Pictured: Health consumers
For background, see Part 1. The company I’m going to talk about is called “Bell Lifestyle Products” and I will use this example to demonstrate the uselessness of Health Canada’s Natural Health Products Database.
The BLP “About Us” page is a testimonial by one of the owners summarizing anecdotal reports for their products; “We are proud to have helped hundreds of thousands of men and women with chronic diseases to restore their quality of life since 1996.” One wonders what they were doing the other 22 years, as the Better Business Bureau (BBB) indicates that they have been in business since 1974. Located in Mississauga, ON, they sell supplements and remedies through mail order on their website and via various local retailers and pharmacies.
Unfortunately, Bell has a checkered past (that they do not clearly disclose). In a fit of sense, further demonstrating that product testing is important for the safety of the public, Health Canada issued a 2003 recall of the product Bell Magic/Magnum Bullet because it contained an undisclosed and unauthorized substance. Bell responded to the recall by responsibly summarizing and directly addressing the issue, making a public apology, and drafting a statement about their commitment to quality control.
Oh, wait. The opposite of that.
They implied that they were misled by their supplier and that the Health Canada investigation was a waste of time and money that deprived thousands of people their only relief from impotence. They also said they lacked the money for proper research of the product, but provided several testimonials instead. Except, it seems like they did have some money to donate their way out of a fine:
“Two years after Health Canada forced us to withdraw the Magicc Bullets, on October 14, 2005, all charges by Health Canada were dropped after we made a donation to the Heart and Stroke Foundation as requested.”
The National Advertising Division of the Council of Better Business Bureaus recommended, in 2010, that Bell Lifestyle Products discontinue certain claims for Bell’s Shark Cartilage product:
“At the outset of the NAD’s investigation, Bell Lifestyle asserted that it had discontinued certain claims, including all claims and testimonials referencing treatment of a specific disease, claims comparing the relative efficacy of Bell Shark Cartilage #1 with synthetic drugs, the performance claims referencing the absolute number of users helped by Bell Shark Cartilage #1, claims that reference a specific percentage efficacy and testimonials referencing alleviation of serious rheumatoid arthritis symptoms and the statements of the consumers who wrote that they avoided surgery after using Bell Shark Cartilage #1.”
On Bell’s page for Shark Cartilage, to years later, they claim that it is effective for long-term arthritis pain relief (a specific treatment for a specific disease – check), they show testimonials comparing the product to drugs (check) and referencing specific diseases (check), they claim that thousands of men and women have been helped (check), and they include testimonials claiming that their symptoms were alleviated and they avoided surgery (check). So the website still contains the very things it was asked not to.
The choice to use shark cartilage and shark fin as ingredients in their remedies has put them on the defensive. They cite the American restaurant industry as their source for shark fin, claim that activists are “intentionally confusing people”, and express appropriate disgust with the practice of shark finning (cutting the fins of a live shark and throwing it back in the ocean). However, shark is not a common dietary item in North America, with the government making the trade of shark fin illegal due to the practice of finning. As to claims that shark cartilage has no medicinal value, they have this to say:
“This is an outright lie. Our shark cartilage is processed differently to preserve the active medicinal ingredients and it gives arthritis pain relief in 98% of all cases. … Go on our web site and read how literally hundreds of men and women are witnessing this fact with their full names and towns. All these statements are 100% true. Most have listed phone numbers. Some skeptics are welcome to call these people to find out whether they are real.” [emphasis added]
“Differently” than what? They don’t specify. A repetition of testimonials, not research papers, is their only defense. A testimonial doesn’t have to be false to be useless. I did contact some of the people listed in their testimonials and I got some quite paranoid responses (for example, one person was upset that I emailed her from a “generic” Gmail address, even though I provided my full name and stated that I am a blogger).
The Better (?) Business Bureau
So with this history, why does BLP have a relatively glowing review from the BBB?
Based on BBB files, this business has a BBB Rating of A on a scale from A+ to F. Factors that lowered this business’ rating include:
- Advertising issue(s) found by BBB.
Factors that raised this business’ rating include:
- Length of time business has been operating.
- No complaints filed with BBB.
- BBB has sufficient background information on this business.
So the significant advertising issues described above only contributed to lowering the grade from an A+ to an A. That the company has been around a long time and that the BBB has “sufficient” background information (though apparently not, as their issues with HC and NAD aren’t disclosed) are not good enough reasons for a high rating.
I submitted a complaint myself, but as I had not purchased a product and was not able to report a direct consumer issue (such as poor customer service, lack of receipt, etc), my complaint was not able to be processed by the BBB. Nor would they accept my information regarding the Health Canada recall or the NAD recommendations. This illustrates a limitation with BBB ratings – they depend on actual customers being unsatisfied with their products and unsatisfied enough that they would complain to the BBB. A complaint based on a lack of credible evidence that these products can even work is outside of BBB’s mandate. As a result, I pursued other options, which I will describe in a later article.
Summary of products
Finding information about Bell Lifestyle Products was like pulling teeth. Several products registered with the Licensed Natural Health Product Database (NHPD) and the NHP Exempted Products Database (EPD) have more than one name. I did manage to sort through everything eventually, so here is a summary of what I found.
Bell Lifestyle Products numbers their products, so when sorted out, it was easy to see that about 20 were missing. I called Bell and they said that there was no particular reason for this and that perhaps they were spaces to be filled in by products later. I asked a few more questions:
- Seeing claims on the site such as “many research studies” support X product, I asked why none of these studies were on the website. I was told that they don’t provide this kind of information and consumers are to search for supporting evidence themselves. Not a great policy for people who don’t know where to find that kind of information.
- I asked about the shark products. I was told that they use shark because “sharks don’t get cancer”. No mention of supporting evidence for efficacy.
- I asked about product registration. I was told that all products are registered with Health Canada because they “wouldn’t be able to sell them otherwise”.
So at least one BLP employee is apparently aware of Health Canada’s natural health product regulations.
Of Bell’s many products, 13 or so have NHPD numbers. The ingredients and claims that are registered with the NHPD generally match those listed on the website, with some exceptions and issues. For example:
- Arthropain (NHPD 80008359 as Joint Relief Capsules). BLP does not guarantee effectiveness because it “works only in a minority of cases”. NHPD says it is “a factor in maintaining joint health”. [Reminder: NHPD approves products for safety and efficacy, yet this one states outright that it only works for a “minority of cases”.]
- Homosysteine (NHPD 80004840 as Bell Cardio Health Capsules). Here’s where things get confusing. There is no product called homosystein in the NHPD but there is no “Cardio Health Capsules” on BLP’s website. A comparison of the ingredients seems to indicate that these are the same product. Claims to help reduce artery inflammation and help prevent memory loss. NHPD approved it for maintaining “good health” and “cardiovascular health”.
- HRT Menopause Combo (NHPD 80005070 as Bell Menopause Capsules). Like Homosystein, the ingredients differ somewhat between the BLP and NHPD listings. Claims to be a hormone replacement therapy capable of treating/preventing common menopause symptoms (hot flashes, etc) and is endorsed by a MH PhD (that stands for Master Herbalist). NHPD approves it to “relieve menopausal symptoms”.
- Co-Q 10 has 2 numbers: 30 mg (NHPD 80003426) and 60 mg (NHPD 80006960). It claims to “improve heart function”. 30 mg is approved to “support healthy heart function” and 60 mg is approved to help “maintain and/or support cardiovascular health”.
- Bell Urinary Tract Infection Capsules (NHPD 80021331) isn’t apparently sold on the website anymore. The closest item is their Bladder & Yeast Infection Caps, but these appear to be separate products.
Health Canada allows companies to change product names after they are registered because this doesn’t affect the safety of the product, but it certainly does make it difficult for consumers to verify which products are registered. A few of the items above are practical examples of why that is a bad idea. Allowing product names to be changed makes it especially difficult to verify whether the a particular product sold on a website is in fact the same product that Health Canada has exempted or approved.
Other sources of confusion are different ingredient notations and inclusion/exclusion of certain ingredients. Even worse, whereas the NHPD has the ingredients listed with a general summary (health claims, indications, and contraindications), the exemption list has nothing to distinguish one product from another similarly-named product, as no ingredients, intended uses, or approved claims are provided.
Bell currently has 32 NHP exemption numbers, though a few have since been issued a NHPD license and some products (Erosyn, Eroxil, and Fertalin) share the same exemption number. Another product (the middle-aged “energy booster”) has the same ingredients as Erosyn et al, but is not registered. (For those keeping track, BLP is apparently selling one product under 4 different names.) Of the products exempted, about a dozen are listed as “not valid”, yet several of those remain for sale on Bell’s website (e.g., shark cartilage capsules). Furthermore, about two dozen products with no registration or exemption numbers (that I could find) are on sale at the time of this writing. This is illegal (see Q5):
“Once the six month compliance promotion period is over in February of 2011, products without a product licence or exemption number may be subject to compliance and enforcement activities and should not be available for sale or imported for sale into Canada.” [emphasis added]
Invalid products are also not permitted to be promoted or sold while being reconsidered for registration. But what does “not valid” mean, exactly? The NHPD exemption website unhelpfully states that it means “no longer valid”, so I emailed them to get a better explanation. According to the response, “not valid” means a number of things that are indistinguishable to the public — because Health Canada doesn’t make that information available — ranging from the company simply withdrawing their application to Health Canada outright refusing the product. The person I corresponded with suggested I call the company to inquire about invalid products. Except when I had called BLP, I was told that all products are registered.
It’s laughable that Health Canada deems it appropriate for a company with a stake in their own reputation and finances to disseminate Health Canada registration compliance information to their customers. There is no information on the BLP website indicating whether a product is registered, exempted, not valid, or none of the above. This is an example why the NHPD and Health Canada regulations for alternative medicine products are useless for the consumer at point of purchase, especially online where the box (which should have the NHP numbers listed) is not clearly visible.
Stay tuned for Part 3, where ingredients and evidence will be discussed, as well as my complaints for specific advertising and NHPD violations seen on Bell Lifestyle Products’ website.