Konsumen Jangan Mudah Terbujuk Iklan Suplemen

Konsumen Jangan Mudah Terbujuk Iklan Suplemen

SUARA PEMBARUAN DAILY
Konsumen Jangan Mudah Terbujuk Iklan Suplemen

Ada Suplemen yang Tadinya Diklaim Bisa Memulihkan Daya Ingat Ternyata Tidak Ada Efeknya

JAKARTA - Konsumen diimbau agar tidak mudah terbujuk iklan suplemen. Pasalnya, dari ratusan item berbagai suplemen yang beredar saat ini di pasaran, hanya sebagian kecil yang memiliki keefektifan dan aman dikonsumsi. Pasalnya, suplemen bukanlah obat, dan bebas diperjualbelikan tanpa perlu dibuktikan keefektifannya dan keamanannya oleh produsen.

Demikian diutarakan ahli farmakologi Prof dr Iwan Darmansjah SpFK yang diwawancara Pembaruan tentang maraknya peresepan suplemen saat ini, Rabu (29/9), di Jakarta.

Menurut dia, produk suplemen saat ini sedang booming karena dipicu oleh undang-undang tentang suplemen kesehatan Amerika Serikat (AS) tahun 1993 yang memperbolehkan suplemen dijual secara bebas, tanpa perlu produsen membuktikan keefektifannya.

Undang-undang itu ditiru oleh negara lain sehingga suplemen pun diproduksi secara besar-besaran. Kemudian, adanya pasar bebas membuat suplemen produksi suatu negara beredar di negara lain.

Celakanya, ujar Iwan, produk-produk obat yang gagal memenuhi syarat dikategorikan sebagai obat, beralih menjadi golongan suplemen. Padahal, suplemen tidak boleh mengandung bahan obat. Artinya, ada pemalsuan suplemen.

Ironisnya, sebagian besar masyarakat mempercayai semua suplemen berkhasiat dan ada fenomena di tengah masyarakat bahwa obat-obatan Barat adalah racun. Di sisi lain, ada juga sejumlah dokter yang cenderung meresepkan suplemen dengan hanya mempertimbangkan unsur materi semata.

"Ini sudah kecurangan. Suplemen tidak ada efeknya diresepkan. Ada suplemen yang tadinya diklaim bisa memulihkan daya ingat ternyata di kemudian hari tidak ada efeknya. Ada satu dua orang yang merasa enak setelah mengonsumsi suplemen, tetapi rasa enak itu muncul dari efek placebo, " katanya.

Sekalipun suplemen belum pasti bermanfaat, konsumen cenderung percaya pada produk suplemen karena produsen dan distributor menggunakan cara-cara pemasaran yang mampu memperdaya konsumen. Perdagangan suplemen sudah tidak terkendali, padahal sebenarnya konsumen telah rugi dengan membeli dan mengonsumsi produk yang belum tentu bermanfaat.

Undang-undang Obat

Menurut Iwan, konsumen saat ini ibarat lepas dari mulut macan tetapi masuk mulut buaya akibat dari adanya fenomena obat-obat Barat berbahaya sehingga konsumen beralih ke suplemen. Untuk mengendalikan hal ini, adalah tugas pemerintah untuk mengerem peredaran berbagai produk suplemen yang sudah tidak terkendali. Karena, pada akhirnya yang akan rugi adalah konsumen, mengingat harga suplemen pun tidak murah.

Peredaran suplemen yang belum bisa dikendalikan saat ini, katanya, lebih karena disebabkan sejumlah pihak memperoleh untung dari situasi saat ini. Bila ada keinginan dari pemerintah untuk mengendalikannya, maka bisa diwujudkan dengan membuat rambu-rambu tentang suplemen. Rambu-rambu itu bisa diatur dalam undang-undang tentang obat, yang sampai saat ini belum ada.

Iwan menegaskan, perlu dibentuk undang-undang tentang obat yang akan mengatur tentang keberadaan obat di tengah masyarakat. Pasalnya, obat adalah kebutuhan pokok, sama penting-nya dengan kebutuhan pokok yang lain. Artinya, obat pun seharusnya diperlakukan sama dengan kebutuhan pokok lain. Jangan hanya menganggap obat sebagai barang dagangan semata. "Rambu-rambu itu akan mengatur kebijakan. Apakah obat sebagai barang dagangan? Seperti apa obat yang dibutuhkan orang dan bea masuk hendaknya dihilangkan, keuntungan dikurangi. Sampai sekarang tidak ada kebijakan tentang hal ini karena obat masih dianggap sebagai komoditas dan menguntungkan pihak-pihak tertentu," tandas Iwan.

Dia menambahkan, di era pemerintah baru, bila ada keinginan untuk membentuk undang-undang obat (termasuk suplemen) maka hal itu bisa diwujudkan. Tetapi yang tidak kalah penting adalah tim penyusun undang-undang, haruslah terdiri dari orang-orang yang benar-benar memahami obat dan tidak berkepentingan untuk mencari keuntungan dari undang-undang yang akan dibentuk. (N-4)

Economic Larceny by Food Supplements

Economic Larceny by Food Supplements

Vignette

A 50-year-old male patient with a body weight of 91 kg consulted me one morning with a long-standing cough which I diagnosed as bronchitis. It was preceded by a short period of a flu, which is known as a viral infection, but all the symptoms had disappeared except the hacking, phlegm-producing cough. Bronchitis is an irritating disease that may last for weeks or months, often hard to cure, even much more difficult than the more serious pneumonia (infection of the lung tissue). While community acquired pneumonia is easily cured by antibiotics, bronchitis is difficult to manage and reacts best with rest and anti-asthma drugs, while antibiotics don’t work. This patient, however, was given - by his doctor - 1 unneeded antibiotic and 7 food supplements, costing him Rp 1.4 million.


The free trading of these dietary supplements was initially triggered by the US FDA: the Dietary Supplement, Health and Education (DSHE) Act of 1994. This law makes it easy to market dietary supplements, because no data on safety and efficacy are needed. This means that no basic studies or clinical trials are required. Soon, all nations have silently applied this rule in their respective countries. Many governments and professionals have questioned this controversial Act and The New England Journal of Medicine has in recent years published several critical papers on the subject. In about 2004 the European Parliament has once voted 26 against 1 to require hard data on a supplements marketing status, but was silently abolished the next year. Professor John S. Dowden from Australia wrote an editorial in the Australian Prescriber last year entitled “ A century of concern about complementary medicines”. From the UK are warnings about how toxic popular food supplements can be, especially when overused or large doses were taken. In 1994, the year of the DSHE, it was reported that the estimated 600 dietary supplement manufacturers in the United States produce approximately 4,000 products, with total annual sales reaching at least $4,000,000,000. Nowadays, that figure is estimated at $ trillion and Nutrilite, the top vitamin, sells at a record $3.1 billion. For Indonesia, herbal medicines is said to be sold Rp 1.5 trillion (?), while the figure for dietary supplements, that include herbal medicines, is unknown. An Internet Drug Store News reported,”Despite controversy over credibility, dietary supplement sales surge, it is the only category in the front end of a drug store that generates as much controversy as it generates sales”.

The main issue is that while drugs undergo rigorous evaluation of efficacy and safety data before marketing, these supplements were allowed – up till now - on the market without the necessary scrutiny. It was only limited by the label (indication) it may claim, no disease claim was allowed, only health claims was agreed. But, health and disease is often difficult to differentiate, and soon we witness all types of diseases, like diabetes, cancer, tuberculosis, etc to become indications of use - of course, lacking evidence. This leaves the beholder to be attracted by its flashy advertisements. It is also contradictory to current requirements of medication that practice Evidence Based Medicine, a strategy that should be followed by the entire medical profession (including nurses, clinical laboratories) and hospitals. The use of any drug must be supported by clinical evidence of its efficacy and safety (‘labelled use’). Without the double blind controlled clinical trial one may not claim efficacy, because any lay opinion of efficacy of a medicine may in fact be riding on the powerful placebo effect. This effect may be seen in a very large percentage of users, for some diseases (like an antibiotic for flu) it might be some 90 % or even more. Many medical practitioners are also unaware that supplements are no drugs and are devoid of any evidence of clinical trials that proves efficacy – and safety. Many supplements have adverse reactions too, and combined with polypharmacy (using more drugs than is really needed) practice are causing interactions between molecules in the body, causing unknown and problematic body reactions, not to be excluded, cancers. The rage of consumption of anti-oxidants, for instance, has been signaled to be a trigger of cancer. Anti-oxidants are good for preserving food, especially cake, but no positive proof (evidence) is there for preserving human health needs, notably in overuse. An array of different brands and shape of bottles filled with oxygenated water is also just replacing the wine-list in European restaurants and hotels. By the way, they sell at some EU 10 – 20.00 a bottle.

Food supplements are eating up household money into useless health cravings, often aided by doctors’ prescriptions. The Act caters for business rather than health. Imagine that, perhaps now, at least 20-30% of the world society is using or trading supplements, further stimulated by multi-level-marketing, a business that is non-functional and nothing is gained in terms of economics that would be lasting. It is created by today’s style of business: short term gains by such events like holiday sales, slashed discounted prices, of things that we really wouldn’t need or use. We may, perhaps, have the largest number of malls (relatively) in greater Jakarta, and yet it is still building more. Economically the whole nation may suffer from a backlash of real growth, and may therefore lack innovation for a positive change. Malls are also providing the place to spend that kind of money; they even become the playground of children and adults, causing transmission of airway diseases.

As the name suggests, DSHE stipulates that the Act includes education (of the public). This would fall on the US FDA shoulders, and indeed a large budget is accompanying this activity – although not enough to be efficacious. Adequate information leaflets are to be inserted in each packet and the internet and other media contributes ample warnings and caveats on supplements. In developing countries, however, no impartial information is provided by governments, while deceiving health advertisements in all media is rampant. While some supplements are producing beneficial results in selected users, very often, devious marketing tactics are attracting sick people more than the efficacious drugs available, overthrowing therapeutic systems. This had all begun with the advent of the “crazy open free market economy” that had started with Ronald Reagan, the once charismatic president of the US. Deregulation, which was followed by the world, had created a (predicted) greed, dishonesty and unethical conduct of immense nature. The serious question to be asked is whether this phenomenon, together with all the scam of unethical health practices, may lead to a further downward spiral of poverty and poor health in disordered countries.

Iwan Darmansjah, MD

A Way To Prevent Dialysis At Kidney Failure

PREVENTION OF DIALYSIS – PLEASE FORWARD THIS TO YOUR FRIENDS WHO NEED IT.

In the garden of my house is a Lychee tree which has been there for over 50 years, but I had never known before that it has in it a medicine of great value.
In Taiwan there are many kidney patients, but perhaps in your neighborhood there are also people who have to undergo dialysis, and maybe there are some who want to try this out. Therefore I hope that you will disperse this prescription to help those who need it – doing so is a rewarding deed. Thank you.

In nearly all large houses you could find a “dialyser” with which blood is made to flow through the machine to clean it from harmful matter. This is performed specially on patients whose kidneys are no more functioning. My kidneys did not function anymore since I have been suffering from diabetes for 20 years, which made me lose interest in life. But as my children were still small I had to carry on living bravely.
I had always been strongly opposed against Chinese medicine before. For 20 years I had sought treatment by doctors, until one day I had to enter the Dialysis Room, and suddenly my mind opened and I thought: “why don’t I try this prescription??” It gave me hope.

After two dialyses a family member offered me this Lychee prescription, saying that this prescription would guarantee that dialysis would become unnecessary for me - and I agreed instantly. On the same day he brought me kidney soup, which I divided in two portions to drink. The following day I drank once more the pig kidney soup as much as 1.5 bowls; I observed that it was stimulating the renal function (urinating). Actually on the third day I was due for another dialysis, but the doctor who examined me said that it wasn’t necessary anymore.
I continued to drink this medicine for about one week, after which, in astonishment, the doctor found that my kidneys were functioning normally and told me that I could be released from the hospital right away.

PRESCRIPTION FOR AVOIDING KIDNEY DIALYSIS
TAKE 7 LYCHEE SEEDS (grind the seeds and wrap in a piece of gauze). Buy 1 pig kidney (slice fine, remove white tendons/membranes), wash it clean, put it with the lychee seeds in a large bowl, add water which has been used for washing rice (from the second wash) as much as 2 bowls, steam it in an electric steamer for a ½ hour. This amount is to be taken at once (all of it). Its efficacy is certain.

I have been prevented by this prescription from having to undergo a dialysis and I hope with this prescription we could help one another. Let us forward this prescription to others with good intention to help.

Medical Articles

LATEST DATA SHOW THAT USE OF ANTIBIOTICS TO TREAT EAR INFECTIONS IS FALLING

The proportion of children who were given an antibiotic specifically to treat otitis media, a commonly diagnosed ear condition, declined from 14.4 percent in 1996 to 11.5 percent in 2001, according to new data from HHS’ Agency for Healthcare Research and Quality (AHRQ). The data also showed declines in both the percentage of children reported to have otitis media and the percentage of children whose parents sought treatment for the condition. The data, from AHRQ’s Medical Expenditure Panel Survey, suggest that campaigns launched in the mid-1990s to reduce the overuse of antibiotics and prevent antibiotic-resistant infection may have been effective. The campaigns, by HHS’ Centers for Disease Control and Prevention, the American Academy of Pediatrics and others, alerted parents and clinicians to the potential dangers of overuse of antibiotics and promoted appropriate use of these medications. The majority of antibiotics prescribed for children in the United States are for respiratory tract infections; treatment for otitis media accounts for about one-third of all antibiotics purchased for children. Respiratory tract infections may be caused either by bacteria that can be treated effectively with antibiotics or by a virus for which antibiotics will not help. “Although antibiotics can help some children with respiratory tract infections, it can be difficult to determine who will benefit from the drugs,” said Carolyn M. Clancy, M.D., director of AHRQ. “These MEPS findings suggest that educational campaigns are working and that parents now are more selective about when they seek medical treatment and antibiotics for their children.” The data also show that between 1996 and 2001, the percentage of children in the United States age 14 and under who used an antibiotic for any reason during a given year declined from 39 percent to 29 percent. In addition, the average number of antibiotic prescriptions used by all children age 14 and under during this period declined from 0.9 per child to 0.5 per child.MEPS researchers also looked at trends in antibiotic use between 1996 and 2001 for children of different ages, races/ethnicities, gender, household income, insurance status, health status, and geographic location. They found that over that period of time, each subgroup of children showed a decline both in the percentage with antibiotic use and the average number of prescriptions for antibiotics. (more)MEPS collects information each year from a nationally representative sample of U.S. households about health care use, expenses, access, health status, and satisfaction with care. MEPS is a unique government survey because of the degree of detail in its data, as well as its ability to link data on health services spending and health insurance to demographic, employment, economic, health status, and other characteristics of individuals and families. Details are in Research Findings 23: Trends in Children’s Antibiotic Use: 1996 to 2001

Apakah fomalin itu ?

Apakah fomalin itu ?
Formalin adalah larutan yang tidak berwarna dan baunya sangat menusuk. Di dalam formalin terkandung sekitar 37% formaldehid dalam air. Biasanya ditambahkan metanol hingga 15% sebagai pengawet.
Formalin dikenal luas sebgai bahan pembunuh hama ( desinfektan ) dan banyak digunakan dalam industri.
Sejauh ini, pemanfaatannya tidak dilarang namun setiap pekerja yang terlibat dalam pengangkutan dan pengolahan bahan ini harus ekstra hati-hati mengingat risiko yang berkaitan dengan bahan ini cukup besar.

Nama lain formalin
Formalin biasanya diperdagangkan di pasaran dengan nama berbeda-beda antara lain:

• Formol
• Morbicid
• Methanal
• Formic aldehyde
• Methyl oxide
• Oxymethylene
• Methylene aldehyde
• Oxomethane
• Formoform
• Formalith
• Karsan
• Methylene glycol
• Paraforin
• Polyoxymethylene glycols
• Superlysoform
• Tetraoxymethylene
• Trioxane

Penggunaan formalin

• Pembunuh kuman sehingga dimanfaatkan untuk pembersih : lantai, kapal, gudang, dan pakaian.
• Pembasmi lalat dan berbagai serangga lain.
• Bahan pada pembuatan sutra buatan, zat pewarna, cermin kaca, dan bahanpeledak.
• Dalam dunia fotografi biasanya digunakan untuk pengeras lapisan gelatin dan kertas.
• Bahan pembuatan pupuk dalam bentuk urea.
• Bahan untuk pembuatan produk parfum.
• Bahan pengawet produk kosmetika dan pengeras kuku.
• Pencegah korosi untuk sumur minyak.
• Bahan untuk insulasi busa.
• Bahan perekat untuk produk kayu lapis (plywood).
• Cairan pembalsam ( pengawet mayat ).
• Dalam konsentrasi yang sangat kecil ( <>

Penggunaan formalin yang salah
Penggunaan formalin yang salah adalah hal yang sangat disesalkan. Melalui sejumlah survey dan pemeriksaan laboratorium,ditemukan sejumlah produk pangan yang menggunakan formalin sebagai pengawet.
Praktek yang salah seperti ini dilakukan produsen atau pengelola pangan yang tidak bertanggung jawab. Beberapa contoh produk yang sering mengandung formalin misalnya ikan segar, ayam potong, mie basah dan tahu yang beredar di pasaran. Yang perlu diingat, tidak semua produk pangan mengandung formalin.

Ciri-ciri produk pangan yang mengandung formalin
Seperti telah dipaparkan di muka, bahwa terdapat sejumlah produk yang secara sengaja ditambahkan formalin sebagai pengawet. Untuk memastikan apakah sebuah produk pangan mengandung formalin atau tidak memang dibutuhkan uji laboratorium. Kita sebaiknya berhati-hati bila menjumpai produk pangan yang mempunyai ciri sebagai berikut:

• Tahu yang bentuknya sangat bagus, kenyal, tidak mudah hancur, awet beberapa hari dan tidak mudah busuk.
• Mie basah yang awet beberapa hari dan tidak mudah basi dibandingkan dengan yang tidak mengandung formalin.
• Ayam potong yang berwarna putih bersih, awet dan tidak mudah busuk.
• Ikan basah yang warnanya putih bersih, kenyal, insangnya berwarna merah tua bukan merah segar, awet sampai beberapa hari dan tidak mudah busuk.

Bahaya Formalin
Dampak formalin pada kesehatan manusia, dapat bersifat

• Akut : efek pada kesehatan manusia langsung terlihat : sepert iritasi, alergi, kemerahan, mata berair, mual, muntah, rasa terbakar, sakit perut dan pusing
• Kronik : efek pada kesehatan manusia terlihat setelah terkena dalam jangka waktu yang lama dan berulang : iritasi kemungkin parah, mata berair, gangguan pada pencernaan, hati, ginjal, pankreas, system saraf pusat, menstruasi dan pada hewan percobaan dapat menyebabkan kanker sedangkan pada manusia diduga bersifat karsinogen (menyebabkan kanker). Mengkonsumsi bahan makanan yang mengandung formalin, efek sampingnya terlihat setelah jangka panjang, karena terjadi akumulasi formalin dalam tubuh.

Pertolongan pertama bila terjadi keracunan akut
Pertolongan tergantung konsentrasi cairan dan gejala yang dialami korban.Sebelum ke rumah sakit : berikan arang aktif ( norit ) bila tersedia. Jangan melakukan rangsang muntah pada korban karena akan menimbulkan risiko trauma korosif pada saluran cerna atas.Di rumah sakit : lakukan bilas lambung ( gastric lavage ), berikan arang aktif (walaupun pemberian arang aktif akan mengganggu penglihatan bila nantinya dilakukan tindakan endoskopi). Untuk mendiagnosis terjadinya trauma esofagus dan saluran cerna dapat dilakukan tindakan endoskopi. Untuk meningkatkan eliminasi formalin dari tubuh dapat dilakukan hemodyalisis (tindakan cuci darah), indikasi tindakan cuci darah ini bila terjadi keadaan asidosis metabolik berat pada korban.