Natural Health Products
WHAT IS A NATURAL HEALTH PRODUCT?
They are natural substances used to restore or maintain good health. Natural products are often made from plants, but can also from microorganisms or animal and marine sources.
WHAT INDICATES THAT IT IS A NATURAL HEALTH PRODUCT?
Natural health products evaluated by Health Canada all have an NPN (i.e., Natural Product Number), or in the case of homeopathic remedies, a DIN-HM. The NPN is an eight-digit number which means that it has been licensed by Health Canada. By having an NPN or a DIN-HM, Health Canada is indicating that the product is authorized for sale in Canada and that it is safe and effective when used according to label directions. If there is no NPN or DIN-HM, it means that there is no control over the product and no evidence of effectiveness and/or safety has been demonstrated. Similarly, for prescription drugs a DIN is assigned to each drug, which is a Drug Identification Number. This DIN is an eight-digit number assigned by Health Canada before it is marketed in Canada. Thus the NPN and the DIN-HM are subject to regulations similar to the DIN, but they are specific to natural health products and homeopathic medicines.
WHAT DOES AN NPN OR A DIN-HM LOOK LIKE?
IS A NATURAL HEALTH PRODUCT ALWAYS SAFE?
Although it is generally safe to use, it is not without risk. Just because a product is called “natural” does not mean it is “harmless”! Natural health products, like prescription drugs, can have side effects and may even be toxic if not taken at the recommended dose. In fact, 12% of Canadians who use natural health products have reported experiencing adverse reactions to these products!
In addition, natural health and homeopathic products may not be suitable for some people with health problems, or they may interact with prescription drugs. These interactions may result in a decrease, cancellation or increase in the therapeutic effects of prescription drugs.
For example, echinacea is a natural product that is not recommended for scleroderma patients. Indeed, echinacea has, among other properties, that of stimulating the immune system. As a result, all diseases considered “autoimmune”, including scleroderma, may potentially interact with echinacea. Thus, this product can exacerbate the symptoms of autoimmune disease by stimulating the immune system.
Another example of a product to be used with caution in people living with scleroderma is melatonin. Although melatonin can lower nighttime blood pressure in people with essential hypertension, it may paradoxically interact with the antihypertensive drug nifedipine. This pharmacodynamic interaction may lead to an increase in blood pressure. Therefore, melatonin may interact with several medications that scleroderma patients may be taking, including anti-inflammatory drugs and immunosuppressants. In addition, its drowsy effect may compound the sedative effects of narcotic pain medications. For all these reasons, scleroderma patients should be very careful before taking melatonin.
A final example is probiotics. Immunosuppressants such as cyclophosphamide or azathioprine may often be necessary to help control the symptoms of the disease in scleroderma patients. However, probiotics are not recommended for this immunosuppressed population because although probiotics are considered “good” bacteria, they can be harmful or even dangerous to someone who is immunosuppressed.
Therefore, even with natural health products, one must be very vigilant and only a pharmacist can check for these numerous potentially harmful interactions.
HOW TO REDUCE THE RISKS
ALWAYS consult a doctor or pharmacist before choosing a product, even if it is a natural or homeopathic product, just as you would consult a health care professional for a prescription drug. This precaution is even more important for people who are taking multiple medications, to ensure that there are no interactions with them.
Furthermore, it is preferable to use natural health products for a short period of time (less than 3 months), as the effects of long-term use are often known because there are very few long-term studies on the subject.
IN SUMMARY
In short, there is still a lack of clinical studies and research on natural health products and homeopathic remedies. Therefore, great caution must be exercised. It is difficult to say with certainty whether a natural health product will interact with prescription drugs, and one should be aware of this risk. Always talk to your doctor and pharmacist when taking a natural or homeopathic product to make sure it is safe and effective.
REFERENCES:
- Government of Canada. Informing You About Natural Health Products. Information Sheet #5 – for Consumers – Informing Yourself. Health Canada [Online], 2015.
- INESSS. Natural Health Products. Quebec. [Online]. 2016, Ordre des Pharmaciens du Québec. Produits de santé naturels, toujours sans danger? Montréal. [Online]. 2016. [In French only]
- Oxygem. Produits de santé naturels. [En ligne], 1998-2014. [In French only]
- Health Canada. Natural health products. Ottawa. [Online]. Last modified on July 25, 2022.
- Villeneuve, Édith. Médecine conventionnelle et médecine alternative : peut-on arriver à faire bon ménage ? Présentation PowerPoint de la rhumatologue Dre Édith Villeneuve, 30 diapos. [In French only].
