Jessica Loucks, BSc, PharmD, ACPR, RPh

Jessica has a BSc in Biochemistry and a Doctor of Pharmacy, and has also completed an Accredited Canadian Pharmacy Residency with the Lower Mainland Pharmacy Services.

Natural health products (NHPs) are readily accessible at pharmacies, health food stores, or on the internet. They often tout themselves as  “natural alternatives” purportedly as effective and safer options compared to prescription medications for managing chronic diseases. However, the critical question remains: do these claims hold true?

To address this question, it’s crucial to understand the distinctions between Natural Health Products (NHPs) and prescription medications regarding patenting and licensing in Canada. Prescription medications undergo rigorous research to prove benefit, with no harm caused. This process typically involves large randomized controlled trials, which require significant manufacturing funding. Pharmaceutical companies fund these trials because if a benefit is proven, they can patent exclusivity of sales for a period before generic (cheaper) alternatives can be manufactured, and are able to recoup their investments.

NHPs, or Natural Health Products, do not undergo the same patenting procedure as prescription medications because they are not classified as “new” products. Consequently, they are not granted market exclusivity. This lack of exclusivity means that there is typically no financial incentive for companies to invest in large randomized controlled trials to prove the efficacy and safety of NHPs. As a result, the evidence base for NHPs may be less robust compared to prescription medications. In 2004, Health Canada implemented a licensing system to enhance the oversight of Natural Health Products (NHPs), aiming to ensure their quality, efficacy, and safety. While the standards for NHPs are generally less stringent compared to those for prescription medications, meeting specific criteria allows manufacturers to obtain a Natural Product Number (NPN). This NPN serves as an indicator that the product has met Health Canada’s requirements, and as a result, the product can legally be sold in Canada. Caution is required, however, when purchasing products online, as they may be bought from outside of Canada and therefore may not have an NPN assigned to them. Knowing the above, how does one select natural health products?

From a pharmacist’s perspective, my initial question to the individual would be: “Why do you want to take this medication?” Addressing the “why” helps us navigate the evidence regarding the known or possible benefits of the specific Natural Health Product (NHP) and determine if it aligns with your intended goals. If there is potential efficacy, the next step involves reviewing the risk of side effects and assessing whether the benefits outweigh the possibility of experiencing these side effects. Lastly, after considering all the factors mentioned above, it’s important to ensure that the NHP does not interact with any prescription medications. This precautionary measure can be undertaken by consulting with a community pharmacist. Navigating these considerations on your own can be daunting. Therefore, I strongly encourage having a conversation with your primary care provider or primary care clinical pharmacist. They possess the expertise to guide you through the benefits and potential risks of Natural Health Products.

Additionally, below are some websites that offer information on the benefits and potential risks of NHPs in patient-friendly language, which may be helpful as you explore NHPs: