A toxicology review of 487 Chinese medicines has been released, demonstrating contamination of many Chinese medicines ( TCM) with modern pharmaceutical grade steroids, hormones and banned diet drugs rather than ancient herbal remedies. The toxicologists analysed medicines that had been linked to severe reactions, including two deaths. Previous research published in the Journal nature Scientific Reports by Curtin University, Murdoch University and University of Adelaide in 2015 also demonstrated contamination by heavy metals, undeclared or illegal contents. This study found almost nine out of ten of these medicines studied had some form of undeclared substance as either adulteration or contamination.

The banned diet drug sibutramine was found in almost one third of adulterated products and other pharmaceuticals found included corticosteroids, diuretics, oral anti-diabetic agents, animal thyroid tissue and erectile dysfunction drugs. Of the analgesic and anti-inflammatory agents found, many such as phenacetin have been withdrawn from regular use in medicine due to toxicity. The products analysed contained an average of 2.5 contaminants and several contained multiple pharmaceutical contaminants.

Chinese medicines are generally believed to be natural and safe, are readily accessible and are gaining popularity worldwide for improving general health and various indications such as weight loss, sexual enhancement, fatigue and muscle building.

Sibutamine ( an appetite suppressant) is the most frequently found contaminant in the recent study and in world literature regarding adulteration of TCM products. Sibutamine has been withdrawn from the medical market due to its association with increased cardiovascular events and strokes. Other banned drugs detected in the adulterated TCMs and health products have been withdrawn from routine prescribing worldwide due to toxicity.

Australia's regulations regarding herbal medicines and supplements are inadequate. 

Most herbal medicines are classified as listed. Unlike registered medicines such as paracetamol, the evidence for listing is much more casual, usually requiring only to  claim that people have been using it for generations without evidence of harm to be listed.

If a product is intended to be used as a supplement, it must be listed with the Therapeutic Goods Administration. The process of listing a substance only requires the registrant to fill out an online form, chose from a list of pre-approved ingredients ( indication low risk and tested for safety in isolation) and state they hold information to substantiate their product's claims. There is no requirement to present it. There is no testing of each batch of supplement for the concentration and safety or potential contaminants to the indicated ingredients that are actually in the bottle. There is no requirement to test for safety of the ingredients in combination.

In a TGA survey in 2012-2013, 145 complementary medicines were tested with 83% deemed to be non-compliant, with 6% failing due to product composition or formulation. Other sample testing has demonstrated undisclosed fillers such as soybean, wheat and rice. Ginko biloba supplements were found to be mixed with fillers and black walnut, a potentially deadly hazard for people with nut allergies. Herbal supplements bought online have been linked to at least six Australian organ transplants since 2011. A Perth man required a liver transplant after taking a protein powder containing green tea extract and a supplement containing garcinia cambogia

These studies highlight the importance of informing your GP if you are taking herbal products or supplements as adulterants may interfere with conventional medicine to cause significant effects, or may alone cause significant effect such as liver damage, heart damage and hormonal side-effects . 

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