02.Pharmacist advice - shadow shop
Our shadow shopper visited 30 pharmacies across Sydney, and in each sought advice about one of the products investigated. She asked to speak to the pharmacist, but in some cases this was too impractical so she could speak only to the assistant. For each product she presented with a relevant symptom complaint and asked two key questions: "does it work?" and "do you recommend it?"
Lemon Detox Diet
Lemon Detox is a “detoxifying” diet that involves drinking a lemon concoction made from lemon juice and the detox kit mixture of maple syrup and cayenne pepper. The kit also contains a laxative tea and sea salt laxative. It costs about $90. Detox diets claim to eliminate the chemicals and toxins that build up in your body. However, there’s no scientific basis to the notion that our bodies need detoxifying – the body does this itself. Cleansing claims aside, detox diets are often used for weight loss - people will lose weight (primarily muscle tissue, due to lack of protein and water) in the short term because they’re not eating. Lack of energy for everyday activities is a real danger on the “optimum” version of the program, which lasts 10 days at only 2500kJ per day.
What the pharmacists said
- Most of the eight pharmacists said the Lemon Detox was hard to do, and some recommended a relaxed version (where you’re allowed one meal a day).
- Some expressed caution, pointing out it was expensive and difficult, and suggested our shadow-shopper take a brochure to find out more.
- Two pharmacists claimed the kit contained enough nutrients for her to survive for a week. While she’d be unlikely not to survive the week, it is severely deficient in almost all nutrients .
- At only two of the pharmacies was she asked questions about her general health. There are certain groups of people who should never follow this type of diet, including pregnant women and diabetics.
- Three pharmacists recommended other less expensive and possibly safer – though equally nonsensical – detox or slimming products, including a homeopathic product.
- The best advice came from a pharmacist who was concerned about using laxatives to cleanse and lose weight, and recommended against it. As she explained quite bluntly: “There’s no evidence behind the detox theory, and if it’s for weight loss, it gets down to calories in and calories out.”
High Tech Health Circulation Booster
The Circulation Booster claims to use mild electrical impulses through the soles of the feet to create muscle contractions, to help relieve pain and reduce swelling while seated. The bumph refers to “cankles” (swollen ankles), the ailment of which our shadow shopper complained. The device is listed on the Australian Register of Therapeutic Goods as a Class II Medical Device (which means they’re safe to use and that the manufacturer is expected to hold evidence to back claims) and costs $400 online for a complete kit, though it can be cheaper at chemists. Some private health insurance funds offer a rebate for the machine. Many chemists offer a free trial (as does the company if you purchase online).
There is some anecdotal evidence that the Circulation Booster helps – some people swear by it. However, not everyone’s convinced of its efficacy. In 2010, the Therapeutic Goods Administration’s (TGA) advertising complaints resolution panel determined there was no conclusive evidence it could provide pain relief, or that it would reduce cankles, improve circulation, ease arthritic pain, reduce fluid retention and swelling, aid fast recovery from muscular injury or relieve aches and pains. This doesn’t mean it can’t do these things – only that it hasn’t been proved it can.
Of greater concern, though, is that swollen ankles can be a sign of cardiovascular disease – something we’d expect pharmacists to be aware of. Bypassing diagnosis by a doctor and buying the machine off the shelf simply to relieve swollen ankles could delay essential treatment for a more serious disease.
What the pharmacists said
- Of all the products, this one was most enthusiastically supported and recommended. Advice was generally good, and this example illustrates the importance pharmacists being involved in the sale of these products – people buying these online would not be so well served.
- At six pharmacies contraindications such as a pace maker, metal implants or pregnancy were mentioned, and at five she was told she may be able to get a rebate from her health fund.
- Three offered very good advice on the basis of questions about her health and the problem, including that she should see a GP.
- Three pharmacists were keen for her to try the machine, without having asked much about her history or recommending she see a doctor.
- Four recommended the product based at least partly on sales success rather than clinical evidence.
- Overall, four out of seven pharmacists recommended our shadow shopper see a doctor - an encouraging result. For example, one of these pharmacists asked why our shadow shopper wanted one and when the swelling was happening. “The pharmacist pointed out that at my age, my legs should not swell from sitting at a desk. I was advised I should get my heart checked and ask my doctor about using the product."
Magnetic pain relief products
Static magnets are weak magnets placed on the body – usually over regions of pain or sometimes acupressure points – where the power of the magnets is claimed to relieve pain. While safe to use, there have only been a few scientific studies evaluating the effectiveness of magnet therapy, and no convincingly positive results. It’s likely that at least part of any treatment effect comes from the pressure and support afforded by the wraps and bands containing the magnets.
What the pharmacists said
- Overall, there wasn’t much enthusiasm for the products – more an attitude of “might as well try it”.
- Only two of eight pharmacists believed in the power of magnets and recommended them – although one of these took a good look at the shadow shopper’s knee and suggested she try some stretches first.
- When asked if the magnets work, five pharmacists used anecdotes to suggest they do, pointing out that other people swore by them, or that they must work because people keep buying them.
- Three suggested she try a normal support bandage first.
- A typical response was: “People keep buying them, so they must work. If you’re going to get a support bandage, you may as well get one with magnets – they may help.”
- Then there was this gem: "There's lots of evidence to show they work but Western medicine hasn’t taken to the idea. The product doesn’t just support the knee like other products - the magnets take away the pain."