Thank you to Dr Dyck for his insightful comments on the lack of regulation of herbs and supplements in Canada. There is actually a Natural Health Products Directorate, which is a part of Health Canada, with quite elaborate regulations for all health products (herbs, homeopathics, supplements, vitamins, and minerals). They have regulations about licensing, manufacturing, labeling (including a requirement to state how much product is in the pill), adverse effects reporting, etc. This was all established in 2004, and information can be found at www.hc-sc.gc.ca/ahc-asc/branch-dirgen/hpfb-dgpsa/nhpd-dpsn/index_e.html.
Unfortunately, the enforcement of these regulations, at least with respect to content of active ingredients, is inconsistent. I feel strongly that it is up to the health practitioner community (MDs, naturopaths, homeopaths, etc), as well as users of these products, to demand that such regulations are stringently enforced.
More than two-thirds of Canadian adults use some form of natural product. Many do so without the knowledge of their physicians (more than 50%), and decisions are often based on recommendations of friends, family members, or the Internet. It is our not-so-small responsibility as health care practitioners to accept the prevalence of use of these products and to ensure that our patients know the appropriate indications, interactions with medications, and potential side effects, and know that the products available are standardized. Our patients will use the products anyway, so we should make sure they use them well.
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