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“Supplement capsules can vary in strength by as much as twenty times - and you only get what you pay for!”

The universal wisdom that ‘you only get what you pay for’ is especially true in the market place for natural and herbal supplements.

The market for supplements is awash with pile’em high, sell’em cheap retailers – in the high street, in the press and on the web.

Nowhere is the expression ‘caveat emptor’ more important – buyer beware or you will be wasting your money on supplements that are so weak that they will probably have little or no effect.

At one level this is just a waste of money, but at a global level it can do untold harm to the reputation of a herb or supplement if a groundswell of disaffected consumers spreads the word “I tried that, and it didn’t work!”

When looking for natural and alternative products there will always be the choice between products recommended by your doctor or qualified health practitioner; products recommended by reputable journalists and medical writers, trusted practitioner brands, such as BioCare, or cheaper alternatives such as shop brands and those only sold directly to the consumer via the press and web.

When using or planning to use supplements it is essential to investigate reliable independent sources to identify recommended daily doses. The web now provides a limitless source of science and opinion.

It is unwise to rely solely on manufacturer recommendations as the following example illustrates.

Ginkgo biloba

It is not surprising that one of the oldest living tree species, dating back 300 million years, should be at the heart of herbal medicine in many cultures. Chinese medicine has used Ginkgo for over 5,000 years.

Gingko biloba is used and recommended for a wide range of conditions associated with preserving and enhancing memory and mental acuity in the elderly, tinnitus and inner ear problems, asthma, bronchitis and coughs The cardio-vascular benefits have been associated with DVT and in improving sexual performance and libido in men and women. The flavonoids in Ginkgo are effective free-radical scavengers and have been shown to be effective in the treatment of macular degeneration and in anti-ageing. There are hundreds of trials, including double-blind and placebo control, substantiating the effectiveness of Ginkgo biloba in a wide range of health conditions.

As with many supplements the active components in capsules, tablets and tinctures can be simply ground-up leaf or root. However, clinical trials are usually based on standardised pharmaceutical extracts that contain 24% flavones and 6% terpene lactones. The usual dosage for this standardised Ginkgo biloba extract (gbe) is 120-160mg per day taken in three divided doses, ie the minimum dosage would therefore be 40mg of gbe three times a day. However, the daily dosage range could be up to 600mg depending on the disorder being treated. As with many herbal supplements, it is essential to maintain the dose over time and benefits only really begin to accrue after 30 days or more.

Given these quite clear recommendations it is astonishing to see the variation in strength that is sold to a gullible public.

The trusted practitioner brand BioCare ( offers Ginkgo plus with each capsule providing 150mg of the standardised gbe, with a recommended daily dose of 3 capsules per day.

By contrast, a typical pile’em high retailer may offer several strengths all with a recommended dose of 1-2 capsules daily. In one case, only the strongest formulation of “120mg which is equivalent to 6000mg of leaf” comes near the accepted dosage levels. The entry level capsule comprises 400mg of powdered leaf which is equivalent to just 8mg of extract. The price for a ‘years supply’ of 365 capsules may look attractive until you realise that you need to take at least 15-30 a day to reach the minimum daily therapeutic dose. “A higher strength extract containing 1000mg of powdered leaf which equates to 20mg of the extract” would still require 2 tablets three times a day to reach recommended levels.

This example with Ginkgo biloba is typical and clearly demonstrates that capsules can vary in strength by as much as twenty times - and you only get what you pay for!

Perhaps it is time for health advertisements to carry a financial health warning!

Good health and caveat emptor!

Barry Fowler BSc Physiol (


The Cleveland Clinic Centre for Continuing Education

Vanderbilt University, Amy Brownlee


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