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In Hong Kong, Folk Remedies Are Sickening Patients

Posted 10 October 2017

An article in the New York Times, written by Rachel Nuwer, makes the point that hidden adulterants are found in Chinese Folk Medicines.

Every few weeks, Dr. Tony Wing Lai Mak, a pathologist at Princess Margaret Hospital in Hong Kong, receives blood and urine samples from yet another patient hospitalized after taking a traditional Chinese medical or health supplement.

His toxicology lab finds the same culprits over and over: adulterants hidden in the dose.

Although the Hong Kong Department of Health regularly issues warnings about the medicines, “we’re still seeing this all the time,” Dr. Mak said.

“These are illegal products that are damaging to people’s health and can even kill. Yet somehow, they’re still here.”

The frequency and serious nature of the cases inspired Dr. Mak and his colleagues to compile a decade’s worth of observations, which they recently published in the British Journal of Clinical Pharmacology.

From 2005 to 2015, they reported, 404 people ranging in age from 1 month to 90 were treated at the hospital after taking tainted supplements.”

“After testing 487 products handed over by sick patients, Dr. Mak and his colleagues discovered 1,234 hidden ingredients, including both approved and banned Western drugs, drug analogues and animal thyroid tissue.”

Continue reading at the New York Times

The article refers to a study published in the British Journal of Clinical Pharmacology

Adulteration of proprietary Chinese medicines and health products with undeclared drugs: experience of a tertiary toxicology laboratory in Hong Kong

Chor Kwan Ching, Sammy Pak Lam Chen, Hencher Han Chih Lee, Ying Hoo Lam, Sau Wah Ng, Mo Lung Chen, Magdalene Huen Yin Tang, Suzanne Suk San Chan, Candy Wai Yan Ng, Jana Wing Lan Cheung, Tina Yee Ching Chan, Nike Kwai Cheung Lau, Yeow Kuan Chong, Tony Wing Lai Mak

First published: 4 October 2017

DOI: 10.1111/bcp.13420

Abstract

Aims
Proprietary Chinese medicines (pCMs) and health products, generally believed to be natural and safe, are gaining popularity worldwide. However, the safety of pCMs and health products has been severely compromised by the practice of adulteration. The current study aimed to examine the problem of adulteration of pCMs and health products in Hong Kong.

Methods
The present study was conducted in a tertiary referral clinical toxicology laboratory in Hong Kong. All cases involving the use of pCMs or health products, which were subsequently confirmed to contain undeclared adulterants, from 2005 to 2015 were reviewed retrospectively.

Results
A total of 404 cases involving the use of 487 adulterated pCMs or health products with a total of 1234 adulterants were identified. The adulterants consisted of approved drugs, banned drugs, drug analogues and animal thyroid tissue. The six most common categories of adulterants detected were nonsteroidal anti-inflammatory drugs (17.7%), anorectics (15.3%), corticosteroids (13.8%), diuretics and laxatives (11.4%), oral antidiabetic agents (10.0%) and erectile dysfunction drugs (6.0%). Sibutramine was the most common adulterant (n = 155). The reported sources of these illicit products included over-the-counter drug stores, the internet and Chinese medicine practitioners. A significant proportion of patients (65.1%) had adverse effects attributable to these illicit products, including 14 severe and two fatal cases. Psychosis, iatrogenic Cushing syndrome and hypoglycaemia were the three most frequently encountered adverse effects.

Conclusions
Adulteration of pCMs and health products with undeclared drugs poses severe health hazards. Public education and effective regulatory measures are essential to address the problem.

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