NON-PRESCRIPTION
DRUGS & SUPPLEMENTS
Are They Being Inactivated by Sloppy Shipping and Storage?
by Hannah F.
Elson, Ph.D.
I remember
reaching for a bottle of vitamin capsules on the supermarket shelf, and
noticing how warm the bottle felt. The spot light in the ceiling was shining
right on that part of the shelf, warming all the illuminated bottles. The store
manager was grateful to be informed about this. Several B vitamins (thiamine,
pantothenic acid, folic acid) as well as vitamin C break down at high temperatures.
Another time, I opened a bottle of capsules containing glucosamine and
chondroitin sulfate, and noticed a very unpleasant odor. The capsules were hard
to swallow because of this mildly putrid smell. The manufacturer’s customer
service representative said this could happen if the bottle was inadvertently
heated. Clearly the drug had degraded. He sent me some coupons for new bottles,
but I was lost as a customer for that brand. This got me thinking, how often
are the non-prescription over-the-counter drugs we buy subjected to unexpected
heating during their storage in hot warehouses, on hot loading docks, or shipment
in hot trucks?
It is so
convenient to order on-line and have our parcels waiting at the door.
Prescription drugs can be ordered this way, as well as non-prescription drugs
and supplements. No chasing down our favorite product brands from store to
store. But there is a down side. If the temperature outside is very hot and the
shipment is not refrigerated, many drugs will degrade. It can get very hot
inside a non-air-conditioned delivery truck, or sitting on a sunny loading dock,
or outside our front door in the summer!
Many drugs
are unstable at high temperatures. Heat may break down their chemical
structures into inactive forms. Higher temperatures may also encourage reaction
with oxygen or water in the air, and result in inactive products, if not
actually dangerous ones. Examples of temperature-labile supplements include
isoflavones, fats and oils, most vitamins, and some ingredients in herbs. Manufacturers
of prescription drugs do temperature stability tests, and if they find the drug
is unstable at high temperatures, they use cold chain shipping to keep the drug
from degrading, since the FDA requires that the drug be fit for its purpose.
There are no such requirements for all the vitamins and herbal supplements that
people are taking. Some drugs’ labels advise storing in a cool place, but the
distributors don’t ship on ice. The stores that sell these items don’t
necessarily keep them refrigerated.
Anecdotally,
I found that if I buy soy isoflavones in a store, sometimes they work and
sometimes they don’t at reducing hot flashes. Certainly there are quality
variations in manufacturing to explain this, and over the years, I have found a
reliable brand. However, if I buy these soy isoflavones from a drugstore on the
web in the summer time, they don’t ever work, no doubt due to the high heat
during shipment. I phoned the site’s Customer Service and offered to pay for
refrigerated shipping, but they don’t offer it. All they will do is refund or replace
the item that doesn’t work. When shipping in the summer time, the inside of a
delivery truck can get extremely hot. Cartons of these supplements can sit on a
hot loading dock awaiting transport. Then they get to a store, and they are
inactive in the summer, active in the winter. Customers trying out a product
will find that it sometimes works, and sometimes doesn’t. Anyone who gets a
product that has no activity will not buy it again, and is lost as a long-term
customer.
The NIH has
been testing the efficacy of nonprescription herbals and supplements. A
clinical trial testing the drug may get some shipments that are active and some
that are inactive due to heating during the shipment, and this can confound
their results. It may explain why different trial results are so conflicting.
It may explain why some drugs show so little activity above the placebo. The
NIH is funding five research centers, receiving a combined total of $35 million,
for a five year study to study to test natural supplements such as black cohosh
(used to relieve menopause-related hot flashes), fenugreek (for diabetes and
several other ailments), resveratrol (for cardiac health), and milk thistle
(for Hepatitis C). Attention to cold chain shipping would make these studies
more reliable.
