The good news is there are ways that people can save money – and save the government and taxpayers money at the same time. We look at some of the cost-saving measures you can take.

1. Understand how the Pharmaceutical Benefits Scheme works

Many commonly prescribed medicines in Australia are subsidised by the government under the Pharmaceutical Benefits Scheme (PBS). The of a medicine under the PBS is generally capped at two different prices: in 2022 this is $6.80 for people who are eligible for a concession (including holders of pensioners, health care, seniors’ health and Department of Veterans’ Affairs cards); and $42.50 for everyone else. 

Given that some medicines can cost hundreds or thousands of dollars, the savings to consumers are enormous.

Track your spending in case you reach the safety net

If you buy a lot of medicine, safety nets also apply, so you pay a reduced price after reaching certain spending limits in a calendar year. 

• For concessional patients this is $244.80, and after that PBS listed medicines are free. 
• For general patients the safety net threshold is $1475.10, after which PBS listed medicines are charged at the concession rate of $6.80. 

If you do go through a lot of medication it’s a good idea to ask your pharmacist for a prescription record form so you can keep track of your spending and receive safety net benefits.

Extra charges to be aware of

For some medicines, extra charges may apply, which can take the cost of medicine over the co-payment amounts. These charges include brand premiums, therapeutic group premiums or special patient contributions, and after hours and delivery fees. These extra fees don’t contribute to your safety net total.

• Therapeutic group premiums and special patient contributions affect very few medicines, and if you’re affected, you can ask your doctor about ways you might be able to reduce the cost – you might be able to change medicines or get an exemption.
• Brand premiums apply to products where a cheaper brand is available but you’ve opted for a more expensive one. You may be able to avoid the brand premium by asking your doctor or pharmacist to switch you to a cheaper, equivalent brand.

2. Shop around for discounts

The co-payment is the maximum price you have to pay. When a PBS medicine costs less than the co-payment, you simply pay the full price. It can be worth shopping around as some pharmacies are able to cut costs by dealing directly with manufacturers, and/or reducing overheads, and sell it cheaper than others.

If your medicine isn’t covered by the PBS, your doctor may write you a private prescription, and you pay the full price. Private prescription costs don’t contribute to your safety net, though you may get a rebate from your private health insurance company so be sure to check.

Under current laws, PBS medicines that are subsidised by the government cannot be discounted, unless it’s supplied as a non-PBS (private) prescription. Pharmacies can and do supply PBS prescriptions as private ones to save you money on the purchase. It also saves the government money, but remember, it won’t count towards your safety net.

If the safety net applies to you, check whether the prescription has been processed as PBS or private – a prescription record form (PRF) sticker is provided for PBS medicines.

3. Buy generic medicines

A generic drug is a copy of a branded drug. It is chemically equivalent to its branded counterpart but usually costs less. Generic drugs must meet the same standards of quality, safety and efficacy as branded drugs. The generic and brand drug may even be made in the same factory by the same manufacturer. 

Some generic drugs may look different to their branded equivalent because they may have different inactive ingredients, also known as excipients, which include coatings, binders, fillers, colourings and so on. However, the active ingredient used is exactly the same, with the same dosage as the branded version. 

Australian regulations require that the generic drug work in exactly the same way as the brand drug – that it’s ‘bioequivalent’. This means the active ingredient in both branded and generic versions must reach the blood system at the same speed and concentration.

While there is potential for excipients to alter the action of the active drug, these bioequivalency requirements mean any given medication should be unaffected by this. However, some people may have sensitivities to certain excipients, such as gluten or lactose, so it’s important to check these ingredients if you decide to switch to a generic brand. Excipients may also affect how the drug works in some individuals, though it’s uncommon.

Generic medicines can be a lot cheaper than the brand product, though for some you may only save one or two dollars. Generic medicines can save you money even if you don’t buy the generic version – having a generic competitor drives prices of the original brand product.

People paying the concessional prescription rate of $6.10 probably won’t save money buying a generic product, unless the price of the generic is lower than $6.10. However, it will save the government – and taxpayer – money.

4. Buy combination medicines

For some conditions, such as high blood pressure or diabetes, it’s common to take more than one type of medicine to manage the condition. Instead of taking two or more pills, these medicines are sometimes combined in a single tablet, which not only saves you money – instead of paying two or more co-payments, you only pay one – it’s also a lot more convenient.

The downside, though, is that for various technical reasons to do with pharmaceutical pricing, combination medicines often end up than the total cost of the individual drugs.

Think twice before…

Buying a medicine new to the market

If your doctor prescribes a medicine that’s new on the market, chances are it will cost you more – new medicines are patent-protected so there won’t be a generic equivalent yet.

But surely newer is better, and therefore worth the cost? Well, not necessarily. Often new medicines are not much different to older ones. In fact a survey of over 3000 new medicines introduced in France from 1981 to 2004 found only 10% had any advantage over existing therapies, and the advantage was mostly small.

Using medicine after its expiry date

Many people take medicine that’s past its expiry date to save money and a trip to the doctor and/or pharmacy for new medicine. Advice on taking expired medicine varies greatly, with some arguing it’s probably safe and worth taking when absolutely necessary and others saying it’s not worth the risk.

There are two issues with expired medicine – safety and potency. There are some expired medicines that are definitely unsafe to take, either due to a critical loss of potency or potential for degradation into undesirable products. These include epinephrine (EpiPen), insulin, some kinds of antibiotics, oral nitroglycerin for angina and eye drops.

The expiry date still applies to unopened medicine. Some medicines start to lose potency after the package has been opened, and should be used within a year of opening, even if that’s before the expiry date. Some, such as antibiotic suspensions and eye drops have a shorter life once opened – check the label for specific instructions.

Yet many medicines stand up well over time. A US military study found that many medicines were still good up to twenty years or more after their expiry date. Another study of medicines found in a pharmacy, some 40 years out of date, were still safe and effective.

Even so, the says it’s not worth risking it.

“Most medicines will slowly deteriorate over time, which can make them less effective and in some cases harmful,” warns NPS MedicineWise Chief Executive Dr Lynn Weekes.

“Australians can take their unwanted, unused or expired medicines to their local pharmacy for safe disposal. Disposing of medicines with their local pharmacist will ensure medicines do not end up in waterways or landfill”.

Storage conditions also affect longevity – the humidity of the bathroom cabinet or the heat of the car glove box will increase the rate of degradation. The tablets stored for the US military and in the pharmacy as mentioned above were kept in optimal conditions. 

How not to save money

There are some things that look like they’ll save you money – but at what price?

Buying online from overseas

In general, Australian medicine prices compare favourably with many other developed countries. However, there are some medicines that are cheaper overseas and it may be tempting to buy them online.

The Therapeutic Goods Administration (TGA) warns that may not meet the same safety, quality or efficacy standards as ones bought in Australia. Potential risks include fake or counterfeit medicine, undisclosed ingredients, medicines past their use-by date or drugs that are contaminated or the wrong strength.

Fake online pharmacy scams

If you’ve ever received an email offering cheap prescription medicines with no prescription required, it could be a scam. At best they may steal your credit card details or upload damaging files to your computer, such as spyware or keystroke loggers. At worse, they might actually send you some medicine that either doesn’t work or even harms your health.

The ACCC has tips on how to spot .

Top tips for saving on medication

• Ask your doctor and/or pharmacist if there’s a less expensive version of your medicine – a different brand, a generic or an older out-of-patent medicine.
• Ask your doctor for a medication review – you may be taking medicine you no longer need. This is a good idea for health reasons, as well as to save money.
• Ask whether you’re entitled to exemptions from having to pay added premiums.
• If you take a particular medication regularly, try shopping around. Some larger chains will buy in bulk, allowing them to discount medicines that cost less than the general co-payment.
• Australian-based online pharmacies may offer a good deal if you need several medicines and don’t need them in a hurry – just make sure the savings are worth the postage costs.
• Don’t be tempted by cheap medicines from overseas.
• The .

The post How to save money on medicine appeared first on ÌÇÐÄVlog.

But is there really any difference between what are all just paracetamol or ibuprofen tablets? Do you get a painkiller that’s more effective when you pay more?

The short answer is no, not really. But given the plethora of painkillers on the market, it’s easy to be fooled. 

ÌÇÐÄVlog investigated the OTC pain-relief market and found drug companies have successfully convinced consumers to pay nearly nine times more than they have to (based on prices at supermarkets and pharmacies in late February to early March 2020) for a humble ibuprofen or paracetamol tablet.

What’s the difference between branded and generic medicine?

When it comes to paracetamol and ibuprofen, there’s no difference in quality between branded and generic. Whether you pay three cents or 26c a tablet, the same dosage of paracetamol will work in exactly the same way. The same goes for ibuprofen.

This may sound like common sense, but it doesn’t seem to be guiding the way we shop for pain-relief drugs.

In fact, we’re more likely to choose Panadol or Nurofen, despite the rise of cheaper pain-relief alternatives on sale.

According to a 2019 survey, 12.4 million Australians buy pain relief products each month, with Panadol and Nurofen accounting for more than half those sales. 

Limited manufacturers

Beyond branded paracetamol and ibuprofen, OTC pain-relief medicines sold in Australia are made by a limited number of companies. Various drug companies manufacture generic painkillers, to which private labels add their own branding.

For example, from its factories in India, Nova Pharmaceuticals manufactures OTC paracetamol and ibuprofen for Coles (private label) and Woolworths (Help@Hand and Essentials). Each paracetamol tablet contains 500mg of active paracetamol, and each ibuprofen tablet contains 200mg of active ibuprofen. 

Although the inactive ingredients may differ, they don’t affect the efficacy of the drug (but check with your pharmacist if you have any allergies or intolerances)

Can some painkillers work faster than others?

Many painkillers on pharmacy shelves are marketed as”rapid action” or “rapidly absorbed” on their packaging. Panadol has various “fast” formulations such as Panadol Optizorb and Panadol Rapid. Nurofen also makes similar claims with its Zavance and Quickzorb range.

Both Nurofen and Panadol’s fast-absorbing drugs can cost up to almost double the price of their regular counterparts. But are they really any faster than regular painkillers, and are they worth the mark-up?

“Most of the hype about ‘faster-acting’ paracetamol or ibuprofen is just that – hype,” says Dr Louis Roller, associate professor in pharmacy practice at Monash University. 

The sentiment is echoed by Gregory Peterson, professor of pharmacy at the University of Tasmania, who says that “on the whole, there is very little convincing evidence for any differences in speed or efficacy between the various forms of ibuprofen or paracetamol”.

Are liquid capsules absorbed faster?

The variety of premium products can be very confusing for consumers. Nurofen’s Zavance liquid capsules are generally the most expensive Zavance product on the market and are claimed to be “absorbed faster than standard Nurofen” – even though they have the same active ingredient (ibuprofen) as standard Nurofen tablets and caplets. 

When we asked Zavance’s parent company, Reckitt Benckiser, about this, a company spokesperson said it’s because the active ingredient is absorbed faster in liquid format capsules than in the standard solid kind.

There is evidence that liquid capsules are absorbed faster than tablets, and Peterson suggests a soluble product, or aspirin, may be faster acting than solid tablets, too. But Roller says that most painkillers, whatever their format, are well absorbed anyway – within 15 to 30 minutes.

Ibuprofen vs paracetamol: What to take when

Panadol and Nurofen are the two main competitors in OTC painkillers, but they actually work differently to relieve pain. 

Ever since ibuprofen went on sale in Australian supermarkets in 2004, ibuprofen has given paracetamol some competition. But it’s not always the best drug for the job.

In many cases, paracetamol and ibuprofen can be used interchangeably. Although it’s still not known exactly how paracetamol works, it’s considered safer than ibuprofen for most individuals, according to Peterson. It also costs less. 

Anti-inflammatory

There are instances where ibuprofen may be a better choice. As an anti-inflammatory, it’s preferred for inflammatory injuries such as sprains. And it’s also recommended for headaches if you get them several times a week (some painkillers themselves cause headaches if you take them too often – but ibuprofen doesn’t).

Conversely, ibuprofen should be avoided by people with stomach ulcers and other gastric problems, high blood pressure, heart failure, asthma or those who are pregnant.

Combination paracetamol/ibuprofen

Peterson says there is clear evidence of the better effectiveness of a combination of one paracetamol and one non-steroidal anti-inflammatory drug (such as ibuprofen) for acute pain such as headaches, compared with either drug alone. (This finding doesn’t apply to persistent or chronic pain.)

Nuramol and Maxigesic are two branded OTC pain-relief products that combine ibuprofen and paracetamol in one tablet. You can also buy generic combination tablets, or simply take separate branded or generic paracetamol and ibuprofen tablets together. 

But Roller says these combinations need to be monitored by a pharmacist because ibuprofen isn’t clinically suitable for everyone.

What’s the right dose of paracetamol or ibuprofen?

For adults and children 12 years and over:

• paracetamol: 4000mg in 24 hours (eight standard 500mg paracetamol tablets or six slow-release 665mg tablets).*
• ibuprofen: 1200mg of ibuprofen in 24 hours (six standard 200mg ibuprofen tablets).

*There is increasing evidence that the maximal safe dosage of paracetamol varies, especially for people who fast or drink alcohol excessively. Speak to your doctor if you have any concerns.

Prescription-only codeine

In 2018, low-dose codeine tablets were reclassified to require a prescription from a GP.

This was because “the risks associated with codeine use are too high without oversight from a doctor,” said the TGA at the time. “Codeine can cause opioid tolerance, dependence, addiction, poisoning and in high doses even death.” 

The change hasn’t stopped GPs from prescribing codeine for those who may need it. But, for others, regular OTC medications such as paracetamol and ibuprofen can be just as effective without carrying the same risks as codeine. 

Are pain-relief medications safe?

A large proportion of the analgesics we found on Australian shelves are made in India (often for non-Indian companies). It’s a country where pharmaceutical manufacturing has come under increased scrutiny in the past from the US Food and Drug Administration (FDA). 

In 2013, Indian drug manufacturer Ranbaxy was found guilty of violating Good Manufacturing Practices (GMP) regulations, as well as making false claims to the FDA and falsifying documents.

Check the number

However, all the experts ÌÇÐÄVlog spoke with said OTC pain-relief medicines in Australia are well regulated, and that there’s no cause for concern about country of origin. 

If it’s got the  number on it, which all OTC painkillers such as paracetamol and ibuprofen are required to have, it’s been through a rigorous regulation process by Australia’s Therapeutic Goods Administration (TGA).

How is pain-relief medication regulated?

According to a spokesperson for the TGA, its laboratories don’t test painkillers before approving them for sale, but rather assess them for safety, quality and efficacy, based on information and data submitted by companies.

Drug manufacturers in Australia are also required to demonstrate compliance with GMP, which is usually done through an inspection.

Overseas drug manufacturers must also prove compliance with GMP by means of documentation, or occasionally an on-site inspection if they can’t provide documentary evidence. Based on the company’s documentation and advice from TGA experts, the TGA decides whether or not to approve the product.

Tips for buying pain-relief medication

• When comparing medicine costs, look at products with the same or comparable active ingredients in the same dosage.
• Generally, the cheapest products come in tablet or caplet form.
• Supermarkets can be more convenient than pharmacies for buying OTC medicines, but they don’t always have the variety, higher dosage or larger pack sizes that pharmacies do.
• If you want something faster acting, choose a soluble product or the cheapest liquid capsule.
• According to recent studies, one standard paracetamol (500mg) and one ibuprofen (200mg) combined may work better than either product alone for acute pain, such as headaches, migraines and sprains. More generally, paracetamol costs less than ibuprofen, and is considered to have fewer adverse side effects.
• If you have any allergies or intolerances, speak to an in-house pharmacist or your GP about the ingredients in a painkiller before you take it.

The post Panadol and Nurofen vs generics: Which is better? appeared first on ÌÇÐÄVlog.

The last few years have seen an explosion in the number of probiotic supplements on pharmacy and supermarket shelves, with more than 200 currently available. In addition, there are many foods – especially yoghurt products – spruiking their probiotic benefits, and enthusiastic home fermenters are brewing up their own probiotic-rich foods such as kefir, kombucha, sauerkraut and kimchi.

In this article we look at the sorts of benefits probiotics have been shown to provide in clinical situations, and the evidence behind some of the claims on consumer probiotic products – including claims related to COVID-19.

Healthy gut bacteria

Some of the most commonly found genus of gut bacteria in adults are Bifidobacterium, Lactobacillus, Bacteroides, Clostridium, Escherichia, Streptococcus and Ruminococcus. There are also yeasts and other microbes. While any one individual may have several hundreds of different species, human populations as a whole have thousands.

Collectively called the microbiome, these organisms play an essential role in digestion, including the production of vitamins and fatty acids, and are critical for normal immune system development. They also keep pathogenic (bad) bacteria in check.

However, there may be situations where additional help is needed – bacteria get out of balance due to poor diet, illness or a course of antibiotics. This is called dysbiosis.

Studies in humans and other animals have found that certain strains of bacteria can have positive effects on conditions related to gut bacteria, and manufacturers have come to the party with microbial concoctions promising all sorts of health benefits.

Probiotics and prebiotics: What’s the difference?

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These are live microorganisms – such as bacteria, yeasts and fungi – which in adequate amounts may have health benefits. 

Studies have shown they can improve digestion, help protect against disease and enhance immune function. Strains of lactobacillus and bifidobacterium bacteria are the most commonly used probiotics as they can survive the passage to the gut. 

Probiotics are most widely available as dietary supplements in tablet, capsule and powder forms or as a component in yoghurts and fermented dairy drinks.

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These are non-digestible food ingredients that can increase the activity of select “good” bacteria. 

Prebiotics naturally occur in bananas, asparagus, leeks, onions, garlic, chicory and wholegrains like wheat, rye, barley and oats. 

Savvy marketers spruik their benefits in foods including breads and infant formulas.

What about synbiotics? 

These are products that contain both prebiotics and probiotics.

Do probiotics work?

While individual studies and anecdotal evidence suggest a wide range of uses, well-studied and accepted uses for probiotics are much fewer. 

Some of the main claims you’ll find on probiotic products are fairly general and relate to digestive and immune system support, although some are more specific, mentioning preventing colds, eczema and relief from the symptoms of irritable bowel syndrome.

What conditions do probiotics help with?

Some of the conditions that might be helped by taking probiotics include: 

Antibiotic associated diarrhoea

that taking widely available types of probiotics alongside a course of antibiotics may help reduce the risk of getting diarrhoea. 

They may also reduce the likelihood of getting a Clostridium difficile infection, which can have long-term serious consequences. 

Successful strains include Lactobacillus rhamnosus GG, L. acidophilus (found in yoghurt), L. caseii and Saccharomyces boulardii (a yeast).

Infectious diarrhoea

Probiotics can also reduce the severity and duration of infectious diarrhoea (caused by rotavirus, for example) .

Irritable bowel syndrome (IBS)

While there are studies that show some benefit from probiotics in reducing symptoms of IBS, there’s no consensus on which strains or dose. 

The symptoms of IBS vary from person to person, so it’s considered unlikely that there’s a one size fits all treatment. That said, they could be worth a try – discuss the options with your doctor.

Inflammatory bowel disease

Probiotics may be useful for treating pouchitis, a side effect of bowel surgery for people with ulcerative colitis. 

However, the evidence for treatment of ulcerative colitis itself is inconclusive, with some studies suggesting a modest effect. Your doctor may be able to recommend products that could help. 

There’s no evidence probiotics are useful for Crohn’s disease.

Eczema and other allergies

There’s some research showing that women taking probiotics in pregnancy and while breastfeeding can prevent eczema in their baby’s early life, although, as yet there’s not enough known about the best species or dose to provide recommendations. 

There are also some studies looking at other allergies, such as hay fever, but there’s not enough evidence to draw any conclusions.

Coughs and colds

Probiotics are popularly thought to reduce the risk of upper respiratory tract infections (including colds, sinusitis and pharyngitis) via their effects on the immune system. 

While some studies have found this to be the case, a large systematic review of the studies considered the overall quality of evidence low, with criticisms about the way the research was conducted, inconsistent results, or for being funded by probiotic companies, and therefore at risk of bias.

Helicobacter pylori (H. pylori) infection

This is a bacteria found in around half the population, and under certain circumstances can lead to stomach and duodenal ulcers and cancers in the gastric system. 

Probiotics from the Lactobacillus genus can be as an addition to standard antibiotic therapy, boosting their effectiveness and reducing some of the side effects of antibiotics. The optimal species and dose are yet to be determined. 

‘Immunity’

Many products make general claims about “supporting” the immune system, or “boosting immunity” – presumably meaning you get sick less often. 

There are various mechanisms by which probiotics may activate certain aspects of the immune system, but it’s difficult to prove that taking them makes you healthier overall. 

An overactive immune system could leave you susceptible to allergies or autoimmune diseases. Meanwhile, people who are immune-compromised should not take probiotics.

Traveller’s diarrhoea

It’s estimated about travelling to certain countries in Asia, the Middle East, Mexico, Central and South America and Africa will suffer from traveller’s diarrhoea (TD), usually caused by (bad) bacteria.

Some studies have found taking probiotics – especially lactobacillus species – while travelling (and some time before and after) can reduce the risk of TD, but other studies have found no effect. The best type of probiotic likely depends on where you’re travelling, and it’s possible that high temperatures and humidity may affect the probiotics. More studies are needed to determine which, if any, will help.

Will probiotics help against COVID-19?

You may have seen claims that probiotics can help protect against COVID-19, though they generally stop short of directly stating the supplements will treat COVID-19.

One argument is based on tenuous links with (inconclusive and poor quality) research on probiotics and colds and flus, suggesting if they’re good for some respiratory infections, they may also be good for COVID-19. It’s also been suggested that they may be helpful for treating diarrhoea that some coronavirus patients get. Most commonly they’re recommended to support or boost immunity, so if COVID-19 comes along you can fight it more effectively. 

It’s early days yet, with much still to be learnt about the virus and no good clinical evidence to support any of these claims.

Health benefits of probiotics

There are numerous challenges in determining whether probiotics can help in a particular condition, and much of the uncertainty about whether over-the-counter products do anything lies in the difference between products tested in clinical trials and those on the market.

Firstly, there are many different species of probiotic, and within each species there may be a number of different strains. These different strains – each typically patented by their developer – may have different effects, regardless of species.

What’s tested in clinical trials may be a single strain or a combination of two, three or more. Strains may enhance or negate the effects of each other. That means the findings in a given trial are pretty much restricted to that exact formulation, and can’t necessarily be generalised to similar strains or species, and certainly not ‘probiotics’ in general (although in some situations, effects may be more widely applicable to more than one specific strain). Nor can you take a few different strains that each seem to do something and combine them for a mega-probiotic cure-all.

Running clinical trials is expensive and time-consuming, so those that are conducted tend to be small and short-term, most strains only have a single clinical trial, and trials that are funded by the manufacturer of a product may be biased.

So you can see, because the action and effectiveness are strain-specific – and specific to a particular combination of strains if there is more than one – for consumers to be confident a product will act as claimed, evidence must be provided for each probiotic product individually, preferably using products identical to those sold to consumers, in large, high-quality, long-term, multi-centre, independently funded trials.

Should a healthy person take probiotics?

If probiotics can help in situations of dysbiosis, can they help make healthy people healthier? The short answer seems to be no. have found that giving healthy people probiotic supplements doesn’t change their microbiome, and they don’t provide any health benefit.

But while they’re likely harmless, they may have unexpected effects. found that rats given probiotics suffered impairment in one aspect of memory. Authors acknowledged the finding was in rats, rather than humans, but this unexpected effect points to a need to exercise caution when recommending people take probiotics.

Israeli researchers also reported an unexpected effect, where the gut bacteria of people taking probiotics for antibiotic-associated diarrhoea took six months to return to normal. 

A found that melanoma patients were less likely to respond to cancer immunotherapy if they were also taking probiotic supplements, although the study was too small to be conclusive.

The bottom line is that there’s not enough known about probiotic supplements to assume they’re unequivocally safe.

Which foods are rich in probiotics?

Fermented foods, such as yoghurt, kefir, sauerkraut and kimchi, contain live bacteria and have been linked with numerous health benefits, although the science is still lacking for many claims. 

However, there’s a good argument for getting your probiotics from yoghurt (and other fermented foods) rather than a pill, as they contain other valuable nutrients.

Certain brands of yoghurt and cultured drinks (for example, Yakult) have been studied in clinical trials, and found helpful for treating diarrhoea and various other conditions. A 2015 Australian study, for example, found that Vaalia yoghurt reduced the incidence of diarrhoea in children taking antibiotics. 

However, results obtained from one brand of yoghurt can’t be applied to all – as with pills, it depends on the strains of bacteria and dose. There’s also some concern that many trials are sponsored by the manufacturers, with the possibility of bias.

Then there are prebiotics – non-digestible food ingredients that can increase the activity of select ‘good’ bacteria. A high-fibre diet is naturally rich in prebiotics, with foods like bananas, asparagus, leeks, onions, garlic, chicory, and wholegrains like wheat, rye, barley and oats particularly beneficial.

Probiotic tips

• Different probiotic strains have different effects. Any product you use for a particular condition needs to be matched to the strain and dose found to work in clinical trials. 
• The effects of probiotics, even when proven in clinical trials, are modest at best. They should supplement, rather than replace, conventional treatments.
• People respond differently to probiotics – for some people they’re accepted in the gut, while for others taking the same probiotics for the same condition, the probiotics pass straight through.
• Generally speaking, you need at least 10 billion colony-forming units (CFU) to have an effect, but the dose depends on the particular probiotic.
• Probiotics don’t  hang around in your gut for long. Therefore you have to take them every day to receive benefits. That may be okay for a defined event, like taking probiotics while on antibiotics. But for more nebulous claims, such as “boosted immunity”, that’s every day, always.
• The most common side effects of probiotics are gas and bloating, but they don’t last long.
• People who are critically ill or have compromised immunity shouldn’t take probiotics, unless approved by their doctor.
• A diet rich in vegetables, fruit and wholegrains, along with other healthy lifestyle measures such as regular exercise, avoidance of smoking or excessive drinking, and stress management will help provide ideal conditions for a healthy microbiome.

Labelling and regulation

In Australia, probiotic products are considered either functional foods and regulated by Food Standards Australia New Zealand (FSANZ), or complementary medicine and regulated by the Therapeutic Goods Administration (TGA). 

While complementary medicines must show the amount of an active ingredient, foods don’t have to disclose the number of probiotic bacteria in a product, which makes it difficult for consumers to make an informed purchase decision. 

The number of probiotic bacteria should be maintained to the end of a product’s shelf life to be of any health benefit. But stability testing isn’t always undertaken by manufacturers and independent testing has shown some products have far fewer probiotics than they claim.

ÌÇÐÄVlog believes that health claims on food or complementary medicines should undergo pre-market assessment by the regulators to prevent manufacturers from making misleading or unsubstantiated claims. All probiotic products should name the probiotic bacteria to strain level and disclose the number of bacteria in the product to help consumers in their purchase decision.

The post What are probiotics? appeared first on ÌÇÐÄVlog.

There are four main groups targeted by protein supplement marketing. We weigh up the usefulness of supplements for each of these groups so you can decide whether they might be helpful, or just a waste of money:

• Athletes who want to build more muscle and recover quickly from exercise.
• People on weight-loss diets looking at protein to help keep hunger at bay, and also make sure they don’t lose muscle as well as fat.
• Older people who may not eat enough protein to prevent losing muscle, and may therefore struggle with day to day activities and ultimately independent living.
• Vegans looking for easy protein.

We’ve also looked at a range of widely available brands for tips on better buys.

Protein for athletes

People who exercise heavily tend to have a greater appetite, and they usually get enough protein from normal food without the need for a special high-protein diet or supplements.

Protein for weight loss

Most Australians get plenty of protein in their diet and don’t need protein supplements to achieve weight loss.

Protein for middle-aged and older people

For some people – especially frail elderly people who have little interest in eating – supplements could be the best option. Your doctor can give you a referral to a dietitian, and you may be eligible for a Medicare rebate.

Do vegans need a protein supplement?

It’s perfectly possible to get enough protein from a well-planned plant-based diet, but some vegans find protein supplements an easy and convenient way to get essential amino acids.

What to buy

We looked at products readily available in supermarkets and pharmacies and came up with product suggestions based on the cost per gram of protein. They range in cost from around 4 cents to 20 cents per gram, which works out at 80 cents to $4 for a 20 gram serve (actual recommended serving sizes vary according to product, but 20 grams is the minimum amount recommended to be effective).

Buying products online may better suit those with niche requirements or a need for larger quantities than a typical user. And, of course, you may need to taste a few different ones to see what you like best.

Low-carb plus artificial sweetener

Many of the widely available protein supplements contain artificial sweeteners, in particular stevia (which is claimed to be natural) and sucralose. This means you can get lots of sweet, flavoured protein for very little energy.

An example is Vital Strength 100% Premium Whey (4.5–7 cents per gram of protein). It’s sweetened with sucralose, comes in chocolate, vanilla and banana flavour, and can be found at supermarkets and pharmacies.

Unflavoured and unsweetened – a versatile option

You can also buy plain whey or vegan protein, with no flavours or sweeteners. This is a very versatile option, as you can add it to sweet and savoury foods and drinks: smoothies, shakes, soups and baked products. It also means you can choose the type and amount of sweeteners you prefer, whether sugar, honey, fruit or artificial sweeteners.

An economical example is Coles Unflavoured Whey Protein Concentrate (4.9 cents per gram of protein).

Older adults

While older adults could use any of the products above, there are supplements that may be better suited to some people because they contain added nutrients, more energy and don’t need special blending or shaking equipment – simply add milk or water and stir with a spoon. But be sure to discuss your options with your doctor or dietitian to find the most appropriate product – if any – for your needs.

One example is Sustagen Hospital Formula Active, which is available from supermarkets and pharmacies (in larger 840g containers, costing between $26–32).

Correction 28/3/19: An earlier version of this story had incorrect pricing information for Sustagen Hospital Formula Active and Vital Strength 100% Premium Whey which we’ve now updated.

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On this page:

• Paracetamol 500mg
• Ibuprofen 200mg
• Aspirin 300mg
• Hayfever and allergies
• Diarrhoea relief (loperamide hydrochloride 2mg)
• Cold and flu medication
• How we did our survey
• Supermarkets vs pharmacies
• What are over-the-counter (OTC) medicines?
• Generic vs branded medicines

But should you buy them from the supermarket or from a pharmacy? To find out which is cheapest, we compared the price per pill* of common OTC products with the same amount of active ingredients from Coles, Woolworths, Aldi, Amcal, Priceline Pharmacy and Chemist Warehouse.

*For simplicity, we’re saying ‘price per pill’, but the individual product may be a tablet, capsule, caplet, etc.

Notification (September 2021): To minimise the risk of poisoning, NSW Poisons Information Centre recommends that you only buy and keep the medicines you’re likely to use in the immediate future. A single packet of 20 tablets should be sufficient for this, as any ongoing use should be assessed by a health professional. 

They also recommend to check your medicine cupboard regularly and return any medicines which are expired or no longer needed to the pharmacy for safe disposal.

Pain relief

We looked at paracetamol, ibuprofen and aspirin pain relief medication.

Paracetamol 500mg

Brands compared: Amcal Paracetamol, Coles Paracetamol, Essentials Paracetamol, Help@Hand Paracetamol, Herron Gold, Hedanol, Mendeleev Paracetamol, Panamax, Priceline Paracetamol, Pharmacy Care Paracetamol, Panadol, Panadol Extra, Panadol Mini Caps, Panadol Optizorb, Panadol Rapid, Value Choice Paracetamol.

Cheapest vs most expensive

Generally, you’re better off buying bulk packs of paracetamol in standard tablet form from pharmacies. The cheapest option we found was a 100 pack of Sanofi Panamax, which cost 2c per pill at Chemist Warehouse. 

Cheap paracetamol tablets are also available at just 3c per pill in bulk (100 pack) sizes at Priceline and Amcal pharmacies and 20-pill packs at Aldi. Coles and Woolies have 20-pill packs for 4c per pill. 

The most expensive option? Panadol Rapid (10 pack) at both Amcal and Priceline, at 35c per pill. 

Need to know

As well as 500mg products, pharmacies also offer higher-dose, modified-release paracetamol tablets – mainly marketed at people with osteoarthritis – such as Amcal Osteo Relief, Osteomol 665 Paracetamol, Panadol Osteo and Paracetamol Osteo-Tab, which contain 665mg of paracetamol. 

Amcal, Chemist Warehouse and Priceline each had a 665mg option for as little as 6c per pill.

Modified-release paracetamol is released more slowly into the body than immediate-release paracetamol. But due to health risks associated with its misuse, as of 1 June 2020 modified-release paracetamol will no longer be available over the counter. Instead, you’ll have to speak to a pharmacist before buying. 

Should I pay more for caffeine?

Some paracetamol products also contain 65mg of caffeine. This is because caffeine can increase the number of people who report good pain relief by compared with the analgesic alone. 

But caffeine comes at a cost. The cheapest combination product we found was Priceline Paracetamol and Caffeine (40 pack) at 22c per pill. If you’d prefer to buy Panadol Extra, you could pay as little as 29c per pill for a 40 pack in Chemist Warehouse – or as much as 50c per pill for 10 caplets in Coles and Woolworths. That’s a whopping 48c more per pill than Panamax, the cheapest 500mg paracetamol-only option. 

You might think that’s not a bad price to pay for boosting pain relief. But you can get the same results by simply drinking a cup of coffee alongside your paracetamol, as a typical cup of espresso contains about 145mg of caffeine  (a dose is two 65mg tablets). That said, given the cost of a barista-made coffee, it’s probably cheaper just to buy the tablets!

Ibuprofen 200mg

Brands compared: Advil, Coles Ibuprofen, Essentials Ibuprofen, Hedafen Ibuprofen, Help@hand Ibuprofen, Herron Blue, Mendeleev Ibuprofen, Nurofen, Nurofen Quickzorb, Nurofen Zavance, Priceline Ibuprofen, Priceline Ibuprofen Sodium, Rafen.

Cheapest vs most expensive

Aldi, Coles and Woolworths all had the cheapest ibuprofen (24 packs of Hedafen Ibuprofen, Coles Ibuprofen and Essentials Ibuprofen, respectively) at 6c per pill. 

Interestingly, that’s better value than all the bulk packs, and a saving of 44c per pill compared with the most expensive option: Nurofen Zavance (10 pack) at Priceline.

Need to know

Some of the ibuprofen products we looked at contain slightly different active ingredients: ibuprofen sodium dihydrate or ibuprofen lysine. 

Studies have shown that these formulations give faster pain relief than standard ibuprofen. But it’s worth remembering that regular ibuprofen is pretty fast acting and 342mg ibuprofen lysine and 256mg ibuprofen sodium dihydrate are the equivalent of 200mg ibuprofen.

This is something to consider if you’re just looking for the cheapest pain relief, as the cheapest ibuprofen sodium dihydrate and ibuprofen lysine options were 10c and 17c more per pill respectively than the cheapest regular ibuprofen product.

Aspirin 300mg

Brands compared: Aspro Clear, Coles Aspirin, Disprin, Solprin, Woolworths Essentials Aspirin.

Cheapest vs most expensive

Cheap aspirin is available for 4c per pill at Coles and Woolworths (24 packs of Coles Aspirin and Essentials Aspirin) and Chemist Warehouse and Priceline (96 packs of Solprin). That’s 17c per pill less than the most expensive option: Aspro Clear (24 pack), which is 21c per pill at Coles, Priceline and Woolworths. 

Need to know

Coles, Woolworths, Amcal, Priceline Pharmacy and Chemist Warehouse also had an extra strength option (aspirin 500mg). Of those, Chemist Warehouse had the cheapest on offer: Disprin Max (16 pack) at 25c per pill. 

Aldi doesn’t sell any aspirin products. 

Low-dose aspirin 100mg

Brands compared: Amcal Aspirin 100, Amcal Aspirin EC 100, 

Astrix, Cardiprin, Cartia, Coles Low Dose Aspirin, Mayne Aspirin, Priceline Aspirin Low Dose, Spren 100. 

Cheapest vs most expensive

Generally, 112 packs from pharmacies are your best buy. The cheapest we found was Mayne Aspirin (112 pack), which costs just 2c per pill at Chemist Warehouse. That’s a savings of 16c per pill compared with the most expensive option: a 28 pack of Cartia at Priceline.

Need to know

If you want to buy in bulk, you’re better off buying multiple packs of Mayne Aspirin from Chemist Warehouse. The biggest pack size we found was a 180 pack of Cardiprin, available at both Amcal and Chemist Warehouse, which works out as 9c per pill.

Hayfever and allergies

We looked at OTC hayfever and allergy medications containing three different types of active ingredients.

Fexofenadine hydrochloride (120mg)

Brands compared: Coles Hayfever Allergy Relief Fexofenadine, Telfast

Cheapest vs most expensive

A 30 pack of Telfast came in at just 65c per pill at Chemist Warehouse.  Packs of 5 Telfast pills were the most expensive, costing $1.40 per pill at both Woolworths and Priceline.

Need to know

Unlike supermarkets, which only had 120mg pills pharmacies also stocked stronger and weaker forms of fexofenadine hydrochloride, with 60mg (Telfast) and 180mg (Telfast, Priceline Pharmacy Fexofenadine, Amcal Fexo 180, Pharmacy Care Fexo 180) available in Amcal, Priceline and Chemist Warehouse. 

Amcal had the cheapest 60mg option, which was Telfast (20 pack) at 35c per pill.

Generally, it’s cheaper to buy the 180mg options in bulk: 70-pill packs range in price from 40c to 43c per pill compared with 10-packs at $1 to $1.60 per pill. 

Cetirizine Hydrochloride 10mg

Brands compared: Amcal Cetirizine, Coles Cetirizine, Help@Hand Hayfever Relief, Pharmacy Care Cetirizine, Priceline Pharmacy Cetirizine, Zyrtec Rapid Acting.

Cheapest vs most expensive

Two 70-pack products tied for cheapest: Amcal’s own-brand Cetirizine and Pharmacy Care Cetirizine (also from Amcal), both costing 41c per pill. Amcal also had the most expensive option – a 14-pack of Zyrtec Rapid Acting, which cost $1.71 per pill.

Need to know

You might expect a product that claims to be “rapid acting” to cost more than a regular own-brand equivalent. But we found Zyrtec Rapid Acting for as little as 50c per pill in 70-pill packs at Chemist Warehouse – $1.21 cheaper than the most expensive option at Amcal.

Loratadine 10mg

Brands compared: Amcal Loratadine, Claratyne, Pharmacy Care Loratadine, Priceline Pharmacy Loratadine.

Cheapest vs most expensive

Priceline Loratadine (100 pack) costs 40c per pill, a whopping $1.86 less per pill than a 10 pack of Claratyne at Amcal, which comes in at $2.26 per pill.

Need to know

Priceline was the only store we looked at that had loratadine 10mg available in packs of 100. Chemist Warehouse’s biggest pack size was 75, Amcal’s was 60, and Coles’ and Woolies’ was just 10. 

Diarrhoea relief (loperamide hydrochloride 2mg)

Brands compared: Amcal Anti Diarrhoea, Coles Anti-diarrhoea, Diareze, Gastrex, Gastro-Stop, Imodium, Imodium Zapid, Priceline Diarrhoea Relief. 

Cheapest vs most expensive

Priceline Diarrhoea Relief (20 pack) was the cheapest overall at just 35c per pill. By contrast, Imodium Zapid (six pack) cost $1.87 from Amcal.

Need to know

Supermarkets only had six and eight packs available. Pharmacies also carried six and eight packs, as well as larger packs of 12 and 20, which tended to be better value.

Some supermarkets and pharmacies also stocked chewable and dissolving tablets. We compared these products and found Priceline Diarrhoea Relief Plus to be the cheapest chewable (active ingredient: loperamide hydrochloride 2mg, simethicone 125mg), at 83c per pill. Amcal had the most expensive option: Imodium Advanced at $2.02 per pill.

Generally, it’s cheaper to buy your diarrhoea relief as capsules or tablets rather than chewable or dissolving tablets.

Cold and flu medication

Supermarkets and pharmacies have a wide range of different cold, cough, sinus and flu medications with various combinations of active ingredients, some of which are only available in pharmacies. 

If you’re not sure which product is right for you, speak to a health professional about your symptoms. 

For our comparison, we looked at a nasal decongestant, two pain relief plus decongestant medicines, and a day/night option.

Nasal decongestant (phenylephrine hydrochloride 10mg)

Brands compared: Amcal Nasal Decongestant PE, Codral Cold Relief Decongestant, Dimetapp Nasal Decongestant, Pharmacy Care Nasal Decongestant PE, Priceline Decongestant, Sudafed PE Nasal Decongestant.

Cheapest vs most expensive

A 24 pack of Priceline Decongestant is 29c per pill. Nasal decongestants were better value in pharmacies than in supermarkets – 20 packs of Codral or Sudafed will set you back about 70c per pill at both the big two.

Pain relief and decongestant (paracetamol 500mg, phenylephrine hydrochloride 5mg)

Brands compared: Amcal Sinus Pain Relief PE, Coles Cold & Flu Pain Relief + Pe Decongestant Capsules, Codral Cold and Flu, Codral Relief Cold & Flu + Decongestant, Demazin PE Multi Action Cold & Flu Relief, Ease A Cold Non Drowsy Cold & Flu Plus Decongestant, Help At Hand Cold & Flu Relief, Panadol Paracetamol Cold + Flu Plus Decongestant, Priceline Cold & FLu Relief, Sudafed PE Sinus + Pain Relief, Vicks Action Cold & Flu Day Relief. 

Cheapest vs most expensive

The cheapest way to buy pain relief and decongestant products is in 48 packs at pharmacies. Demazin PE Multi Action Cold & Flu Relief cost as little as 28c per pill at Chemist Warehouse. 

Generally, we found the bigger the pack size the better the value, although the exceptions were Amcal and Priceline, whose home-brand 24 packs cost about 40c per pill. 

The most expensive product we saw was Codral Relief Cold & Flu + Decongestant, which cost about 90c per pill at Priceline and Woolworths.

Need to know

When comparing the costs of the cheapest combined product with the cheapest stand-alone paracetamol plus the cheapest phenylephrine hydrochloride (PE) products, the combined option was cheaper by 3c per pill.

Some paracetamol and PE products also contain 100mg guaiphenesin (an expectorant that thins and loosens mucus, easing congestion). We found that 16 packs of Codral Relief 6 Signs Cold & Flu ranged in price from 87c to 97c per pill.

Pain relief and decongestant (ibuprofen 200mg, phenylephrine hydrochloride 5mg)

Brands compared: Nurofen Cold & Flu PE, Nurofen Cold & Flu Multi-Symptom Relief Tablets, Sudafed PE Sinus + Anti Inflammatory Pain Relief.

Cheapest vs most expensive

Sudafed PE Sinus + Anti Inflammatory Pain Relief is 43c per pill for a pack of 48 at Chemist Warehouse. A 20 pack of the same product costs about 78c per pill at Woolworths or Coles.

Day/Night tablets (paracetamol 500mg, phenylephrine hydrochloride 5mg, chlorpheniramine maleate 2mg)

Brands compared: Amcal Cold & Flu Relief PE Day Plus Night, Codral PE Cold & Flu Day & Night, Demazin PE Multi Action Cold & Flu Relief Day & Night, Dimetapp PE Sinus Day/Night, Mendeleev Cold & Flu Day/Night, Priceline Day + Night Cold & Flu Relief PE, Sudafed PE Sinus + Pain Relief Day/Night, Vicks Action Cold & Flu Day & Night Relief.

Cheapest vs most expensive

Mendeleev Cold & Flu Day/Night (48 pack) is 21c per pill at Chemist Warehouse. A 24 pack of either Codral PE Cold and Flu Day/Night or Sudafed PE Sinus + Pain Relief Day/Night costs 62c per pill at Amcal.

Need to know

Only available in pharmacies.

How we did our survey

Prices (non-sale) were those promoted on each supermarket or pharmacy’s website or in-store in Sydney branches in late February to early March 2020. We only compared products with the same or comparable amounts of active ingredient on a price per pill basis (for ease, we treated tablets, caplets, capsules,etc, as comparable). We didn’t look at liquid elixirs or products aimed at children. 

Different dosage forms

Most OTC medicines we looked at had multiple dosage form options to choose from, such as tablets, capsules, mini-caps, caplets, liquid capsules, dissolving tablets, chewable tablets and enteric-coated pills. Our price comparison looked at the cheapest product per unit, no matter what form it came in. 

Generally, the cheapest products were those that came in tablet or caplet form.

But although other dosage forms such as mini capsules, effervescent tablets, chewable tablets and liquid capsules can be more expensive, the price per pill varies from store to store, so it’s worth shopping around to find the best price if you prefer one form to another. 

Supermarkets vs pharmacies

Sometimes you don’t have time to go to the pharmacy and just want the convenience of grabbing your pain relief alongside your potatoes from your local supermarket. 

Supermarkets sell a number of OTC medicines (although Aldi only had paracetamol and ibuprofen on offer), but it’s worth remembering they don’t always have the variety, higher dosage, or larger pack sizes that pharmacies do. You can also get expert advice from an in-house pharmacist. 

You might assume that supermarkets are cheaper than pharmacies, but we found that this wasn’t always true.  Yes, some own-brand supermarket options equalled or beat pharmacies on price, but when comparing brand for brand and size for size, pharmacies would often work out cheaper per pill. So it’s worth shopping around, especially if you buy OTC medication regularly.

What are over-the-counter (OTC) medicines?

OTC medicines are non-prescription, non-complementary medicines used to treat mild health problems such as headaches, aches and pains, sore throat, nose congestion, fever, fungal infection or an upset stomach. They’re available at pharmacies, with selected products available in supermarkets, health-food shops and other stores. 

All OTC medicines are either listed or registered with the Australian Register of Therapeutic Goods. Listed medicines are available off the shelf for people to buy. Registered medicines are considered higher risk and while many are also available off the shelf, some are only available from a pharmacist after a consultation. 

Generic vs branded medicines

When it comes to active ingredients, there really isn’t any difference between a branded medication and it’s generic equivalent. According to the Therapeutic Goods Administration, generic medicines must contain the “the same quantitative composition of therapeutically active substances” as the originator medicine. 

Not buying a big name brand can lead to some serious savings. For example, Panadol and Nurofen are, respectively, the first and second most-bought pain relief brands in Australia. When comparing 500mg paracetamol, the cheapest Panadol product was at Chemist Warehouse – a 100 pack of Panadol tablets costing 13c per pill. That’s 11c per pill more expensive than the cheapest non-Panadol product.

A comparison of 200mg ibuprofen products told a similar story when we looked at the price of various Nurofen products: Amcal and Chemist Warehouse had the cheapest option – Nurofen (96 pack) at 16c per pill. That’s 10c more than the cheapest non-Nurofen product.

That said, if you have allergies or intolerances, you should always talk to a pharmacist and check the inactive ingredients in case it contains something you’re allergic to.

For more information, read our guide on generic vs branded prescription medications.

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They may seem like a harmless product, and you might feel that you’re helping out a friend or family member by buying from them. 

Unfortunately, essential oils may be a lot less innocuous than you think.

Is it safe to consume essential oils?

NSW Poisons Information Centre does not recommend consuming essential oils or even using them on your skin without a carrier oil (which dilutes essential oils before they’re applied to the skin). 

“There’s very little information around the safety and efficacy of most essential oils, although we do have good data around the toxicity of a few,” says Genevieve Adamo, the centre’s senior specialist in poisons information and toxicovigilance.

“Eucalyptus oil, clove oil and peppermint oil are particularly nasty – ingesting as little as 2–3ml can cause sedation or drowsiness and 5ml can cause coma.

“We’ve also seen instances where people have picked up the wrong bottle and inadvertently dosed their child or baby with 5ml of an essential oil instead of 5ml of a medicine. That has the potential to cause serious poisoning.”

What are essential oils?

Essential oils are plant-derived volatile oils that have the aroma and other properties of the plant, and can be used in aromatherapy and to make perfumes.

Ingestion of some essential oils can cause:

• seizures
• mucosal irritation
• nausea
• vomiting
• burns
• and chronic exposure can potentially cause organ damage.

“Even with very small exposures there’s a risk that they can be aspirated into the airways which can cause a chemical pneumonitis, which is damaging to the lungs,” says Adamo.

If poisoning occurs from ingesting essential oil, call 000 or the poisons information hotline on 13 11 26.

Can you trust the health claims made by Doterra?

Doterra’s website states that “all [essential oil] application methods are safe when used appropriately including aromatic, topical, and internal methods” and that oils can be used in recipes to replace herbs or spices, added to water, tea, smoothies or other drinks, or taken internally (the company also provides recipes).

“People have a perception that anything natural is safe and that’s not the case,” says Adamo.

In 2017, NSW Poisons fielded 66 calls about exposure to Doterra oils. So far in 2018, there have been 90.

“We’re certainly seeing a much larger number of calls about exposures to these MLM essential oils, which used to be unheard of,” says Adamo.

“We have significant concerns around the fact that we do not know if the people selling essential oils in an MLM situation have any independent qualifications or training, and that the Poisons Centre has never, to its knowledge, been consulted to provide information regarding the safety or toxicity around essential oils for the purpose of using it to train people.”

We reached out to Doterra’s Australian office for comment and received no reply.

Jon Wardle, associate professor of Public Health at Sydney’s University of Technology says it’s important to remember just how concentrated essential oils are, and that companies selling them often promote use that isn’t evidence-based.

“To be fair, even Doterra has put some money into research, but most of the research that does exist [into essential oils] is all relatively limited and inconclusive,” says Wardle.

Case study: Kim’s ongoing health issues

“They made drinks and finger food with essential oils, without our knowledge and consent – and it was actually ingesting the oils that caused my eventual adverse reaction,” she remembers.

“The seller said the oils were ‘organic’, ‘pure’ and ‘CPTG – Certified Pure Therapeutic Grade’. I was told there was an ‘oil for everything’.”

On the seller’s advice and company book, Hungerford started regularly using the oils in a diffuser, via inhalation, topical use and ingestion – and applied certain oils neat to a wound on her knee. Her scar never healed properly and is now permanent.

During 2017 to 2018, prior to medical intervention, Hungerford developed sunburn-like redness and rashes to several areas of her body after using the essential oils, as well as ongoing respiratory issues such as an asthma cough.

“My doctors and I attribute these issues to sensitisation caused by essential oils. I no longer use essential oils, particularly lavender, and can’t have them near me or I suffer reactions,” she says.

“I questioned the Doterra team members about their qualifications but they had none. They’re just sales reps.”

Making claims to sell more products

Both Adamo and Wardle say they have growing concerns about the rise of unregulated, home-based ‘wellness’ distributors who dispense advice to consumers that they’re not qualified to give.

“The main concern is that a lot of MLM sellers are just normal everyday people – no medical training, no health literacy, they’re not qualified professionals able to make judgements,” says Wardle.

“It’s amplified by the MLM model, which encourages selling as much product as you can.”

Be wary when buying from friends

The typical ‘party-plan’ set-up that invariably includes demos, finger food and friendly chit-chat will also come with a not-so-subtle pressure to buy – and it’s hard to resist if you know the seller, says Wardle.

“Research shows that friends and family are by far the most influential in regards to our health, even more than practitioners or doctors – and MLMs are mostly built around networks,” he says.

“So when you hear stories at one of these parties [about how an essential oil worked] it can be a powerful motivator. 

“But my advice would be don’t buy anything you don’t want to. And realise you’re walking into a situation that’s not necessarily a health push, but a sales push.”

How to check health claims

Poisons centres and government health departments often have information about essential oils and the risks, such as Western Australia’s Department of Health’s fact sheet.

A second opinion from a pharmacist, doctor or health expert with a special interest in complementary medicine might also be useful, adds Wardle.

“We don’t want to say that no one should use Doterra ever, but people should definitely be more critical,” he says.

Adamo says consumers need to ask questions, look critically at the evidence and consider the qualifications of the person providing the information.

“Would you consider buying medications from people who aren’t qualified health professionals?” she says.

“And the people who are selling these products need to consider their responsibility and liability in the information that they’re providing to their customers.”

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On this page:

• Is creatine expensive?

Not surprisingly, it’s now one of the most popular dietary supplements on the market.

But does the evidence behind the hype stack up?

What is creatine?

Creatine is a naturally occurring compound made from amino acids found in protein, and plays an important role in energy production within our cells. It’s stored mostly in muscles and also in the brain – places where lots of energy is needed.

Our body produces some creatine, mainly in the liver, and it also comes from meat and fish in your diet. But increasingly it’s being taken as a supplement in the form of creatine monohydrate, especially by athletes and bodybuilders – sales in the US alone are estimated at 2500-4000 tonnes per year.

What can creatine supplements do?

Its usefulness in certain sports is well-documented, and creatine supplements have been used this way for several decades. But because of its role in various aspects of human physiology, creatine has been or is currently being investigated for various other uses, most excitingly in areas that could lead to a much improved quality of life for people with certain medical conditions and age-related changes.

No matter what the usage or condition, not everyone benefits to the same degree and some may not benefit at all. It’s not clear why this is, but a creatine supplement seems to be most useful when existing creatine levels are low, which may occur in vegetarians, vegans, and people who don’t eat much meat. The body can only use so much, so if you’ve got enough, having more won’t help – any extra is excreted in urine. However, there have been cases where excessive amounts have been linked with more serious health effects, particularly kidney problems.

Likely effective

There’s good evidence creatine is effective for:

• improving some aspects of sports performance
• improving weightlifting performance
• improving muscle strength and performance for people with muscular dystrophy
• maintaining or building muscle in older adults.

Possibly effective

There’s preliminary evidence, but more research is needed for:

• building or maintaining bone (in older adults)
• improving cognitive performance (memory, reasoning).

Unlikely to be effective

Current evidence shows it’s unlikely to be effective for:

• aerobic exercise
• slowing the progression of Parkinson’s disease
• slowing the progression of Huntington’s disease (especially for women).

Insufficient evidence

More research is needed for:

• Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease
• stroke prevention.

Is creatine safe?

Creatine appears to be safe when appropriate doses are taken, even over long periods of time. The most common side effect is weight gain, associated with increased water in muscles. In large doses, gastrointestinal effects such as nausea and diarrhoea have been reported, and sometimes more serious problems.

Experts recommend caution for people with kidney problems or who have potential for kidney problems, such as a family history of kidney disease or diabetics, and suggest discussing your need to take creatine with your doctor.

Caution is also recommended for pregnant and breastfeeding women, and children and adolescents under 18, due to a lack of information about side effects in these groups.

Creatine supplements are only loosely regulated in Australia, with no routine independent safety and quality testing. They sometimes contain other ingredients, which aren’t always labelled, that can cause serious health problems in some people – for example stimulants.

Is creatine expensive?

Creatine monohydrate typically comes in a powder form in containers that last a month or more. Depending on the brand and dose, creatine supplements cost around 10–25 cents per day.

Bottom line

There’s some good evidence that creatine can help athletes in certain types of sport, but make sure you use it as directed and don’t expect miracles. As for other applications, especially for medical conditions where it’s not yet proven safe or effective, it’s best to talk to your doctor about whether it may be helpful.

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On this page:

• What does iron do?
• Types of iron
• Iron absorption
• Iron deficiency
• Do I need a supplement?
• Too much iron

What does iron do?

Iron’s most important role in the body is as part of haemoglobin, the red pigment in your blood that carries oxygen to your body’s tissues.  And low oxygen equals low energy. Iron is also an important nutrient for your immune system, builds protein in the body and helps transmit nerve signals.

Types of iron

There are two types of iron in food. And although Popeye was right about needing iron, eating spinach isn’t the best way to increase your intake. Haem iron, found in animal products, is much easier for our bodies to absorb.

Haem iron

• Red meat is a particularly good source.
• Also found in other animal products like chicken and fish.
• Our bodies absorb 20–35% of the haem iron in animal foods.

Non-haem iron

• Found mainly in plant foods such as bread, cereals, fruit and vegetables.
• Much harder to absorb – between 2 and 15% is absorbed from plant foods.

Iron absorption

How much iron our bodies absorb varies between individuals, and partly explains the large percentage range above. Generally speaking, a person with a mixed western diet that includes animal foods will absorb about 18%, and a vegetarian will absorb about 10% of the iron in their diet. Absorption naturally increases if your body is running short on iron or when you need extra, such as during pregnancy.

How much iron you absorb from food also depends on what you eat and drink in combination.

Foods that help

Vitamin C-rich foods and the protein in meat both increase the amount of iron you absorb from fruits, vegetables and cereals.

Tip: Add a glass of OJ to your breakfast and you’ll probably double the amount of iron your body gets from a breakfast cereal.

Foods that hinder

Some compounds in foods, called inhibitors, bind with iron and stop it being absorbed through the walls of the bowel into the bloodstream.

Some inhibitors are hard to avoid, because they’re found in foods which also contain iron, but others you can simply avoid eating or drinking at the same time as you consume your iron. This is particularly important for non-haem iron, which is harder to absorb anyway.

Iron inhibitors include:

• tannins found in tea and coffee
• phytates in beans, peas and lentils and in fibre-rich cereals such as bran
• oxalates in spinach and some other dark green vegetables
• phosvitin in egg yolk
• antacids and aspirin
• calcium and zinc supplements.

How much iron do we need?

The average person needs to absorb just a small amount of iron each day to stay healthy (around 1mg for adult males, 1.5mg for menstruating females). The Australian (RDI) for iron is the amount of dietary iron required to meet the needs of most of the population, and it’s different for different age groups and life stages.

Iron deficiency

If you’re low in iron, you may begin to notice tiredness, irritability and difficulty concentrating.

Eventually, getting too little iron will empty your body’s iron reserves. At this stage blood cell production falls, leading to iron-deficiency anaemia. This is unlikely to be fatal, but it will mean a reduced quality of life. Besides making you more rundown, low iron also increases your risk of infection.

Who’s at risk?

Women of child-bearing age lose more iron because they menstruate. Women need even more iron during pregnancy, as their baby draws down extra iron as it grows.

Baseline data from the (ALSWH) suggest that one in three women have had diagnosed iron deficiency by the age of 45-50 years.

Also at risk of iron deficiency are:

• babies
• vegetarians
• athletes
• regular blood donors.

Men and post-menopausal women generally easily meet their iron needs through a normal diet.

Do I need a supplement?

Look at your diet before popping any pills. You can usually improve your iron intake by eating better.  Don’t take an iron supplement ‘just in case’ — you may be wasting your money. There’s also a small chance you’re seriously overloading your body.

Get a blood test

If you’re feeling tired and run down, talk to your doctor first to see if there may be another problem. A simple blood test can tell you if you’re iron-deficient.

If you are, your doctor will discuss with you how to treat the deficiency. Ideally you should change your diet and eat more iron-rich foods, but if this isn’t doable or still not enough, a supplement may be recommended, particularly if you are pregnant.

Iron-boosting tips

• Include red meat, fish or poultry as a regular part of your diet (unless you’re a vegetarian).
• Have a piece of citrus fruit or glass of juice with your breakfast cereal.
• Choose an iron-fortified breakfast cereal and don’t add unprocessed bran — it’ll inhibit iron absorption.
• If you’re on a weight loss diet, be particularly careful to include enough iron-rich foods.
• Limit tea and coffee to between meals.
• Choose tomato, broccoli, cauliflower, pumpkin and cabbage — the non-haem iron in them is more easily absorbed.
• Choose more iron-rich foods if you donate blood or have heavy periods.
• If you have to take other mineral supplements, such as calcium or zinc, don’t take them with meals.

Too much iron

Most of us are unlikely to get too much iron from food alone. However, about 1 in 200 people of northern European origin has a genetic predisposition for , a genetic abnormality which can cause excessive iron absorption and storage in the body – it’s the most common genetic disorder in Australia.

Unchecked, it can damage the liver, pancreas and heart. As iron slowly accumulates, insidious signs might present the same symptoms as other health issues, like early-onset arthritis or stomach complaints.

The most common symptoms include:

• tiredness
• fatigue
• feeling unwell for a prolonged period of time
• abdominal pains
• swollen liver
• joint pains
• slate grey appearance or bronze complexion
• loss of sex drive.

You should see your GP if you’ve noticed any of these symptoms.

Warning: For a toddler, just a handful of iron pills can be poisonous. If you have small children keep any vitamin and mineral supplements in their original, closed container, out of reach and sight, preferably in a locked cabinet.

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On this page:

• Vitamin lollies and goat milk chews
• Blooms Back, Neck & Shoulders +
• Dick Wicks Magnetic Knee Support
• Bioglan Melatonin
• Combined paracetamol and ibuprofen pills
• Sudafed PE and others
• Eye drop products with benzalkonium chloride
• Fluoride-free toothpaste
• Cough medicine

But scanning the shelves, we found a surprising number of products that couldn’t possibly live up to their claims, others that might do more harm than good and some that don’t offer very good value for money.

Here are 10 you might give a miss.

Vitamin lollies and goat milk chews

These are essentially treats with little nutritional value. Save your money and buy real food and milk (lactose-free or goat) instead.

Blooms Back, Neck & Shoulders +

Even if this turmeric and magnesium supplement works, oral medicine can’t target pain in specific areas of the body.

Dick Wicks Magnetic Knee Support

There’s no good quality evidence to show that magnetic bandages work any better than regular bandages, which are a lot cheaper.

Bioglan Melatonin

Melatonin helps some people with sleep problems, but there’s no evidence homeopathic melatonin such as Bioglan Melatonin works.

Toddler and junior formula

Apart from being more expensive than fresh or powdered milk, some toddler and junior formulas contain less protein and calcium, and filling up on these may discourage healthy eating.

Combined paracetamol and ibuprofen pills

Combination pills offer a convenient, though more expensive, type of painkiller that may be more effective than paracetamol or ibuprofen alone. However, they’re not suitable for all types of pain, and confusion around dosage has raised concerns.

Sudafed PE and others

Studies have found that phenylephrine, or PE, the active ingredient in various decongestant medicines, isn’t effective.

Eye drop products with benzalkonium chloride

These can cause eye irritation in some people, and there are concerns that long-term use can damage the surface of the eye.

Fluoride-free toothpaste

Many so-called “natural” toothpastes don’t contain fluoride which, when used as recommended, is a safe and effective treatment to prevent dental cavities.

Cough medicine

There’s a surprising lack of evidence that cough medicines work.

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On this page:

• Rigorous or Lax regulation?
• Consumers in the dark

We’re talking about the listing or registration number from the Australian Register of Therapeutic Goods (ARTG), which is administered by the Therapeutic Goods Administration (TGA). Somewhere on the front of the label you’ll find a number, preceded by AUST L or AUST R. The L stands for listed, and the R stands for registered. The difference is significant.

Rigorous or Lax regulation?

Listed products (AUST L) are considered low risk by the TGA, and companies must be able to demonstrate safety and quality. They include some over-the-counter medicines, including sunscreen and most complementary medicines and vitamins.

The company must also hold evidence it works, but the TGA doesn’t look at the evidence for every product that is listed on the ARTG. However, it does conduct some random and targeted reviews of a small percentage of products each year.

Reviews of studies on commercially available complementary medicines have found that while some have been well-studied and found to be effective, many have not, and scientific evidence for their effectiveness is often scant, poor quality and/or inconclusive, if there’s any at all.

Similarly, vitamins and minerals are useful for correcting dietary deficiencies, but benefits in doses above and beyond recommended daily intake are few and far between, and in large amounts some can be harmful.

Registered products (AUST R) are considered higher risk than listed products, and the TGA individually assesses each one for safety, quality and evidence that it works as claimed. The level of evidence required is much stronger, usually in the form of clinical trials to prove they’re effective. 

All prescription medicines are registered, as are many over-the-counter medicines, including painkillers, cough and cold medicines, and fungal creams. A small number of complementary medicines are registered.

Consumers in the dark

Given the difference in regulatory requirements for listed and registered products, we were interested to find out how much consumers understood. In a national survey of 1052 people ÌÇÐÄVlog Consumer Pulse found that 80% had never actually noticed these numbers on the label, and a further 7% weren’t sure.

Among the 142 people who were aware that the label contained these codes, many weren’t really sure what the difference was between AUST R and AUST L. And when it came to evidence they work, almost half (43%) erroneously thought listed products had been evaluated by the TGA to see if they worked, while a further 23% weren’t sure.

Overall, when people were asked if they were concerned that many herbal medicines and dietary supplements hadn’t been tested by the TGA to see if they work, more than three-quarters (77%) said they were at least a little concerned, and only 7% were unconcerned. Eighty-two percent thought that highlighting this would be useful.

Registered medicines aren’t always safe – which is why they’re subject to greater scrutiny by the TGA. Before they can be sold, they often undergo many years of clinical testing on thousands of people, and all known risks are documented. While all medicines – even placebo medicines – have side effects reported, if the risks are considered too great they won’t be permitted on the market.

Even after registered medicines go on the market, safety continues to be monitored and if problems emerge at this point, the product may be withdrawn from the market or perhaps more tightly regulated. On an individual level, a doctor will also check they’re safe for their patients – some medicines can affect some people differently to others, especially if they’re taking more than one medicine.

When it comes to listed products, however, in addition to the questionable efficacy, there are questions about how safe they are. And with patients often neglecting to tell their doctor they’re taking them, doctors may be kept out of the loop.

The TGA doesn’t actually test the products for safety and quality. There is a list of ingredients that the TGA considers safe in medicines, though sometimes only in limited amounts. As long as products only contain these ingredients in the allowed amounts, they are likely to be safe for consumers. Sometimes there are lab tests of products and inspections of manufacturing facilities to ensure good manufacturing practice is upheld.

The problem may lie with ingredients that aren’t listed on the label. For example, Australian researchers found that nine out of ten traditional Chinese medicines (TCMs) were found to be adulterated with toxic substances, pharmaceutical drugs and/or animal DNA not listed in the ingredients.

The group analysed 26 different TCMs purchased in Australia, most being for coughs and colds or general wellness. They found various heavy metals (arsenic, cadmium and lead) exceeding allowable levels, toxic substances (strychnine and brucine), pharmaceutical medicines (antibiotics, pseudoephedrine, warfarin, paracetamol) and banned or restricted herbs considered to be harmful.  

In addition, some herbal ingredients permitted by the TGA in listed products have been found in some studies to be harmful – for example, green tea extract, garcinia combogia and bitter orange.

Finally, there’s also the potential for certain herbal medicines to interact with other medicines you’re taking, changing their effectiveness or resulting in unwanted side effects. If you decide to take alternative medicine, make sure you tell your doctor or pharmacist about all medicines you’re taking.

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