Fake and diluted ingredients, including herbs and animal parts,are increasingly finding their way into traditional Chinese medicines. Investigators have found many supposedly medicinal powders diluted with everything from flour to corn starch to sand.

Sometimes the dilutions are the result of cutting corners by manufacturers, but often its done by middlemen and retailers seeking to increase their profit margins.

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There is little or no governmental regulation of these medicines, and the problem is getting worse. As one traditional Chinese medicine manufacturer noted, counterfeiters are posing a great threat, as fake products are made to closely resemble genuine ones.

Counterfeiters can produce fake medicinal herbs with starch and gypsum powder, or mix dirt or dust with the herbs to increase their weight.

Dilution, Inert Ingredients and Placebos

Many legitimate, regulated drugs and food products contain inert or inactive ingredients or fillers. Sometimes these ingredients help delay or speed up the bodys absorption of a drugs active ingredient, for example, while fillers in food may add flavor or bulk, coloring or increase shelf life.

While some Chinese herbs and medicines have active ingredients and work as promised, many others do not, and their efficacy relies on the placebo effect. Because the placebo effect works when the patient believes a drug or treatment is effective, there are relatively few complaints from consumers themselves. The effectiveness is often the same whether the medicines are real, diluted or fake.

This is not to say that altered, diluted, or fake medicine of any kind is good, of course. Though most of the ingredients used to dilute drugs are relatively harmless, some can be toxic. In some cases Chinese herbal medicines may even be contaminated with prescription medications.

A 2002 study in The Journal of Internal Medicine reported that an analysis of 2,600 samples of Chinese herbal remedies in Taiwan showed that 24 percent were adulterated with at least one synthetic medicine. The case reports showed that two or more adulterants were present in 14 of 15 Chinese herbal medicines.

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