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Health professionals await natural medicine r -

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Health professionals await natural medicine regulation

Reporter: Peter McCutcheon

KERRY O'BRIEN: The Pan Pharmaceutical scandal two years ago exposed weakness in the regulation of
herbal and natural remedies. The massive recall of Pan products prompted the Federal Government to
commission a review of the burgeoning alternative therapies industry. That review found that the
sometimes dangerous side-effects of complementary medicines were being widely under-reported and
the Federal Government has since agreed to overhaul its reporting system and to develop a public
information campaign. Many health professionals believe these are improvements that can't come soon
enough, as Peter McCutcheon reports.

PETER McCUTCHEON: Brisbane optometrist Julie Newport recently had a serious health scare. Her
menstrual period just wouldn't stop.

JULIE NEWPORT: I'm 37, and you think, "Oh, well, it's not unknown for people to come down with
horrible things and die in front of their children", sort of thing. So I - I was a little
concerned.

PETER McCUTCHEON: The problem had Julie Newport and her GP stumped until, almost as an
afterthought, she mentioned she'd been taking large doses of fish oil for dry eyes.

JULIE NEWPORT: It was the very last thing that I came up with, and she said, "Well, yes, that's
probably the most likely answer."

PETER McCUTCHEON: This is the sort of adverse reaction to complementary medicines that many health
professionals believe is being widely underreported.

GERALDINE MOSES, ADVERSE REACTIONS HOTLINE: We need people to start talking, to realise that these
things are not just straight safe; there can be side-effects.

TONY LEWIS, COMPLEMENTARY HEALTHCARE COUNCIL: We believe that the products are inherently safe, but
we obviously have to have mechanisms in place to pick up the occasional interaction and bad
reaction.

PETER McCUTCHEON: Australians are consuming more complementary medicines than ever before. Although
the vast majority of these herbal and natural mixtures are safe, their growing popularity also
increases the chances of the occasional complication.

GERALDINE MOSES: I'm not saying that we're all dropping dead like flies but there are safety
issues. Was there anything wrong with her immune system?

PETER McCUTCHEON: Geraldine Moses runs Australia's only telephone hotline for consumers who are
worried about the side-effects of their medication. Based at the Mater Hospital in Brisbane, she's
been concerned at the growing number of calls about complementary medicines. About 6 per cent of
calls to this consumer hotline are about herbal or natural medicines - more than double the rate of
reports to the Therapeutic Goods Administration by industry and health professionals.

GERALDINE MOSES: There's an enormous range. The spectrum ranges from minor things like skin rashes,
taste disturbances, funny-looking fingernails to very serious reactions that could include painful
neuropathies, which means damage to nerves.

DR PETER WHITING, GASTROENTEROLOGIST: We don't have enough information to offer exact figures on
the risks, and that's our problem.

PETER McCUTCHEON: Brisbane gastroenterologist Dr Peter Whiting has seen some of the most extreme
cases of what he believes are adverse reactions to herbal remedies. Dr Whiting co-authored a
scientific paper describing how six patients developed severe hepatitis after taking a range of
herbal medicines, including black cohosh.

DR PETER WHITING: But we are seeing the tip of the iceberg, obviously. These are people who are
referred to a tertiary liver centre where there's liver transplantation available. We have no idea
about the subacute, or those patients who feel unwell with mild abnormalities in their liver tests,
who don't make it to see us.

PETER McCUTCHEON: The Federal Government commissioned a review of the complementary medicines
industry two years ago after the recall of suspect products manufactured by Pan Pharmaceuticals.
Some of the review's key recommendations included increased research, a public education campaign
about the potential for adverse reactions to complementary medicines and improved reporting
systems.

TONY LEWIS: We do need a much better system of reporting. I agree totally with that recommendation.
It needs to be vastly improved.

PETER McCUTCHEON: Tony Lewis from the peak industry group the Complementary Health Care Council
agrees there may well be underreporting of adverse reactions but says consumers should not be
alarmed.

TONY LEWIS: They are very, very low-risk products. If you compare them say to pharmaceutical
products, extremely low risk. If you compare them to food, for example, and look at the cases
involving bad reactions to food, you find that the rate of reaction for complementary medicines is
a lot lower than for a lot of foodstuffs.

PETER McCUTCHEON: But the greatest area of concern according to the Federal Government's review was
the interaction between complementary and orthodox medicines. The risks increase considerably when
patients don't tell their doctors about their complementary medication.

DR PETER WHITING: Often people won't tell us that they are on herbal medicines. Anywhere up to 30
or 40 per cent of people who are on herbs or other complementary medicines will not tell a medical
practitioner because they perceive there is a conflict between the medical practitioner and those
practising alternative medicines.

PETER McCUTCHEON: The Federal Government is now working on a new strategy to improve the quality
and quantity of reporting adverse reactions to complementary medicines. The man who headed the
government's review of the industry, Dr Michael Bollen, says such a strategy should target
practitioners as well as the general public.

DR MICHAEL BOLLEN: Of the population are taking complementary medicines in addition to other
medication, and it's the potential there for interaction that's of as great a concern.

PETER McCUTCHEON: But as Julie Newport's case illustrates, it's all too easy to forget to tell GPs
and specialists about complementary medication. As a health professional herself, she knew about
the effects of fish oil, but almost neglected to tell her doctor.

JULIE NEWPORT: I did know. It was just one of those stupid things that you don't think these things
could apply to you, and sure enough, it did.