 1: these two. Uh. And the problem is is again, doctors
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  Speaker 1: don't know any more about herbs than you or I,
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  Speaker 1: and doctors can get sued a lot more easily if
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  Speaker 1: they say take this herb and the person dies. If
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  Speaker 1: we say that, we're just like, oh man, sorry I
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  Speaker 1: didn't do that. Doctors like, okay, well there goes my practice.
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  Speaker 1: Um So, of course doctors aren't going to recommend the stuff.
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  Speaker 1: So c am cam never took off at all. And
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  Speaker 1: um so, why why wouldn't the FDA regulate herbs? Well? Uh,
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  Speaker 1: I think the research you found or you posited was
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  Speaker 1: that urban ingredients, UM and supplements don't have to be
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  Speaker 1: classified as drugs their dietary supplements. No, that's exactly right,
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  Speaker 1: and this came about through the Dietary Supplement Health and
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  Speaker 1: Education Act, which was issued in which is right. When
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  Speaker 1: this stuff is really gearing up, there are a lot
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  Speaker 1: of questions like should the FDA get involved in the
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  Speaker 1: government said no, not only that, we're gonna put herbs
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  Speaker 1: squarely out of the FDA's jurisdiction. See with UM any
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  Speaker 1: kind of pharmaceutical, even even in over over the counter
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  Speaker 1: drug Are we talking about approval here? Yeah, where you
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  Speaker 1: and I would have to basically test these compounds testimon
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  Speaker 1: rats and then you know, possibly other primates and then
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  Speaker 1: moved human trials. It costs millions of dollars, and not
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  Speaker 1: necessarily to the pharmaceutical companies. They get a lot of
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  Speaker 1: their research done for free by universities. But it does
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  Speaker 1: somebody's putting in millions. If not, you know, tens of
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  Speaker 1: millions of dollars and an average of eight and a
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  Speaker 1: half years to get it to the FDA for approval.
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  Speaker 1: And the FDA either says no or they say yes,
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  Speaker 1: and then they decreate as a controlled substance like a pharmaceutical,
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  Speaker 1: prescribed pharmacy or over the counter. Right right. I thought
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  Speaker 1: it was interesting that you you the fact that only
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  Speaker 1: point one percent of compounds first tested received FDA approval.
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  Speaker 1: That is way way low. Yeah, and I mean completely
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  Speaker 1: I have to go back to the drawing board. But
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  Speaker 1: you have to prove step by step that this is
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  Speaker 1: not harmful to humans before the FDA approves it. What
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  Speaker 1: the Dietary Dietary Supplement Health and Education Act, the d
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  Speaker 1: s h g A basically says, is not anymore, not
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  Speaker 1: with herbal, not with herbal supplements. Yeah, these shoes. On
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  Speaker 1: the other foot, the FDA has to prove that these
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  Speaker 1: herbs are harmful before they can get them taken off
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  Speaker 1: the shelves. And basically they have to prove that the
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  Speaker 1: herb poses a a significant health risk or an imminent
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  Speaker 1: public health risk, public safety risk. Yeah. And I bet
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  Speaker 1: that FDA only gets involved if there are you know
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  Speaker 1: a bunch of cases where this happens. Yeah, yeah, I mean,
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  Speaker 1: like think about right exactly. Um So, and it's a
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  Speaker 1: really long process. It's a really involved process, and the
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  Speaker 1: FDA like most other federal agencies, is perennially understaffed and underfunded,
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  Speaker 1: so it can be very difficult to get something taken
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  Speaker 1: off the market, even if it is, you know, hurting
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  Speaker 1: people in the meantime, it stays on the market until
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  Speaker 1: they can you know, draw that line exactly. So, um,
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  Speaker 1: there there are some limitations to it to what a
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  Speaker 1: dietary supplement. Herbal manufacturers can say. One thing they can't
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  Speaker 1: do is they can't say that their, um, their products treat, cure,
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  Speaker 1: or mitigate a disease right now. This is how they
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  Speaker 1: market themselves. Correct. Yes, yeah, So for example, uh, somebody
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  Speaker 1: who who manufactures an herbal supplement with passion flower, Uh,
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  Speaker 1: they can't say that the product treats anxiety. Instead, they
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  Speaker 1: can say something like it quiets an anxious mind, right,
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  Speaker 1: which to me sounds a lot like the old nineteenth
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  Speaker 1: century tonic commercials Tonic every times like Heroin. It quiets
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  Speaker 1: the anxious mind kind of thing. You know. It sounds
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  Speaker 1: a lot like that, and it gets the same point
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  Speaker 1: across as well. You're basically saying anxious anxiety, same thing quiets,
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  Speaker 1: cures whatever. Um. There's also one other thing that that
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  Speaker 1: you you can't use ingredients that are already banned. UM.
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  Speaker 1: In April two thousand and seven, a Chinese product called
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  Speaker 1: sang Jong Zoo tong Tan I believe that's what it's called.
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  Speaker 1: Probably just butchered it um. It was taken off the
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  Speaker 1: market in the US because it contained human placenta. So
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  Speaker 1: the FDA does have some teeth her there. But for
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  Speaker 1: the most part, if you and I want to go
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  Speaker 1: somewhere and you know, manufacture it, we can sell them
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  Speaker 1: to our hearts content, kill a bunch of people, make
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  Speaker 1: a lot of money, and then get out before the
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  Speaker 1: FDA can ever say, bood kick back on the beach somewhere.
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  Speaker 1: Let's go do it with life. Yeah. So, if you
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  Speaker 1: want to find out more about herbal supplements, the FDA,
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  Speaker 1: all sorts of other stuff, just go check it all out.
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