Use Caution When Searching Complementary and Alternative Medicine (CAM) Websites
The Internet provides immediate access to an enormous array of health information, and the public’s response to this offering has been overwhelming. Today, almost half those who use the Internet to search for health information say that the material they find on the Internet influences their decisions about medical treatments and care.
Dietary supplements—vitamins, minerals, herbs or other botanicals, amino acids, plus substances such as enzymes, organ tissues, and metabolites—comprise a significant portion of the CAM industry. In fact, the dietary supplement industry has grown to $13.9 billion annually. Information on these products abounds on CAM web sites. And yet, the effectiveness of many of these supplements remains unproven. Here are some things you need to know when searching CAM websites.
What’s on the Internet?
There’s no shortage of data regarding dietary supplements on the Internet. A study in the September 17, 2003 issue of the Journal of the American Medical Association ( JAMA ) identified over 500 websites dedicated to oral herbal supplements. Of these, 76% are retail sites selling products or linked directly to a vendor. The remaining sites include personal sites without links to vendors; government, industry or academic sites describing particular supplements; and sites containing referenced articles about the supplements.
According to the JAMA study, 81% of the sites evaluated claim to treat, prevent, diagnose, or even cure specific diseases. But how credible are these claims?
According to recent research, web-based health claims about supplements are not always true. A study in the August 2003 issue of the journal Mayo Clinic Proceedings , which evaluated content of websites promoting the popular and controversial dietary supplement ephedra (recently banned by the FDA as a result of its potential danger to users) highlights this fact. The researchers found that 41% of the websites they analyzed contained incorrect or misleading statements, some of which could directly result in serious harm to consumers.
Failure to Disclose Information
However, it is not only the claims made on these websites that can be misleading. The information many sites choose not to disclose can be equally dangerous. In the JAMA study, more than half of the 338 retail CAM websites evaluated, omitted the standard federal disclaimer, which basically informs the user that the website’s information is general nature and can't take the place of medical evaluation, diagnoses, and treatment by a health care provider.
The Mayo Clinic Proceedings study also found significant omissions: 41% of the sites did not disclose potential adverse health effects such as heart attacks, strokes, arrhythmias, increased blood pressure, and heart palpitations; and as many as 53% left out the recommended dosage of supplements. Essentially, the information—or lack thereof—presented on several CAM websites which was intended to enhance your health actually jeopardizes it.
Lack of FDA Regulation
The 1994 passage of the Dietary Supplement and Health and Education Act (DSHEA), which states that manufacturers don’t have to prove the safety or efficacy of a dietary supplement before it is placed on the market, limited the Food and Drug Administration’s (FDA’s) control over dietary supplements. The act also made it easier for less-than-reputable information regarding dietary supplements to be posted on the Internet.
Although the DSHEA stripped some of the FDA control over dietary supplements and placed the burden of determining the safety and efficacy of these supplements more heavily on the consumer, it did not leave consumers completely without guidance.
Government Supports Research on Dietary Supplements
When the DSHEA passed, Congress established the Office of Dietary Supplements (ODS) at the National Institutes of Health (NIH) to promote a greater understanding of dietary supplements. To this end, the ODS evaluates scientific information on supplements, stimulates and supports research, and disseminates results to the public. The ODS Web site contains a database of federally funded research projects on dietary supplements. If you have questions about the ingredients found in dietary supplements, as well as related health outcomes and biological effects, you can access the ODS database to learn more.
Tips for Navigating CAM Websites
Paying close attention to the language CAM websites use to describe supplements can also alert you to false or misleading information, suggests the National Council Against Health Fraud. The organization warns consumers to beware of the following “red flags”:
- Vague claims—such as “breakthrough,” “miracle cure”, and “magical”—that present no legitimate research to support them
- Use of pseudomedical jargon, such as detoxify or purify, to describe a product’s effects
- Claims that a product is backed by scientific studies, without references to those studies
- Failure to list side effects
- Accusations that the government, the medical profession, or drug companies are suppressing information about a given supplement
So, the next time you’re searching the Internet for information on a new supplement, remember to read the claims made on CAM websites with caution be aware that there may be significant omissions in the information you’re being given. Your best bet for accurate information is a government or not-for profit web site. Finally, remember to always consult a physician before using a dietary supplement or other non-FDA-regulated substance.
National Center for Complementary and Alternative Medicine
National Council against Health Fraud
Office of Dietary Supplements (ODS)
Ashar BH, Miller RG, Getz KJ, Pichard CP. A critical evaluation of Internet marketing of products that contain ephedra. Mayo Clin Proc . 2003;78(8):944–6.
Costello RB, Coates P. In the midst of confusion lies opportunity: fostering quality science in dietary supplement research. J Am Coll Nutr . 2001;20(1):21–5.
Dietary Supplement Health and Education Act of 1994. Available at: http://vm.cfsan.fda.gov/~dms/dietsupp.html . Accessed January 29, 2004.
Fox S, Rainie D. The online health care revolution: How the Web helps American stake better care of themselves. Pew Internet & American Life. Available at: http://www.pewinternet.org . Accessed February 2, 2004
Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in searches and overall Internet access. Available at: http://www.pewinternet.org . Accessed February 2, 2004
Healthfinder: Your Guide to Reliable Health Information on the Web. Available at: http://www.healthfinder.gov/aboutus/disclaimer.htm Accessed March 1, 2004.
Morris CA, Avorn J. Internet marketing of herbal products. JAMA . 2003; 290(11):1519–20.
Sarubin A. The Health Professional's Guide to Popular Dietary Supplements. Chicago, IL; The American Dietetic Association; 2000.
Last reviewed June 2008 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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