Buyer Beware of Natural Products Sold Online

Pharmacists know that many patients look to natural products for relief from medical problems. Somehow, the word “natural” implies “good” or “wholesome,” which creates an attraction for patients. Many popular natural herb, vitamin, and mineral products are effective for specific conditions, but others are not.

Although most pharmacies carry a line of natural products, patients often turn to the Internet to find information on those supplements and purchase them. However, researchers from the University of Virginia Health System in Charlottesville supposed companies that market their natural products online often skimp on information that patients may need. Their specific concerns involved patients with chronic kidney disease (CKD) and end-stage renal failure (ESRD), who are at risk for poor outcomes if they use natural products indiscriminately.

For a study that appeared in the November 2014 issue of the American Journal of Nephrology, the researchers identified 184 websites that promote and sell natural products, and then compared the manufacturers’ claims to proven scientific data. Their method was questionnaire-based, and 2 independent reviewers assessed each website. After the questionnaires were completed, the researchers analyzed the data using statistical analysis.

Among the most prevalent problems, the researchers found:

• 28% of websites claimed their products could decrease CKD progression
• 60% failed to remind patients to consult a physician before taking the supplement, and
• More than 90% did not mention the potential for drug interaction, disease interaction, or caution in use during pregnancy or in children.

Manufacturers most often claimed that uva ursi, dandelion, parsley, corn silk, juniper, celery, buchu, horsetail, marshmallow, and stinging nettle could be beneficial in CKD. However, those 10 plant ingredients have not been studied adequately in humans, and the National Kidney Foundation actually advises CKD patients to avoid horsetail, parsley, uva ursi, and stinging nettle. Furthermore, previous animal studies determined that those natural products could have harmful effects and potential drug interactions with medications often taken by patients with CKD or ESRD.

As a result, the researchers urged nephrologists and other health care professionals to be aware of the insufficient evidence for the use of those products in patients with kidney disease. They also called upon regulators to examine the current policy governing natural products, as well as increase the information requirement to protect unsuspecting patients.