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Safety of herbs and natural products in Canada

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Are herbal supplements safe ?

Herbal product regulations in Canada 

In 2004, the Natural Health Products Regulations came into effect in Canada.  NHP (Natural health products) are defined by Canada Health as: vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products like amino acids, facial products, shampoos, antiperspirants, mouthwashes and essential fatty acids. These products to not need a prescription and those that do would fall under Food and Drug Regulations. At this time, Health care practitioners do not have to be licensed under Health Canada to compound products on individual basis for their patients or to retailers of such products. The license requirements only applies to person or company that manufactures, packages, labels and/or imports NHPs for commercial sale in Canada.

In Canada, natural health products that have been licensed have a eight-digit Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) on their label. npn numberIn theory, they can’t be sold in Canada unless they have the proper product license. To get such a license, there is an application process they applicants have to go through and a series of detailed information must be provided like: medicinal ingredients, source, dose, potency, non-medicinal ingredients and recommended use(s). Now, like anything, there is always exceptions or exemptions. If a product has not yet been approved by Health Canada, it may be provided an exemption number that will be on the label as : EN-XXXXXX. The products with the EN and number have gone through some initial assessment in order to make sure safety, quality and efficacy has been met but have not fully received certification yet. It seems Canada Health has done this in order to allow continuing access to these products for the general public, kind of like if it was a probably period pending approval.  As a consumer, I was not even aware that there where regulations in regards to these products.

Health Canada also requires that claims on products be backed up by proper evidence. What is proper evidence is where some herbalists, traditional doctors and conventional doctors disagree. Health Canada considers as evidence: clinical trials, published studies, journals, and traditional resources. Depending on the claim of the products, more or less evidence is needed to support the health claim and its safety. But, because as we know, it is often hard to establish double blinded studies, clinical trials when it comes to herbals, there lies the difficulty in its regulations. To be licensed in Canada, a NHP label must include a list of things. Health Canada also requires licensing for sites where natural health products like herbs are manufactured, packed, labeled or imported. Health Canada require that these companies promote good manufacturing practices and it requires adverse reaction reporting. Health Canada also regulates the human clinical trials. Practionners have on-line access to up-to-date information on licensed NHPs by using the  Licensed Natural Health Product Database (LNHPD). Also, practionner have access to safety issues through the The MedEffectDatabase. You can also visit the Canadian Homeopathic Pharmaceutical Association for more information.

 

In 2012, I called the Health Canada department to inquire about animal products. They told me that they didn’t regulate products that are for us in animals, so they had me called the CFIA (Canadian Food Inspection Agency). I talked to a veterinarian working for the CFIA. As far as he knows, he says they have regulations for veterinary drugs and veterinary biologics.  But, by definition veterinary herbals and natural supplements do not fall under those designations. According to him, natural health products labeled for use in animals (herbals, food supplements like omega 3, etc) don’t seem to be controlled directly by Canada Health nor the CFIA. After making other calls to different suppliers, the conclusion is that there are no agency regulating veterinary herbal products or natural products designed for use in animals in Canada. Animal health natural products and supplements fall into a grey zone and are currently not regulated. Only voluntary adherence by some companies guarantee their products sold to animals. I have looked into different herbal and nutraceuticals suppliers in Canada, and only a few have actual quality control protocols in effect.

In April 2014, I found out that in Januray 2012, Health Canada, the Canadian Animal Health Institute and North American Compendiums had joined to develop a notification program for low risk veterinary health products (LRVHPs) used in cats, dogs and horses that are not intended for food.  These products include botanicals, vitamins, minerals and homeopathic preparations. This is a voluntary program which means that animal supplement companies are not required by law to follow any safety or GMP (good manufacturing practices) guidelines. Natural Health Veterinary Products approved by this Program will use the initial NN instead of NPN which is reserved for human products. This type of program will help consumer know that when they buy a product with the NN number, that these companies have good Manufacturing practices and quality control systems in place. Furthermore, these products will have procedures in place in case of recalls and also will control what kind of claim can be put on their labels. Veterinary supplement companies wanting to apply for this program can visit this website http://www.lrvhp.ca

A study done by the University of Guelph published in October 2013 showed that a lot of over-the-counter human herbal products contained fillers or omitted ingredients on their labels or had the wrong ingredients listed. Something like over 60% of the products tested contained herbs not listed on the labels, 32% had product substitution and 20% contained fillers like rice, soybeans and wheat. Here is a link to the article for more in dept information about what the researchers found.

The moral of the story is: check your suppliers and check your own human products. Are you buying products that have NPN (for people) or NN numbers (for pets) ? Are you sure that the vitamins you are giving to your family are safe and quality controlled? I have found an improvement in the amount of NPN/NN products now available in the pharmacies but more work needs to be done. In regards to animal vitamins and over-the-counter products, I have yet to see much improvement in that department. I only buy products  from suppliers that I have researched, trust and that have established quality and security controls in place (GMP measures). In the event of a recall, I am contacted directly by my suppliers and I can contact my clients directly to prevent issues.

Written by Dr Cindy Lizotte, DVM, MBA, CVFT (CHI institute), CVA (IVAS), Grad Dip Vet Western Herb Med (CIVT) Cert CVHM (IVAS)

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Food Therapy in Traditional Chinese Medicine

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 Hippocrates said — “Let food be thy medicine & let thy medicine be food”.

One of the five major branches of Traditional Chinese Medicine is Food Therapy. The other branches are acupuncture, exercise, Tui-Na massage and herbal therapy.  Food therapy is based on the theory that different types of food can be used as treatment for various medical conditions. There is a large variety of fruits, vegetables, proteins, and herbs that can be beneficial in healing different ailments.

Food therapy is a great idea for clients that want to feed their pets home-made food, are already preparing home-made diets for their pets or are interested in supplementing whole foods to dry commercial diets.

Food Therapy is based on two fundamental principles: “Food Energetics” and “Pattern Differentiation.” Let’s discuss these two principles in added detail.

Food Energetics

This principle refers to the effect food has on multiple processes of the body, particularly the digestive, metabolic, and physiological systems. Each food has what is called a “Xing,” which is essentially the “temperature” of the item. This temperature refers to the particular food’s overall effect on the dog’s metabolism.

In the West, food is most often described by its contents and ingredients: fats, proteins, and carbohydrates. In the East, however, food is described by the effect it has on the body when consumed, particularly the “temperature” of the food. The temperatures of food are hot, warm, neutral, cool, or cold. Chili peppers, for example, are considered hot, heating up our bodies when eaten, while watermelon is considered cooling. You may notice that you prefer to eat rich broth soups in the winter, whereas in the summer, you may find a strong preference for salads. Without knowing it, you have been using the basic principle of Food Therapy for your own health!

Types of food are also classified by their “Flavor.” In Traditional Chinese Medicine, there are over five flavors that have distinct actions within the body. These flavors include salty, sour, bitter, sweet, and pungent. For example, the Sour flavor is paralleled with the Wood Phase which focuses on the Liver and Gallbladder. The Bitter flavor is correlated with the Fire Phase, affecting the Heart and Small Intestine. Each flavor has a particular quality, ranging from draining to detoxifying.

Lastly, foods may have a particular action within the body, either directly affecting a meridian or an organ.

Pattern Differentiation/Bian Zheng

The second principle in Food Therapy is one of the most important parts of Traditional Chinese Medicine — Pattern Differentiation/Bian Zheng. This principle distinguishes patterns of disharmony within individual dogs. The patterns of disharmony are numerous, often including theories such as Yin/Yang (cold, hot), Location/Jiao (upper, middle and lower Jiao), Five elements Theory (Fire, Earth, Metal, Water, Wood), Eight Principles (yin/yang, hot/cold, interior/exterior, excess/deficiency), and six Pathogenic Factors (wind, cold, damp, heat, summer heat, dryness). When a Traditional Chinese Veterinary Medicine practitioner diagnoses any of the above patterns, the treatment is generally the inverse of the diagnosis, therefore balancing the body and restoring health. These patterns and principles can be quite complicated and would each deserve a blog on their own. For the purpose of this food blog we will not go into great details about each. Here is a simplistic chart of the 5 elements and what is associated with them based on TCM concept.

5element-chart

 

Food Combinations

Once Food Energetics and Pattern Differentiation have been evaluated, a practitioner will choose a food combination for your dog. Combinations include multiple types of food as well as culinary herbs designed to balance the dog’s physical and physiological imbalances.

Food Properties

— Tonic-type foods

These are best used to strengthen body function, and are particularly helpful for dogs with chronic issues. These foods maintain and improve available energy within the body. Tonic-type foods include beef, chicken, date, fig, ham, lentil, molasses, oats, sweet potato, and squash.

— Blood tonic foods

These types of foods are best used to improve the quality of immediate nourishment for your dog’s body. Blood tonic foods include apricot, beef, bone marrow, chicken egg, dark leafy greens, liver, oyster, nettle, parsley, sardine, and spinach.

— Yin tonic foods

These foods maintain and improve subtle body nourishment, as well as overall soothing of the body with cooling properties. Yin tonic foods include apple, asparagus, cheese, duck, honey, mango, milk, peas, pineapple, pork, rabbit, tofu, and yam.

— Yang tonic foods

These types of foods help to maintain and improve the animal’s ability to generate warmth and stimulate many system functions. Yang tonic foods include basil, cinnamon bark, clove, fennel seed, fenugreek, garlic, ginger, kidney, lamb, rosemary, shrimp, and walnut.

It’s important to remember that food is medicine. Sometimes we rely too much on drugs, supplements, and vitamins, forgetting that food can not only be a supplement to our health, but can also heal us.

If you’re interested in learning more about Food Therapy, consult a Traditional Veterinary Chinese Medicine practitioner in your area. Traditional Chinese Medicine is a complex form of medicine and best left to a professional for diagnosis.

I am certified by the Chi Institute as a Chinese Veterinary Food Therapist (CVFT) and you can contact me for a food therapy consult. Please be advised that an initial exam is required to perform a full Traditional Chinese Medicine diagnosis in order to better assess the TCM pattern that is present in your pet.

Written by Dr Cindy Lizotte, DVM, MBA, CVFT (CHI institute), CVA (IVAS), Grad Dip Vet Western Herb Med (CIVT) Cert CVHM (IVAS)

Resources

Ferguson, Bruce. Introduction to Food Therapy in Traditional Chinese Veterinary Medicine. Australian Veterinary Association Proceedings. 2008.

Spring allergies in pets

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Seasonal environmental allergies in dogs and cats

The Moncton area has been  hit by so many snow storms/blizzards this year that we almost forget that spring is upon us. With the onset of spring, many plants and flowers will start to bloom, sending pollen and allergens out into the world. Many humans suffer from spring allergies and our canine and feline counterparts do as well.

What’s the science behind allergies?

Simply put, allergies are a result of an unbalanced immune system. When the immune system is functioning as it should be, the body of your dog is monitored constantly, allowing molecules and safe foreign substances to work properly, while identifying and recognizing hazardous viruses and bacterias.

When a dog or a cat has an allergy, the immune system becomes hypersensitive. It can mistake benign substances, such as pollen, as being harmful to the body. Then, the pet’s body begins to attack the substance, calling in all defenses to battle the substance. Unfortunately, this ultimately hurts the pet’s overall system and ignores the usual bodily tasks that are essential to health.

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This is the face of a cat with severe allergies. E-Collars prevent scratching and is required in some cases.

Symptoms of Pollen Allergies   

The most common symptom of allergies in pets is itching. Scratching, biting, clawing, and chewing in an attempt to relieve the “itch” are normal symptoms. This constant, persistent action often keeps pets awake at night, makes them frustrated, and causes skin damage (redness). It does not take long scratching to break open the skin, allowing bacteria or yeast to enter the body. For pets that have itchiness in their ears, they may claw with their feet and their nails can cause serious damage to themselves.

Treatment for Pollen Allergies

There are typically three standard treatment options for allergies: avoidance, symptomatic therapy, and immunotherapy. We will mention a fourth alternative option which includes diets, acupuncture and natural options.

A) Avoidance

Avoidance is simple — unfortunately, it is nearly impossible to limit your pet from going outdoors! Airborne allergens particularly, such as pollen and dust, are extremely difficult to contain and prevent your pet from coming into contact with. However, there are some steps you can take to ensure your dog or cat’s exposure to pollen is as limited as possible.

Good housekeeping techniques go a long way when helping pets with pollen allergies. Start washing your pet’s bedding at least once a week. After a walk or a bathroom break, use a damp cloth to wipe your pet’s coat. Make sure to pat them dry after, leaving humidity/water on the skin may lead to infections. Brushing your dog or cat can help as well, as it distributes natural oils and eliminates mats.

Also, increase your dusting and vacuuming frequencies. Consider purchasing an air purifying system to avoid reintroducing allergens into your home. During the spring, a peak allergy season, try to limit your pet’s time outdoors. The amount of outdoor pollen is highest at dawn and dusk — avoid letting your dog outside during these times.

B) Symptomatic therapy

This form of therapy means to simply treat your dog’s symptoms acutely. This includes anti-inflammatory drugs, antihistamines, and corticosteroids in an effort to counteract inflammation. Although these drugs do come with some significant side effects, sometimes it’s worth it for your pet’s comfort.

Essential fatty acids supplements, such as an Omegas supplement, are recognized as a safe andelimay omega 3 helpful treatment for allergy pets. Fatty acids ease inflammation, promote healthy skin and coat, and improve overall skin cell health. Refer to our previous blog on Omegas for more information about them.

C) Immunotherapy

Immunotherapy consists of “allergy shots,” a small dose of the substance the dog is allergic to in a saline solution. The standard frequency of dosage is once or twice per week for months (it may vary based on the dermatologist and his/her protocol). The clients will be shown how to administer these injections to their pets at home. The goal of these injections is to accustom your dog’s body to the substance until the dog no longer reacts to it in the environment.

Although immunotherapy often sees good results (approximately 70% of the cases respond), it may be an expensive procedure, both in terms of cost and time. It may lead to a control of the allergies without the need for drugs like prednisone. For more information, talk to your veterinarian. I often refer my cases to Dr Yu or Dr Pye ( board certified dermatologists) for allergy testing. You can visit Yu of Guelph Dermatology website: http://yuofguelphvetderm.com for more information. These board certified dermatologists also visit the Moncton area clinics and the AtlanticVeterinaryCollege a few times a year in order to offer skin testing.

D) Alternative Options

Many holistic practitioners recommend switching any “itchy” pet to a good quality, balanced homemade diet (our blog on this subject) or raw diets (our blog about raw food for pets). Decreasing your dog’s exposure to chemicals and preservatives gives the body a chance to use the rich nutrients found in real, unprocessed foods.

Some pets suffering from allergies have found relief in acupuncture or homeopathic remedies. Natural options like Chinese and western herbal formulas, mushrooms (our blog about immunity and mushrooms), pre and probiotics and homemade diets often tend to end up being more costly then the conventional drugs like Vanectly P, commercial dry diets and depomedrol injections. But, in some cases, they may help rebalance your pet’s immune system instead of just calming it down or suppressing it. Sometimes, a combination of natural options and conventional therapies will be needed or suggested. Each pet is unique and each therapy needs to be design accordingly. Talk to your holistic veterinarian or integrative veterinarian about what would be best for your pet.

As any human suffering from allergies knows, it is important to be patient and persistent when dealing with it. There are many treatment options, both conventional and alternative, and while your patience may be tested when trying to find an option that works, one of these options may be the resolution to your pet’s allergy!

Written by Dr Cindy Lizotte, DVM, MBA, CVFT (CHI institute), CVA (IVAS), Grad Dip Vet Western Herb Med (CIVT) Cert CVHM (IVAS)